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Patriot Waiting Games



Pueblo Marine Corps veteran David Jiron had a stroke this past April. Once out of the hospital he went through the Veterans Administration to seek follow-up treatment at one of its facilities. The VA scheduled the treatment for this coming October.

Rather than wait about half a year to see a medical provider about the aftereffects of the stroke, Jiron used his costly private health insurance to get treatment within the local Parkview health-care system.

The Veterans’ Choice Program is supposed to cut down on VA wait times by allowing veterans to receive treatment at community medical facilities, which in turn would be compensated for their services by the VA. In theory, a veteran making a trip to the family doctor would be no different than being treated by a primary care doctor at a VA facility.

Jiron praises the Choice program for how quickly the VA got him an eye exam (within a week) at a non-VA facility. Yet the VA would not allow him to use the program for his stroke follow-up at Parkview. Jiron also was frustrated that the program won’t pay the tab for the teeth cleaning he needs, and getting it done through a VA facility is difficult because he was told the VA was “short-staffed” when it came to routine dental work. As for wait times at VA facilities, he is still waiting to see a neurologist at an out-of-town VA facility related to his April stroke.

Veterans’ Choice

Jiron is Southern Colorado service officer for Disabled American Veterans. The national nonprofit organization supports the Veterans’ Choice Program, which was established the Veterans’ Choice, Accountability and Transparency Act of 2014. Signed into law by President Barack Obama and then extended by Congress and President Donald Trump this past April, the Veterans’ Choice Act came about after it was widely reported in 2014 that about 35 veterans died while waiting for appointments at VA facilities in Phoenix. Although the Choice Program was extended this year it is still considered a temporary benefit. The extension Trump signed in April and which took effect on Aug. 7 was for $2.1 billion to pay for Choice services nationwide, and when that money runs out, the Choice Program will need another extension from Congress to keep operating.

Andrew Grieb at the Colorado DAV’s Denver headquarters says his organization backs the Veterans’ Choice Program and sees it as playing a role in what the DAV hopes would become an “integrated VA health system.”

Jiron says the VA needs to “turn around” adding that current VA Secretary David Shulkin seems to be the person to do just that. But Jiron is not the only one with issues regarding Veterans’ Choice.

Small-town, big concerns

The town of Springfield in extreme southeastern Colorado has no VA facility making it a prime location for the Choice Program. The Southeast Colorado Hospital District serves Springfield and the towns of Pritchett, Vilas and Campo. David Engel is the CEO of the hospital district, which entices veterans on its Facebook page to take part in the Choice Program at its facilities. Yet despite the promotion Engel says the number of veterans taking part in program is “sparse” for two reasons. The first is that, he says, the VA rejects veterans for the Choice Program if they carry other pricey insurance like a private plan, a plan through work or Medicare. The other is that, once a veteran jumps through the VA hoops and uses Choice to see a primary care provider within the hospital district, that vet again has to clear VA hurdles to see a specialist that the primary care provider recommends. Engel, who’s relatively new to his position at the district, adds that staff members have told him of significant delays in getting reimbursed from the VA through Choice for the hospital district’s services.

Engel says as an alternative to VA Choice Program many veterans living in the communities served by his hospital district drive as far as Amarillo, Texas, to get treatment at VA facilities there.

Telling stats

VA wait times in southeastern Colorado are daunting. Brandy Morrison, congressional liaison and acting public affairs officer for the VA’s Eastern Colorado Health Care System reveals some eye-popping statistics, which were last updated on July 31. The AVERAGE wait time for a new patient to receive care at the VA’s PFC James Dunn Clinic in Pueblo is 69 days; at the VA clinic in La Junta, 54 days; at the VA’s PFC Floyd K. Lindstrom Clinic in Colorado Springs, 52 days; at the VA facility in Lamar, 36 days; at the VA clinic in Alamosa, 29 days. The new-patient wait times at the VA facility in Salida is relatively outstanding at a mere six days. The picture for average primary care wait times for patients already established in the VA system is much, much brighter:  13 days for Alamosa; 11 days for Lindstrom in the Springs; seven days each for Lamar and James Dunn in Pueblo; four days for La Junta; and for Salida, one day.

Morrison adds that a national VA statistics website uses an average of new patient and existing patient wait times for primary care and at least one other factor to come up with its numbers. Using those statistics, the national average VA primary care wait time is 4.9 days compared with 26.68 for La Junta, 22.38 days for Alamosa, 18.35 days for Lamar, 13.99 days for Pueblo’s Dunn Clinic, 12.95 the Springs’ Lindstrom Clinic and 2.88 days for Salida.

Choice restrictions

Morrison says regarding the Veterans’ Choice Program designed to cut down on VA wait times, veterans are eligible to use the program through three avenues. The first is that if wait times for the services they require are greater than 30 days. The second is if veterans needing care live 40 miles or greater from the nearest VA facility. The third is what Morison calls a “geo-burden” which means if a veteran is separated from a VA facility by such obstacles as mountains or bodies of water. Note that a veteran having other forms of insurance is not on Morrison’s list for a veteran being turned down for the Choice Program.

Yet Morrison says relatively few veterans in the Eastern Colorado region choose to take advantage of the Choice Program. In fact, she says, during the third quarter of federal fiscal year 2017 (which runs from Oct. 1, 2016, to Sept. 30) 71 percent of the veterans served by the VA’s Eastern Colorado Health Care System chose to stay with the VA for their primary care needs rather than go through the Choice Program.

Yet for a veteran opting to go into the community to use the Choice Program, Morrison says a VA employee will place them into the program and forward all pertinent medical information to the VA “third-party administrator” or TPA (which is a company called Health Net Federal Services) for appropriate scheduling.

“Once Health Net receives and accepts the referral,” Morrison says, “they begin their scheduling attempts to get the veteran scheduled as timely as possible with the provider of their choice. Since May of 2017, the VA is the primary insurance for all services received through the Veterans Choice Program.”

Regarding payment to Veterans Choice Program providers,

Getting paid

Morrison says she cannot speak to that because Health Net handles all payments to the providers as part of its contract with the VA.

And, as Southeast Colorado Hospital District CEO Engel previously indicated, reimbursements from the Choice Program are hard to come by. And, by way of example, Pulp has learned of one story about an eye care clinic in the Pueblo area having its reimbursement check sent to an eye clinic in Alaska.

Health Net Federal Services communications director, Molly Tuttle, gives a generic response to Pulp’s concerns about delayed Choice Program reimbursements.

“It is our honor and responsibility to serve the veteran community,” Tuttle, who is based in northern California, says. “We strive to provide excellent service to every veteran, every time. Health Net Federal Services has no higher priority than the fulfillment of our Veterans Choice Program obligations in support of our continuing and long-term commitment to the veteran community.

“We strive to address issues as they arise and continue to work with our over 14,000 community providers to service the state’s more than 80,000 Choice eligible veterans in Colorado,” she adds. “Developing a complex and consistent new program like Veterans’ Choice is a team effort, and HNFS is working closely with Congress, the Department of Veterans Affairs, the Colorado VA Medical Clinics, and local health care providers to ensure veterans have the appropriate, coordinated and convenient care they have earned for their service to our nation.”

Congressmen respond

The office of U.S. Rep. Scott Tipton (R-Cortez) representing Colorado’s 3rd District says VA wait times and the Veterans’ Choice Program do have issues. “As the Veterans’ Choice Program has been administered, it has become clear there are problems that need to be addressed, including administrative burdens and red tape in the referral process, as well as issues with payments for Choice providers,” says Liz Payne, the congressman’s communications director, in an email.

“Despite the identified problems, there are countless examples where we have seen the Choice Program work for veterans who had no access to care prior to the program’s implementation, and Congress and the VA continue to work to ensure the programs is as efficient and as streamlined as possible. Congressman Tipton and his staff also continue to work with veterans across (his district) to help them navigate the Choice Program process. We are currently serving over 1,000 veterans on Choice Program-specific casework.”

Colorado 4th District U.S. Rep. Ken Buck (R-Greeley) has this to say in an email about the Veteran’s Choice Program: “I support giving veterans more health care options through the Veterans’ Choice Act, but I recognize the challenges faced by the act over the past few years. Congress needs to continue working to improve this act so that veterans receive the care they need, when they need it.”

Kyle Huwa, Buck’s communications director, says in an email the congressman’s staff is looking into concerns Pulp has raised about long wait times at VA facilities in southeastern Colorado and the effectiveness of the Veterans Choice Act.

“Once he has more information on the specifics of the issue,” Huwa says, “he can address that question.”

Although southeastern Colorado has obvious problems with VA wait times and the Veterans’ Choice Program, there is reason to be upbeat. Air Force Veteran Phil Andreski is pleased with the VA service he receives. “No complaints from me,” he says in an email. “Don’t use VA other than getting hearing aids, and I’m satisfied.”

Andreski is the southeastern Colorado representative for the United Veterans Committee of Colorado, a Denver-based veterans’ advocacy group. He adds that he has not received any complaints from the veterans he knows about long VA wait times or the Veterans’ Choice Program.

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The Unknown Road to Pueblo’s Mayor



Between now and Election Day, when the Pueblo voters elect its first mayor, the city is tasked with updating city code, making room for a mayor and the staff that will accompany the new leader and ensuring a smooth transition. How that will happen, though, is largely unknown.

Pueblo City Council hasn’t dictated any audits, created any advisory groups or made any formal reports on how the transition should occur. But council president Chris Nicoll, who said he’s still considering whether to throw his name into the mayoral race, expects the members to make a decision over the spring.

Specifically, Nicoll, who helped lead a failed effort to create a mayor in Pueblo in 2009, said he’d like to see a group of citizens, appointed by the council, make up an advisory council that sees the transition through. Among that body, Nicoll said he’d like to see somebody from the Pueblo County Clerk and Recorder’s Office, especially as how a mayor will be selected is yet to be determined.

City leaders have options on that front. They’ll have to decide whether to conduct a runoff election, which county clerk Gilbert “Bo” Ortiz said might conflict with requirements for when ballots have to be mailed out, or a ranking system. In that scenario, which Ortiz suggested an option the city could consider, the winner of the election would have the most first and second votes combined.

Nicoll said he envisions that committee being able to dictate to the council what should get done in the eight months leading up to the change, whether that be an audit or hire a consultant.

The Nov. 6 election will be a mile marker for Pueblo city government. The city has held a council-city manager form of government since 1954 and refused to give it up in the past. Voters overwhelmingly said no to a mayor less than a decade ago.

Nick Gradisar, the now-mayoral candidate who pushed for the question to appear on the 2016 ballot, previously told PULP he thinks attitudes of voters have changed. Those who voted “yes” on the measure barely outnumbered the “no” votes.

Part of it, he said, could be attributed to the ways of the north. Denver has a strong mayor. And Colorado Springs is proving the system to be worth the risk, with former Colorado Attorney General John Suthers at the helm.

Perhaps, Gradisar said, Puebloans are also a little tired of little change in the city.

“We’re sort of going backwards while the rest of the state is going forwards, I think it’s hurt us significantly,” he said at a press even before the election.

Either way, a mayor is coming. And it’s a rare occurrence for Colorado.

In fact, “very, very rare,” said Colorado Municipal League Executive Director Sam Mamet. He’s been with the organization that works on the behalf of Colorado municipalities for nearly 40 years. Changing forms of government doesn’t happen often and when it does, it can be challenging.

“It’s not easy at all and I am concerned they don’t have an adequate transition plan in place,” he said. “You just don’t snap your fingers and make it so. There is a transition and it will be a little complicated. It can be done and it will be done because the voters said so.”

Mamet pointed to the rough patch that Colorado Springs endured after it elected its first mayor.

“In the case of Colorado Springs, for the first couple of years it was pretty rocky between mayor and council over prerogatives,” he said. “This will come into play right out of the box for whatever budget the mayor may submit.”

After then-Mayor Steve Bach finished his term in 2015, the “Colorado Springs Gazette” chronicled the only term of the city’s first mayor. While Bach, which the city’s newspaper called a “political neophyte,” sparred with city council and ultimately cost the city on moving policy forward, he also dealt with the natural disasters during his term and the ending of the Great Recession.

Bach couldn’t get money for roads or stormwater. He was criticized when firefighters weren’t deployed to devastating fires fast enough. One former councilwoman told the newspaper that the constant clash between the mayor’s office and council made it hard to maintain a long-term vision for the city — something Pueblo is searching for in a lead lawmaker.

As in Colorado Springs and Denver, Pueblo will have clear, separate governing bodies once a mayor is elected. But Mamet points out that power is already pretty separated in Pueblo. For example: water. In several cities across the state the water department is an extension of city hall. But in Pueblo, the division is governed by a publicly-elected board of five members and gets all of its revenue from its customers.

Mamet wonders how the Board of Waterworks of Pueblo might interact with a mayor and vice versa on the topic that often rises to the surface as a top priority for communities in Colorado and across the West.

“There are potential issues, that’s why a thoughtful transition process is necessary with a very clear legal analysis,” Mamet said.

Pueblo City Attorney Dan Kogovsek said in an email the city charter won’t have to be updated, only the city code, but didn’t offer up any instances that would require council approval. Nicoll said he believes the council will be able to do a majority of that in a few actions.

“There needs to be a thorough legal analysis by the city atty on what should be considered,” Mamet said.

He also agrees with Nicoll that a stakeholders group should be formed and adds that a commission to study the charter would be beneficial, as would the elected civil service commission overseeing personnel policies of the mayor’s office.

Already two months into 2018, Nicoll said he’s confident that the city will be ready to take on a mayor.

“I’m not panicked about it. We have some time,” he said. “It’s just we need to work through this issue.”

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Middle schoolers have a plan to stop rock art tagging in Western Colorado




GRAND JUNCTION, Colo. (AP) — Arron Buehler’s day in a western Colorado canyon might not have had the Hollywood panache of Ferris Bueller’s day off, but something about seeing Buehler’s name scrawled on the sandstone escarpment gave Chris Joyner pause.

Joyner, spokesman for the Grand Junction Office of the Bureau of Land Management, looked at Buehler’s name — and those of many others emblazoned on rock in a canyon south of Grand Junction — and said that, paradoxically, there might be a reason for hope.

It was just last year that Buehler posted his name, next to Elizabeth, who left her mark in 2017.

Few of the names appeared to be more than a year or two old, and, “That tells me there’s opportunity here,” Joyner said.

The more recent the markings, the more likely the vandals are to be found, and the more likely it is that other methods might discourage younger people from following Arron Buehler’s lead, Joyner said.

Joyner and BLM archaeologist Alissa Leavitt-Reynolds are working in Grand Junction to deal with vandalism on federal lands, whether it be by graffiti artists such as Charley Humpy (who helpfully added, “Remember me” next to his name and yes, the BLM is doing all it can to achieve total recall), drug users ditching evidence in the desert, mayhem by “marksmen” and plain old dumping.

As much as Arron Buehler and a multitude of companions — Brian, Charley, Dizz, Dominique, Kay, Megan, Elizabeth, Jon, Sam and Tosha all seem to be begging for court dates (and Tosha, did you know your name covered an ancient petroglyph?) — Joyner said prosecution ought not be the only response to a growing trend of vandalism and worse on western Colorado’s rocky outcrops and arid landscapes.

Citations for vandalism aren’t tracked by the Colorado U.S. Attorney’s Office, which prosecutes offenses on federal land, so no precise numbers are available.

An Army veteran, Joyner is using his post 9/11 GI Bill funds at Johns-Hopkins University to study ways to divert people from what he terms “dysfunctional visitor behavior.”

“Dysfunctional visitor behavior” has a more authoritative ring than “vandalism” and “littering” and Joyner said he hopes that a scholarly approach can help agencies fend off some of the destructive activity on federal lands before it takes place.

Some of his research suggests that “informed participation in nearby historic and cultural sites” can influence the way many residents perceive those sites, Joyner said.

The students in Ginger DeCavitch’s social studies classes at Mount Garfield Middle School experienced “informed participation” last summer.

DeCavitch took her students into Bangs Canyon to see the mica mine and found the defaced escarpment “as we were stepping over broken beer bottles and charcoal” from fires.

Vandals had used charcoal to scratch names and slogans on the rock, DeCavitch said.

“They call it tagging” and few participants see any issue with defacing the rock, taking selfies and posting them on social media, DeCavitch said.

She contacted the BLM soon afterward to see if her class could help clean up the mess they found.

“They all wanted to go back,” enough that some students hauled 40-pound containers of water down an occasionally difficult trail to help clean the site, DeCavitch said.

Her middle school students sat silent as members of the Southern Ute tribe described how they perceived the canyon and the ancient markings, many of which had been defaced, DeCavitch said.

Far from being discouraged, her students were enthused about tackling the enormity of the defacement, DeCavitch said.

“We have a plan that we’ll be back,” she said.

Introducing young people properly to wild lands is one way to discourage future vandals and dysfunctional visitors.

It’s one “foot-in-the-door” tactic that Joyner hopes land managers take up.

Visitors also can be endowed with a sense of ownership by agreeing with a simple proposition — the idea that one ought not litter on public lands, for instance — and then be brought along to agree with how to visit them appropriately, Joyner said.

It’s part of a human tendency to want to be consistent, he said. People who agree not to litter tend to want to build on that as opposed to act in contradictory fashion, he said.

Even providing a small gift or trinket can engender a sense of responsibility among potential vandals, Joyner said.

Other techniques include the “broken-window” approach — the idea that replacing broken glass as soon as it’s found and thus denying miscreants their moment of victory — isn’t as easy as it might be in other environments, Joyner said.

DeCavitch’s class, for instance, learned that while cleaning up a mess might eliminate an eyesore, it also could erase history.

Her eager middle-schoolers couldn’t go forward with the cleanup until members of the Southern Ute Tribe, headquartered in Duchesne, Utah, approved the plan, DeCavitch said.

While Joyner’s studies have suggested that males 16 to 25 who live within 60 miles of Grand Junction are the likely offenders, one look at the escarpment suggests that young women are more active participants than crime statistics might suggest, Joyner said.

One study suggests that younger people prefer non-coercive approaches, but Joyner said that doesn’t mean the BLM is losing interest in prosecuting vandals and others.

Far from it.

BLM officials routinely contact school officials and consult high school yearbooks to match the names they come across with people who could be prosecuted.

Some miscreants make it easier, posting selfies of themselves with their works. Some even lower the level of difficulty by including hashtags.

The criminal exposure can reach felony levels because of the difficulty and expense of dealing with cleaning up or restoring the markings that date back hundreds of years.

If the malefactors are found, Joyner said, “We don’t write warning tickets.”


Information from: The Daily Sentinel,

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The #WhatNow of #MeToo for the #COLeg



AP Photo/David Zalubowski

When several lawmakers, lobbyists and staff at the state Legislature came forward this fall to allege they were victims of sexual harassment by lawmakers, two big questions followed: how often does this happen? What can be done to prevent more cases?

Reporters have asked state officials the first question repeatedly, returning to readers with little response from the state. The latter prompted a conversation from leadership, but as for what’s next—how the allegations, formal complaints, and legislature’s response—will impact politics under the gold dome and whether women will feel any safer is to be determined.

So far, top state lawmakers have decided to hire a human resources officer—who would be independent from the legislature—to be a contact person when incidents involving sexual harassment are brought forward. Now, leadership is tasked with handling and investigating such claims.

The group also decided to hire an independent consultant to review the legislature’s sexual harassment policy, and lawmakers, staff, and aides will undergo another round of sexual harassment training this year. Typically, those working at the Legislature are only required to go through training every two years.

Those changes are a good start, said Erin Hottenstein, executive director of Colorado 50/50, an organization that aims to get more women in public office. But the legislature stopped short of changing any current policies. And Colorado 50/50 called for an entire overhaul.

“I’m very pleased that there was a recognition that the policy needs to be improved,” Hottenstein said.

But there weren’t any specific recommendations regarding transparency, which Hottenstein said is significant in looking at what happens next.

Lawmakers and staff said they couldn’t disclose how many sexual harassment claims that leadership in each chamber have received because they were personnel issues.

“I think there’s a way to be transparent and safe,” Hottenstein said. “There should be a high- level summary document that shows on a certain date a sexual harassment complaint was made and who it was against and a date of a deposition and what the result was.”

Hottenstein said transparency becomes crucial in these cases because it leads to accountability and the public’s right to know what actions the people elected to office are taking.

In October, Pueblo Rep. Daneya Esgar broke her silence posting on Facebook that she was no stranger to sexual harassment and experienced it just a week earlier with a colleague she works with regularly as a lawmaker. The post was part of the #MeToo movement after a New York Times expose highlighted the stories of several women who said they’d been sexually harassed or assaulted by Hollywood producer Harvey Weinstein.

Then, a flood of other allegations were brought to the surface in Colorado politics. Rep. Faith Winter said fellow House member Steve Lebsock had harassed her at a legislative party in 2016. Winter and a lobbyist say they filed formal complaints against Lebsock.

An intern said Sen. Randy Baumgardner harassed her with sexually suggestive comments. The same went for Sen. Jack Tate of Centennial, who was accused of telling an intern that if she wanted to get ahead in her career, he could help.

Rep. Paul Rosenthal, who is openly gay, allegedly groped a man and used his seat to try and get a date with another.

But the case between Lebsock and Winter gained the most attention, even prompting Lebsock to take a polygraph test, which the administrator says he passed, to prove his innocence. Lebsock has hinted that the entire incident may be a case of dirty politics, alleging that Winter is the one lying.

When several lawmakers were asked if the case would mean a splintered Democratic party in the House, they were unsure, but optimistic about the session.

Still, there haven’t been any resignations over the allegations, though several, including leadership and editorial boards from across the state, said these legislators should step down from their seat. Some even called for House Speaker Crisanta Duran to step down from her position because she promoted Lebsock to a chairmanship despite knowing there was an incident between him and Winter.

The transparency piece has yet to be addressed by state lawmakers, and it’s unclear whether any policy or legislative changes will address that in the coming months. But for what it’s worth, the women who have broken their silence about sexual harassment in the Legislature are supportive of the changes leadership has discussed.

“I’m encouraged to see the direction leadership is taking when it comes to developing new and independent methods of dealing with complaints of sexual harassment at the Capitol,” said Esgar, who still hasn’t named the colleague she said grabbed her thigh at a legislative event earlier this year. “I’m hopeful that new ideas are still being formulated and considered, when it comes to ways to change the culture itself.”

The lawmaker added that a new session will certainly mean new ideas will come to light, “it’s our responsibility to lead the state in changing cultures to help make work environments safe and productive for all employees on every level.”

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