El Paso

VA Health Access
& Facility Survey
YEAR FOUR
2017
BY: MATHEW S. MCELROY,
MPA, MS, AICP
WITH THE OFFICE OF
CONGRESSMAN BETO O’ROURKE
Are you a veteran having
trouble getting an
appointment with the VA?
If so, please call my office
for help at 915-541-1400.
FOREWORD BY
CONGRESSMAN BETO O’ROURKE
I am grateful to all of the veterans in El Paso
who participated in this survey to help give
us a better understanding of strengths,
weaknesses and opportunities within the El
Paso VA.

It is clear that mental health wait times are

improving. It is just as clear that we have a
real challenge in meeting the primary care
demands in El Paso. I will do my best to use DAYS
these findings to seek better performance at
on average, to see a primary
the El Paso VA. or specialty care provider

Sincerely,

Beto O’Rourke
16th Congressional District, Texas

Mental health wait times have fallen

from 71 days to 56 in the last four years

El Paso VA Health Access and Facility Survey - Year Four 1

 The responses to questions about
community care and sharing medical
information will help the VA improve
a recently launched pilot program to
ensure that every veteran receives
the best care that the VA and the
community can provide.
2 Office of Representative Beto O’Rourke
KEY FINDINGS

Compared to a year ago, 46.5 percent of respondents

47% believed that service in the El Paso VA system greatly or

somewhat improved, up almost nine points from last
year (37.8 percent).

44.3 percent of veterans surveyed lost their primary care

44% providers over the last 12 months. 38.7 percent of those

surveyed have not yet been assigned another primary
care provider.

66%
2017 marked the highest level of veterans being able to
obtain a mental healthcare appointment (66.2 percent),
up almost four points from last year.

The experience of veterans receiving mental healthcare

services has also improved for the fourth consecutive

7.65
POINTS
year, reaching 7.65 (11 point scale). This is well above the
5.43 average first recorded in 2014.

Side by side comparisons for matching questions year over year are provided in
the tables on page 6.

El Paso VA Health Access and Facility Survey - Year Four 3

 Our work is beginning to show
progress. Mental health wait times
have fallen.

4 Office of Representative Beto O’Rourke

METHODOLOGY
The population for this survey was provided by the Office of Texas’ 16th
Congressional District and comprised of a listing of 17,101 veterans within the
district, representing a meaningful portion of the entire veteran community in
El Paso County. The list of veterans was matched to phone numbers and email
addresses by a third party service provider and the congressional office. Once this
was done, a sample of the full population was randomly selected to participate.
The author and senior staff from the 16th District updated this year’s survey
instrument. After review by VA staff, only minor changes were made. Revisions to
individual questions were avoided so that data would be directly comparable to the
findings in previous years. The questions added this year should prove useful in the
years ahead as wait times for community medical providers can be benchmarked
against VA wait times. Further, the open-ended response to the quality of mental
healthcare question should allow the 16th District Staff and VA to review concerns
that may have gone unheard before or see what approaches VA patients have found
the most useful.
The original instrument was constructed after an extensive review of existing
documents, such as the Inspector General’s report on the El Paso VA and published
healthcare and mental healthcare access studies. The original survey instrument was
independently tested by three different focus groups of local veterans. The panels
included patients who had received care at the El Paso VA for several years and
representatives from veterans’ service organizations that aid veterans in receiving
care and helping them navigate the appointment making and benefits processes.
The surveys were fielded by telephone and email. A total of 873 surveys were
collected via SurveyMonkey (protected for duplicates, forwarding prohibited) and an
automated telephone polling system (Gravis Marketing). Veterans were contacted
first by email (eleven waves), then via telephone (four waves) to provide ample
opportunity to participate. All survey data collection concluded on June 20, 2017.
It is important to note that these results reflect the experiences of veterans within
the 16th District and that geographic area differs from the full area served by the El
Paso VA. This, in addition to respondents’ ability to provide exact dates by immediate
recall, will lead to some differences between VA reported statistics and those here.
However, the experiences of veterans are a critical triangulation and evaluation
component for measuring improvements in access to care.

- Mathew S. McElroy, MPA, MS,AICP

El Paso VA Health Access and Facility Survey - Year Four 5

QUESTION 2014 2015 2016 2017
Have you attempted to make an
appointment for mental health
care services at the El Paso VA
clinic in the last 24 months?

Yes 36.6% 36.9% 34% 32.9%

No 63.4% 63.1% 66% 67.1%

Have you attempted to make an

appointment for mental health
care at the El Paso VA Clinic in the
last 12 months?

Yes NA NA 75.7% 77.3%

No NA NA 24.3% 22.3%

Were you able to obtain a mental

health appointment?

Yes 63.5% 65.6% 62.4% 66.2%

No 36.5% 34.4% 37.6% 33.8%

Was the mental health appointment for:

An initial visit/appointment 19% 17.8% 18.6% 19.3%

Regular or follow up appointment 76.6% 77.5% 76% 77.8%

Unsure 4.4% 4.7% 5.4% 2.8%

At your most recent mental health

appointment, did you see:

A counselor
58.8% 60.5% 58.7% 51.6%
(counselor, social worker, psychologist)

A psychiatrist 31.1% 30% 33.2% 37.3%

Unsure 10.1% 9.5% 8.2% 11.2%

6 Office of Representative Beto O’Rourke

QUESTION 2014 2015 2016 2017

How many days went by between your 71 63.85 56.5 56.45

request for the appointment and seeing a day day day day
mental health care provider? avg. avg. avg. avg.

When you received a mental health

avg. avg. avg. avg.
appointment, how many times did the El
of 1 of 1 of 1.93 of   1.14
Paso VA have to cancel or reschedule it?

In the last 24 months, if you attended

42 42 44.7 41.1
your VA mental health care appointment,
min. min. min. min.
how much time did the provider spend
avg. avg. avg. avg.
with you?

In your opinion, was the time allotted for

your appointment appropriate to address
your mental health care needs?

Yes 58.8% 60.7% 59.3% 76.5%

No 27% 25.5% 26.4% 17.6%

Unsure 14.2% 13.8% 14.3% 5.9%

If you received mental health care

services at the El Paso VA, using a
number between 0 and 10, where 0 is
5.43 6.55 6.59 7.65
the worst experience possible and 10 is
avg. avg. avg. avg.
the best experience possible,
please rate the quality of mental health
care you received.

Have you put off your mental health care

because of the difficulty in obtaining an
appointment?

Yes 42.5% 40.2% 40% 32.4%

No 49.6% 53.4% 53.7% 63.4%

Unsure 7.9% 6.4% 6.3% 4.2%

El Paso VA Health Access and Facility Survey - Year Four 7

QUESTION 2014 2015 2016 2017
Do you believe any untreated mental
health issues made it harder to schedule
your appointments?

Yes 32.9% 31.6% 35.3% 30.5%

No 39.6% 45.8% 43.3% 53.1%

Unsure 27.5% 22.5% 21.3% 16.3%

Not including mental health, have you

been treated at the Department of
Veterans Affairs health facility in El Paso
in the last three years?

Yes 79.5% 82.4% 81.1% 81.7%

No 20.5% 17.6% 18.9% 18.3%

Not including mental health, was your

most recent health care visit:

Within the last year 88.7% 86.1% 86.8% 87.3%

Between 1 and 2 years ago 9.2% 10.4% 10.2% 9.1%

Over 2 years ago 2.1% 3.5% 2.9% 3.6%

Not including mental health, was your

most recent health care appointment for:

Primary health care services

56.1% 60.1% 60.6% 61%
(general medicine, family medicine)

Specialty health care services

(cardiology, neurology, sleep clinic, 37.9% 33.2% 31.8% 33.4%
orthopedics)

Urgent care or triage nurse

3% 4.3% 3.4% 2%
(sick call, walk in triage)

Unsure 3% 2.4% 4.2% 3.6%

8 Office of Representative Beto O’Rourke

QUESTION 2014 2015 2016 2017
Not including regularly scheduled
routine care visits, how many days went 85 77.4 64.2 57.9
by between your request for your most day day day day
recent non-mental health appointment avg. avg. avg. avg.
and seeing a health care provider?

Including mental health, how many times 9.7 7.91 7.24 11.6
per year on average do you have a health appts. appts. appts. appts.
appointment at the El Paso VA? avg. avg. avg. avg

Not including mental health, how would

3.1 3.1 3.14 3.29
you rate your overall level of satisfaction
avg. avg. avg. avg.
with the care provided at the VA clinic?

Very unsatisfied 15.3% 15.9% 13.8% 15.7%

Unsatisfied 19.6% 20.4% 18.4% 14.3%

Unsure/Neutral 16.4% 18.6% 18.1% 15.1%

Satisfied 34% 32.3% 39.1% 34.9%

Very satisfied 14.7% 12.8% 10.5% 20%

Not including mental health, have you

had to travel to a VA health care facility
outside of El Paso within the last three
years for treatment because the service
was not available locally?

Yes 10.8% 12.6% 11.4% 13.2%

No 86.6% 86.7% 87.2% 86.2%

Unsure 2.6% 0.7% 1.4% 0.6%

Compared to a year ago, in your

judgment the service of the El Paso VA
Health Care System:

Has greatly improved N/A 9% 12.6% 17.2%

El Paso VA Health Access and Facility Survey - Year Four 9

QUESTION 2014 2015 2016 2017
Has somewhat improved N/A 24.3% 25.2% 29.3%

Is more or less the same N/A 48.8% 44.7% 37.1%

Is somewhat worse N/A 11.1% 12% 11.3%

Is much worse N/A 6.9% 5.5% 5.1%

Has the El Paso VA sufficiently explained

your eligibility and rights to participate in
the VA Choice program?

Yes N/A 31.6% 48% 53.5%

No N/A 56% 40.1% 33.1%

Unsure N/A 12.4% 12% 13.3%

It is important to me that...

I receive all of my health care at the VA

N/A 18.5% 20.9% 21.5%
regardless of wait times

I receive timely access to health care

regardless if it is provided at the VA N/A 81.5% 79.1% 78.5%
or by a provider in the community

Has the VA sent you to see a provider or

doctor outside of the VA?

Yes N/A 66.7% 68.1% 73.4%

No N/A 32.3% 30.2% 24.2%

Unsure N/A 1% 1.7% 2.4%

How would you rate your overall level of

satisfaction with the community medical
provider you saw?

Very unsatisfied N/A 12.3% 11% 14.8%

Unsatisfied N/A 8% 8.9% 7.7%

Unsure/Neutral N/A 13.7% 13.9% 12.4%

Satisfied N/A 41.6% 39.8% 39.7%

Very satisfied N/A 24.4% 26.3% 25.4%

10 Office of Representative Beto O’Rourke

QUESTION 2014 2015 2016 2017
How would you rate the VA for sharing
your medical records and other
important information related to your
health care with other providers or
doctors you may have seen in the
community?

Very unsatisfied N/A 11.2% 9.8% 15.1%

Unsatisfied N/A 15.2% 14.5% 9.3%

Unsure/Neutral N/A 34.9% 34.9% 37.5%

Satisfied N/A 31.6% 32.4% 28.8%

Very satisfied N/A 7.1% 8.5% 9.3%

How many days went by between your

request for an appointment and seeing a
community medical provider?

NA NA NA 52.3

Have you lost your Department of

Veterans Affairs (VA) primary care
provider (PCP) in the last 12 months?

Yes NA NA 42.7% 44.3%

No NA NA 57.3% 55.7%

How did you find out

your PCP left?

VA informed me NA NA 32% 34.4%

I tried to access VA services

(e.g. showed up for an appointment,
NA NA 43.6% 41%
refilled prescription, called to confirm my
appointment etc.)

Other NA NA 24.4% 24.5%

El Paso VA Health Access and Facility Survey - Year Four 11

QUESTION 2014 2015 2016 2017
Have you been assigned a new primary
care provider?

Yes NA NA 65.9% 61.3%

No NA NA 34.1% 38.7%

How long have you been without a

primary care provider?

Under 30 days NA NA 11.5% 12.4%

1 to 2 months NA NA 10.6% 15.4%

3 to 4 months NA NA 6.7% 21.2%

5 to 6 months NA NA 11.5% 13.5%

Over 6 months NA NA 10.6% 37.5%

Do you receive telehealthcare for any

condition for which you are seen at the
Department of Veterans Affairs (VA)?

Yes NA NA 20% 20.2%

No NA NA 80% 79.8%

How satisfied with your telehealthcare

are you (using a number between 0
6.5 6.9
and 10, where 0 is the worst experience NA NA
avg. avg.
possible and 10 is the best experience
possible)?

Which of the following is most important

to you with regard to the current VA
facility in El Paso?

Access to expanded and improved

primary care 34.8% 37.4% 37.7% NA
(general medicine, family medicine)

Access to expanded specialty care

(such as cardiology, neurology, sleep 25.3% 29.4% 27% NA
clinic, orthopedics)

12 Office of Representative Beto O’Rourke

QUESTION 2014 2015 2016 2017
Ability to be admitted to
7.9% 3.6% 4.5% NA
a hospital bed within a VA hospital

Access to better mental health care 9.4% 9.2% 7.9% NA

Not having to travel outside

10.3% 12.6% 12.2% NA
of El Paso for medical care

Unsure 12.1% 7.7% 10.6% NA

Do you believe the VA facility in El Paso

should be expanded?

Yes 88.5% 87.1% 85.1% NA

No 4% 4.4% 4.7% NA

Unsure 7.5% 8.5% 10.2% NA

How would you rate your overall level of

satisfaction with the current VA medical
facilities?

Very unsatisfied 16.2% 15.1% 11.3% NA

Unsatisfied 23.1% 21% 20.6% NA

Unsure/Neutral 24.6% 30.2% 27.7% NA

Satisfied 28.6% 27.9% 32.3% NA

Very satisfied 7.5% 5.7% 8.1% NA

What is your gender?

Female 9.4% 12.3% 13.7% 25.4%

Male 90.6% 87.7% 86.3% 74.6%

(If female) How important to you is it to

see a female provider or doctor?

Very Important N/A 29.4% 35.2% 24.7%

Somewhat important N/A 19% 17.2% 22.4%

El Paso VA Health Access and Facility Survey - Year Four 13

QUESTION 2014 2015 2016 2017
Unsure/Neutral N/A 16.7% 19.7% 24.7%

Somewhat not important N/A 11.9% 9% 8.2%

Not important N/A 23% 18.9% 20%

What is the highest level of education

you have completed?

Less than high school 0.5% 0.9% 2.4% 1.1%

High school diploma/GED 18.9% 24.5% 27.8% 24.4%

Associates degrees 30.8% 29.5% 25.3% 27.5%

4 year degree (Bachelors) 27.5% 26.4% 26.3% 27.2%

Masters degree or higher 22.3% 18.7% 18.2% 19.8%

Do you currently have health insurance

aside from the coverage provided by the
VA?

Yes 71.5% 70.4% 70.4% 70.5%

No 25.9% 27.4% 27.2% 26.3%

Unsure 2.5% 2.1% 2.3% 3.2%

Are you currently employed?

Yes 34.3% 34.5% 32.2% 32.2%

No 31.1% 31.1% 33.4% 31.8%

Retired 33.5% 33.6% 33.5% 35.6%

Unsure 1.1% 0.7% 0.8% 0.4%

14 Office of Representative Beto O’Rourke

If my office can assist you or a family member
with the VA or any other federal agency,
please call us at 915-541-1400.

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