Why the Lower Shore Needs a Community VA Clinic

American Legion Post 56 Commander

July 28, 2014

On March 4, 1865, President Abraham Lincoln gave his second inaugural address to a war-torn nation that was filled with anger, angst, and uncertainty. Lincoln understood it was the people fighting the Civil War who shouldered the burden for the nation. So he elegantly spoke about the need “to care for him who shall have borne the battle and for his widow, and his orphan.” However, those immortal words that were spoken 149 years ago seem to have fallen on deaf ears in America.

We live in a time where the unemployment rate of our veterans still outpaces their civilian counterparts by three to five points and it’s about to get worse with significant military drawdowns. Another startling fact is that one-third of the adult homeless populations are veterans, and over 70 percent of them have some type of substance abuse issues.

The early recruiting promises and contracts regarding medical, dental, and retirement pensions have also fallen into the abyss. The majority of the broken expectations are due to politically oriented budget-cutting on both sides and elected officials who have little understanding of veterans’ issues since the majority of them never served in the military.

Promises of care for veterans have been around for centuries: in 1776 the Continental Congress encouraged enlistments by providing pensions to disabled soldiers, and some states and communities actually made individual pacts to care for their returning veterans. In 1812 the federal government authorized its first medical facility for veterans that eventually evolved into the establishment of the Veterans Administration in 1930 when Congress authorized President Herbert Hoover to “consolidate and coordinate government activities affecting war veterans.”

The VA has been effective in dealing with some veterans’ needs and extremely deficient in other cases as the media bears witness in Arizona. However, the Eastern Shore has a ray of hope that comes in the form of two very hard-working ladies named Wendy Ainsworth and Jamie LeCates-Brown. Ainsworth is the Veterans Service Representative and Manager for the Accomack Field Office, and Lecates-Brown is her administrator.


According to the last census, there are over 5,600 veterans on the Shore, and these two women are technically responsible for all of them. They see or speak to several hundred veterans and their families each month regarding compensation and pensions, survivor benefits, home loans, burial benefits, appeals, education, and medical benefits.

One of the biggest problems that we have on the Lower Shore, especially for older veterans, is the difficulty of traveling to their VA appointments. There’s a Community Based Outpatient Clinic (CBOC) in Pocomoke, Maryland, and a VA Medical Center in Hampton. However, a majority of these veterans never use their VA privileges due to gas prices and the bridge tolls.

So where do they obtain the medical treatment that they rate? In most cases, nowhere — or they suffer the indignity of a crowded waiting list hoping that their medical condition does not worsen. Worse yet, they slip through the bureaucratic cracks of the VA system and are never assisted.

These VA appointment issues are a major problem, and Ainsworth’s office has established a shuttle service with another service organization that utilizes a van that picks up veterans and drives them to their VA appointments in Hampton. The only catch is that all of the scheduled VA appointments must be made no later than 1 p.m. — anything past that means the veteran must find his or her own way back to the Shore.

The problem is compounded trying to obtain an appointment in an already overcrowded VA system and then getting a ride back to the Shore from that appointment. The Accomack Field Office does their best to notify medical centers when veterans arrive or contact them at their office seeking crucial medications and treatments. However, despite their best efforts to accommodate them, far too many of these veterans end up on that dreaded waiting list.

A Community Based Outpatient Clinic on the Lower Shore would increase access to primary care and reduce the travel time and expenses to VA Medical Centers. It would provide the most common outpatient services by granting access to health care that most of the veterans don’t have, create health promotion, promote health maintenance, conduct screenings, assist in the management of acute and chronic diseases, screen for mental health issues, serve as a primary care provider, promote woman’s health care, provide immunizations, and conduct some limited medical testing.

There are over 20 regions where the VA operates CBOCs, called the Veterans Integrated Service Networks (VISN). In Virginia the regions are VISN 9, VISN 5, and VISN 6. The Shore falls under VISN 6, which also encompasses West Virginia and North Carolina.

Virginia has three VA Medical Centers in VISN 6 with Hampton as our parent facility. There are six outpatient clinics, all located in North Carolina, and 26 Community Based Outpatient Clinics, with over half of them located in North Carolina.

The closest CBOC to the Lower Shore is in Virginia Beach. Prior to the CBOC opening in Pocomoke, many Shore veterans did not utilize the VA facilities in Hampton due to the time, travel, and expenses involved. However, the veterans using the Pocomoke CBOC would still have to travel to Baltimore for extensive care.

The Shore is blessed with veterans from WW II, Korea, Viet Nam, and the latest men and women from Desert Storm, Operation Enduring Freedom, and Operation Iraqi Freedom. Most of these men and women have never asked for anything in return for their military service. However, with an aging population, 9 million veterans over the age of 65, and a slipping economy, these veterans certainly deserve better than what they have.

Rudyard Kipling described the plight of English soldiers plight in his poem “Tommy,” where he wrote:

For it’s Tommy this, an’ Tommy that, an’ chuck him out, the brute!
But it’s Savior of ‘is country when the guns begin to shoot.

It’s time for the VA to place a CBOC on the Lower Shore — not just because the veterans need one, but because they have earned one.

Submissions to COMMENTARY are welcome on any subject relevant to Cape Charles. Opinions expressed are those of the writer and not necessarily of this publication.



9 Responses to “COMMENTARY
Why the Lower Shore Needs a Community VA Clinic”

  1. Antonio Sacco on July 28th, 2014 2:29 am

    Now that is the kind of leadership in Joe Vaccaro we need in Northampton and Cape Charles. If you recall he was fired by the Cape Charles Town Council because he was too smart for them and they were jealous of his leadership and intelligence. Yes Joe, you are absolutely correct about no facility here for Veterans. If you all recall, when the Industrial Park was sold (secretly) to the Baldwin family by the [County Supervisors] Tankard bunch, they gave me three minutes to change their minds about turning the Industrial Park into a rehabilitation center for our wounded warriors coming back from Iraq — just three minutes to state that I had a senator, Yale professors, and financial backing, but oh no — the Baldwins with their buddies on the Board led by Tankard gave the Baldwins 160 acres for a few bucks. If given to me instead of the Baldwins, there would be over 200 specialized medical personnel plus other workers like cooks, cleaners, etc. What a beautiful surrounding for our wounded warriors to get better — fishing, kayaking, hunting, and much more, but nothing can get past the Baldwins in this town, and that has to stop. Replace them with folk like Joe Vaccaro. God bless you Joe.

  2. Marshall Timm on July 28th, 2014 8:49 am

    We’ll put, Joe Vaccaro, and thank you for staying Semper Fidelis!

  3. Wayne Creed on July 30th, 2014 10:31 am

    “As these new details make painfully obvious …some VA executives are so driven in their quest for performance bonuses, promotions and power that they are willing to lie, cheat and put the health of the veterans they were hired to serve at risk,” said Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans’ Affairs. What Mr. Miller is talking about is the results of an investigation into the VA which show the depth of fraudulent scheduling, manipulation of data and in some cases intimidation of staff to hide delays in medical care to veterans in the 6-million patient national systems. While on the surface Mr. Vaccaro’s goal of a VA CBOC on the shore seems laudable, it appears he is trying to solve a systemic/programmatic problem with a geographic solution (building yet another brick and mortar structure which will have to be staffed and maintained). During the healthcare debates, there was some talk of also using the Affordable Healthcare Act to also clean up the VA, but that seemed to fall through the cracks. We should lobby our representatives to revisit it. It seems a better solution than building more clinics would be to allow veterans who have earned the benefit, to use it to get medical treatment anywhere they want it. They should be able to choose their own doctors, and see them at their local clinics and hospitals. If they still want to use VA services, that should be an option, but not a requirement. It seems long term, energies should be focused on fixing the process and the system, rather than expanding VA clinics (which are riddled with fraud, corruption and incompetence).

    Given there are three facilities, including the mother ship, within 45 minutes to an hour away, it seems that access to the services is the issue, not a lack of facilities. This is not just a Veteran’s problem, but an overarching Eastern Shore problem. Try being a child that needs mental health services, and see how that works out for you. There is only one child psychiatrist on the shore and he doesn’t take patients. The only alternative is to make an appointment across the bay (several months waiting lists), and then someone has to take off from work to get them there. Not only access to services, but also being able to get across the bay to access the myriad of employment opportunities, as well as internships and apprentice programs that exist at shipyards is also a big issue. Ultimately, we need to lobby for a Star Transit form of service that affordably gets Eastern Shore residents across the bay. It will never be convenient, but it will be an option, and an opportunity.

    Unfortunately, the approach being advocated by Mr. Vaccaro has infected town and county governments here on the shore, and has become so ingrained that there may be no turning back. It seems there is a tendency to flatly misdiagnose the problem, and then attack it with a 700 ton Manitowac crane when all we really needed was a small backhoe. The bloated, expensive staffs, huge debt, and dangerous (egregious) zoning plans are all traceable to process and methodology. Until that is changed, well, get used to more of the same, and remaining stuck here.

  4. Joe Vaccaro on July 30th, 2014 6:04 pm

    Once again, Mr. Creed has so elegantly missed a simple point. It appears he wants to use this article as a forum for his own personal objectives. If Mr. Creed has a cogent plan for any of this rant, we’re all ears. This article has nothing to do with Affordable Health Care, child psychiatrists, Star Transit, or a 700 ton crane (LOL!). The article has identified an actual problem for veterans on the Shore. The solution might involve a multitude of options, but “throwing around” unfocused rhetoric doesn’t solve the issue. A CBOC on the Shore is a simple starting point.

  5. Tony Sacco on July 30th, 2014 10:05 pm

    Joe — I am with you 100%. I was ahead of all of you on this subject years ago, speaking of just what the Veterans needed here, but the Tankard bunch in Eastville rejected it.

    I ran for supervisor and lost. A gentleman leaving the voting building said, “Tony I liked your idea about making the Industrial Park into a center to help the Veterans.” I asked, “Did you vote for me?” His answer was NO.

  6. Wayne Creed on July 31st, 2014 8:40 am

    The House on Wednesday overwhelmingly approved a $17 billion overhaul of the troubled Veterans Affairs Department.The 420-5 vote sends a conference agreement worked out by negotiators in both chambers to the Senate, where it is also expected to be approved. It will then be delivered to the White House for President Obama’s signature. The three-year bill provides $10 billion in funding to pay for veterans to get health care at private facilities. Another $5 billion would go toward allowing the Veterans Affairs Department to hire more doctors, nurses and other medical staff. “Our bill will allow veterans suffering long waits for care the option to be seen by a local doctor at a private hospital,” said Rep. Dan Benishek (R-Mich.). “It’s long overdue that Congress took action to provide the quality of care our veterans have earned,” said Rep. Ron Barber (D-Ariz.). Under the bill, veterans may seek treatment at non-VA providers who participate in Medicare if they live more than 40 miles away from a VA facility, or if agency physicians cannot see them within 30 days.

  7. Joe Vaccaro on July 31st, 2014 1:16 pm

    A CBOC can actually work out of existing medical facilities and that means that the VA wouldn’t have to build/rent a facility or hire more staff. The tricky part is getting a “CBOC” approved for the area, and that’s the crux of the issue.

  8. Clarry Ellis on July 31st, 2014 7:44 pm

    Has anyone thought of reaching out to Riverside? Didn’t they just announce a downsizing of the new hospital? Why not see if there is an opportunity to combine some of the new VA funds with their own efforts and build a consolidated facility with the capacity to handle the healthcare needs of all Shore residents?

  9. Joe Vaccaro on August 1st, 2014 10:23 am

    Clarry & Tony — Thank you for the comments and insights. We are exploring all the options to make this CBOC become a reality for the Shore. Of course the best way to pursue it is using the existing facilities, but that’s not our call. We are merely trying to call attention to an existing problem and move the proverbial ball down the field. The only thing that I can tell you is that “now” that we raised the CBOC issue, there’s a meeting scheduled to discuss the way ahead. We look forward to working with the VA and the medical professionals on the Shore to make this happen.