Hamilton's new Veterans Affiars clinic brings care to rural area

HAMILTON – Dan Fadness' family has served in every American war except for the American Revolution, and that's only because that particular soldier passed away two years before the conflict began.

Fadness, a 73-year-old veteran of the 1155th Tech Ops Squadron of the U.S. Air Force, finished off his service years ago on the Aleutian Islands.

"Keeping the Russians honest," he quipped.

"I wouldn't say it's a tradition but we've tried to be there when we could," he added, with a wry mix of humility and pride.

These days, Fadness lives with his wife, Roberta, in Salmon, Idaho, and for a long time he had no need for the medical services afforded former soldiers by the U.S. Department of Veterans Affairs.

But when he did begin to look into those services, it quickly became clear that to actually meet with a VA physician, he'd have to do some driving. For a long time, veterans of the Salmon area – as well as the Bitterroot Valley – had to take trips to Boise, Missoula, Helena or Butte to receive the care that they've earned through their military service.

Thanks to a widespread effort by the VA and the federal government to expand medical services to veterans in rural areas, much of that hassle ends Friday with the ribbon cutting at a new VA medical clinic in Hamilton.

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On Thursday, the Fadnesses took a drive over Lost Trail Pass and into Hamilton to check out the new facility and the adjoining new home of the Valley Veterans Service Center.

Dan liked what he saw.

"They're going the right direction in trying to provide for those that have provided for them in the past," he said.

Located on Fairgrounds Road just west of Hamilton High School, the new clinic will offer a variety of medical services to the 1,500 or so local veterans who used the VA's services in the last year – approximately 4 percent of the 32,000 treated in the state – and, possibly, the many more who might seek service now that it is conveniently available.

"VA Montana is striving to get out to the veterans, be where they live and not require them to travel hundreds of miles for health care," said Teresa Bell, a planning and public affairs representative with Montana's VA health care system in Helena.

One of the ways that the new clinics are making this possible is through a technology called Telehealth, which allows veterans to meet with physicians and specialists virtually via a two-way audio and visual device.

"This gives us the ability to hook up with a specialist or a doctor in another area or even another state," explained Telehealth clinical technician Becky Bauer during a walk-through of the Hamilton facility Thursday afternoon.

In her hands, Bauer held a number of "peripheral devices" – digital stethoscopes and otoscopes that can be used by an on-site technician to transmit images and audio gathered by the devices to doctors elsewhere for real-time examination.

The technology also allows patients to digitally meet with mental and behavioral health professionals or virtually attend appointments with, for example, diabetic health counselors or prosthesis technicians without making long, expensive trips for half-hour sessions.

And while the technology is no replacement for a hands-on meeting with a doctor and can't really be used for complex or emergency treatments, it will allow patients to do most of their follow-up examinations – including routine treatment for chronic illnesses such as heart disease and high blood pressure – with those professionals without leaving their immediate geographic region.

"Patients who have complex medical needs may have to go to our Missoula clinic and see a doctor face to face," said Bell, "but routine follow-ups can be done in Hamilton without having to travel."

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When the Hamilton clinic becomes fully staffed – sometime in September most likely – there will be one Telehealth technician and two registered nurses on the full-time staff.

Hamilton was chosen for the clinic, Bell explained, not only because of its high population of veterans, but because it was identified geographically as a location where a high percentage of veterans were being underserved.

"Hamilton has a pretty good population that travels to Missoula, and 50 miles may not seem that far, but in the winter 50 miles is a long ways in the Bitterroot," she said.

According to Kim Kurokawa, a facility Telehealth coordinator at Fort Harrison, while the Telehealth system isn't cheap – a single system rings up somewhere in the $40,000 range – it has exponential value not only to the VA, which reimburses veterans for their travel, but to the veterans themselves.

"Someone who has to come into Missoula or Fort Harrison has to take time out of their day and possibly even have family drive them in; that's a huge expense for them in their lives. Instead, they're going to come to Hamilton on their lunch hour," Kurokawa said. "It won't take the place of a provider putting their hands on a veteran, but it's a great way to provide a substantial amount of their care."

For Sen. Jon Tester – a member of the Senate Veterans Affairs Committeewho has – the expansion of the VA's medical services to rural areas is an important part of the promise that the country has made to its bravest citizens.

"These are folks that have served this country so very, very well and they deserve it," said Tester. "It's all part of this country's obligation to live up to the promises we make to our veterans."

Some of the funding that has made the new clinics possible has come from a recently passed VA budget that increased clinic funding by some $30 million.

Much of the awareness that Tester said led to his work on that front is due to the listening sessions that he's attended all over the state, including a few in the Bitterroot Valley.

"Because of those listening sessions, we've been able to advocate for some pretty darn good things for Montana's veterans," he said.

"Veterans who live in rural areas don't live as long as veterans who live in urban areas, and I think one of the reasons for that is access to health care.

"These clinics improve (that access) and I think it will help them not only have a better quality of life, but they'll be able to live longer," Tester said.

"It's absolutely what veterans in the valley deserve."