By Rick Maze
Times staff writer

An internal Department of Veterans Affairs report finds that some medical benefits, such as home-based treatment, adult day care and respite care, have been improperly denied to eligible veterans.

The report from the VA inspector general also says, as veterans have long suspected, that the VA is not meeting its goal of cutting the waiting time to 30 days for initial care and does not even seem to count the waiting time for specialty care such as cardiology, orthopedic surgery and gastroenterology.

Sen. Daniel Akaka of Hawaii, ranking Democrat on the Senate Veterans' Affairs Committee who had requested the investigation after hearing complaints about roadblocks in the way of getting treatment, said the report "has once again shown us that underfunding [the] VA means that veterans do not get the care they deserve, be those long-term care services or critical cardiac procedures. Indeed, investigators found that budget shortfalls led to illegal restrictions on care."

Akaka said some improvements have been made and he expects more to follow because Congress appears willing to provide money that the Bush administration does not.

Under a 1999 law, the VA can provide service to veterans in their own homes or community settings when hospital care is not appropriate. This includes having home-based primary or specialized care, home health aides, adult day care and respite and hospice care.

"Even though non-institutional care services are available to all eligible veterans, some medical facilities limited access of certain non-institutional care services to only the highest priority veterans, such as those with at least 70 percent service-connected disability," the IG report says. "Some medical facilities were either unable or chose not to provide veterans with non-institutional care in remote regions of their geographic areas."

VA officials pledged to do better. First, they promised in a response to the report to remind facility directors, nursing directors and chiefs of staff that non-institutional care is part of the VA benefits package. Second, officials said the VA would "incrementally expand" coverage to remote areas, although this would only be done as the budget allows.

The IG report also recommends that the VA figure out how to measure waiting time for elective health care and to cut the waiting time, something VA officials also pledged to do.