Teresa Parsons, a former Army nurse who was wounded while serving in Iraq, was excited when she recently applied for a new job at the Department of Veterans Affairs. She hoped it would allow her to continue helping fellow veterans with her medical skills.
But as budget and personnel cuts hit the agency—with a planned workforce reduction of 80, 000 people this summer—those plans are now on indefinite hold.
“The job that I had applied for at the VA is gone now, ” said Parsons. “My application was in, and I got an email on the 21st of January that said that the job announcement has been canceled. The position has been unfilled for a very long time, and now it’s not going to be filled at all.”
She was one of dozens of veterans, VA employees and community members who lined the sidewalk in front of the state Capitol Friday afternoon waving signs to protest the cuts being undertaken by the administration of President Donald Trump.
The VA has confirmed that in Hawaii it has laid off a “small number ” of probationary employees working for the VA Pacific Island Health Care System, but would not discuss what roles they were in. The VAPIHCS is responsible for serving veterans across the Hawaiian Islands as well as the U.S. territories of Guam, the Commonwealth of the Northern Mariana Islands and American Samoa—giving it an area of responsibility of approximately 2.6 million square miles as it works to serve veterans across remote, far-flung islands.
The cuts are part of a larger push to fire large swaths of the federal workforce being undertaken by the Department of Government Efficiency, a newly formed White House office that was the brainchild of billionaire Elon Musk—the world’s richest person—and is staffed mainly by junior programmers and engineers who previously worked at Musk’s various technology companies.
In recent years the VA has sought to expand operations in Hawaii’s rural communities and U.S. Pacific territories to serve veterans who live in those areas in their communities and cut down on long journeys to VAPIHCS headquarters at Tripler Army Medical Center. There have also been plans to extend some services to veterans living in the island nations of Palau, the Marshall Islands and the Federated States of Micronesia, which have historically had high levels of enlistment in the U.S. military and have sizable veteran populations.
Since the end of the Vietnam War, the United States has relied on an all-volunteer military to fight its wars. Residents of the Pacific islands served in the military in particularly high numbers during the post-9 /11 wars in places like Iraq and Afghanistan. A study of 2003 recruiting data by the Heritage Foundation found Pacific Islanders—including Native Hawaiians—joined the Army at a rate 249 % higher than that of other ethnic groups.
But the places they call home have long been underserved.
Hawaii veterans routinely travel long distances to get services, sometimes traveling inter island for appointments, and have contended with long wait times. Veterans in Guam, CNMI and American Samoa have even more hurdles to accessing care and benefits.
For the VA workers trying to close the gaps, the job comes with its own challenges as they try to reach veterans across the islands. Julie Goodman, a VA mental health therapist who attended Friday’s protest, said that “it’s hard to retain people, there’s a lot of turnover and then there’s barriers to working in the outer islands. … A lot of our programs already weren’t fully staffed.”
VAPIHCS has few dedicated facilities of its own, with some of its operations at Tripler Army Medical Center. It largely relies on partnerships and contracts with other hospitals and clinics across the Pacific’s far-flung islands to provide for patients. Recently, the VA managed to secure funding from Congress to build the long-planned Daniel K. Akaka VA Clinic in Kalaeloa and opened April 8, aimed at serving Leeward Oahu veterans. The VA has also been on a hiring spree to fill positions in the islands.
On Monday morning the Akaka clinic opened a new urgent care center.
“Today we open the first VA urgent care for veterans in the Pacific Islands, ” said Dr. Adam Robinson, director of VAPIHCS. “As we celebrate the structure, let’s also remember that it isn’t the building that makes the urgent care ; it is the people. The dedication and caring of our staff—the work everyone does in service of those who have worn the cloth of our nation—that’s what really makes this urgent care possible.”
Later in the afternoon, Robinson—who previously served as 36th surgeon general of the Navy before moving to the VA—announced he would retire at the end of the month after 50 years of federal service.
In his announcement, which was posted to VAPIHCS’ social media pages, Robinson wrote, “Through it all, I have been reminded, time and again, that service is not about rank or title—it is about people. … We’ve grown our VAPIHCS ohana, and focused steadfast on doing the right thing, resulting in our staff providing safe, quality, and compassionate care to our veterans every day. Together, we’ve created robust health care models that will sustain our veteran community for years to come.”
Suzanne Abarca, a Navy veteran who attended Friday’s protest with her husband, Tom—a Marine veteran—said that while access has been a challenge for many veterans in Hawaii and the Pacific, the quality of treatment itself stands out. She said, “The VA here in Hawaii, is amazing, and I really don’t want to have cuts to that, because it’s incredible, best medical care I’ve ever gotten. We just fixed the system, let’s not break it again, you know ?”
The VA has a complicated history, with scandals around the country around substandard care and veterans falling through the cracks as they struggled to access benefits they’d earned. Critics have called for cutting down on bureaucracy and working more closely with private-sector health care providers and insurers to “streamline ” health care for veterans.
VA Secretary Doug Collins has insisted the cuts are needed to cut down on a bloated system. In an op-ed published in The Hill on earlier this month, he declared that “we owe America’s veterans—and hundreds of thousands of excellent VA employees—solutions.”
“Our goal is to reduce VA employment levels to 2019 numbers of roughly 398, 000 employees from our current level of approximately 470, 000 employees—a nearly 15 percent decrease, ” Collins wrote. “We will accomplish this without making cuts to health care or benefits to veterans and VA beneficiaries.”
But a VA social worker focused on suicide prevention—who requested anonymity because they feared reprisal for speaking—said that cuts and new policies are already taking a toll at VAPIHCS.
The social worker told the Honolulu Star-Advertiser, “We’ve already seen an impact in our wait times related to mental health. And we save people’s lives every day. We’re the first line when it comes to the veteran that wants to harm themselves by suicide or harm someone else, and we get them immediate help ; and these cuts in funding and reductions in workforce are going to make it much harder to be available.”
Parsons said, “Privatization is not ever going to be cheaper, and it’s not ever going to be better, especially here in Hawaii where we have so much issues with health care access for the general public. … I’m not saying that (the VA doesn’t ) have difficulties, that they don’t have things that need to be dealt with—you know, issues like access, all those kind of things. But cutting 80, 000 people from the VA is not going to change that.”
Eli Foster, a combat veteran of Iraq and Afghanistan who attended the Friday protest, said, “This has absolutely nothing to do with streamlining the VA. It’s an excuse that they’re using to basically go after folks that they want to go after to loosen up money so they can give a big tax cut to rich guys like Musk.”
In addition to new facilities, the VAPIHCS has worked to provide more telehealth options in the islands, particularly when it comes to mental health care, especially since the COVID-19 pandemic. VA officials and veterans alike have previously said the push has in some cases helped cut down on unnecessary travel for veterans living in rural and remote island communities.
But care providers say there is now a push to cut back on telehealth and remote work options.
“The push towards telehealth (was to ) be able to reach out so the veterans don’t have to fly two hours or a day and stay in a hotel, ” said Parsons. “Now the whole push is we’re going to pull back telehealth because we want people to come in ? That’s not what people who live in Hilo and American Samoa and Saipan, that’s not what they want. They want specialty providers who can come in and by telehealth and give them hope.”
Mental health care and suicide prevention have in recent years seen a major push from veterans groups and the VA. According to data from the VA, between 2001 and 2020 the suicide rate among veterans between ages 18 and 34 increased by 95.3 %. During that same time period, the suicide rate among veterans between ages 55 and 74 rose 58.2 %.
With the limited facilities and challenges serving neighbor islands, it offered many new workers, especially those working in mental health, remote and work-from-home positions where they served veterans across the islands. Now, VA workers say, a push to return to the office will only put further strain on the system.
“There’s not enough space as is. Even before COVID there was three of us therapists stuffed in one office. And now they’re trying to make us all come back with even more, ” said Goodman. “There’s a lot of veterans on this island that need care, right ? And we should have more space. … That’s what blows my mind, is the VA here (in Hawaii ) doesn’t even have its own hospital, we have to share with Tripler. So that creates a lot of barriers.”
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