Some veterans struggle to obtain health care
By Amy Jeter | The Virginian-Pilot | Published: April 30, 2014
In the midst of a life scarred with mistakes, Dwight Alexander did one thing right in the eyes of society.
He joined the Army.
Before that, he got caught buying goods with a stolen credit card. Afterward, he became addicted to crack cocaine.
During his 26-month Army stint, something went wrong enough that Alexander's discharge papers say "other than honorable."
For years - decades, actually - that didn't matter to him. Now it does.
At 61, he's fresh out of prison, staying at the Union Mission homeless shelter in Norfolk, trying to build a better life piece by piece.
He wishes he could get veteran benefits, including medical care from the U.S. Department of Veterans Affairs, but his discharge status makes that impossible for now, questionable at best for the future.
Over nearly four months, doctors with charity programs have set his broken leg, checked his blood-sugar levels and signed him up for more care. But Alexander worries about relying on them over the long term.
"Some hospitals will not deal with uninsured people," he said. "I have nothing now."
Alexander doesn't qualify for Medicaid, the government insurance for the poor, but he would if Virginia's General Assembly decides to expand the program under the federal Affordable Care Act. Expansion is a sticking point in the ongoing budget impasse.
About 12,300 of Virginia's 840,400 veterans could be in the same situation, according to statistics from the Commonwealth Institute for Fiscal Analysis.
Some Democrats have referenced them as a reason for expanding Medicaid.
"The least we can do for these brave individuals, many with serious medical conditions, is ensure that they and their families have access to affordable and quality health care," wrote Lt. Gov. Ralph Northam, an Army veteran, in an opinion piece published in February in The Pilot.
Republicans say this small population would be better served by existing programs bolstered by their proposed budget, such as free clinics and community health centers, or through other improvements to Virginia's system.
Largely left unsaid: Most veterans disqualified from VA health care either served less than two years or have military records with serious flaws.
They aren't in the vast majority of veterans, who leave the military with an "honorable" discharge, said Donald Gordon, a Pennsylvania attorney who specializes in military law.
They don't have a discharge status of "general under honorable conditions" either. They are the ones with a "bad conduct" or "dishonorable" discharge - designations that typically come after a court-martial or a guilty plea in relation to crimes, such as drug dealing, rape or murder.
Others who left the service "under conditions other than honorable" logged a significant, though not catastrophic deficiency: a pattern of underage drinking, for example, or an extended period of absence without leave.
Some get that discharge designation for drug use, then face a conundrum: They're unable to get VA health care for an addiction they say they formed trying to cope with the stress of service.
Asked whether he realized that a large proportion of uninsured veterans were not honorably discharged, Northam replied in an email from his policy director: "There are a number of different reasons why Veterans don't qualify for VA benefits. In addition, there are some veterans who qualify for VA benefits but live in very rural parts of the state and can't easily access those benefits, so some of these vets would also benefit from Medicaid expansion."
Del. Scott Lingamfelter, an Army veteran, said in an interview that he cares about all veterans, and that he'd be happy to explore options other than an expanded Medicaid for those who don't qualify for VA health care because of mistakes made during their service.
However, he said, the military's system for benefits eligibility serves a purpose.
"It may not seem fair to some people," said Lingamfelter, a Prince William County Republican. "But one of the incentives to soldier well and keep your nose clean while you're serving is that you could lose benefits if you are discharged with other than an honorable discharge."
Alexander wasn't thinking that far ahead when he enlisted in the Army. He joined the service at 17 in exchange for the dismissal of criminal charges related to buying things with someone else's credit card.
It was 1970. The Vietnam War raged, but Alexander was stationed in Germany. Europe dazzled the teenager from Norfolk's Brambleton section.
During the day, he drove an armored personnel carrier. On weekends, he worked as a DJ and bartender.
Within two years, the partying caught up with him. He went absent without leave five times for more than 80 days, according to his service record. A special court-martial found him guilty of AWOL. Another found him guilty of AWOL and an assault on a female civilian. He also was disciplined for assaulting a fellow solider.
"They gave me a choice," Alexander remembered. "We can dismiss you, or we can kick you out the hard way. So I took the dismissal."
He left the Army on Oct. 18, 1972.
His "other than honorable" discharge meant it would be difficult for Alexander to get veterans' medical care for anything that wasn't service-related, unless he could get his discharge status upgraded. He thought they said it would automatically change after two years. No one told him it actually would entail an uphill battle.
It didn't concern him then.
Back in the States, Alexander bounced between New York and Norfolk. A marriage failed. His mother died. Another marriage failed.
He eked out a living loading and unloading produce trucks. Then he got in with Norfolk auctioneers, helping them transport furniture and guide clients through the showroom.
Alexander returned to partying, but with a new twist: crack cocaine.
From 2001 on, his criminal record grew and grew. Trespassing. Grand larceny. Drug possession. Again and again and again and again.
Somewhere along the way, he participated in a rehab program for homeless veterans. It didn't stick.
In fall 2011, two judges in two cities sentenced him to a total of 40 months in prison.
Alexander got out in January. He says things have changed.
He's off drugs and alcohol, cutting back on cigarettes. He reads the Bible and has appointed himself to help out with meals and chapel at the shelter - "a way of saying 'Thank you,' " he says.
As Alexander looks for work at auction houses and hotels, he saves the scant paper trail of his emerging life. A letter from the Virginia Employment Commission denying benefits. His military discharge report. A copy of a July application to change his discharge status and the five-page denial that arrived this month.
A short, handwritten letter from his son, who has three children and is serving a 41-year sentence at Sussex I State Prison: "I love you Daddy and I miss your letters."
"It's all coming down to me," said Alexander, who wants to help out with those grandchildren.
So far, no one has been optimistic when he's asked about veteran benefits. But he has seen several doctors.
The Bon Secours Care-A-Van gave Alexander a free check-up in March when the mobile clinic stopped at the Union Mission.
In February, Sentara Norfolk General Hospital's emergency department treated his right leg, which broke when he fell on black ice. Sentara's Ambulatory Care Clinic has seen him three times for follow-ups and scheduled a primary care visit for next month.
He owes nothing for the clinic visits because he has no income, but he has a bill for $140 from Medical Center Radiologists for X-rays at the hospital and the clinic.
Alexander's file also includes a $346 bill from Emergency Physicians of Tidewater and a $1,820 bill from Sentara. He's applied to them for charity assistance. "They'll reduce by so much percentage," he said. "Then once I get employed, I'll set up a payment plan."
Though he appreciates the care he's gotten, Alexander said he'd prefer VA health care or Medicaid. With that coverage, he wouldn't have to worry about applying for charity, missing bills, owing money and possibly being taken to court for his debts.
"I really need insurance," Alexander said.
Amy Jeter, 757-446-2730, firstname.lastname@example.org