LIHU'E, Kaua'i — Veterans are denied ready access to specialized healthcare if they live on Neighbor Islands, they told the U.S. Senate Committee on Veterans Affairs in the first of four days of hearings this week.

Sen. Daniel Akaka, D-Hawai'i, the committee's ranking member, and committee chairman Sen. Larry Craig, R-Idaho, heard two hours of testimony from Veterans Administration officials, healthcare specialists and veteran service organizations. Their visit was part of a four-day series of hearings on four islands.

"It is far more difficult for our veterans to obtain full healthcare services than it is for our fellow veterans on the Mainland," said retired Navy Capt. Lynn Aylward-Bingman, a former member of the Navy nurse corps.

Some specialists visit the Kaua'i Community Based Outpatient Clinic only a few times annually, and veterans must wait if they are unable to fly to Honolulu or arrange authorization to see a local healthcare provider, Aylward-Bingman said.

"It is not acceptable to have to wait months, in pain, before a veteran is seen by a specialist who only comes to Kaua'i for a single day once every three or four months," she said.

Akaka said the Senate committee is trying to identify the unique needs of Hawai'i veterans, and is hearing that travel in Hawai'i, much like Alaska where many villages are not connected by road, is a serious logistical challenge to veterans. Interisland travel can be difficult for elderly and disabled veterans, and expensive flight costs are not always paid for, he said.

Last year, Akaka introduced legislation that would provide new satellite clinics with both healthcare and mental health services on Moloka'i and Lana'i, which have none, and a medical care clinic on the west side of Kaua'i. It also calls for a new VA mental healthcare center in Hilo on the Big Island.

A $10 million mental health center with an inpatient post-traumatic stress treatment program also would be built on the grounds of Tripler Army Medical Center.

Local veterans also said the local veterans clinic is inadequate for its task in serving former military personnel locally.

Frank Cruz, president of the Kaua'i Veterans Council, said the facility is at capacity, has inadequate parking and is not equipped to handle the anticipated increase in demand for services from veterans of the Middle East conflicts.

"It has outgrown itself," said Vietnam veteran Edward Kawamura.

The federal government concedes there are parking issues, but considers the clinic entirely adequate, said Dr. Jonathan Perlin, undersecretary for health in the Department of Veteran Affairs.

"I'm very proud of the level of support here," Perlin said, noting that it serves 1,016 veterans, while a Mainland healthcare provider handles on average 1,200 patients.

Federal officials also said they are hopeful that technology can overcome the travel barrier, through the use of tele-health services, in which doctors are able to make audio-video contact with patients while they are on different islands.

"I personally have 'seen' patients on one island while attending patients on another island," said Dr. James Hastings, director of the Veterans Administration's Pacific Islands Health Care System.

Hastings said it is too early to make any decisions about the adequacy of the Kaua'i clinic. He said the expansion of technology in the healthcare field may develop so that the existing clinic remains entirely adequate, even as its patient load increases.

But others argued that the needs are certain to outgrow existing levels of care. The community not only will be faced with an increasing number of veterans from the Middle East conflicts, but by an aging population that includes an aging veteran population.

"(In Hawai'i), between 1970 and 2000, the older adult population increased by 207 percent while the total population increased by 57 percent," said Colette Browne, a professor in the School of Social Work at the University of Hawai'i.

Akaka said the state has roughly 10,000 veterans aged 65 or older receiving VA care. The state's only veterans nursing home, at Tripler Army Medical Center, has 60 beds and is operating at capacity. A new 95-bed facility should open in Hilo in early 2007.

Speakers said that will require additional long-term healthcare options, including more care homes on more islands and increased support for families that choose to care for their aged veterans themselves.

Reach Jan TenBruggencate at jant@honoluluadvertiser.com.