When U.S. military veteran Mary Parmenter moved from Minneapolis to Bremerton, she was looking forward to her retirement in Washington, knowing that the Department of Veterans Affairs would care for her if she needed assistance.

Shortly after her arrival, Parmenter developed an inflammation in her leg that, she thought, had all the signs of deep-veined thrombosis.

She called the VA’s “telehealth” line and they told her to drive to Seattle. That began a two-year ordeal to gain reasonable access to specialized medical care.

When she talked to a nurse on the help line she was to drive to Seattle VA hospital to get it checked out, Parmenter said. “I was astounded. They wanted me to drive when my leg was swollen, not knowing my condition.”

She begrudgingly drove to Seattle – unaware of other, more convenient options – whereupon she was told that the ultrasound technician had just left and that she would have to come back in three days to obtain a diagnosis.

“It never occurred to me that when I retired there would be such a difference in quality of care,” she said. “It’s outrageous the kind of things that have happened to me and other veterans.”

Parmenter is now one of a growing group of local veteran activists raising awareness of the need for expanding transportation alternatives and specialized care in the West Puget Sound region.

Kitsap County is home to some 35,000 veterans, according to estimates by the Kitsap County Veterans Assistance Program. When combined with the greater Olympic Peninsula, there are more than 72,000 veterans who rely on hospitals in Seattle and Tacoma for specialized care.

“Geographically, for all intents and purposes, we’re out in the wilderness,” said Fred Scheffler, a Bainbridge Island resident and veteran.

Scheffler, who will soon chair the Kitsap County Veterans Advisory Council, has been a vocal advocate of increasing the access to care for Kitsap and Olympic Peninsula veterans.

“We need to have a reallocation of VA resources,” he said. “I know people who come from as far as LaPush and Forks and all those areas, and it takes some of them 13 hours to get to the VA hospital in Seattle.”

There are resources available to veterans in the West Puget Sound area, including a clinic in Bremerton and a clinic operated under a joint agreement in Port Angeles. A mobile clinic also visits rural communities outside of Kitsap County.

However, these clinics are usually staffed by contracted doctors, and the clinics emphasize primary, preventative health care.

The importance placed on primary health care, said Jeri Rowe, director of public affairs with the VA Puget Sound Health Cware System, was a policy that was enacted prior to the start of the wars in Iraq and Afghanistan.

“At this point there is continued focus on expanding community-based care, and we assume that is the direction we’re moving regionally,” Rowe said. “And having something in your community is a lot better than having to go to Seattle or American Lake (south of Tacoma) for every appointment.”

However, advocates think there can be compromise and some more legwork on both sides. They point to the hospital at Bangor Naval Base and wonder why a joint operating agreement couldn’t be set up, or increasing transportation options among the public and volunteer busing options.

Some, like Scheffler, see a need to build an entirely new facility in Kitsap, one that will serve all veterans in western Puget Sound.

At a conference at American Lake in October, many of these issues were raised. Some veterans told horror stories of having to wake up at 2 a.m. to make sure they caught their buses. Some have even slept at bus stops to make sure they made their connections; upon arriving at the VA hospital, some were told their appointments had been changed despite their planning.

“People have always complained about this,” said Leif Bentsen, a human services planner at the Kitsap County Veterans Assistance Program. “The VA has its limitations. And it’s extremely difficult especially when some of these people have trouble just getting out of their driveways.”

Then there is the critical issue of veterans who will return to the U.S. from Iraq and Afghanistan with injuries that need more specialized care than is available in west Puget Sound area.

“There are a lot of veterans out there and you can’t place them at a disadvantage because there will be more,” Scheffler said. “We can’t have the same situation that happened when veterans came back from Vietnam.”

Rowe agreed that many of those coming back from wars abroad would require a different kind of medical attention.

“Many of those people will require specialty care and many will require hospital visits for their specific conditions,” she said.

Rowe said the state VA office has its hands tied when it comes to funding facilities. Monies for VA health care are doled out at the federal level based on complex calculations of need and population.

“The only way we can change anything is by population,” Rowe said. “It’s a complicated process that takes a number of years. There are specific criteria of determination, and funding is competitive across the country.”

Expansion of the resources required to address health care for veterans in the state and West Puget Sound likely won’t occur unless action is taken at the federal level.

Sen. Patty Murray, D-Washington, has made it one of her goals to expand veterans’ medical services and benefits. As a member of the Senate Appropriations Veterans Affairs Subcommittee, she is not only taking a look at access issues but also ensuring that veterans are covered for non-service related injuries – a program that was scrapped by the Bush Administration.

“When we recruit men and women to fight for us here or abroad we tell them we will provide health care,” Murray said. “We can’t just come back years later and say, ‘Sorry, we don’t have the money.’ It’s our responsibility to come up with those resources.”

Murray admits funding and access issues in Washington State will be hard to solve, but still maintains progress has been made and will continue to occur in the 2009 legislative session.

“In Washington, travel time and getting access is always a challenge,” she said. “We’ve been working to help rural communities and trying to get virtual access for veterans. We have also increased the mileage reimbursement for trips to VA medical facilities.”

But for many west Puget Sound veterans, change isn’t coming quick enough.

After Parmenter’s ordeal, which ended two years later with a private diagnosis of Goosefoot Bursitis, she helped organize the Women’s Veterans of America. The group is lobbying for wider access and more specialized care for women within the VA system.

Although she admits it is an uphill battle, she remains guardedly optimistic.

“I’ve been told they are working on it and people are doing the best that they can. But they need to do better,” she said. “Right now there is no consistency, no one knows who you are, and there is no emergency care.”

She said there is a growing frustration with system by many veterans in the region.

“Sometimes it feels like we’re living in the dark ages over here.”