Central Texas VA: More Veterans, Longer Waits, Fewer Resources per Patient

1. A dense veteran population

Nationally, 6.2% of civilian adults are veterans (U.S. Census Bureau, American Community Survey 2020 to 2024). Around Fort Cavazos the share is about three times higher: 18.5% in Bell County, 18.4% in Coryell County and 19.7% in Lampasas County, or nearly 1 in 5 adults. For comparison, the rate is 5.5% in Marion County, Indiana, home of the Indianapolis VA.

The Central Texas VA Health Care System, based in Temple, says it "serves more than 252,000 Veterans in 39 counties."

Sources

1. U.S. Census Bureau, ACS 2020 to 2024, table B21001, via Census Reporter: censusreporter.org
2. Central Texas VA Health Care System, About us: va.gov

2. Specialty wait times

VA publishes average wait times by clinic. For gastroenterology at the Temple medical center, the average wait was 139.9 days (about 140) for new patients and 31.2 days (about 31) for established patients, in data dated October 12, 2026 and checked October 13, 2026. The same snapshot showed new-patient averages of 160.4 days for pulmonology, 177.7 for sleep medicine and 115.7 for OB/GYN. These numbers update daily.

VA's SAIL scorecard tells a similar story across specialties. In the first quarter of FY2026 (October to December 2025), the average new-patient specialty care wait at Temple was 56.7 days, past the cutoff for the slowest 10% of VA facilities (51.5 days). Indianapolis averaged 36.5 days, near the VA median of 36.8. Temple was past that slowest-10% cutoff in every quarter of FY2025 as well.

Indianapolis moved to a new electronic health record in August 2026 and now reports clinic waits with a different metric, so its daily clinic waits are not compared here.

Sources

1. VA Access to Care, facility data for station 674 (Temple): accesstocare.va.gov
2. VA SAIL scorecards, FY2026 Q1 (data.va.gov dataset sjd3-g9jr): data.va.gov; FY2025 (dataset wias-udhn): data.va.gov

3. Funding and staffing per patient

VA OIG facility reports publish each facility's medical care budget, unique patients and direct-care staff. The latest year available for both Central Texas and Indianapolis is FY2021. Both are VA's highest complexity level (1a).

On these figures, Central Texas had about 19% less budget per patient and about 31% more patients per direct-care staff member than Indianapolis.

Sources

1. VA OIG, Comprehensive Healthcare Inspection, Central Texas Veterans Health Care System, May 9, 2023 (22-00041-105), Table B.1: vaoig.gov
2. VA OIG, Comprehensive Healthcare Inspection, Richard L. Roudebush VA Medical Center, January 3, 2024 (22-03165-46), Table B.1: vaoig.gov

4. Projected growth

In its 2022 market assessments, VA projected the number of enrolled veterans in the Central Texas Market to grow 19.8% from FY2019 to FY2029, from 131,904 enrollees. For the Indiana Market, which includes Indianapolis, VA projected a 2.0% decrease over the same period.

Sources

1. VA AIR Report Vol. II, Market Recommendations, VISN 17, March 2022: department.va.gov
2. VA AIR Report Vol. II, Market Recommendations, VISN 10, March 2022: department.va.gov

5. The Copperas Cove clinic

A new two-story VA outpatient clinic in Copperas Cove broke ground on October 8, 2026. Completion is scheduled for September 2028, with the first patients expected in January 2029. Planned services include primary care, mental health, ambulatory surgery, imaging, lab, endoscopy and an infusion clinic.

It is an outpatient (ambulatory care) clinic. No published source lists inpatient beds or an emergency department, so hospital admissions and emergency care will still mean a trip to Temple or a community hospital.

Sources

1. Cullinan Properties, development award announcement: cullinanproperties.com
2. LEO A DALY, Copperas Cove VA clinic breaks ground: leoadaly.com

6. OIG, GAO and AIR findings

VA's own 2022 assessment (AIR)

VA's AIR market assessment described the Temple medical center (built 1967, tower 1997) as having a "lack of clinical space onsite," with outpatient clinics "housed in unrenovated hospital bed units." It also reported "challenges in recruiting and retaining specialty and sub-specialty providers," noting that "multiple specialties have been staffed at one or less than one full-time equivalent." VA recommended a new multi-specialty clinic near Killeen.

Counterpoint: the same report recommended narrowing Temple's inpatient mission to less complex care, not building a new full-service hospital. The AIR Commission was never seated after the Senate blocked it in June 2022, so these were VA recommendations, not adopted decisions.

OIG staffing shortage reports

In VA OIG's annual surveys, Central Texas reported 32 severe occupational staffing shortages in FY2025 (22 clinical, 10 nonclinical), including gastroenterology and primary care, and 17 in FY2026 (11 clinical, 6 nonclinical), including gastroenterology, hematology/oncology, diagnostic radiology and five registered nurse categories. Indianapolis reported 19 and 12.

Counterpoint: these lists are self-reported by facilities, not audited vacancy counts, and the Central Texas count fell by almost half from FY2025 to FY2026.

OIG community care inspection, VISN 17 (March 2026)

Reviewing FY2024 records, OIG found the Temple community care office lacked adequate clinical staff; its own staffing tool showed a need for 24 more clinical staff. Staff did not send community providers approval letters for an estimated 98% of requests for additional services, did not import diagnostic reports for an estimated 34% of patients reviewed, and the oversight council met 10 of 12 required times.

Counterpoint: OIG reported that staff were unaware of the approval-letter requirement, and Temple leaders cited trouble recruiting specialists. These are process and staffing-level problems that management can correct.

National OIG and GAO findings

OIG's June 2026 national audit found that in the first quarter of FY2025, 45% of VA consults and 60% of community care consults missed scheduling standards. GAO reported that as of February 2026, VA still had not set a standard for how soon a community care appointment should occur, a priority recommendation open since 2020.

Counterpoint: these findings are national and not specific to Central Texas. They show that sending more veterans to community care does not by itself guarantee faster care.

Sources

1. VA AIR Report Vol. II, VISN 17, Central Market section: department.va.gov
2. Senate Veterans' Affairs Committee statement on bipartisan opposition to the AIR Commission process, June 2022: veterans.senate.gov
3. VA OIG 25-01135-196, severe occupational staffing shortages FY2025 (August 12, 2025): vaoig.gov
4. VA OIG 26-01046-271, severe occupational staffing shortages FY2026 (September 11, 2026): vaoig.gov
5. VA OIG 25-00107-75, community care inspection, VISN 17 (March 18, 2026): vaoig.gov
6. VA OIG 25-01015-138, Audit of Consult Timeliness in VA and Community Care (June 17, 2026): vaoig.gov
7. GAO-26-108943: gao.gov; GAO-20-643: gao.gov

7. Counterpoints

The public record also shows real strengths and real investment:

• Temple holds a 4-star CMS Overall Hospital Star Rating (5 stars in 2024), higher than the Indianapolis VA's 3 stars.
• In VA's SAIL data for FY2026 Q1, Temple had a lower 30-day mortality ratio (0.875 vs. 0.971) and a better patient-safety composite (0.714 vs. 0.831) than Indianapolis, and shorter waits for specialized mental health care (49.9 vs. 103.1 days).
• VA's FY2026 Q2 maintenance awards list 12 projects at the Temple campus, including boiler plant replacement, fire-alarm upgrades and surgery elevators.

The issue is access and capacity: space, staffing levels, scheduling processes and funding that have not kept pace with demand. It is not hospital quality or the effort of the people who work there.

Sources

1. CMS Provider Data, Hospital General Information: data.cms.gov; VA release on the 2024 5-star rating: va.gov
2. VA SAIL scorecards, FY2026 Q1: data.va.gov
3. VHA Non-Recurring Maintenance Project Awards, FY2026 Q2: department.va.gov

Questions and answers

Why focus on the Central Texas VA?

Veterans make up nearly 1 in 5 civilian adults in Bell, Coryell and Lampasas counties, compared with 6.2% nationally, and VA projected Central Texas enrollment to grow 19.8% from FY2019 to FY2029. Public data show long specialty waits at Temple.

How long is the wait for gastroenterology at Temple?

VA's Access to Care site reported an average of 139.9 days for new patients and 31.2 days for established patients, in data dated October 12, 2026. The figure updates daily.

Does Central Texas get less funding per patient than a comparable VA?

In FY2021, VA OIG figures work out to $9,871 per unique patient for the Central Texas system versus $12,201 for the Indianapolis medical center. The Central Texas figure covers the whole health care system and the Indianapolis figure covers the medical center only, so the comparison is approximate.

Will the new Copperas Cove clinic help?

It should add outpatient capacity. First patients are expected in early 2029. It is an outpatient clinic, and no published source lists inpatient beds or an emergency department.

Is this a criticism of VA doctors and nurses?

No. The sources point to space, staffing levels, scheduling processes, oversight and funding. Temple holds a 4-star CMS hospital rating, higher than Indianapolis. The issue is access and capacity, not the effort of the people providing care.

About this page

This page reports only what government agencies and other public primary sources have published, and it attributes characterizations to their sources. It is nonpartisan: the problems it describes span administrations and Congresses. Wait times and staffing figures change often; check the linked pages for the latest. If you find an error, please report it so it can be corrected.

Veterans in crisis can reach the Veterans Crisis Line by dialing 988, then pressing 1. To report a problem with VA care, contact the VA OIG hotline.

Last reviewed October 15, 2026.