NPR — along with seven public radio stations around the country — is chronicling the lives of America's troops where they live. We're calling the project "Back at Base." This story is part of a three-part series about veteran benefits (Part 1 / Part 2).
For veterans in San Juan County, Wash., getting health care from the U.S. Department of Veterans Affairs almost always begins with an hourlong ferry ride.
Even routine bloodwork requires a three-hour one-way trip.
Friday Harbor, Wash., is one of four island stops on this ferry ride, and the only incorporated city in San Juan County. Travel to the west side of the island, and your cellphone pings you that you're in Canada, even though you're still in the U.S. Just a short walk from the ferry terminal is American Legion Post 163, where Peter DeLorenzi, a veterans service officer, helps area vets.
"Because I get veterans from Orcas and Lopez and besides San Juan Island, and so it's a really convenient place to meet," he says. "If a veteran is an invalid or anything, I will go out to the house."
According to the VA, there are more than 1,700 veterans in San Juan County, about one for every 10 residents. But many are not taking advantage of the VA benefits they've earned. VA spending is just under $2,500 per veteran, the lowest in the state.
DeLorenzi dedicates a lot of time trying to bring those numbers up. Some of the 60 or so veterans he works with each year become frustrated with the process and just drop out.
Even DeLorenzi gave up applying for a VA mortgage after he was turned down on a loan for a manufactured home.
"Doesn't qualify. All those programs you see that they advertise, oh, 'This is new homes for vets' and stuff like that," he says. "Well, manufactured homes are just about the only thing that most of us can afford."
The VA does sometimes provide loans like that, but it's complicated.
Then there are the big VA benefits: health care and disability. Many of the veterans who live on the islands are older. Diabetes is a problem and so is hearing loss.
DeLorenzi says some vets can be self-reliant to a fault, so a little VA outreach would make a big difference.
"A lot of us are a little proud to seek help," DeLorenzi says. "We think we can do it ourselves. Sometimes that's OK, and then sometimes we need a little help."
But even vets who may want help, including some who struggle with post-traumatic stress disorder, can't get VA counseling. A VA contract position for a counselor to serve the county has been unfilled for five years.
So a lot of the responsibility for reaching out to veterans who could benefit from counseling falls to a tight-knit community of local vets.
"You just hear things, you hear people talking," says Shannon Plummer, the American Legion post commander. "You hear that, you know, 'Hey I've got a friend of mine that was in Vietnam, and he's now wanting to talk. Would you be willing to have a talk with him?' We jump right to it."
There is a Veterans Center on the mainland charged with providing counseling for the county, but efforts to build a better relationship have been frustrating.
Last May, Plummer says the San Juan County Veterans Advisory Board (VAB) formally invited their representative from the Bellingham Vet Center to come visit the island. He says they've had no success.
"We've tried to contact the individual several times, without any response," he says. "I don't know why he doesn't make himself available."
In a statement, the Bellingham Vet Center says there's always room for improvement and they're hoping to have a counselor to serve the county sometime this year.
Still, Plummer remains puzzled by the lack of contact. He says the Vet Center needs to put in the time and build trust if it wants to help the islands' vets.
"Unless you get out," he says, "then you don't know what you have out here."
What you have are hard-to-reach vets missing out on their benefits. And until recently, the burden to sign up was mostly on them.
Then in November, for the first time, two VA employees drove a camper-sized mobile vet center 137 miles from another vet center in Tacoma, Wash., to Friday Harbor. The visit was part of a national effort to provide outreach to rural communities.
The VAB advertised and word got around. About 20 vets showed up, some were lined up when the doors opened. Most inquired about benefits, but none were willing to speak with the on-board counselor. Building that trust takes time.
NPR's Robert Benincasa contributed to this report.