Veterans services officer reports modest federal funding gains, urges unified medical-transport request

Mikhail Madsen, Ouray County veteran services officer, gave a six‑month report to the Board of County Commissioners, saying the county’s federal benefit funding rose modestly compared with 2023 and 2024 and outlining outreach, casework and grant strategies.

Madsen cited the annual federal GDX census as the primary source of the funding comparisons. He said San Diego County increased compensation and pension funding by about 16% (roughly $158,000) while ‘‘your county’’ saw an increase of about $73,000, or roughly 4% year over year. He said Mesa County’s much higher per‑capita funding is likely related to the presence of a VA hospital that concentrates services and claims.

On access to care, Madsen noted long travel times for specialty medical appointments from Ouray and San Miguel counties to Montrose or Grand Junction during bad weather and called transportation ‘‘the number 1 thing’’ limiting veterans’ ability to get C&P exams and specialty care.

Madsen described outreach efforts including a Fourth of July parade presence, a Veterans Day lunch at the Christian Center and an Elks Club dinner in Telluride. He also maintains regular clinic hours in the Sherbano every second Tuesday and said he typically receives two to three new veteran contacts per week while maintaining a longer list of returning clients.

The VSO reported operational disruptions tied to federal IT problems: ‘‘My main software that I use, VBMS, is down, and I’m not able to open up the claims and see what the status is right now,’’ Madsen said, adding he had opened a support ticket and understood staff in Washington and Denver were addressing it.

Madsen thanked the board for approving an appeal grant to pay for private medical opinions (nexus letters) and described an individual case in which a Vietnam veteran had been denied PTSD and tinnitus benefits three times; the county grant of about $1,500 covered a specialty nexus letter needed to meet the adjudicative standard linking a service event to a diagnosis.

On transportation funding strategy, Madsen said he had met with regional representative Scott Barty, who advised that submitting separate grant applications for San Miguel and Ouray likely looked like duplicate requests. Madsen said Barty recommended unifying the request and ‘‘ask for 1 vehicle and share that asset between both counties’’ rather than seeking two separate vehicles. Madsen said last year the office had requested a $55,000 GMC Acadia but that a smaller new SUV (he suggested a $30,000 Subaru Forester) or a used Forester (~$15,000) would be more competitive.

Commissioners asked whether surplus sheriff’s SUVs (high‑mileage vehicles) could be repurposed. One county official said they would not want veterans to ride in vehicles that were unreliable and recommended seeking a safe vehicle with a warranty or other assurances.

On reporting, Madsen said state reporting changed from activity counts to an hours‑based submission (for example, 80 hours per month) that both county managers now sign electronically; commissioners recommended he send the timecard reports to liaison staff so county leadership would have visibility.

Madsen also described using non‑identifying outputs from large‑language models to help draft diagnostic and medical narratives for claims, saying that tool use has improved his efficiency when preparing materials for adjudicators: ‘‘I’ve had good success with having AIs tell me, hey, you should do these 10 things.’’

He closed by reiterating ongoing barriers—travel time, IT outages and stricter adjudicative decisions—and asking the board for help with unified grant asks and other support. The board had no formal action; Madsen’s report concluded with a short Q&A and practical steps to coordinate next grant applications.