Almost six months later, the story is the same: still no access to on-Island health care for Vineyard veterans, with no clear end date for the waiting game.

It’s been about four years since officials became aware that a contract for on-Island health care expired, and ever since, veterans have been largely forced to take long trips off-Island to receive health care.

The Martha’s Vineyard Hospital and the Veterans Administration signed a contract in 2000 to provide care for veterans; it expired in 2004, but the administration did not realize it until 2008.

Since then, there’s been a protracted fight to sign a new contract and restore the health care. Last November, more than 20 veterans met with national representatives about the issue.

In January, there was hopeful news: at a meeting with Cong. William Keating, state Sen. Dan Wolf and state Rep. Tim Madden at the Vineyard Haven American Legion, veterans were told that a contract should be in place by late February.

But that time came and passed without a contract, as administrative roadblocks held up the process. The word from VA officials back then was that they were shooting for the spring.

“Well hello, it’s summer,” said Dukes County veterans agent Jo Ann Murphy yesterday.

“There’s nothing new,” Ms. Murphy said. “Last I heard the contract has been to Martha’s Vineyard Hospital and back to the VA contractor office.”

Ms. Murphy said she was at a conference at the end of June and heard someone say that there would be a contract in place soon. Ms. Murphy recalled saying, “Hi, I’m the agent from the Vineyard, and I beg to disagree with you.”

It wasn’t clear what the hold-up was. “I have no idea,” she said. “I get questions every week: ‘Well, what’s going on, are we there yet?’”

The initial contract took nine to 10 months to finalize, Ms. Murphy said. “Why is this taking years?”

With health care unavailable on the Island, veterans, some World War II veterans, have had to venture to a clinic in Hyannis or the VA Hospital in Providence, R.I., to receive care and treatment.

Ms. Murphy said she does give the VA credit for one thing: the organization is filling prescriptions for veterans.“World War II vets are on a lot of medicine,” she said.

Refills can be called in — Ms. Murphy said she frequently calls them in herself — and they arrive in the mail five to seven days later. Prescriptions cost $9 a month.

Tom Antonaccio, public affairs officer at the Providence VA hospital, said he has been checking on the contract status once a week, and last he heard, the contract is “under review at our higher headquarters.” He said it has been under review for about two weeks now, and after the contract is approved, it can be awarded to the Martha’s Vineyard Hospital.

There are three contracts up for review, he said, beginning with the main contract, which provides for basic medical services (essentially primary care) and serves as the basis for the agreement. There are also contracts for laboratory services and diagnostic images. Mr. Antonaccio said the main contract has to be approved first.

Mr. Antonaccio said he does not know when that might be, and that there have been setbacks in the past with the contract having to be reworked. “We think we’ve got everything the way it needs to be,” he said. “We feel optimistic that we’ve got the right mix in place here.”

He emphasized that the contract only needed to be approved at the regional level, not the national level, which he said would speed up the process.

Mr. Antonaccio said he would be happy to provide updates for all concerned people, and urged them to call him directly instead of calling elected officials or other groups, which further drags out the process.

In an e-mail to the Gazette yesterday, Vineyard legislative liaison Nell Coogan reflected surprise at the news that the issue remained unsettled. “The last time Rep. [Timothy] Madden had heard about the issue he had been told that the issue had been resolved,” Ms. Coogan wrote. “He is extremely frustrated to hear that the contract is still outstanding and he has already reached out to Congressman Keating’s office to inquire as to why this has not yet been resolved and to push for immediate action to finalize this contract to ensure our Island veterans have immediate access to the care they need and the care they can get right here in their community.”

Mr. Keating reflected similar frustration.

“Since this issue was brought to my attention when I took office, I’ve demanded the VA expedite this process, I have had multiple meetings with them and my staff has a standing monthly meeting on this very issue,” he said in an e-mail to the Gazette. “This needs to be rectified immediately and I will keep putting pressure on the VA until it gets done. I am not going to let this issue just fade away.”

World War II veteran Nelson Smith said he has had to go to Hyannis once a year for a physical, and when the doctor found something in his blood work, he had to have a friend drive him to the Providence VA hospital for a procedure. When he got there, it turned out the specialist was out for the day, and he was out of luck. The hospital said they’d call back; it’s been two and a half years, he said, and he hasn’t heard from them.

“They all tell you how they’re doing their best, but they’re not doing their best,” he said.