With a long wait for on-Island health care in the past — though some frustration lingers — Island veterans and Providence VA Medical Center representatives met Wednesday night to discuss the sometimes complicated details of the new contract between the Providence VA and the Martha’s Vineyard Hospital.

More than 50 people, most of them veterans, came to the American Legion Post 257 in Vineyard Haven to hear the details of the new contract from a panel of representatives from the VA. While there was some talk of the long lapse in Island health care access, which required veterans to go off-Island for most care, most of the discussion centered on the future.

“We were in this room not too long ago, but too long ago,” Cong. William Keating told the audience, recalling another town hall meeting at the VA in January, when word was that a contract was just around the corner.

The previous contract between the VA and the hospital expired several years ago, but the VA did not realize the contract expired until around 2008, when Island veterans started receiving bills for care. The push to restore access was complicated by bureaucratic delays and personnel issues, but the contract was finally signed by all the relevant parties in August and September, and has gone into effect.

On Tuesday, a panel of representatives from the VA sat at a table at the front of the room, offering paperwork, pamphlets and stress balls before the meeting.

“We needed every ounce of attention and oomph that we could,” Mr. Keating said. “But we all knew this day would come.”

“Veterans left their homes to defend us elsewhere,” he added. “They shouldn’t have to leave their homes to get health care.”

Mr. Keating’s stop at the American Legion came after a daylong swing through the Vineyard, during which he toured the new town pier and Coast Guard dock in Menemsha, and the Martha’s Vineyard Museum and had lunch at Linda Jean’s restaurant in Oak Bluffs.

Mr. Keating, who left shortly after the meeting started to catch a ferry, first got a handshake from Viet Nam veteran Woody Williams, who has been a forceful advocate for restoring health care. Mr. Williams pressed the VA representatives for more information. “Tell us what you’ve given us,” he said. “We had something in place, and all of a sudden, overnight and under the cover of darkness, we lost that. Now you guys would not meet with us throughout this process . . . we have no clue what is in this contract.”

“I certainly appreciate your frustration,” Providence VA public affairs officer Tom Antonaccio said. “We were banging our heads against the wall.”

He said the driving question was how to provide service to Island veterans, with information from other islands, like Puerto Rico and Hawaii.

Mr. Antonaccio said the agreement includes three separate contracts for basic care lab work and diagnostic imaging that have been combined into one contract.

The contract is good for one year, with options to renew yearly for four additional years.

“It gives us the first year to work closely with folks at Martha’s Vineyard Hospital,” Mr. Antonaccio said.

Congressman William Keating speaks to Island veterans — Ivy Ashe

A website, MyHealthyVet (myhealth.va.gov), allows veterans to get wellness reminders, contact doctors with non-urgent messages and see lab results online, and a Telehealth system allows veterans with chronic conditions to monitor those conditions over time. The outpatient pharmacy chief said that prescriptions can be refilled by phone or online. There were a range of questions, from how veterans can be eligible for care (it depends on service-related conditions and income) to whether certain treatments were covered. Some asked specific questions about health concerns.

One frequent concern was emergency room trips. The VA representatives were clear: unless the trip is truly an emergency, veterans would get a bill for visiting the ER.

There was a lot of talk about a vesting system, which Mr. Antonaccio said would take place over the coming months to make sure Island veterans are enrolled in the VA system.

“Are you vested?” one man said to another. “I don’t know,” he responded. “Me, either.”

Dr. Monty VanBeber, the associate chief of staff with the Hyannis clinic, said he would come to the Island for the vesting process, which will make sure veterans are enrolled in the system. He also said he would be responsible for coordinating care with other providers.

“Woody Williams has been a really good voice for the vets,” said Tisbury selectman and county commissioner Tristan Israel.

Mr. Israel questioned the yearly contract renewal process, and when the contract renewal would start to make sure there wouldn’t be a lapse in coverage.

Contracting officer Lorrie Baines said the government can only award a contract for up to five years, and that at the end of five years, the contract can be awarded without soliciting bids. But the contract can be modified at any time if it’s not working, she added.

“When that happens, keep veterans here informed going forward,” Mr. Israel said.

Nelson Smith, a World War II veteran, criticized a lack of communication between the VA and the Martha’s Vineyard Hospital. “How does our hospital communicate with the VA so everything is on the same record for each veteran?” he asked.

Mr. Antonaccio was frank. “The first six months to a year are not going to be all sunshine and roses,” he said, but added that the VA leadership spent two hours earlier Wednesday meeting with hospital leadership.

“Everybody now has an understanding that we have to do a better job communicating,” he said.

After the meeting, veterans filled out paperwork and asked further questions. “I thought it was good, I thought it was very informative,” said Ed Colligan, 82, who served in the Coast Guard during the Korean War. He said he’d had to go to Jamaica Plain for hearing treatment, and was pleased about the prospect of receiving service closer to home.

“So far, so good,” he said. “At least we are getting it here . . . so we don’t have to go off-Island.”

“They did a lot of hard work getting this together,” he added. “It was a long time coming.”

William Stafursky, a Viet Nam vet, was more cautious in his appraisal, saying he would wait to see the details of the contract. “Until I’ve seen it, I’m not happy.”

He contrasted what he called “the public face,” of the VA to the long wait. “It doesn’t take three years,” he said.

Travis Bissey, 35, an Iraq veteran, said that though he’d never used the VA system before, “I think it’s going to be good.”

“It’ll help out a lot of people,” he said.

Dukes County veterans agent Jo Ann Murphy said she was pleased that the VA would be coming to the Island to do intake — and that she didn’t have to spend her nights puzzling over all the little details. “I can sleep tonight,” she said.