Tag: va scandal
What About That VA Hospital Scandal?

What About That VA Hospital Scandal?

The unofficial end of summer, Labor Day, may serve as a bookend to a scandal that exploded around the unofficial start, Memorial Day. We speak of the very long wait times to see primary care providers at veterans hospitals and, more seriously, the doctoring of records by some hospital administrators to hide that reality.

Back in May, this writer erred in underestimating the wrongdoing at hospitals run by the Department of Veterans Affairs. She’d been swayed by friends who had nothing but praise for their VA hospital experiences — and independent studies by the likes of RAND showing higher patient satisfaction in VA hospitals than in privately run ones.

Also, the blast of outrage bore all the signs of another right-wing attack against “evil” government and, with it, a call to privatize another of its services.

The media, meanwhile, were facing the news desert of a quiet, long weekend. So what perfect timing — especially over a holiday honoring those who served — to flog the accusation that the government was killing veterans by the thousands.

That incendiary charge has thus far proved to be unfounded. The VA inspector general’s office has been investigating the deaths of veterans waiting for primary care appointments. So far, it’s failed to find evidence of veterans dying because they were on those lists.

The inspector general did uncover some worms, however: Hospital administrators were faking data about those delays. Punishment is being meted out.

At the bottom of this emotional story sits a very plain vanilla villain: the nationwide shortage of primary care medical professionals. This scarcity plagues the entire American health care system, government-run and private alike.

In a highly market-based system such as ours, providers go where the money is. That would be the more lucrative medical specialties — and in hospital settings rather than doctors’ offices.

In most other countries (though not Canada), patients have shorter waits to see primary care providers. Reliance on expensive specialists to treat conditions that a family doctor could handle helps explain why America spends so much more on health care than do other rich countries.

The reason we know more about the waits at the VA than the ones in the private sector is governments require that such records be kept. The private system does not.

A $16 billion fix for the VA’s primary-care problem was signed this month by President Obama. Thousands of such doctors, nurses and other health care professionals are being hired. Most of the money, however, will pay for veterans on long waiting lists — or who live more than 40 miles from a VA facility — to see private providers.

Thus, conservatives got some of what they wanted and some of what they didn’t. In their plus column, the system is now somewhat more privatized. In the minus column, conservatives had to approve spending these billions — and after they had blocked a vote in February to spend large sums on some of the same things.

A handful of Republicans refused to vote for the bill, insisting that the entire VA system needs a multiple bypass.

“We need structural changes,” said Rep. Jack Kingston, a Georgia Republican, “a purge of those who made this mess, and more choices for our veterans.” “More choices” is code for privatization.

Turns out government can’t promise good health care to the growing numbers of veterans — whether through public or private facilities — without spending a lot of money. That’s the way it goes.

All is quiet now on the VA hospital front. But where are the two-inch headlines noting that the three-inch headlines about murdering veterans were way off? Don’t even bother answering.

Follow Froma Harrop on Twitter @FromaHarrop. She can be reached at fharrop@gmail.com. To find out more about Froma Harrop and read features by other Creators writers and cartoonists, visit the Creators Web page at www.creators.com.

AFP Photo/Brendan Smialowski

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VA Fails To Acknowledge ‘Severity Of Problems,’ New Report Says

VA Fails To Acknowledge ‘Severity Of Problems,’ New Report Says

By Richard Simon, Los Angeles Times

WASHINGTON — In another damning report on the Department of Veterans Affairs, the U.S. Office of Special Counsel on Monday assailed the VA for what investigators said was its unwillingness to acknowledge the “severity of systemic problems” that have put patients at risk.

The special counsel, Carolyn N. Lerner, reported in a letter to President Barack Obama that investigators found a “troubling pattern of deficient patient care,” and expressed concern about what she termed the department’s unwillingness to acknowledge the impact of its problems on patient safety. Her office is now investigating more than 50 cases brought by whistle-blowers.

“The VA, and particularly the VA’s Office of the Medical Inspector, has consistently used a ‘harmless error’ defense, where the department acknowledges problems but claims patient care is unaffected,” she wrote. “This approach has prevented the VA from acknowledging the severity of systemic problems and from taking the necessary steps to provide quality care to veterans.

“As a result, veterans’ health and safety has been unnecessarily put at risk,” she said.

The Jackson, Mississippi, VA medical center operated “ghost clinics” where veterans were scheduled for appointments with no assigned provider, resulting in veterans leaving without treatment, she said, and nurse practitioners at the same facility improperly prescribed narcotics to veterans in violation of federal law, among other problems.

In Buffalo, New York, health care professionals do not always comply with VA sterilization standards, the report said, and in Little Rock, Arkansas, suction equipment was unavailable when it was needed to treat a veteran who later died. In Grand Junction, Colorado, the drinking water had elevated levels of Legionella bacteria and standard maintenance procedures to prevent bacterial growth were not performed, Lerner wrote.

In Brockton, Massachusetts, a veteran who was in a mental health facility from 2005 through 2013 had only one note written in his medical chart; the note, written in 2012, addressed treatment recommendations, according to Lerner. Another veteran who was admitted to the facility in 2003 did not receive his first comprehensive psychiatric evaluation until 2011, she said.

The VA Office of the Medical Inspector “failed to acknowledge that that the confirmed neglect of residents at the facility had any impact on patient care,” she said.

U.S. Representative Jeff Miller (R-FL), chairman of the House Veterans’ Affairs Committee, said the letter highlights the VA’s attempts to “downplay the impact serious deficiencies in VA health care have had on patients.”

“In the fantasy land inhabited by VA’s Office of the Medical Inspector, serious patient safety issues apparently have no impact on patient safety,” he said in a statement. “It’s impossible to solve problems by whitewashing them or denying they exist.”

Acting Secretary of Veterans Affairs Sloan Gibson said in a statement Monday that he was disappointed in the “failures within VA to take whistle-blower complaints seriously” and that he has directed a review of the operation of the Office of the Medical Inspector, to be completed within 14 days.

The special counsel’s letter comes after the VA’s own reports have found systemic problems in scheduling of patients in a timely manner, including instances of staff falsifying records to cover up long waits.

Lerner said her office also had found the use of a “bad boy” list at the VA facility in Fort Collins, Colorado, for staff who scheduled appointments for greater than 14 days than the veteran’s desired date for an appointment. Staff members were instructed to alter wait times to make the waiting periods look shorter, the special counsel said.

The office also is investigating allegations that two schedulers were reassigned from Fort Collins to Cheyenne, Wyoming, for not complying with instructions to “zero out” wait times. After the employees were transferred, officially recorded wait times for appointments drastically improved, according to the special counsel, “even though the wait times were actually much longer.”

Photo via Wikimedia Commons

Audit Reveals ‘Systemic’ Access To Care Woes For U.S. Veterans

Audit Reveals ‘Systemic’ Access To Care Woes For U.S. Veterans

Washington (AFP) – An audit on health care access for U.S. veterans released Monday confirmed the existence of fake waiting lists, prompting a top official to slam “systemic” problems for America’s wounded warriors seeking treatment.

The report is the latest revelation in a political scandal that last month led to the resignation of Eric Shinseki as Veterans Affairs secretary.

The audit showed that 13 percent of scheduling staff got instructions from supervisors or others “to enter a date different than what the veteran had requested in the appointment scheduling system” to conceal wait times in official statistics.

Eight percent of scheduling staff said they used “alternatives to the official Electronic Wait List.”

“In some cases, pressures were placed on schedulers to utilize unofficial lists or engage in inappropriate practices in order to make waiting times appear more favorable,” according to a fact sheet provided by the Department of Veterans Affairs.

Allegations last month that staff manipulated scheduling data and that veterans may have died waiting for treatment at a VA clinic in Phoenix, Arizona, put President Barack Obama’s administration on the defensive and ultimately cost Shinseki his job.

“There have been lapses of integrity, we’ve got systemic problems with scheduling practices,” Acting Veterans Affairs Secretary Sloan Gibson said Monday as he presented the report.

“We’re going to get veterans off the wait list, and we’re going to get them in the clinics where they can be seen and cared for. That’s our first priority.”

The audit found that, around the country, there were roughly 57,436 veterans waiting to be scheduled for an appointment according to May 15 data.

In addition, it cited another 63,869 veterans who have enrolled in the VA health care system over the past decade and have not been seen for an appointment.

In total, of the more than six million appointments scheduled across the Veterans Health Administration system on May 15, some 242,000 — or four percent — had a wait time of longer than 30 days.

Officially, a veteran is not supposed to wait longer than two weeks for medical appointments at VA facilities.

However, the audit showed that such a “target for new appointments was not only inconsistently deployed throughout the health care system but was not attainable given growing demand for services and lack of planning for resource requirements.”

“There have been lapses of integrity, we’ve got systemic problems with scheduling practices,” Acting Veterans Affairs Secretary Sloan Gibson said Monday as he presented the report.

“We’re going to get veterans off the wait list and we’re going to get them in the clinics where they can be seen and cared for. That’s our first priority.”

Based on the findings of the audit, the Department of Veterans Affairs has, among other things, decided to freeze bonus payments, acquire and put into place “long-term scheduling software solutions” and establish “access timeliness goals.”

The audit involved more than 3,772 interviews of clinical and administrative staff at 731 VA medical centers and clinics.

AFP Photo/Brendan Smialowski

Senate Reaches Bipartisan Deal To Fix VA ‘Crisis’

Senate Reaches Bipartisan Deal To Fix VA ‘Crisis’

By Richard Simon, Los Angeles Times

WASHINGTON — Senators on Thursday announced a bipartisan deal on legislation aimed at improving veterans’ health care in response to reports of Veterans Affairs employees falsifying records to conceal long waits for medical appointments.

Senators Bernie Sanders, a Vermont independent and chairman of the Senate Veterans Affairs Committee, and John McCain (R-AZ) announced the agreement from the Senate floor as a group of senators headed to Normandy for the 70th anniversary of the D-Day landings.

The agreement would allow veterans facing long waits at VA facilities to seek care from private doctors,expand the VA secretary’s authority to fire or demote staff for poor performance, establish 26 new VA health facilities in 18 states and provide $500 million for hiring of new VA doctors and nurses.

“Right now, we have a crisis on our hands,” Sanders said.

Added McCain: “We are talking about a system that must be fixed. It’s urgent that it be fixed.”

The proposed legislation also would extend college education benefits to the spouses of service members killed in the line of duty and guarantee in-state tuition for veterans at public colleges and universities. It also would establish a commission of experts to examine the VA health care system and recommend improvements.

The legislation could clear the Senate by the end of next week. But this being an election year, nothing is certain, even on veterans’ care, an issue that traditionally enjoys bipartisan support.

McCain asked colleagues to set aside their usual partisan bickering and act on the VA reform legislation swiftly.

“We have, for all intents and purposes, in some ways betrayed the brave men and women who are willing to go out and sacrifice for the well-being and freedom of the rest of us,” he said.

McCain is a decorated Vietnam veteran and former POW whose support for the legislation should help it win votes. Indeed, Senator Richard Burr of North Carolina, the top Republican on the Senate Veterans Affairs Committee, threw his support behind it.

McCain said the legislation would give veterans a choice of seeking private care if they face a “wait time that is unacceptable” at VA facilities or live more than 40 miles from a VA facility.

The rare agreement in a hyper-partisan Congress, reached after negotiations between Sanders and McCain, came as the U.S. Office of Special Counsel announced that it is investigating allegations of reprisals against 37 VA whistleblowers, including some who have alleged improper scheduling of veterans for health care.

As Congress ratcheted up its response to the VA scandal, the Senate Appropriations Committee on Thursday provided funding for the Justice Department to play a bigger role in the investigation of VA employees falsifying records to cover up long waits for medical care.

And the House Veterans Affairs Committee called a Monday night hearing that could shed new light on the scope of the VA mess. The panel asked for an update from the VA inspector general, who has been investigating 42 sites and issued an interim report last week that found a systemic problem nationwide in scheduling veterans for health care in a timely manner.

Whistleblowers who have complained about reprisals work at VA facilities involving 19 states, but the Official of Special Counsel, an independent federal investigative agency, declined to name the facilities.

“Receiving candid information about harmful practices from employees will be critical to the VA’s efforts to identify problems and find solutions,” said Special Counsel Carolyn Lerner. “However, employees will not come forward if they fear retaliation.”

In the meantime, members of Congress stepped up efforts to find out about problems at VA facilities in their own states. Republican senators on Thursday sent a letter to acting VA secretary Sloan Gibson seeking answers about reports of unauthorized wait lists at VA facilities in the Midwest.

Gibson was visiting the Phoenix VA on Thursday, and White House deputy chief of staff Rob Nabors, whom President Barack Obama tasked to conduct a broad review of veterans health care, was to visit VA facilities in Ohio on Thursday.

AFP Photo/Noorullah Shirzada