This is a long article. You might want to go to the source if you're not workblocked as it breaks up the wall of text a little better.
A fatal wait: Veterans languish and die on a VA hospital's secret list By Scott Bronstein and Drew Griffin, CNN Investigations updated 9:19 PM EDT, Wed April 23, 2014
(CNN) -- At least 40 U.S. veterans died waiting for appointments at the Phoenix Veterans Affairs Health Care system, many of whom were placed on a secret waiting list.
The secret list was part of an elaborate scheme designed by Veterans Affairs managers in Phoenix who were trying to hide that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor, according to a recently retired top VA doctor and several high-level sources.
For six months, CNN has been reporting on extended delays in health care appointments suffered by veterans across the country and who died while waiting for appointments and care. But the new revelations about the Phoenix VA are perhaps the most disturbing and striking to come to light thus far.
Internal e-mails obtained by CNN show that top management at the VA hospital in Arizona knew about the practice and even defended it.
Dr. Sam Foote just retired after spending 24 years with the VA system in Phoenix. The veteran doctor told CNN in an exclusive interview that the Phoenix VA works off two lists for patient appointments:
There's an "official" list that's shared with officials in Washington and shows the VA has been providing timely appointments, which Foote calls a sham list. And then there's the real list that's hidden from outsiders, where wait times can last more than a year.
Veterans dying waiting for healthcare Are we fulfilling our promise to veterans?
Deliberate scheme, shredded evidence "The scheme was deliberately put in place to avoid the VA's own internal rules," said Foote in Phoenix. "They developed the secret waiting list," said Foote, a respected local physician.
The VA requires its hospitals to provide care to patients in a timely manner, typically within 14 to 30 days, Foote said.
According to Foote, the elaborate scheme in Phoenix involved shredding evidence to hide the long list of veterans waiting for appointments and care. Officials at the VA, Foote says, instructed their staff to not actually make doctor's appointments for veterans within the computer system.
Instead, Foote says, when a veteran comes in seeking an appointment, "they enter information into the computer and do a screen capture hard copy printout. They then do not save what was put into the computer so there's no record that you were ever here," he said.
According to Foote, the information was gathered on the secret electronic list and then the information that would show when veterans first began waiting for an appointment was actually destroyed.
"That hard copy, if you will, that has the patient demographic information is then taken and placed onto a secret electronic waiting list, and then the data that is on that paper is shredded," Foote said.
"So the only record that you have ever been there requesting care was on that secret list," he said. "And they wouldn't take you off that secret list until you had an appointment time that was less than 14 days so it would give the appearance that they were improving greatly the waiting times, when in fact they were not."
I feel very sorry for the people who work at the Phoenix VA. They all wish they could leave 'cause they know what they're doing is wrong.
Doctor: It's a 'frustrated' staff "I feel very sorry for the people who work at the Phoenix VA," said Foote. "They're all frustrated. They're all upset. They all wish they could leave 'cause they know what they're doing is wrong.
"But they have families, they have mortgages and if they speak out or say anything to anybody about it, they will be fired and they know that."
Several other high-level VA staff confirmed Foote's description to CNN and confirmed this is exactly how the secret list works in Phoenix.
Foote says the Phoenix wait times reported back to Washington were entirely fictitious. "So then when they did that, they would report to Washington, 'Oh yeah. We're makin' our appointments within -- within 10 days, within the 14-day frame,' when in reality it had been six, nine, in some cases 21 months," he said.
In the case of 71-year-old Navy veteran Thomas Breen, the wait on the secret list ended much sooner.
"We had noticed that he started to have bleeding in his urine," said Teddy Barnes-Breen, his son. "So I was like, 'Listen, we gotta get you to the doctor.' "
Teddy says his Brooklyn-raised father was so proud of his military service that he would go nowhere but the VA for treatment. On September 28, 2013, with blood in his urine and a history of cancer, Teddy and his wife, Sally, rushed his father to the Phoenix VA emergency room, where he was examined and sent home to wait.
"They wrote on his chart that it was urgent," said Sally, her father-in-law's main caretaker. The family has obtained the chart from the VA that clearly states the "urgency" as "one week" for Breen to see a primary care doctor or at least a urologist, for the concerns about the blood in the urine.
"And they sent him home," says Teddy, incredulously.
Sally and Teddy say Thomas Breen was given an appointment with a rheumatologist to look at his prosthetic leg but was given no appointment for the main reason he went in.
The Breens wait ... and wait ... and wait ...
No one called from the VA with a primary care appointment. Sally says she and her father-in-law called "numerous times" in an effort to try to get an urgent appointment for him. She says the response they got was less than helpful.
"Well, you know, we have other patients that are critical as well," Sally says she was told. "It's a seven-month waiting list. And you're gonna have to have patience."
Sally says she kept calling, day after day, from late September to October. She kept up the calls through November. But then she no longer had reason to call.
Thomas Breen died on November 30. The death certificate shows that he died from Stage 4 bladder cancer. Months after the initial visit, Sally says she finally did get a call.
"They called me December 6. He's dead already."
Sally says the VA official told her, "We finally have that appointment. We have a primary for him.' I said, 'Really, you're a little too late, sweetheart.' "
Sally says her father-in-law realized toward the end he was not getting the care he needed.
"At the end is when he suffered. He screamed. He cried. And that's somethin' I'd never seen him do before, was cry. Never. Never. He cried in the kitchen right here. 'Don't let me die.' "
Teddy added his father said: "Why is this happening to me? Why won't anybody help me?"
Teddy added: "They didn't do the right thing." Sally said: "No. They neglected Pop."
First hidden -- and then removed Foote says Breen is a perfect example of a veteran who needed an urgent appointment with a primary doctor and who was instead put on the secret waiting list -- where he remained hidden.
Foote adds that when veterans waiting on the secret list die, they are simply removed.
"They could just remove you from that list, and there's no record that you ever came to the VA and presented for care. ... It's pretty sad."
Foote said that the number of dead veterans who died waiting for care is at least 40.
"That's correct. The number's actually higher. ... I would say that 40, there's more than that that I know of, but 40's probably a good number."
CNN has obtained e-mails from July 2013 showing that top management, including Phoenix VA Director Sharon Helman, was well-aware about the actual wait times, knew about the electronic off-the-books list and even defended its use to her staff.
In one internal Phoenix VA e-mail dated July 3, 2013, one staffer raised concerns about the secret electronic list and raised alarms that Phoenix VA officials were praising its use.
"I have to say, I think it's unfair to call any of this a success when Veterans are waiting 6 weeks on an electronic waiting list before they're called to schedule their first PCP (primary care physician) appointment," the e-mail states. "Sure, when their appointment is created, it can be 14 days out, but we're making them wait 6-20 weeks to create that appointment."
The e-mail adds pointedly: "That is unethical and a disservice to our Veterans."
Last year and earlier this year, Foote also sent letters to officials at the VA Office of the Inspector General with details about the secret electronic waiting list and about the large number of veterans who died waiting for care, many hidden on the secret list. Foote and several other sources inside the Phoenix VA confirmed to CNN that IG inspectors have interviewed them about the allegations.
VA: 'It is disheartening to hear allegations' CNN has made numerous requests to Helman and her staff for an interview about the secret list, the e-mails showing she was aware of it and the allegations of the 40 veterans who died waiting on the list, to no avail.
But CNN was sent a statement from VA officials in Texas, quoting Helman.
"It is disheartening to hear allegations about Veterans care being compromised," the statement from Helman reads, "and we are open to any collaborative discussion that assists in our goal to continually improve patient care."
Just before deadline Wednesday, the VA sent an additional comment to CNN.
It stated, in part: "We have conducted robust internal reviews since these allegations surfaced and welcome the results from the Office of Inspector General's review. We take these allegations seriously."
The VA statement to CNN added: "To ensure new Veterans waiting for appointments are managed appropriately, we maintain an Electronic Wait List (EWL) in accordance with the national VHA Scheduling Directive. The ability of new and established patients to get more timely care has showed significant improvement in the last two years which is attributable to increased budget, staffing, efficiency and infrastructure."
Foote says Helman's response in the first statement is stunning, explaining the entire secret list and the reason for its existence was planned and created by top management at the Phoenix VA, specifically to avoid detection of the long wait times by veterans there.
"This was a plan that involved the Pentad, which includes the director, the associate director, the assistant director, the chief of nursing, along with the medical chief of staff -- in collaboration with the chief of H.A.S."
Washington is paying attention
The Phoenix VA's "off the books" waiting list has now gotten the attention of the U.S. House Veterans Affairs Committee in Washington, whose chairman has been investigating delays in care at veterans hospitals across the country.
According to Rep. Jeff Miller, chairman of the House Committee on Veterans' Affairs, what was happening in Phoenix is even worse than veterans dying while waiting for care.
Even as CNN was working to report this story, the Florida Republican demanded the VA preserve all records in anticipation of a congressional investigation.
In a hearing on April 9, Miller learned even the undersecretary of health for the VA wasn't being told the truth about the secret list:
"It appears as though there could be as many as 40 veterans whose deaths could be related to delays in care. Were you made aware of these unofficial lists in any part of your look back?" asked Miller.
"Mr. Chairman, I was not," replied Dr. Thomas Lynch, assistant deputy undersecretary, Veterans Health Administration.
Congress has now ordered all records in Phoenix, secret or not, be preserved.
That would include the record of a 71-year-old Navy veteran named Thomas Breen.
Every single person involved should be charged with manslaughter. They knowingly and willingly, through course of (in)action, allowed people to die. Throw every single law, privision and addendum at them. Don't let them dispense so much as a band-aid.
The way we treat our veterans in this country is nothing short of shameful.
And this is why when folks want a Federal gov't run healthcare system for the whole US I laugh. Vets are about 8% of the population, and we can't even properly manage their care.
I consider myself very lucky I don't rely on the VA.
The following is the attempt by the the good folks at Ranger Up to address VA issues. It is NOT politically correct at all, and has some bad words.
It's a damn shame and insult to the guys and gals that served, and the whole process is an insult and disappointment to the guys and gals that swore to take care of them.
Underfunding and over-subscription is part of the problem, setting goals without providing the means to meet them another, and then there are just horrible human beings who don't give a feth and who should not be in any kind of position of authority if they don't subscribe to the mission of the agency they serve.
A decent portion of the blame goes to DCIMO. They are quick to send our troops to war, where they will get injured (both physically and mentally) and require our assistance when they return. By the time they decide to increase funding to actually hire folks and prepare for them to enter the VHA system it is already too late. It takes 6 months to a year to hire and train somebody (government for you there), probably longer to get completely new programs off the floor. But by the time we have the first wave of new veterans hit the door after initial deployment in OEF (and then OIF) the VHA was already behind.
I only work in the Hospital side of things, and compared to every other facility I have ever worked at (profit, non-profit, religious, etc) the VHA (at least my VAMC) is the best system I have worked in. But in-patient and out-patient services (including primary care) are two completely different animals and I hear from frustrated veterans even at our facility. I don't work that area so I don't know what goes on there, but I pray that we do a better job for them than this crap.
CptJake wrote: And this is why when folks want a Federal gov't run healthcare system for the whole US I laugh. Vets are about 8% of the population, and we can't even properly manage their care.
That being said, the standard of care we provide our veterans is shameful. I don't understand why we always seem to find the money to launch these bs wars but never the money to care for the men and women we sent.
I think this is another scandal that's been building up for some time now. I want to say I remember hearing rumors about this kind of thing way back when I lived at Bragg, but I can't remember (it was 8 years ago).
I only work in the Hospital side of things, and compared to every other facility I have ever worked at (profit, non-profit, religious, etc) the VHA (at least my VAMC) is the best system I have worked in. But in-patient and out-patient services (including primary care) are two completely different animals and I hear from frustrated veterans even at our facility. I don't work that area so I don't know what goes on there, but I pray that we do a better job for them than this crap.
I've read that there's a shortage in the US of nurses and general care physicians. Have you noticed this and could it be a contributor to this problem?
I'm not sure what the underlying motivation was here. Clearly, they've got standards they have to meet and they fudged the numbers to do by putting folks on the waiting list. But why?
-Were they incapable of meeting the standards?
-Was there some profit in "meeting" the standards?
-Just for the evilulz?
Assuming they were incapable of meeting the standards, and that was found out what would have happened?
-Some personal loss for the leadership?
-An increase in resources so they could meet the standards?
-Cuts, penalties or fines to the program for under performing?
Some combination for any of these options? This just seems so odd, I'd certainly prefer it had a explanation that's a bit less moustache-twisting villainy than one might assume.
I mean if there was no way they could service everyone with the current resources, and copping to that in the official records would only cut their resources further. Their actions are understandable if unfortunate. Playing by the rules would have still had those waiting and dying doing just as much waiting and dying, but with the possibility that even more people get cut off from the services.
I'd certainly like to believe something like that was the case, before running with the idea that this was throwing people under the bus to preserve their own jobs or bonuses or the like.
Ouze wrote: Yeah, words fail me. People better go to federal PMITA prison over this.
I... just have no words on this.
Wherever you fall in the political spectrum... private healthcare vs public debate...
It just doesn't matter in this regard.
I've advocated that the VA system need to be overhaul'ed to such degree that not only it's the best healthcare system in the world, but so fething good, that it's a benefit that private citizen/companies should drool over.
Because, let's face it... the armed service men/women deserves nothing less than that.
I've read that there's a shortage in the US of nurses and general care physicians. Have you noticed this and could it be a contributor to this problem?
I don't know about physicians. On the in-patient side (at least at our hospital) we have a lot of residents since we are affiliated with a teaching hospital and medical school. But I don't think that there are a lot of resident primary care programs out there. Primary Care certifications are usually Fellowships, and they will probably do those elsewhere.
Nursing always has a shortage. Part of the problem for us is that a lot of people look at $ and not the total benefit package. New nurses (and even some transfers) will get paid less working for the VA when they start out. But you get excellent health insurance, you can transfer to pretty much any federal agency anywhere if you want to, and you get 5 weeks of paid vacation the first year you start. (The vacation was a big one for me, but I'm European and I don't think most Americans are actually used to taking vacations.) So if you are just looking at numbers the VA doesn't look that attractive, although now that I have been here 5 years I make more than I would in the private sector, and you would have to be a screw-up to not get your grade-increases. We also had the pay freeze (so no COLA for 4 years, which affected every federal agency though) and we lost our bedside retention bonus (so 10% effective pay cut) which drove a lot of people off although that doesn't affect the out-patient side of things because they never got that to begin with. They fixed that now at our facility and gave the 10% increase to outpatient nursing staff as well so maybe that will help.
So I do think that the shortage doesn't help, especially with people that have a short term outlook on money. Sure they can make more money now somewhere else (and be fired just like that), but in the long term there are more opportunities and pay here.
No amount of money can fix "I don't give a feth about the mission of the VA" though, and I do think that there is some level of that going on in all levels of the VA. We have people who run this place like a private hospital and only look at the money and who don't give a feth about who we serve, and that pisses me off to no end. I could take care of patients anywhere, I'm here to take care of our veterans. Not everybody has that mindset though.
That's pretty sad. I don't like either of my jobs, but damn I still do them the best of my ability >.<
I've been considering dumping both my jobs the past few weeks and becoming an EMT (cause I'd actually like to do something that feels important) and the idea that someone can be rushed for emergency care and just be turned away at the door is mind jarring.
Chongara wrote: I'm not sure what the underlying motivation was here. Clearly, they've got standards they have to meet and they fudged the numbers to do by putting folks on the waiting list. But why?
-Were they incapable of meeting the standards? With the resources they had, probably not. But then you work on fixing that instead of fudging the numbers.
-Was there some profit in "meeting" the standards? I'm sure there are performance bonuses and target bonuses for being lean and efficient...
-Just for the evilulz? Probably not for the lulz, but somebody clearly didn't give a feth...
Assuming they were incapable of meeting the standards, and that was found out what would have happened?
-Some personal loss for the leadership? Ideally an increase in resources so that they could meet them. But probably just a "if you can't meet the standards, we will just find somebody that can".
-An increase in resources so they could meet the standards? That's what should happen.
-Cuts, penalties or fines to the program for under performing? Can't really cut or fine the program. But somebody should be held responsible, all the way up to DC where some of the responsibility originates.
Some combination for any of these options? This just seems so odd, I'd certainly and prefer it had a explanation that's a bit less moustache-twisting villainy than one might assume.
Probably a mix of frustration combined with way to much "I don't give a feth".
I mean if there was no way they could service everyone with the current resources, and copping to that in the official records would only cut their resources further. Their actions are understandable if unfortunate. Playing by the rules would have still had those waiting and dying doing just as much waiting and dying, but with the possibility that even more people get cut off from the services.
Drawing attention to the problem would probably still get them fired in retaliation, I don't know what the culture in that VISN is like. But if I had the option of getting fired for drawing attention to a legitimate problem or getting fired for lying about the problem, I would hope that I have the integrity to get fired for making people aware about it. It seems like there should be some whistle-blower protection there if you do the former.
I'd certainly like to believe something like that was the case, before running with the idea that this was throwing people under the bus to preserve their own jobs or bonuses or the like.
I wouldn't be afraid if that was a contributing factor though, sad as it may be.
LordofHats wrote: That's pretty sad. I don't like either of my jobs, but damn I still do them the best of my ability >.<
I've been considering dumping both my jobs the past few weeks and becoming an EMT (cause I'd actually like to do something that feels important) and the idea that someone can be rushed for emergency care and just be turned away at the door is mind jarring.
That's actually very illegal.
The ED is required by law to stabilize the patient when they walk in the door regardless their inability to pay for the services.
An ER has to evaluate you, and if you don't have a life threatening emergency they can turn you away without any treatment. That's the summary of the law.
It's not the best law, but looking at some of the crap that comes into the ER and takes up time and space of staff it is not surprising. I used to turn people away pretty frequently and refer them to the walk-in clinic for stuff like "I've had a gout flareup for 3 days" or "I'm out of medicine" or "my chronic back pain for 5 years is acting up".
Chongara wrote: I'm not sure what the underlying motivation was here. Clearly, they've got standards they have to meet and they fudged the numbers to do by putting folks on the waiting list. But why?
-Were they incapable of meeting the standards? With the resources they had, probably not. But then you work on fixing that instead of fudging the numbers.
-Was there some profit in "meeting" the standards? I'm sure there are performance bonuses and target bonuses for being lean and efficient...
-Just for the evilulz? Probably not for the lulz, but somebody clearly didn't give a feth...
Assuming they were incapable of meeting the standards, and that was found out what would have happened?
-Some personal loss for the leadership? Ideally an increase in resources so that they could meet them. But probably just a "if you can't meet the standards, we will just find somebody that can".
-An increase in resources so they could meet the standards? That's what should happen.
-Cuts, penalties or fines to the program for under performing? Can't really cut or fine the program. But somebody should be held responsible, all the way up to DC where some of the responsibility originates.
Some combination for any of these options? This just seems so odd, I'd certainly and prefer it had a explanation that's a bit less moustache-twisting villainy than one might assume.
Probably a mix of frustration combined with way to much "I don't give a feth".
I mean if there was no way they could service everyone with the current resources, and copping to that in the official records would only cut their resources further. Their actions are understandable if unfortunate. Playing by the rules would have still had those waiting and dying doing just as much waiting and dying, but with the possibility that even more people get cut off from the services.
Drawing attention to the problem would probably still get them fired in retaliation, I don't know what the culture in that VISN is like. But if I had the option of getting fired for drawing attention to a legitimate problem or getting fired for lying about the problem, I would hope that I have the integrity to get fired for making people aware about it. It seems like there should be some whistle-blower protection there if you do the former.
I'd certainly like to believe something like that was the case, before running with the idea that this was throwing people under the bus to preserve their own jobs or bonuses or the like.
I wouldn't be afraid if that was a contributing factor though, sad as it may be.
You don't really start a giant conspiracy over "I don't give a feth" though. Especially if there aren't personal consequences on the line. If you don't care and it can't hurt you, just let the failures happen. They took a non-trivial amount of effort and risk in doing this, especially when they started putting pressure on their subordinates to keep things hush-hush.
They were definitely invested in this situation in a big way, or the leadership just wouldn't have done what they did.
d-usa wrote: An ER has to evaluate you, and if you don't have a life threatening emergency they can turn you away without any treatment. That's the summary of the law.
It's not the best law, but looking at some of the crap that comes into the ER and takes up time and space of staff it is not surprising. I used to turn people away pretty frequently and refer them to the walk-in clinic for stuff like "I've had a gout flareup for 3 days" or "I'm out of medicine" or "my chronic back pain for 5 years is acting up".
Right... that's what I meant.
I've been to about 5 different private hospital system throughout the US (no idea about VA tho) and each institution is very concientous of not violating EMTALA.
The penalties is like $50G per incident ... but no institution want the public backlash associated with these incidents.
You don't really start a giant conspiracy over "I don't give a feth" though. Especially if there aren't personal consequences on the line. If you don't care and it can't hurt you, just let the failures happen. They took a non-trivial amount of effort and risk in doing this, especially when they started putting pressure on their subordinates to keep things hush-hush.
They were definitely invested in this situation in a big way, or the leadership just wouldn't have done what they did.
Well, the failures could definitely hurt them and cost them their job, so there are personal consequences for that. Covering it up "might" cost you your job if somebody finds out about this, so we will have to see if there are some big consequences (and hopefully there will be).
In an ideal world they would just do the job they were supposed to do, they would be unable to meet the goals, they would be able to tell DC why they didn't meet the goals, and then DC would give them the resources to meet them in the future. Everybody keeps their job and veterans now get the care they deserve.
In a less ideal world you would do the job you were supposed to do, you would be unable to meet the goals, you would get the blame and get fired, and you would expose the crap system to the press so that public pressure might give the veterans the care they deserve later.
In the crap world that happened they didn't do the job that they were supposed to do, they didn't meet the goals, they covered it up, and hopefully somebody gets fired and there will be enough public outrage to get veterans the care they deserved in the first place.
CptJake wrote: And this is why when folks want a Federal gov't run healthcare system for the whole US I laugh. Vets are about 8% of the population, and we can't even properly manage their care.
I will never understand why the VA is allowed to operate in the Dark Ages like it does. In some places, the files aren't even digitized yet. I vaguely recall a GSA issue not long ago where a building was becoming structurally unsound due to the amount of paper records piling up.
All that said, I also feel like the VA being allowed to operate blindly with little to no oversight is a huge issue. SOMEONE has to be making sure that the VA is doing what it's supposed to do. Clearly, that isn't getting done.
CptJake wrote: And this is why when folks want a Federal gov't run healthcare system for the whole US I laugh. Vets are about 8% of the population, and we can't even properly manage their care.
I will never understand why the VA is allowed to operate in the Dark Ages like it does. In some places, the files aren't even digitized yet.
Pretty much all records are in VistA now, so they are electronic.
A big problem that still continues, for no reason other than all agencies wanting to win the turf war, is that the military records are not in a compatible system with the VA records. I want to say that each military branch also has their own electronic standards, but I'm not 100% certain about that.
So what ends up happening is that folks leaving the military have to have their electronic records printed out, carry them to the VA, have them scanned back in or entered manually to be compatible with our system, and then the paper records that were brought in have to be stored.
There should be no reason why all the branches and the VA can't use the same system, or at the very least a database that lets every piece of data be utilized by each system without having to use the intermediate paper step that delays a lot of the care.
I vaguely recall a GSA issue not long ago where a building was becoming structurally unsound due to the amount of paper records piling up.
We had a similar issue. We moved our medical records department into a different building so that we could expand our ER and add a new urgent care clinic. The other building had to be structurally reinforced so that they could support the weight of these records.
All that said, I also feel like the VA being allowed to operate blindly with little to no oversight is a huge issue. SOMEONE has to be making sure that the VA is doing what it's supposed to do. Clearly, that isn't getting done.
Well, they were making sure. They were audited to make sure that everybody gets seen in a timely manner from the moment they came in to schedule an appointment. The problem in this particular case was not as much a lack of oversight, it was the incredible amount of effort that was undertaken to circumvent that oversight.
Dreadclaw69 wrote: Absolutely despicable. That is no way to treat the people who served their country
It's no way to treat anyone regardless of what they have done.
This, yes. I find it strange that we're saying "That is no way to treat the people who served their country", and not simply, "That is no way to treat people".
Dreadclaw69 wrote: Absolutely despicable. That is no way to treat the people who served their country
It's no way to treat anyone regardless of what they have done.
This, yes. I find it strange that we're saying "That is no way to treat the people who served their country", and not simply, "That is no way to treat people".
Maybe because we are talking specifically about veterans. But I get your point so lets not get caught up with an unnecessary sidebar that distracts from the topic at hand.
Dreadclaw69 wrote: Absolutely despicable. That is no way to treat the people who served their country
It's no way to treat anyone regardless of what they have done.
This, yes. I find it strange that we're saying "That is no way to treat the people who served their country", and not simply, "That is no way to treat people".
Maybe because we are talking specifically about veterans. But I get your point so lets not get caught up with an unnecessary sidebar that distracts from the topic at hand.
Fair enough. Topic is dropped, and regardless of semantics, it makes what's going on no less nightmarish.
So when I was in school I relied on VA health care, I have a service linked disability so I qualified. One week I had a super nasty cold couldn't get out of bed just destroyed by whatever virus/bacteria had a hold of me. I called my primary provider (main doctor) for an appointment and was given a time slot 4 weeks out. I responded with "It will be cured or I'll be dead by then" they responded with come to the ER. The ER waits at VA hospitals are ridiculous, like 8-12 hours ridiculous.
Eventually I figured out that if you went to the ER at like 3am you could get seen in an hour or two.
I'm happy to pay for private insurance these days and do so without complaint.
hotsauceman1 wrote: Y'know the sad thing, I have seen that argument before, that it is their fault they got injured.
I hate California Colleges sometimes.
The weird part is that I've seen people in the Army (and Army brats) say it
Sometimes the whole self sacrifice thing is taken a little too seriously.
d-usa wrote: At any large ER, an 8 hour wait for a non-emergent care is not really out of the ordinary though.
When I cut my hand open prying stuff off of an ebay Rhino, I was at the ER for about 4-5 hours before they finally got around to stitching me up. They at least bothered to get it gauzed up in a couple hours.
Nothing like being the guy ACTUALLY hurt at the ER, and it take forever to get in. Have to deal with the guy who has a head cold and the woman with the toothache first though. Wouldn't want to give the impression that the guy with blood running down his arm is more special than they are.
d-usa wrote: At any large ER, an 8 hour wait for a non-emergent care is not really out of the ordinary though.
When I cut my hand open prying stuff off of an ebay Rhino, I was at the ER for about 4-5 hours before they finally got around to stitching me up. They at least bothered to get it gauzed up in a couple hours.
Nothing like being the guy ACTUALLY hurt at the ER, and it take forever to get in. Have to deal with the guy who has a head cold and the woman with the toothache first though. Wouldn't want to give the impression that the guy with blood running down his arm is more special than they are.
The guy with the blood is not any more special in the ER though, especially if its just a cut that can be fixed with a couple of stitches.
Based on ESI Triage laceration and toothache would have been Level 4, so they would be the same urgency. Ideally whoever came in first at that level would be seen first at that level. Depending on available resources (you can xray a toothache and treat him in the hallway, but you need an actual room to do suturing) one might skip ahead though. Head cold could be a Level 5 or 4 (depending on the symptoms ), and most places treat 4 or 5 the same.
Anybody level 3 or higher would be seen before the level 4 or 5, it doesn't matter if they arrived 5 minutes later or 5 hours later.
The idea of "they should be able to fix a small problem quickly, so I should be in and out quickly" is the exact opposite of how an ER actually works.
That's not defending an ER at a VA, that's talking about ERs anywhere.
Edit:
The standards of care and expectations from an ER might be another topic that would be had elsewhere though, that way we can focus on the reprehensible actions by the officials in Phoenix.
daedalus wrote: A lot of that is surprising and not things I would agree with, but I agree to keeping the thread on-topic.
It's the reason why, after the long delay of moving our records department, we build a new urgent care clinic at our facility. So quick "in-and-out" stuff can quickly go in-and-out, and the ER can focus on the serious stuff that takes time and resources to treat.
So for walk-in problems we have a three-tiered approach at our VA:
- If you are a regular patient here you will go see your primary care physician on a walk-in basis, that keeps all your care with the same person. Even though everybody can access all your records there is a benefit to having that continuity of care. - If your PCP is totally filled up, or you don't have a PCP at our facility, then you get send to the urgent care clinic. - If your problem is too involved for urgent care (the same person does triage for the ER and Urgent Care) then you get directed to the ER instead.
It has helped with our times and improved our care for our veterans
(Figured that talking about how specifically we handle things in our VA might be a bit more on-topic than "all ERs have long wait times" in general...).
d-usa wrote: At any large ER, an 8 hour wait for a non-emergent care is not really out of the ordinary though.
Agreed but "aint nobody got time for that" and by not having access to primary care and suggesting the ER they make the waits longer for everyone else by jamming it up with non critical issues. It was such a wierd system, have a cold 4 weeks, podiatrist oh we can get you into him in 1 day.
d-usa wrote: At any large ER, an 8 hour wait for a non-emergent care is not really out of the ordinary though.
Agreed but "aint nobody got time for that" and by not having access to primary care and suggesting the ER they make the waits longer for everyone else by jamming it up with non critical issues.
Agreed. I do think that often times the PCP is more to blame for ER overcrowding than patients themselves.
It was such a wierd system, have a cold 4 weeks, podiatrist oh we can get you into him in 1 day.
Well, the rate of combat-related toe problems is probably a lot lower
First, as an employee of the VA (VBA), I find this to be appalling. Sadly, I can believe it, and see it happen somewhat on the benefits side of the house too. Whenever I handle a case for an 80+ year old vet, I do what's in my power to get their claim done sooner/faster/quicker. For terminal vets and the like, we actually have a dedicated team for that. In my dealings with them, they generally do a good job IMO. Sadly, much of our direction from senior management is all about the numbers.
Secondly, CptJake, loved the video! As both a vet and a VA employee, I really appreciated all of the aspects. With that being said, I see myself (and some of those I am fortunate to work with) more as this:
(CNN) -- Veterans Affairs Secretary Eric Shinseki told the Wall Street Journal on Tuesday that he will not resign in the wake of his department being accused of deadly delays in health care at some of its hospitals.
"I serve at the pleasure of the president," Shinseki told the newspaper when asked whether he would step down. "I signed on to make some changes, I have work to do."
The White House stood its ground when asked whether Shinseki will continue to lead the department.
In its daily briefing -- a question-and-answer session dominated by lengthy discussions on the conflict in Ukraine, abducted Nigerian schoolgirls and the White House climate change report -- press secretary Jay Carney offered only a few sentences when asked whether Shinseki's job was safe.
President Barack Obama takes seriously the allegations that veterans died waiting for care at the Phoenix VA hospital, Carney said, reiterating that the VA's inspector general is conducting an independent probe into the allegations.
"The President remains confident in Secretary Shinseki's ability to lead the department and take appropriate action," Carney said, repeating the White House response this week to two veterans groups' calls for Shinseki's ouster.
Shinseki said Tuesday that is "very sensitive to the allegations" coming from the Phoenix probe.
"I need to let the independent IG (inspector general) complete his investigation," he told the Journal.
Calls for his resignation
On Monday, the nation's largest veteran organization, the American Legion, and another veterans group, Concerned Veterans for America, called for Shinseki's resignation.
The calls came after months of CNN exclusive reporting on U.S. veterans who have died awaiting care at VA hospitals across the country, including in Phoenix.
"It's not something we do lightly. But we do so today because it is our responsibility as advocate for the men and women who have worn this nation's uniform," said Daniel M. Dellinger, national commander of the American Legion.
Added Pete Hegseth, CEO of the Concerned Veterans of America, in a statement:
"We're proud to stand with The American Legion as they take this courageous and historic stand. As America's largest veterans organization, their moral authority on this issue is unimpeachable. We applaud their demands for accountability at the very top of the Department of Veterans Affairs."
Dozens of deaths
Shinseki told the Wall Street Journal that he would increase the communication among the leaders atop his department and veterans and address what appears to be a lack of faith in top management.
"If veteran service organizations are voicing concern about that, I will accept I have work to do to bolster confidence in their health care system," he said.
CNN has been reporting on delays in care and patient deaths at VA hospitals for the past six months, including at hospitals in South Carolina, Georgia and Texas.
After CNN's coverage, the VA acknowledged in April that 23 veterans had died as a result of delayed care in recent years, but sources tell CNN that number could be much higher.
In an exclusive report two weeks ago, CNN interviewed a retired VA doctor from Phoenix who charged that more than 40 American veterans have died waiting for care at the VA hospital there.
Throughout the network's reporting, CNN has submitted numerous requests for an interview with Shinseki, but in the six months that CNN has been reporting on the delays, Shinseki has yet to speak to CNN.
CNN is not alone in getting virtually no response from VA officials.
U.S. Rep. Jeff Miller of Florida, chairman of the House Veterans Affairs Committee, issued this statement late Monday:
"For nearly a year, we have been pleading with top department leaders and President Obama to take immediate steps to stop the growing pattern of preventable veteran deaths and hold accountable any and all VA employees who have allowed patients to slip through the cracks.
"In response, we've received disturbing silence from the White House and one excuse after another from VA."
VA spokesman Drew Brookie's statement, released late Monday, read:
"The Department of Veterans Affairs (VA) takes any allegations about patient care or employee misconduct very seriously. If the VA Office of Inspector General's investigation substantiates allegations of employee misconduct, swift and appropriate action will be taken. Veterans deserve to have full faith in their VA care.
"Under the leadership of Secretary Shinseki and his team, VA has made strong progress in recent years to better serve veterans both now and in the future. The secretary knows there is more work to do."
Shinseki told the Wall Street Journal that he would increase the communication among the leaders atop his department and veterans and address what appears to be a lack of faith in top management.
"If veteran service organizations are voicing concern about that, I will accept I have work to do to bolster confidence in their health care system," he said.
Firing people would be a good start for that, lots of firing people...
Shinseki told the Wall Street Journal that he would increase the communication among the leaders atop his department and veterans and address what appears to be a lack of faith in top management.
"If veteran service organizations are voicing concern about that, I will accept I have work to do to bolster confidence in their health care system," he said.
Firing people would be a good start for that, lots of firing people...
That, taking personal responsibility, and resigning
Not sure how I missed this reply, especially posted like 10 minutes after my own post, but I'm glad to see that things are clearing up. I remember the database issue coming up in another thread, and sadly am not shocked that so many groups use different systems. I'm at the FTC and we work closely with both the SEC and DOJ/Anti-Trust, yet we all use completely different systems requiring completely different data sets. It's ludicrous, but I do understand.
As to the VA dude not resigning, I'm actually for it. Swapping out leadership at this point will only delay any positive changes that might have been made, as Congress and the President battle over who gets to sit in the chair. I don't expect department heads to be omniscient, so forcing someone to resign because a bunch of chuckleheads took great steps to hide their shenanigans isn't cause for resignation in my book. Let the guy clean the mess up, deal with those that broke the law, and then he can see about getting out. Resigning now just exacerbates the situation.
Shinseki told the Wall Street Journal that he would increase the communication among the leaders atop his department and veterans and address what appears to be a lack of faith in top management. "If veteran service organizations are voicing concern about that, I will accept I have work to do to bolster confidence in their health care system," he said.
Firing people would be a good start for that, lots of firing people...
If the VA is like any other government agency, they will scapegoat the lowest possible person, and move on.
Honestly, scandals like this are inevitable, given the cost to any person involved to report it. A whistleblower will, at absolute best, be marginilized, harrassed, and never promoted. I've seen reprots of managment hiring Private Investigators to try to dig up dirt on whistleblowers. Those that are fired can usually at least sue, and after five or so years, recieve a small settlement.
In practice, the rule of thumb for federal employees is that "snitches get stitches."
Edit: the success rate of those that file Whistleblower protection claims is less than 2%. Or was in ~2009.
Since support for their veterans seems to be such a big part of the US military's 'sell', perhaps they should think about bringing the services 'in house' and dump the VA completely
They'd be better placed to see what was going on, if those working within it were under the military chain of command it should be easier to remove weak links and since services would also be available to serving personnel they should have higher buying power and thus get goods & services cheaper
Three mental health administrators at the Malcom Randall VA Medical Center in Gainesville have been placed on administrative leave after U.S. Department of Veterans Affairs officials found a “secret” waiting list of more than 200 patients, a local union president said Thursday. …
News recently surfaced of alleged secret waiting lists and falsified records at VA hospitals around the country, including reports of allegations that some veterans on such a list at the Veterans Affairs Health Care system in Phoenix had died while waiting for appointments. Reports have said the secret waiting lists were meant to hide delays and could have been used so management executives could get bonuses related to shorter wait times.
Muriel Newman, union president for the local chapter of the American Federation of Government Employees, told The Sun that the VA administration had placed chief psychiatrist Dr. Rajiv Tandon, administrative officer Karen Chin and Peter Durand, the chief of the mental health service call line, on administrative leave after the discovery of the list at the Gainesville VA hospital.
Wisnieski confirmed those three employees have been placed on paid administrative leave while a review is conducted into the list and the circumstances surrounding it.
...
Secretary of Veterans Affairs Eric Shinseki said he accepted the resignation of his top health official on Friday, a day after the two testified before Congress about a growing scandal over deadly healthcare delays for veterans.
“Today, I accepted the resignation of Dr. Robert Petzel, undersecretary for health in the Department of Veterans Affairs,” Shinseki said in a statement.
...
Let's hope this is just the beginning and some actual fething effort to address these things... instead of the usual whitewash.
Dreadclaw69 wrote: Let me guess, this was the work of rogue agents in the Cincinnati branch.... oh wait, wrong scandal.
Well... to be fair, we now have more accountability at the VA than we did at State with Benghazi, or at Treasury with the IRS scandal.
OrlandotheTechnicoloured wrote: Since support for their veterans seems to be such a big part of the US military's 'sell', perhaps they should think about bringing the services 'in house' and dump the VA completely
They'd be better placed to see what was going on, if those working within it were under the military chain of command it should be easier to remove weak links and since services would also be available to serving personnel they should have higher buying power and thus get goods & services cheaper
Honestly, this is a horrible idea... See, for anything other than papercuts, the Army (not sure about the other branches) will simply send you off to a specialist. Depending on your base/hospital, that specialist will most likely be off-post. And since you're being sent to a civilian health clinic for care, they generally don't report back (well, that's not really true... they do, just to TRICARE, but having an army doc that looks at the TRICARE paperwork is like finding real grass inside Dallas Stadium). This situation is how I had been diagnosed with RA for over 2 years, and been on certain meds for over a year, but my doc didn't notice until well after it was time for him to initiate a Med Board (even though I'd told him I wasn't taking it any longer).
Since I'm now out, and there seem to be some VA types here, do any of you guys know about the medical center at American Lake in Washington?
For years, employees at a Texas VA complained that their bosses were cooking the books. For years, the VA insisted there was no widespread wrongdoing. Editor's Note: This story has been updated with new information. Last week, President Obama pledged to address allegations of corruption and dangerous inefficiencies in the veterans’ health-care system. But before the president could deliver on his pledge, the scandal has spread even further. New whistleblower testimony and internal documents implicate an award-winning VA hospital in Texas in widespread wrongdoing—and what appears to be systemic fraud.
Emails and VA memos obtained exclusively by The Daily Beast provide what is among the most comprehensive accounts yet of how high-level VA hospital employees conspired to game the system. It shows not only how they manipulated hospital wait lists but why—to cover up the weeks and months veterans spent waiting for needed medical care. If those lag times had been revealed, it would have threatened the executives’ bonus pay.
What’s worse, the documents show the wrongdoing going unpunished for years, even after it was repeatedly reported to local and national VA authorities. That indicates a new troubling angle to the VA scandal: that the much touted investigations may be incapable of finding violations that are hiding in plain sight.
“For lack of a better term, you’ve got an organized crime syndicate,” a whistleblower who works in the Texas VA told The Daily Beast. “People up on top are suddenly afraid they may actually be prosecuted and they’re pressuring the little guys down below to cover it all up.”
“I see it in the executives’ eyes,” the whistleblower added. “They are worried.”
The current VA scandal broke in Phoenix last month, when a former doctor at a VA hospital there became the first whistleblower to gain national attention. The doctor's allegations of falsified appointments—and veterans dying while they waited for treatment—unleashed a wave of similar claims from VA employees nationwide. In Cheyenne, Wyoming, Chicago, and Albuquerque, more VA whistleblowers came forward claiming that the same fraudulent scheduling was being used in the hospitals where they worked. At last count, the VA inspector general’s investigation had expanded to 26 separate facilities. The torrent of claims led to Senate hearings, calls for VA Secretary Eric Shinseki to resign, multiple investigations and President Obama’s own public statement last week. Paul Rieckhoff, founder and chief executive officer of Iraq and Afghanistan Veterans of America (IAVA), believes that even more revelations are coming.
“This newest case just further illustrates that the scandal is much more far reaching than most people realize,” Rieckhoff said, “Phoenix was just the tip of the iceberg. Scandal has become the new normal, it’s the status quo at the VA right now.”
But, despite the political uproar and the growing investigations, the root causes of the VA crisis have remained murky. New documents and whistleblower testimony obtained by The Daily Beast shed light on exactly how fraud is being perpetrated in the VA and its underlying causes. There’s enormous pressure to report favorable wait times for VA patients, the Texas whistleblower explained, even if those wait times are completely false.
“If [VA] directors report low numbers, they’re the outlier. They won’t stay a director very long and they certainly won’t get promoted. No one is getting rewarded for honesty. They pretty much have to lie, if they don’t they won’t go anywhere,” the whistleblower added. Weighted more heavily than other performance measures, the wait time numbers alone “count for 50% of the executive career field bonus, which is a pretty powerful motivator.”
Though VA hospitals may be struggling with increasing patient loads and inadequate resources—including too few medical providers—they are punished for acknowledging those problems. The VA’s current system appears to reward executives’ accounting tricks that mask deep structural issues and impede real solutions.
The whistleblower—who will alternately be called “the clinician,” referring to the job they have held with the Texas VA for almost a decade—asked to remain anonymous due to fear of losing their job or being otherwise punished for speaking out.
ANATOMY OF A FRAUD
The clinician has been alerting authorities to the wrongdoing at their facility for years but the corruption has persisted despite multiple reports and investigations by the VA’s inspector general.
The case of Dr. Joseph Spann, a recently retired doctor who reported malfeasance in the Texas VA system, where he worked for 17 years, raises the possibility that official investigations may only be hiding the problems they were charged to root out.
After retiring in January of this year Spann sent a letter to VA investigators accusing a VA employee of manipulating patient wait lists to hide treatment delays for veterans. The rigged reporting scheme Spann described in his letter, which threatens veterans’ lives by delaying their treatment, is the same method that has been exposed in Phoenix, Cheyenne, Albuquerque, and scores of other VA hospitals across the country.
According to Spann, Dr. Gordon Vincent, chief of radiology at Olin E. Teague Veterans Medical Center in Temple, Texas, didn’t just break VA policy by manipulating veterans’ appointments himself. He ordered VA employees across central Texas to engage in the same fraudulent practice.
The VA said it investigated Spann’s charges, and, after, finding nothing to substantiate the claims, cleared Vincent and the Texas VA.
But documents obtained by The Daily Beast appear to show Dr. Vincent doing precisely what Spann accused him of—the activities the VA said it could not substantiate. < see link for actual documents >
In the above document, taken from the VA’s internal record system, you can see Dr. Vincent cancel an ultrasound appointment for a veteran suffering from cirrhosis. Vincent tells the doctor who submitted the original order to change the desired date—the day the provider selected for the procedure based on their diagnosis and clinical judgement—citing the facility’s patient backlog.
Veterans are supposed to be seen within 14 days of their desired date, according to VA policy. By changing the desired date, Dr. Vincent, a VA section chief, was violating well-established scheduling rules detailed in an official VA memo from April 2010 and re-emphasized in a separate policy directive from June of that year. But forging veterans’ desired dates seems to have been widely considered a low-risk, high-reward form of cheating. Changing the dates made it seem as if patients were being seen within the prescribed 14-day window, which reflected well on the hospital and put its staff in line for bonuses.
For the veterans seeking care, however, it had no such benefits.
In his letter to the VA’s Inspector General’s Office, Spann wrote, “I cannot categorically say that I ever saw a patient die from such manipulated scheduling, but I did see several cancer patients have their possible surgery or chemotherapy treatments delayed awaiting the required radiology tests.”
The VA whistleblower, who provided The Daily Beast with the records implicating Dr. Vincent, works as a medical provider for sick veterans. “It’s plain and simple common sense,” the clinician said. “Every delay in a patient’s diagnosis is an injury. The more severe the veteran’s condition, the worse the injury caused by the wait as the disease is allowed to progress.”
Now that the VA has exonerated Dr. Vincent, there may be no one left to evaluate the injury caused by the appointments he canceled.
NOTES ON A SCANDAL
This document described is only one piece of evidence in a larger docket against Vincent, which is itself part of a larger record of corruption in the VA that extends far beyond Vincent or any one individual. In 2011, the VA’s inspector general investigated the Central Texas health-care system in response to complaints it had received. The inspector general found that manipulated appointments were widespread and hid significant delays, but the report doesn’t seem to have led to a single VA official being disciplined or officially held responsible for gaming the system. This internal VA email chain from 2011, provided exclusively to The Daily Beast, clearly instructs medical providers to falsify their schedules in the same manner that was exposed in Phoenix three years later. Though a VA executive warns that the original message is encouraging fraud, by the email’s conclusion two other doctors have written suggesting that it’s a common occurrence. The email was originally sent to every medical provider in the Central Texas VA health-care network.
The first message in the chain comes from a scheduling coordinator, James Anderson, who tells doctors across the state to use January 2 as the desired date for veterans. The Central Texas VA Chief of Staff, William Harper, then reproaches Anderson, saying, “You cannot do this!!!! This is essentially fraud. The desired date is what it is and if we don’t meet the standard then we will work to improve.”
(The Central Texas VA referred all questions to the national Department of Veterans’ Affairs office in Washington, D.C. Representatives at the national VA declined to comment on the record for this story.)
After the warning from Harper and questions about scheduling from several other doctors, including Spann, the final comment in the thread concerns Dr. Vincent. The message reads: “It doesn’t help if you insist on a date that doesn’t meet their 30-day criteria. Vincent just cancels the order. End of story. ”
In other words: it never mattered what was entered to show the “desired date” requested by the patient or the medical provider treating them. Despite Harper’s protestations, if the entry didn’t help meet the VA’s performance objectives it never made it into the system.
Nevertheless, the VA recently cleared Vincent of wrongdoing and, while acknowledging scheduling malpractice, blamed it on mistakes made by lower-level clerks.
“I saw the press release saying it wasn’t Vincent or any of the executives, that the schedulers were entering the desired dates incorrectly but they were not directed to do so by management. That’s just not true and we’ve got mountains of evidence proving it,” the clinician told The Daily Beast.
PERFORMANCE INCENTIVES
On the ultrasound request form, Dr. Vincent writes that he canceled the order because it was “entered in error.” But that would have come as news to the medical provider who actually interacted with the veteran and entered the date based on their evaluation of the patient’s needs. The real reason for canceling it, according to both Dr. Spann and the whistleblower who spoke with The Daily Beast, was to meet the VA’s performance objectives—whatever the cost.
Meeting the performance objectives, which made executives eligible for bonuses and put them in line for promotions, became the overriding imperative among VA executives, according to both Spann and the whistleblower.
The VA’s 2012 performance plan, provided to The Daily Beast by the whistleblower, contains five critical elements to evaluate success, each one containing multiple sub-criteria. But critical element No. 5, the “Results Driven” component that contains the “wait time” criteria, is worth 50% of the overall score. That’s as much as all the other elements combined.
And scoring high on the performance measures is of paramount consideration in a VA hospital. “This is what your bosses, the executives, are being evaluated for,” the whistleblower said. “So if you work for them you must support this because that’s how they’re prioritizing their evaluation of your job.”
The VA’s performance measures were originally established to provide uniform criteria for evaluating employees. The idea was to use the grading system to reward those who met the standard with bonuses and identify those who were lagging behind. But over time, VA executives realized that the wait time numbers they reported were almost more important than anything else—including the actual care they provided veterans—in how they were judged by the VA’s leadership. At that point the measures became a perverse incentive, encouraging VA facilities across the country to hide problems by cheating their numbers. Eventually, cooking the books became an alarmingly regular procedure—a standard that might have remained if it hadn’t been exposed in Phoenix and unraveled over the past month.
COVER-UP?
The problems in the Central Texas VA system outlined here may be new to most readers, but they have been on the record for years. They are certainly no surprise to the VA’s Office of Inspector General (OIG), which has received multiple complaints about the facility and investigated it in 2011.
VA To Improve Veterans’ Health Care With New $500 Million Waiting Room
WASHINGTON—Responding to recent allegations concerning agency misconduct and an overall lack of quality treatment for the nation’s servicemen and women, Secretary of Veterans Affairs Eric Shinseki announced plans Tuesday to improve health care for American veterans with a new $500 million state-of-the-art waiting room.
In a press conference held at the White House, Shinseki revealed details of the sprawling, 150,000-seat complex, which will reportedly be capable of comfortably accommodating veterans for periods ranging from 90 minutes to several hours each day. The secretary emphasized that his department is “One hundred percent committed” to enhancing medical care for American soldiers by providing them with the most modern amenities, ranging from a high-tech ceiling-mounted sound system that pipes in a continuous stream of soft music, to flat-screen televisions playing at low volume on every wall, to water coolers that offer both hot and cold options.
So far it seems like my VA has not been touched, I'm really hoping this stays this way.
If this many VA systems have been involved then there seems to be really only two explanations:
1) If it is a true single-office leadership issue, then this goes up pretty high. Since the problem spans multiple VISNs it could be something that originated above the VISN level. This would mean that somebody at the national level would have been the source.
2) It really originated at individual VA systems and the idea and technique spread via word of mouth at conventions and regional/national meetings. I really hope it is #2.
d-usa wrote: So far it seems like my VA has not been touched, I'm really hoping this stays this way.
If this many VA systems have been involved then there seems to be really only two explanations:
1) If it is a true single-office leadership issue, then this goes up pretty high. Since the problem spans multiple VISNs it could be something that originated above the VISN level. This would mean that somebody at the national level would have been the source.
I actually think that's highly unlikely... unless those executives are also under that performance-based bonus scheme.
2) It really originated at individual VA systems and the idea and technique spread via word of mouth at conventions and regional/national meetings. I really hope it is #2.
To me... this is the most probable. However, the only thing that really concerns me is that the VA’s Office of Inspector General (OIG) seemingly didn't investigate this well. Why not?
CNN) -- At least 1,700 military veterans waiting to see a doctor were never scheduled for an appointment and never placed on a wait list at the Veterans Affairs facility in Phoenix, Arizona, raising the question of just how many may have been "forgotten or lost" in the system, according to an agency report made public Wednesday.
Describing a "systemic" practice of manipulating appointments and wait lists at the Phoenix facility, the VA's Office of Inspector General called for a nationwide review to determine whether veterans at other locations were falling through the cracks.
The preliminary report sparked outrage from all corners, with Veterans Affairs Secretary Eric Shinseki calling the findings "reprehensible" and ordering the 1,700 veterans be immediately "triaged" for care, while at least one prominent lawmaker called for the agency's chief to resign.
The VA is under fire over allegations of alarming shortcomings at its medical facilities. The controversy, as CNN first reported, involves delayed care with potentially fatal consequences in possibly dozens of cases.
CNN has reported that in Phoenix, the VA used fraudulent record-keeping -- including an alleged secret list -- that covered up excessive waiting periods for veterans, some of whom died in the process.
The big questions remain under investigation, according to the report: Did the facility's electronic wait list omit the names of veterans waiting for care and, if so, at who's direction?
And were the death of any of these veterans related to delays in care?
"To date our work has substantiated serious conditions at the Phoenix facility," said the report, which also found another 1,400 veterans at the Phoenix VA who did not have a doctor's appointment but were on the VA's formal electronic wait list.
The report also found "numerous allegations" of "daily of mismanagement, inappropriate hiring decisions, sexual harassment, and bullying behavior by mid- and senior-level managers."
Overall, there are 26 VA medical centers under investigation.
Deputy National Security Adviser Tony Blinken told CNN that President Obama has been briefed on the report, and found it "deeply troubling."
When pressed on whether Obama still supports Shinseki, Blinken said: "We're focused on making sure these veterans who've delivered for this country get the care they need."
Still, Sen. John McCain, an Arizona Republican, told CNN's Wolf Blitzer described the finding as terrible and said it was "about time" the Justice Department launched its own investigation.
He also said Shinseki should probably resign, which the Cabinet officer has said he has no plans to do.
"I haven't said this before, but I think it's time for Gen. Shinseki to move on," McCain said.
There have been calls from other members of Congress for him to step down over the scandal, but McCain's voice on military matters carries enormous weight considering his experience as a combat veteran, a Vietnam prisoner of war, and his work in the Senate on related issues.
President Barack Obama said last week he needed more time to assemble the facts and promised accountability if problems were found. For now, he's sticking with Shinseki.
The VA has acknowledged 23 deaths nationwide due to delayed care. Griffin told a Senate committee in recent weeks that his investigation so far had found a possible 17 deaths of veterans waiting for care in Phoenix, but he added that there was no evidence that excessive waiting was the reason.
The report comes hours before a House committee hearing on the Phoenix VA issues.
Griffin recommended that Shinseki "take immediate action" to "review and provide appropriate health care" to the 1,700 veterans identified in Phoenix as not being on a wait list.
It also recommended that he initiate a nationwide review of waiting lists "to ensure that veterans are seen in an appropriate time, given their clinical condition."
I think Mr. McCain is right, heads need to roll over this. I also have no issue with the President needing more time to investigate - this needs to be rooted out, hard and deep.
I think Mr. McCain is right, heads need to roll over this. I also have no issue with the President needing more time to investigate - this needs to be rooted out, hard and deep.
If heads do roll, can they do it the George Carlin method?
Spoiler:
*NSFW... start at about 3:45 for the bit I'm really talking about
Heads need to roll, but the end result will probably the firing of some low level folks and transfers (aka: all expense paid moves with a possible promotion) for the higher ups.
When the NHS brought in targets and bonuses you may be shocked to learn that lots of hospital administrators started to spend money not on healthcare, or patient services, but on consultants to help them achieve their targets. So the taxpayer paid for consultants to help the administrators get paid more, and shrink the budget for care for the taxpayers.
If the bonuses are tied to specific performance goals, it stands to reason that while consultants were called in, then the goals were also met; so a win for everyone, no?
If the system was gamed, as it was here; then it's fraud and should be prosecuted.
curran12 wrote: I am pretty stunned and how this is growing and growing. I will be flabbergasted if Shinseki has his job by the end of it.
Especially when, in his senate hearings, he claims that he's outraged, and could use offensive language (but doesnt)... he sure as gak dont sound like he's all that pissed off... I mean, were I him and sitting there getting grilled by senators and congressmen, I'd have veins popping out of my neck, flipping tables and whatnot.
curran12 wrote: I am pretty stunned and how this is growing and growing. I will be flabbergasted if Shinseki has his job by the end of it.
Especially when, in his senate hearings, he claims that he's outraged, and could use offensive language (but doesnt)... he sure as gak dont sound like he's all that pissed off... I mean, were I him and sitting there getting grilled by senators and congressmen, I'd have veins popping out of my neck, flipping tables and whatnot.
The vibe I get from him is one of overwhelming complacency and leniency. You're right, there's absolutely no urgency or emotion in anything he says.
d-usa wrote: Heads need to roll, but the end result will probably the firing of some low level folks and transfers (aka: all expense paid moves with a possible promotion) for the higher ups.
It's sickening.
Agreed.
Well... Obama and Shinseki is having a serious meeting today. Possible resignation?
At this point, any executives caught in this ought to be fired pronto and prosecuted if found in conspiracy to commit fraud.
I know we're hungry to see some heads roll... but, really the issue at hand is how do we "fix" this (and don't just say throw money at it, it's mostly a structural issue than funding).
I'm not sure why, but it seems that the vet groups want change, but want Shinseki to stay. I would have thought that they would have wanted him replaced.
Co'tor Shas wrote: I'm not sure why, but it seems that the vet groups want change, but want Shinseki to stay. I would have thought that they would have wanted him replaced.
Maybe the vets who want him to stay didn't have to feel his AWESOME policies while in the army?? By that I mean of course, they didn't have to wear a beret when they weren't Ranger, Airborne or SOF.
I think putting the shitbags who took bonus $$$$ 'earned' by falsifying waiting lists/status in a Fed Pen for several hard years goes a long way towards fixing the problem. Negate the incentive to cheat by attaching a massively painful penalty, and publicize the implementation.
Ok.. now I'm seeing it. Definitely looks real since Reuters has it front page.
While I can't say much about Shinseki's overall body of work at the VA, let's hope the next guy cleans house. Would it be too much to ask for Mattis, or McCrystal to take the job?
Ensis Ferrae wrote: Ok.. now I'm seeing it. Definitely looks real since Reuters has it front page.
While I can't say much about Shinseki's overall body of work at the VA, let's hope the next guy cleans house. Would it be too much to ask for Mattis, or McCrystal to take the job?
President said that VA executives involved were fired.
There is such a leadership issue, judging by the extend, I don't expect anyone to fix anything soon. Maybe enough people will leave with a 50% paycut and we will see a difference. But I'm pretty bitter and pessimistic right now.
Honestly, even Mattis could not be effective. His leadership style would piss off the entrenched multi-decade employed civilian bureaucrats that inhabit the organization. They would passively resist any move he made. Unless you just fire the top few layers, and any middle layer managers who have more than 5 years there, the problem will continue in some way.
Automatically Appended Next Post: My pessimistic side sees The Solution involving enrolling all vets into the ACA and providing ACA vouchers/subsidies.
d-usa wrote: There is such a leadership issue, judging by the extend, I don't expect anyone to fix anything soon. Maybe enough people will leave with a 50% paycut and we will see a difference. But I'm pretty bitter and pessimistic right now.
I hear you... it's a major bureaucratic issue that's going to take serious political cajones to change.
You know my general opposition to Obama... but, he's saying all the right things at this speech now and right now, I applaud him for taking this task "head on" right now. I only hope we (congress/media/joe schmoe) keep the pressure up to enact meaningful reforms.
But I agree with the consensus here that a problem that is so deeply rooted is going to be very, very hard to eradicate completely. Sure the top level executives are out, but that is not a magic bullet to the many middle managers and lower-end executives who still gamed the system to their benefit.
This is probably the most important quote from the whole article:
John Gingrich, Shinseki’s chief of staff until 2012, summed up the problem in even starker terms: “When people don’t have integrity, it is hard to transform them.”
My pessimistic side sees The Solution involving enrolling all vets into the ACA and providing ACA vouchers/subsidies.
I've worked in almost every form of health system that currently exists in the US over the last 15 years. And I honestly feel that (on the inpatient hospital side of things) the VA is better than almost all of them. There is always room for improvement though. Think of all the problems Medicare and Medicaid already has, and now try to imagine adding all the veterans into that same system. I think it would create a lot more problems than solutions.
One common thing that I hear from my patients, and I think even a lot of the veterans complaining in the hearings said the same, is that once you make it into the system they are usually pretty satisfied.
I think a big problem, apart from the lack of ethics and morals from individuals involved, is that the system was suddenly stressed by three things at once:
1) Over a decade of war: Tons of new veterans entering the system in large numbers, and the system wasn't ready.
2) Baby Boomers: Vietnam veterans are getting older, and just as the baby boomers are straining the health system all over the US as they age and require more care the veterans born during that same period are adding an increased strain to the VA.
3) The Economy: The VA is the safety net for many people. There was probably a large number of veterans from many conflicts that have never utilized the system because they had jobs and health insurance. When the economy tanked it resulted in old and new veterans being unable to find employment and health insurance, so when they couldn't make it on their own they came to the government because that's what they were promised. That we would take care of them after serving.
The new veterans from the current wars is a biggie, but both the aging population and people falling into the safety net would have been a big stress on the system. All three combined created a perfect storm. gak hit the fan quick, and people took the easy way out instead of standing up for our veterans.
So a bit of the leadership got ejected which is a good start. I am under the impression its the department that does the scheduling and enrolling needs to be in the vertical and horizontal for massive removal
A buddy of mine posted a link to a local (for him) article about how this same sort of scandal has hit his local VA Clinic in Alabama.... As I suggested, it was going to "look worse" before it got better.
But it looks like we didn't do the "secret list" crap, so I'm happy about that.
I'm inpatient, so I have no clue how our outpatient clinics and appointments are going. I just hope the VA here and every whenever gets this crap straightened out.
A whistleblower in Atlanta has revealed that VA employees were switched from processing VA applications to those of the ObamaCare.
Scott Davis told the Atlanta Journal:
“We don’t discuss veterans. We do not work for veterans. That is something that I learned after working there. Our customer is the VA central office, the White House and the Congress. The veterans are not our priority. So whatever the initiatives are or the big ticket items, that is what we focus on.”
He later appeared on the Neil Cavuto show...
Davis: What I think happened, Neil, is that there was pressure by people in Washington for us to hit our numbers. You’ve heard a lot about the 14-day turn around time for the hospitals. But what most people don’t know is that there’s a five-day turn around time for health applications. And if we don’t hit that five-day turn around time, it affects performance goals for people in senior leadership positions.
Cavuto: So if you don’t have that, and you’re not paying that out, it looks like you’re meeting your numbers and then some, right?
Davis: Absolutely. But what also happens, Neil, is that we’re currently neglecting not only the right thing to do, which is to process applications, not delete them. We have a huge system integrity issue at VA. For example, the VA right now can’t even tell the investigators what happened to those applications, because they can’t verify where they are, what happened to them, if they were deleted, why were they deleted, and why there was no paperwork showing the justifications for those deletions.
Cavuto: We’ve asked for a statement out of the VA on this and we have yet to get one, Scott. I’m trying then to give them the benefit of the doubt here. It seems like a crazy situation. Did you or any of your co-workers ever get so overwhelmed — not you specifically — but they just say the heck with it, more files, more applications, just dump them in the trash, we’re overwhelmed. Do you think that has gone on?
Davis: I know that there was rumors that suspect those activities before I started work thing in 2011. What I can tell you is that there’s so much pressure on the employees to get stuff done so management can meet goals, it’s easy to make mistakes, it’s easy to have mishaps. What happens is, instead of the VA focusing on doing what’s right for our nation’s veterans — meaning taking time, processing each application diligently and appropriately — pressure is placed on front line employees to overwork themselves, rush through the application process, to hit goals for members of management.
Cavuto: When you say to hit goals, is the goal a dollar goal or is it get the applications complete? Sometimes keep on top of this so there are no delays, or is it keep on top of it and get rid of something that could hurt our numbers?
Davis: Well, for what I’ve witnessed, it’s based on a performance goal.
Cavuto: How is that performance measured?
Davis: That performance is measured based on our ability to turn around an application from beginning to end within a five-day turn around. There’s an acceptable percentage that we have to have, which is in excess of 80% for all applications that comes into that office. What you find is that there’s extensive pressure on the staff to process applications, to focus our attention to applications based on specific campaigns. For example, I shared with your producer that we actually put incoming applications aside so we could focus on the ACA related applications that came in over last summer. That’s wrong. We should treat each veteran equally and focus on applications, as they come in, not because of special campaigns coming out of D.C.
Jesus... Is this the face of government run health care???
A whistleblower in Atlanta has revealed that VA employees were switched from processing VA applications to those of the ObamaCare.
You know, there is a legitimate scandal going on here without the need to insert stupid bs like this. And that is why there are problems getting gak done in DC. Because when there is a legitimate problem we end up tainting it with crap like this.
His own statements don't match up with what he is saying there, and it sounds like he either doesn't understand the legitimate reasons for why some of that stuff was done or he knows he is full of crap and just milking it for his own 5 minutes of fame.
The purging is probably the only legitimate complaint in his whole story. And it's probably happening for the same reasons as the lists. People trying to meet unrealistic goals. We know what the problem is, now work on fixing it.
But Breitbart and FoxNews jumping on this as an anti-ObamaCare issue when it doesn't exist is bs. Help the fething veterans by fixing this legitimate issue and don't use them for your own political BS.
A whistleblower in Atlanta has revealed that VA employees were switched from processing VA applications to those of the ObamaCare.
You know, there is a legitimate scandal going on here without the need to insert stupid bs like this. And that is why there are problems getting gak done in DC. Because when there is a legitimate problem we end up tainting it with crap like this.
His own statements don't match up with what he is saying there, and it sounds like he either doesn't understand the legitimate reasons for why some of that stuff was done or he knows he is full of crap and just milking it for his own 5 minutes of fame.
The purging is probably the only legitimate complaint in his whole story. And it's probably happening for the same reasons as the lists. People trying to meet unrealistic goals. We know what the problem is, now work on fixing it.
But Breitbart and FoxNews jumping on this as an anti-ObamaCare issue when it doesn't exist is bs. Help the fething veterans by fixing this legitimate issue and don't use them for your own political BS.
Bret Baier moved to The Atlanta Journal-Constitution ?
Edit
I'm on my fourth attempt to enroll in VA health care
A whistleblower in Atlanta has revealed that VA employees were switched from processing VA applications to those of the ObamaCare.
You know, there is a legitimate scandal going on here without the need to insert stupid bs like this. And that is why there are problems getting gak done in DC. Because when there is a legitimate problem we end up tainting it with crap like this.
His own statements don't match up with what he is saying there, and it sounds like he either doesn't understand the legitimate reasons for why some of that stuff was done or he knows he is full of crap and just milking it for his own 5 minutes of fame.
The purging is probably the only legitimate complaint in his whole story. And it's probably happening for the same reasons as the lists. People trying to meet unrealistic goals. We know what the problem is, now work on fixing it.
But Breitbart and FoxNews jumping on this as an anti-ObamaCare issue when it doesn't exist is bs. Help the fething veterans by fixing this legitimate issue and don't use them for your own political BS.
I don't know... this is symptomatic of the same problem D...
He's going to testify tomorrow regarding people being shifted from processing VA applications last summer to working on Obamacare enrollment, with an attorny specialization whistleblowing... It deserves scrutiny.
That is not what he is testifying over. There is a good reason why the news organization that has been front and center on this story has not mentioned this guy. He is the prime example of why people don't take this gak seriously, because some people manage to take a legitimate scandal and conspiracy theory it into a laughing stock.
The VA crisis is a very legitimate problem that we need to fix. I take care of these guys daily and it pisses me off to no end that there are people in my organization that played with the lives of these guys and that some of them died because of it.
The fact that you are coming in going "guys guys, I known there is a real problem here, but this guy is saying that ObamaCare is the real problem" is just the idiotic conservative partisan circle jerk that will kill.
Use your brain for once. Be smart and stay away from whatever anti-Obama pit of idiocy you normally hang out at. Don't you dare take what is happening to these guys and use it to fuel your conspiracy theories against the guy you hate. You are an intelligent man, act like it for once.
"He was pulled from processing veterans applications to process ObamaCare applications" is the kind of headline that is just pandering to people who don't want to spend 5 seconds forming an independent thought. And that he is making the idiot-news circle with that side of the story says a lot about him.
"We lost thousands of applications" is the legitimate news here, and a giant problem, and also what he is testifying over.
The ObamaCare thing is not, because anybody able to do 5 seconds of thinking can see that it is a non-story.
"He was pulled from processing veterans applications to process ObamaCare applications" is the kind of headline that is just pandering to people who don't want to spend 5 seconds forming an independent thought. And that he is making the idiot-news circle with that side of the story says a lot about him.
"We lost thousands of applications" is the legitimate news here, and a giant problem, and also what he is testifying over.
The ObamaCare thing is not, because anybody able to do 5 seconds of thinking can see that it is a non-story.
To the first quote... Spending less than 5 seconds thinking about it tells me this: The VA is completely separate from HHS or CDC or whatever the "Obamacare" thing falls under. That said, you don't just "transfer" from the VA to another federal branch. would anyone believe me if I said, "Hey guys, I was working on this project while I was an FBI agent, but that project became gakky, so I transfered over to the CIA." ??
Don't get me wrong, the ACA and Obamacare are a complete fething nightmare for people, and that deserves attention. But Vets dying over the VA's incompetence deserves it's OWN attention, not to be lumped in with "Obama scandal of the week" tripe on the headline news programs.
"He was pulled from processing veterans applications to process ObamaCare applications" is the kind of headline that is just pandering to people who don't want to spend 5 seconds forming an independent thought. And that he is making the idiot-news circle with that side of the story says a lot about him.
"We lost thousands of applications" is the legitimate news here, and a giant problem, and also what he is testifying over.
The ObamaCare thing is not, because anybody able to do 5 seconds of thinking can see that it is a non-story.
To the first quote... Spending less than 5 seconds thinking about it tells me this: The VA is completely separate from HHS or CDC or whatever the "Obamacare" thing falls under. That said, you don't just "transfer" from the VA to another federal branch. would anyone believe me if I said, "Hey guys, I was working on this project while I was an FBI agent, but that project became gakky, so I transfered over to the CIA." ??
Don't get me wrong, the ACA and Obamacare are a complete fething nightmare for people, and that deserves attention. But Vets dying over the VA's incompetence deserves it's OWN attention, not to be lumped in with "Obama scandal of the week" tripe on the headline news programs.
That would depend on what the union contract is. I would like to see their "Statement of Work" to see how this happen. If it happen. Which seems to have had happen. If there is a clause in the Statement of Work allowing them to be pulled from the primary job to assist in priority job then its on whoever wrote the contract up fault
"He was pulled from processing veterans applications to process ObamaCare applications" is the kind of headline that is just pandering to people who don't want to spend 5 seconds forming an independent thought. And that he is making the idiot-news circle with that side of the story says a lot about him.
"We lost thousands of applications" is the legitimate news here, and a giant problem, and also what he is testifying over.
The ObamaCare thing is not, because anybody able to do 5 seconds of thinking can see that it is a non-story.
To the first quote... Spending less than 5 seconds thinking about it tells me this: The VA is completely separate from HHS or CDC or whatever the "Obamacare" thing falls under. That said, you don't just "transfer" from the VA to another federal branch. would anyone believe me if I said, "Hey guys, I was working on this project while I was an FBI agent, but that project became gakky, so I transfered over to the CIA." ??
There is a perfectly legitimate and reasonable explanation for the "they pulled me over to do ObamaCare applications" statements, you just have to actually read the crap he is saying. And if you think about it you realize that he either has an axe to grind, is incompetent, or is just looking for his 5 minutes in the spotlight.
Most likely explanation once you actually read what he is saying (which actually was "we were told to prioritize veterans applications filed due to ObamaCare" and not "we were told to ignore veterans applications all together and do ACA applications instead") and look at the actual information is this: starting this year you have to have health insurance. If you don't you pay a fine. Your VA coverage satisfies the requirement under the ACA. Lets prioritize the applications of people who don't have any other source of coverage so that veterans who are already suffering and are waiting for care and who don't have any other source of healthcare so that they don't get hit with a fine because of our slow process. People who already have other coverage (private coverage, tricare, Medicare/Medicaid) have some coverage and will not have to pay a fine so let's work on them after that.
Now we can argue if this would have been the right thing to do, or if all applications should have been "first in first out" like our whistleblower friend wanted it to be. And that is a discussion worth having. I will even agree that there is a high likelihood that this was a political move designed to prevent people from going on the news and saying: "the VA has been screwing up my application for 3 years, and now I have to pay a fine because they can't get it processed faster?"
But that is all a whole lot different than "the VA threw away applications to work on ObamaCare instead".
Don't get me wrong, the ACA and Obamacare are a complete fething nightmare for people, and that deserves attention. But Vets dying over the VA's incompetence deserves it's OWN attention, not to be lumped in with "Obama scandal of the week" tripe on the headline news programs.
But conservatives have been getting good at that. They manage to take any legitimate scandal and hit it with a dose of "this is bad, but how can we make this 'Obama hates America and will destroy us all' bad?". And then people get tired of it and turn off because the partisan witch hunt overshadows the actual problem.
I want this gak fixed. I want people fired. I want management that doesn't scream at us for wanting a better system and who tell us "tough gak" when the staffing sucks and then go home instead of helping. I want veterans to get the best they could ever have here at the VHA. And right nor people are pissed enough where it might actually happen. I don't want all that energy for reform to go away because people see this type of "this is all because of ObamaCare" bs and turn the TV off because it just becomes another partisan issue based on lies.
I want this gak fixed. I want people fired. I want management that doesn't scream at us for wanting a better system and who tell us "tough gak" when the staffing sucks and then go home instead of helping. I want veterans to get the best they could ever have here at the VHA.
Agreed... I'm now on a waiting list to be seen for my initial care, since, ya know I was medically discharged from the military, I don't need any medication or anything (to be completely honest, I'm nowhere near as bad as some folks out there, if I don't get my meds, I turn into a pissed off tin-man. I completely realize that there are Vets out there who, if they don't get their meds, they'll die)
and I agree with you, that people going onto the news like this new "whistleblower" dilute the issues at hand, which create unnecessary hurdles to getting this stuff fixed.
I do think 100% that there are some fethed up issues, and I can 100% believe that there was a political motivation to prioritizing veteran applications that would be negatively affected by the ACA rule. I want to hope that it was a "they can't afford a fine on top of everything else, let's focus on helping them first" situation, but would not be the slightest bit surprised if it was a "we can't have them bitch on the news about paying a fine for our own screw-up, process them first to shut them up" situation either.
The "we lost applications" aspect of his story is certainly something we should focus on, and DC needs to know if/how/why that happened. There is nothing worth excusing there.
I just don't want a legitimate issue becoming a political sideshow because some people hijack it for silly reasons.
President Obama on Thursday signed a $16.3 billion bill to overhaul the troubled Veterans Affairs Department, saying the country had a “sacred duty” to protect its military service members.
The bill, approved by Congress last week, would allow veterans to seek private care outside VA facilities, and would also provide money for the VA to hire more doctors and nurses. The effort came after reports that some veterans had waited months to get care from the VA.
“As a country, we have a sacred obligation to serve you as well as you served us,” Obama told an audience of military service members, veterans and their family members at Fort Belvoir in Virginia. “We are going to spend each and every day working to do right by you and your families.”
Veterans Affairs chief Robert McDonald attended the ceremony, along with House Minority Whip Steny Hoyer (D-Md.), Senate Veterans’ Affairs Committee Chairman Sen. Bernie Sanders (I-Vt.) and Rep. Michael Michaud (Maine), the top Democrat on the House Veterans' Affairs panel. Reps. Pete Gallego (D-Texas.) and Raul Ruiz (D-Calif.) were also present.
GOP Reps. Jeff Denham (Calif.) and Rep. Jackie Walorski (Ind.), who are both members of the House Veterans' Affairs panel, also attended the ceremony. House Veterans' Affairs Chairman Jeff Miller (R-Fla.), however, was not at the ceremony. He was visiting a Veterans Affairs facility in El Paso, Texas.
Waits at Veterans Affairs hospitals became a full-fledged national scandal this spring, as an inspector general report found patients seeking care from a Phoenix VA hospital had waited an average of 115 days for an initial doctor’s appointment. Official data claimed the wait time was only 24 days. The investigation also showed 1,700 veterans had been intentionally kept off official patient rolls.
Those findings led VA Secretary Eric Shinseki to resign in May.
The new law would grant the VA secretary additional powers to fire incompetent managers, something Obama noted in his comments.
“If you engage in an unethical practice, cover up a serious problem, you should be fired,” Obama said.
Obama also said the measure “will not and can not be the end of our effort.”
The new law provides $10 billion for veterans to seek medical care at non-VA providers if they live more than 40 miles from an agency facility, or if they do not get a doctor’s appointment within 30 days.
But it is unclear how long that funding will actually last and when the VA will need to go back to Congress for additional money.
In a statement, Miller said the legislation should serve as a “wakeup call” for the president.
“I sincerely hope the president views this event as more than just a photo-op or speaking engagement,” said Miller, who called on Obama to become “personally involved in solving VA’s many problems.”
During the ceremony, Obama also made his first public comments about the killing of Major Harold Greene, who was shot in Afghanistan on Tuesday. Greene is the highest-ranking military officer to die in that war.
“Our prayers are with the Greene family, as they are with all the gold star families and those who've sacrificed so much for our nation," Obama said. "Now, four months from now, our combat mission to Afghanistan will be complete."
I hope they clean house from this point forward...
This won't be a quick fix, so we must remain vigilant.
Ensis Ferrae wrote: I really have to wonder what exactly "allows veterans to seek private care outside of VA clinics" would entail...
This sort of seems a bit of a nebulous thing, like the ACA.
Without reading the actual wording in the bill (if it even clarifies it at all) I would imagine it is something like "if no appointment is available within X days the facility has to authorize and pay for care at a private physician". We do similar things for other outside services (specialized treatment, scans, patient needs to be in a hospital and the hospital is full).
My only small concern about treatment with outside physicians is our fancy computerized records. It actually does a great job at keeping track of everything that was ever done or prescribed and makes it easy to keep track of care. So outside visits would have to be scanned in and they wouldn't have access to years of history about the patient. But if that lack of access becomes a problem then they should work on a fix for that instead of using that as an excuse not to have people be seen.
E-mails: VA secretary sought changes in Phoenix report
A top Department of Veterans Affairs official and a White House appointee successfully pressed for changes in an inspector general's report on the Phoenix VA medical center.
According to newly released documents, the report was amended to add a finding that there was no conclusive evidence that delays in care resulted in veteran deaths.
In recent congressional testimony, acting VA Inspector General Richard Griffin adamantly denied that changes in the final report, which downplayed links between delayed care and up to 40 veteran deaths, had been "dictated" by VA headquarters.
But e-mails released Friday by the House Committee on Veterans' Affairs show that Sloan Gibson, who had been acting VA secretary, personally corresponded with Griffin in early August, asking him to amend the report.
Specifically, Gibson asked the inspector general to add findings about a Phoenix whistle-blower's claim that up to 40 veterans died awaiting care.
E-mails show White House deputy chief of staff Rob Nabors, appointed by President Barack Obama this summer to monitor the VA scandal, also urged the change. The e-mails also asked the OIG to share its planned "message" to the media about veterans' deaths.
Once the report was revised to include new language, records show,Assistant Inspector General John Daigh sent an e-mail to a VA administrator, asking, "Was the message on the deaths well received by leadership?"
Later, Gibson sent a note to Griffin, whom he addressed as "Griff."
"Thanks on all counts!" for changes in the Phoenix report, he wrote. "I appreciate the focus on the 40 deaths ..."
Robert McDonald was confirmed as the new VA secretary in July; Gibson returned to his post as deputy secretary.
On Friday, VA officials released a statement saying the agency had no role in deciding what would be in the final report.
"VA does not and cannot dictate the final content of any reports to the independent entity that authors them," the statement said.
Rep. Jeff Miller, R-Fla., chairman of the House committee, sent a letter to the president this week asking Obama to expeditiously replace Griffin with a permanent inspector general. The position has been vacant since George Opfer retired Dec. 31.
"In the midst of the largest and most damaging scandal in VA's history," Miller wrote, "it is vitally important that VA Office of Inspector General have an independent and objective leader in place to combat waste, fraud and abuse."
In a separate letter to Griffin, Miller asked that his oversight committee be provided all drafts and other versions of investigations in the future.
OIG spokeswoman Joanne Moffett said correspondence about the Phoenix report does not reflect "dubious motives" or indicate Gibson was trying to improperly influence the OIG.
Instead, she said, it shows he was trying to ensure a thorough report. Moffett noted that inspector-general probes over the past decade repeatedly exposed scheduling fraud, yet VA administrators failed to correct the problem.
As an agency leader, Gibson moved "to address wait-time issues once and for all," she said.
The language with regard to 40 deaths was inserted because media had widely reported on alleged fatalities, she said, and the topic needed to be addressed publicly. It was "not at the request of VA," she added, but based on internal deliberations among OIG staffers.
With regard to Miller's letters, Moffett said VA officials could not respond because they had not seen them Friday.
The Aug. 26 OIG report confirmed that Phoenix VA Health Care System systematically falsified appointment records and provided untimely care to thousands of patients, some of whom suffered adverse affects.
With regard to allegations that 40 veterans had died, however, the report said inspectors "were unable to conclusively assert that the absence of timely quality care caused the deaths of these veterans."
In subsequent press interviews, Gibson recited that phrase as a vindication for the VA; some media reported that the finding debunked allegations by the Phoenix whistle-blower, Dr. Sam Foote.
Foote never asserted that patients had died "because" of untimely treatment. He said they died while awaiting care in a dishonest system, and he asked the inspector general to investigate a potential linkage.
No previous OIG report has ever listed untimely care as the cause of a death, and medical experts say that would be an impossibility: Death is caused by a disease or injury, and delayed care could only be a contributing factor.
Foote testified that the OIG finding was a "whitewash" and a retaliatory smear that would discourage other potential whistle-blowers. Members of Congress also expressed skepticism about the finding, and grilled VA officials during hearings.
In testimony before the House Committee on Veterans' Affairs, Griffin repeatedly was asked if his office was pressed to revise the Phoenix report by VA headquarters. He acknowledged some "minor things" were changed as a result of consultation, but insisted no revisions were "dictated" by VA administrators.
I know I ramble on about F&F, ghazi and the IRS ordea... but, this?
Heads need to fething roll for this. It's an absolute disgrace.
thing is a PR political thing to them...