VA Audit: Wait Times Exceed Three Months for More Than 57K Vets
More than 57,000 veterans have been waiting for medical appointments at Veterans Affairs medical centers throughout the country for longer than three months, according to a federal audit of the centers released yesterday, the New York Times reports.
According to the Times, the audit -- which involved 731 VA medical facilities -- for the first time provided information on the scope of a growing scandal surrounding reports of delayed care and subsequent cover-ups.
The audit found that nearly 64,000 additional veterans have been enrolled in the VA health system for longer than a decade but have not yet seen physicians despite requests for appointments (Oppel, New York Times, 6/9). Meanwhile, nearly 43,000 appointments had been scheduled for more than 90 days in the future as of mid-May, Reuters reports (Lawder/Stephenson, Reuters, 6/9).
The audit also showed wide variations in wait times at VA centers across the country. For example, patients waited an average of 17 days for appointments at a VA center in Bedford, Mass., compared with 81 days at a center in Baltimore (Jaffe/Hicks, Washington Post, 6/9).
Further, the audit concluded that at least one instance of data manipulation regarding patient wait times occurred in about 76% of VA hospitals and clinics. In addition, 13% of appointment schedulers said they had been instructed by superiors to falsify wait-time data.
In addition, the audit confirmed claims that a VA goal of scheduling patients for appointments within 14 days created incentive for administrators to manipulate data to ensure long wait times would not reflect poorly on their job performance. According to VA, such measures will no longer be included in employees' performance reviews.
In addition, the audit highlighted claims that a provider shortage has led VA clinics to struggle with increased demands for care.
According to the audit, in interviews with more than 3,700 administrative and clinical VA staff members, the employees cited the shortage as the biggest impediment to timely care. It noted that VA's 14-day scheduling goal "was not attainable given growing demand for services and lack of planning for resource requirements" (New York Times, 6/9).
Senate Veterans' Affairs Committee Chair Bernie Sanders (I-Vt.) said there is "no question there are parts of the country that we don't have the doctors and nurses that we need," but added that he "would not be surprised that" the VA could likely "do a lot better" at allocating its resources (Washington Post, 6/9).
House Veterans' Affairs Committee Chair Jeff Miller (R-Fla.) said the audit's findings show that "corruption is ingrained in many parts of the VA health care system" (New York Times, 6/9).
House Speaker John Boehner (R-Ohio) said the findings are "a national disgrace," adding that the House this week would consider a measure to allow veterans to seek care at private centers if their wait to see VA physicians would be longer than 30 days (Reuters, 6/9).
White House press secretary Josh Earnest said that the findings highlight President Obama's commitment to solving the issues while providing "a look at exactly what the scope of this problem is."
Acting VA Secretary Sloan Gibson said the audit "shows the extent of the system problems we face ... problems that demand immediate action" (Washington Post, 6/9).
According to Reuters, VA said it is working to contact all veterans who are waiting for care (Reuters, 6/9).
Following the audit's release, Gibson pledged to spend $300 million to increase VA medical employees' hours and to contract with private care centers to allow veterans to seek care outside the VA health system. In addition, he said he would institute new patient satisfaction surveys and VA centers and eliminate the 14-day scheduling goal.
However, VA officials said they still are working to determine how much money and how many new providers VA will need to address the issues (Washington Post, 6/9).
Meanwhile, acting VA Inspector General Richard Griffin announced an immediate hiring freeze for senior VA officials, saying that the department will "trigger administrative procedures" against those who oversee facilities that have been found to have manipulated wait time data.
Further, Gibson said the VA inspector general would conduct an external audit of the agency's scheduling practices (Kesling, Wall Street Journal, 6/9).
Monday House Hearing
Just hours after the audit's release on Monday, the House Veterans Affairs Committee heard testimony from the VA Office of Inspector General, VA officials and the Government Accountability Office, the Washington Post's "Federal Eye" reports.
According to "Federal Eye," the hearing mostly focused on several reports that warned of the inappropriate scheduling practices prior to reports of the national scandal.
Specifically, testimony touched on:
- Leadership problems within the VA, including reports that superiors had ordered employees to falsify documents and the department's "cover-up culture";
- The possibility of criminal investigations, which several lawmakers have called for;
- Protecting whistleblowers who shed light on the inappropriate practices;
- Persistent IT issues at VA, including outdated scheduling technology; and
- Whether to allow veterans to seek care outside of the VA health system (Hicks, "Federal Eye," Washington Post, 6/10).
In addition, witnesses at the hearing cited provider shortages and a need to change the department's culture to address the issues (Fuller, "218," Roll Call, 6/9).
House Passes Accountability Bill
In related news, the House on Monday approved legislation that would hold VA officials accountable for following the recommendations of investigations, the Washington Post's "Federal Eye" reports.
Under the bill, VA's OIG would track VA management's response to allegations raising public health or patient safety issues. If OIG determines that recommendations that result from such investigations are not being implemented on schedule, the office would notify the VA secretary, who would then identify the responsible managers. The names would not be released to the public.
The managers would then receive a "counseling and a mitigation plan to resolve the issue." In addition, the employees' performance reviews would reflect their compliance with the plans. The employees would also be ineligible for bonuses or performance rewards until the issues are solved (Yoder, "Federal Eye," Washington Post, 6/9).
The bill would also require OIG to notify Congress of the issues (Marcos, "Floor Action," The Hill, 6/9).
Reid Promises Quick Vote on Bipartisan VA Bill
Meanwhile, Senate Majority Leader Harry Reid (D-Nev.) said on the Senate floor on Monday that he is "happy to schedule a vote ... as quickly as possible" on a bipartisan bill aimed at addressing the VA issues, The Hill's "Floor Action" reports (Cox, "Floor Action," The Hill, 6/9).
The bipartisan measure was developed by Sanders and Sen. John McCain (R-Ariz.). The bill would expand health care options for veterans and give the secretary of the Department of Veterans Affairs greater authority to fire low-performing employees (California Healthline, 6/6).
VA Watchdog Group Will Not Comply With OIG Subpoena
Also in related news, the Project on Government Oversight, a watchdog group that has been monitoring the issues with VA wait times, said Monday that it would not comply with a subpoena from the VA's OIG requesting its correspondence with current and former VA staff, the Washington Times reports.
According to the Times, the group received the subpoena weeks after it launched as confidential tip line for VA whistleblowers. Around 700 people have given information about VA to POGO.
POGO Executive Director Danielle Brian said in a statement that the group would not release the records and that the subpoena infringes on the group's constitutional rights. She added that the group's "mission ... would be severely damaged if we violated the trust of our sources."
According to the Times, VA OIG's office declined to comment on the subpoena and POGO's refusal to comply (McElhatton, Washington Times, 6/9).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.