Veterans Affairs' secret waiting lists

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According to reports by CNN in 2014, veterans hospitals across the country were delaying care of veteran patients, at times to the point that some veterans conditions deteriorated vastly or died due to the wait times. To cover for the long delays, some hospitals resorted to "secret lists" for patients awaiting care in order to keep their official wait times down.[1] President Barack Obama launched a probe into the extent of the problem. He named Deputy White House Chief of Staff Rob Nabors to lead the probe on May 15, 2014.[2] Following repeated calls for his resignation, U.S. Secretary of Veterans Affairs Eric Shinseki stepped down on May 30, 2014.[3]

CNN reports

The following reports were released by CNN:[1]

  • US-DeptOfVeteransAffairs-Seal.jpg
    On November 20, 2013, it was reported that at Williams Jennings Bryan Dorn Veterans Medical Center in Columbia, South Carolina, patients were not receiving routine gastrointestinal procedures until up to a year after requesting an appointment, at times even longer. A review of 280 gastrointestinal patients showed that 52 of the patients showed complications due to the delay in care and early detection. The VA confirmed six deaths resulted from delayed care at the hospital, but CNN's sources suggested the number could have been as high as 20.[4]
The Dorn hospital also received an addition $1 million in federal funding in 2011 in order to treat the patients on long waiting lists. However, according to documents, only one-third of the federal funds went to the intended destination.[4]
  • The Charlie Norwood VA Medical Center in Augusta, Georgia, experienced the deaths of three patients due to long delays in treatment and had a waiting list of over 4,500 patients.[4]
  • Between 2010 and 2011, VA internal documents indicated 82 veterans died or were dying in part due to delayed care from VA hospitals in the United States.[5]
  • In the Phoenix Veterans Affairs Health Care system in Phoenix, Arizona, at least 40 veterans died waiting for care. The VA system in Phoenix used a secret waiting list. The secret list was used as a placeholder for patients whose care would be delayed for months. VA guidelines require care be given in a timely manner, usually within three weeks, but the Phoenix system used the secret list to hold names between the times appointments were made until the appointment could be made within the required VA timeline.[1]

Whistleblower

The whistleblower in the Phoenix system, Dr. Sam Foote, explained that as more veterans enrolled in the system, the stress on medical professionals grew. As the doctors and other professionals felt more stress, many began to leave the VA, leaving fewer people to care for the growing number of veterans. He noted that as the stress mounted on a fewer number of practitioners, medical mistakes became more common.[6]

Foote saw bonuses and promotions being awarded to the administrators for their reports on improved wait times, but he also heard about appointment schedulers being told that the patients they were calling for had already died. Foote lodged complaints with the VA's office of the inspector general, but he then started to get increased hours and more patients. He then contacted the media with his story and the reports eventually found their way to Rep. Jeff Miller (R-FL) and the federal investigation began.[6]

Further investigations

Members of the House Veterans Affairs Committee began investigating the VA hospital delays in November 2013.[4] In April 2014, Rep. Jeff Miller (R-FL) ordered all records be preserved and intended to make the issue a congressional investigation.[1]


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The VA hospitals in Nashville and Murfreesboro, Tennessee, had 4,752 new patients go through their facilities during a six month period ending March 31, 2014. Of those, only 29.6 percent saw treatment in the 14-day window goal set by the Veterans Affairs Department, representing the lowest score nationwide excluding those with the secret lists. The facilities with the highest percentage of new patients seen were located in Clarksburg, West Virginia, where 93.7 percent were seen in the 14-day window.[7]

A VA internal report showed that staff at nearly two-thirds of the nation's 216 facilities were instructed to falsify wait time information on reports. In an editorial in Time, Rep. Jeff Miller, chair of the House Veterans Affairs Committee, stated, "Any VA administrator who ordered subordinates to purposely manipulate appointment data should be fired immediately."[8]

The Robert J. Dole Medical Center in Wichita, Kansas, had a waiting list of 385, of which 20 were in danger of not receiving adequate, timely care for medical problems.[9]

Pittsburgh, Pennsylvania, VA Director and CEO Terry Gerigk Wolf was placed on administrative leave on June 13, 2014. The Pittsburgh VA system had a waiting list called the New Enrollee Appointment Request (NEAR) list with over 700 names, some of which were waiting more than a year for their first appointment. Wolf insisted that she had been told by other regional VA officials not to notify the congressional delegation about the list.[10]

Sen. Coburn findings

Sen. Tom Coburn (R-OK) released a report on June 24, 2014, that covered 10 years of VA medical care and facility operations. The initial findings of the investigation included an estimate of over 1,000 patients dying due to lack of adequate care, unnecessary and abused prescriptions and long waiting lines. The report also estimated about $845 million worth of payouts in malpractice suits. Some findings highlighted by Politico include:[11]

  • a noose being placed on a minority employee's desk with management taking no action to resolve the racial tensions,
  • a doctor in Kansas was forced to register as a sex offender after giving five of his female patients unnecessary breast and pelvic exams,
  • an Oregon social worker was placed on administrative leave after having an affair with a patient,
  • the average primary care doctor sees 2,400 patients a year while VA doctors were only seeing 1,200 per year and
  • families in 167 different claims against the VA included delayed care in the description, resulting in $36 million in payouts.

Hospital official bonuses

Despite the delays in care in facilities across the United States, many hospital and regional directors received bonuses worth between $7,500 to $80,000.[12]

Calls for Shinseki resignation

Former VA Secretary Eric Shinseki
On May 5, 2014, the American Legion, the largest veteran organization in the U.S., and Concerned Veterans for America called for the resignation of Secretary Shinseki.[13] American Legion's director stated, "At least let us know that the problems exist and they have a plan to take care of it," when asked about the lack of communication from the VA. Shinseki responded to the calls for resignation, saying, "I serve at the pleasure of the president. I signed on to make some changes, I have work to do."[14]

Shinseki resignation

President Obama accepted Shinseki's resignation on May 30, 2014.[3] Sloan Gibson, who was confirmed in February 2014 to be Shinseki's deputy secretary, was named acting secretary of veterans affairs until a replacement could be nominated and confirmed.[15]

Other resignations

The VA's undersecretary for health, Dr. Robert Petzel, resigned on May 16, 2014, though he had already announced his retirement in September 2013 and his replacement was named on May 1, 2014.[16]

Actions taken

Congressional investigations


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Background
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The director and two other high-ranking officials in the Phoenix VA system were placed on administrative leave on May 1, 2014, with their replacements being appointed on May 10. Former director Sharon Helman was replaced by interim director Steve Young who was charged with oversight of the 85,000 veterans and $500 million budget while the investigation was underway.[17]

Shinseki testified before the Senate Veterans Affairs Committee on May 15, 2014, stating, "I’m committed to take all actions necessary to identify exactly what the issues are, to fix them and to strengthen veterans’ trust in VA health care. If any allegations are substantiated by the inspector general, we will act." Sen. Richard Burr (R-NC) questioned the leadership ability of the secretary and others in the department, claiming, "VA senior leadership, including the secretary, should have been aware that VA was facing a national scheduling crisis. VA leadership either failed to connect the dots or failed to address this ongoing crisis, which has resulted in patient harm and patient deaths."[2]

White House probe

Prior to the hearing, President Obama announced that Deputy White House Chief of Staff Rob Nabors would lead a review of the VA's scheduling process and patient safety rules.[2] Two organizations, Iraq and Afghanistan Veterans of America (IAVA) and the Project on Government Oversight (POGO), also launched a whistle-blower website for those who were affected by the controversial secret waiting lists. The head of POGO stated, "Whistle-blowers shouldn’t have to go it alone. We can help whistle-blowers hold the VA accountable, and keep the focus on solutions rather than attempts to hunt down those who voiced concerns."[18]

Proposed legislation

Veterans Choice Card

Sen. Bernie Sanders (I-VT) and Rep. Jeff Miller (R-FL) came to terms on a piece of proposed legislation that would provide relief to eligible veterans following the waiting list scandal on July 28, 2014. A similar bill passed the Senate in June 2014, but its success in the House would largely hinge on the costs involved. The legislation proposed providing veterans with a "Veterans Choice Card," allowing them to receive treatment from doctors outside of the VA system. It also proposed changing the ratings system of VA employees from quantitative (wait times) to the quality of the care received. Other stipulations in the bill included:[19]

  • $5 billion spending increase to pay for additional staff and doctors,
  • requiring the VA to lease 27 new facilities with the intent of opening new care centers,
  • the expansion of a scholarship program benefiting the spouses of soldiers who have died in conflict since September 11, 2001,
  • providing counseling to those who suffered from sexual trauma while in the military and
  • requiring regular audits of VA care and staffing levels.

On July 30, 2014, the legislation proposed by Sanders and Miller passed the House by a vote of 420-5, passing it on for the Senate to debate. According to Miller, "The Department of Veterans Affairs is in the midst of an unprecedented crisis caused by corruption, mismanagement and a lack of accountability across the board. This is an honest solution to an urgent problem. One that is focused on making government more accountable and providing veterans with real choice in their health care decisions." Sanders did not see any reason for the bill to be delayed by Senate, stating, "My expectation is that the Senate will do the same thing as soon as tomorrow. The veterans of this country are entitled to quality and timely health care. This legislation will take us a long way toward making good on that promise."[20]

The bill passed through the Senate on July 31, 2014, the day before the Senate was scheduled for August recess. The vote passed by a measure of 91-3, with the three voting in opposition being Sens. Bob Corker (R-TN), Tom Coburn (R-OK) and Jeff Sessions (R-GA). The bill's co-sponsor, Rep. Miller, stated on its passage, "We are now just one signature away from making government more accountable and providing veterans with real choice in their health care decisions. I am confident the president will do the right thing and sign this bill into law." Sen. Corker claimed the legislation did not completely address the issues with the VA and that it was a rushed piece of legislation, defending his opposition vote by claiming, "It’s embarrassing that Congress not only refuses to face today’s decisions with the courage our men and women in uniform have demonstrated for decades, but rushed through a piece of legislation without thoroughly reviewing its full fiscal impact on future generations and without knowing if it will address the systemic problems that exist at the VA."[21]

On August 7, 2014, President Barack Obama signed H. R. 3230, the "Veterans' Access to Care through Choice, Accountability and Transparency Act of 2014," at Fort Belvoir, an army base in Virginia.[22] The plan will put aside $16.3 billion to pay for private physicians for veterans on waiting lists and to hire more health providers at VA hospitals and clinics.[23]

Obama's executive orders

On August 26, 2014, President Obama announced 19 new executive orders aimed at improving the functionality of Veterans Affairs hospitals across the country in addition to providing other benefits for veterans. The executive orders enacted programs in the following areas.[24]

  • Access to quality healthcare - improved efficiency, accountability and transparency
  • Mental health initiatives for veterans
  • Mortgage interest rate reductions
  • Student debt relief
  • Improvements on the GI Bill
  • Job placement programs
  • Combating veteran homelessness
  • Increased funding to the U.S. Department of Veterans Affairs
  • Working through the disability claims backlog

Prior claims against the VA

A report by the Dayton Daily News examined VA records going back to 2001 and revealed that the department paid $34.7 million in 167 claims containing "delay in treatment" in their descriptions. The report stated that it was unclear how many of them met the department's "delayed care" description, but stated that the number of veterans who died due to problems at VA facilities could be as high as 1,100 from 2001 through the first half of 2013.[25]

Recent news

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See also

External links

References

  1. 1.0 1.1 1.2 1.3 CNN, "A fatal wait: Veterans languish and die on a VA hospital's secret list," April 24, 2014
  2. 2.0 2.1 2.2 Politico, "Eric Shinseki ‘mad as hell’ over VA scandal," May 15, 2014
  3. 3.0 3.1 Politico, "President Barack Obama accepts Eric Shinseki’s resignation," May 30, 2014
  4. 4.0 4.1 4.2 4.3 CNN, "Hospital delays are killing America's war veterans," November 20, 2013
  5. CNN, "Veterans dying because of health care delays," January 30, 2014
  6. 6.0 6.1 AZ Central, "The doctor who launched the VA scandal," June 3, 2014
  7. Tennessean, "Wait times at Midstate VA hospitals longest in nation," June 3, 2014
  8. Time, "Why Veterans Affairs Can’t Root Out Its Corruption," June 2, 2014
  9. The Wichita Eagle, "20 patients put at risk by Wichita VA secret waiting list," June 6, 2014
  10. CNN, "Congressmen charge VA told local VA hospital to stymie their search for information," June 13, 2014
  11. Politico, "Tom Coburn report details VA problems," June 24, 2014
  12. House Committee on Veterans Affairs, "VA Accountability," accessed April 28, 2014
  13. CNN, "Two key veterans groups call for VA chief Eric Shinseki to resign," May 5, 2014
  14. Wall Street Journal, "Veterans Affairs Secretary Eric Shinseki Says He Won't Resign," May 6, 2014
  15. New York Times, "V.A.’s Acting Chief: West Point Graduate and Ex-Leader of U.S.O.," May 30, 2014
  16. NPR, "Top VA Health Official Resigns Amid Scandal Over Treatment Delays," May 16, 2014
  17. Huffington Post, "Changes Are Coming To The Embattled Veterans Affairs Health Care System," May 10, 2014
  18. Fox News, "Whistle-blower website launched to expose VA wrongdoing," May 19, 2014
  19. The Washington Post, "House, Senate negotiators reach deal on veterans bill," July 27, 2014
  20. Politico, "House approves VA reform bill," July 30, 2014
  21. The Hill, "Senate passes VA overhaul in 91-3 vote," July 31, 2014
  22. USA Today, "Obama's day: The VA bill," accessed August 7, 2014
  23. Huffington Post, "Obama To Sign $16.3 Billion Veterans Affairs Spending Bill," accessed August 7, 2014
  24. The White House, "FACT SHEET: President Obama Announces New Executive Actions to Fulfill our Promises to Service Members, Veterans, and Their Families," August 26, 2014
  25. Dayton Daily News, "‘Delay in treatment’ a factor in more than 100 deaths at VA centers," May 17, 2014