The Star Beacon; Ashtabula, Ohio

World, nation, state

June 1, 2014

Warnings on ‘gaming’ patient waits go back years

WASHINGTON — The report this week confirming that 1,700 veterans were “at risk of being lost or forgotten” at a Phoenix hospital was hardly the first independent review that documented long wait times for some patients seeking health care from the Department of Veterans Affairs and inaccurate records that understated the depth of the problem.

Eleven years ago, a task force established by President George W. Bush determined that at least 236,000 veterans were waiting six months or more for a first appointment or an initial follow-up. The task force warned that more veterans were expected to enter the system and that the delays threatened the quality of care the VA provided.

Two years ago, a former hospital administrator told senators during an oversight hearing that VA hospitals were “gaming the system” and manipulating records to make it appear that wait time standards, the criteria for awarding manager and executive bonuses, were being met.

Since 2005, the department’s inspector general has issued 19 reports on how long veterans have to wait before getting appointments and treatment at VA medical facilities, concluding that for many, sufficient controls don’t exist to ensure that those needing care get it.

For example, in October 2007, the VA inspector general told the Senate Committee on Aging that “schedulers at some facilities were interpreting the guidance from their managers to reduce waiting times as instruction to never put patients on the electronic waiting list. This seems to have resulted in some ‘gaming’ of the scheduling process.”

That’s virtually identical to language in a 2010 VA memorandum, and again in the latest inspector general’s report this week that led dozens of members of Congress to call for VA Secretary Eric Shinseki to resign. He abided by those wishes Friday, telling Obama that he had become a distraction as the administration tried to address the VA’s troubles.

The series of reports over the years also raises questions about whether Congress should have done more to solve the problems that have so grabbed the nation’s attention in recent weeks.

“Anyone in Congress who thinks they’ve done enough for the VA is simply deluding themselves,” Democratic Sen. Jay Rockefeller of West Virginia said in response to Shinseki’s resignation. “Year after year, when members of Congress have had the opportunity to provide legitimate funding increases for the VA, they’ve done just enough to skirt by.”

Pointing to the Bush task force report from 2003, Joseph Violante, legislative director for Disabled American Veterans, said the problem of access to health care has been known for a decade.

“In our mind, a lot of the problem that is taking place on the health care side is due to a lack of sufficient funding, and that’s Congress’s jurisdiction. We think they’ve fallen short over the years,” Violante said.

Rep. Jeff Miller, the chairman of the House Committee on Veterans Affairs, said money is not the problem at the VA. He notes that the president has traveled the country touting the spending increases that have occurred in VA’s budget during his presidency.

Spending for VA medical care has nearly doubled in less than a decade, from $28.8 billion in 2006 to $56 billion last year.

“They can’t even spend the money that we appropriated to them. If money could have solved this problem, it would have been solved a long time ago,” Miller said. “It is manipulation and mismanagement that has created the crisis that exists today.”

Miller, who became chairman of the House Committee on Veterans Affairs in 2011, makes the case that the investigations that have been undertaken by the VA’s inspector general and the Government Accountability Office were generally conducted at the request of members of Congress. When he has sought to follow up about whether the VA was meeting investigators’ recommendations, Miller said he has been stonewalled.

The committee has had an acrimonious relationship with VA leadership and even developed a section on its website called “Trials in Transparency” that list some of the more than 100 requests for information made by the committee that it says are still outstanding.

The problems in Phoenix, Miller said, came to light because of his committee’s work with a whistleblower that VA would not pay attention to, Dr. Samuel Foote, who retired after spending nearly 25 years with the department.

Foote said up to 40 veterans may have died while awaiting treatment at the Phoenix hospital and that staff, at the instruction of administrators, kept a secret list of patients waiting for appointments to hide delays in care. He believes administrators kept the off-the-books list to impress their bosses and get bonuses. The IG said that while its work was not complete, it had substantiated significant delays in access that negatively impacted the quality of care at the Phoenix hospital. The IG has not substantiated whether any veterans in Phoenix died due to a delay in treatment.

But it’s clear that media reports citing a specific number of 40 veteran deaths gave a human element to the story that triggered greater urgency from the public, veterans groups and lawmakers. In a matter of weeks the American Legion went from being a strong supporter of Shinseki to asking for his resignation.

“For some reason, something triggered the media’s appetite for this story when we’ve been asking VA to participate and give us information. I don’t know if it was the number of 40 veterans,” Miller said.

As he gave his final speech as VA secretary, Shinseki acknowledged that he once viewed the department’s problems concerning wait times as limited.

“I no longer believe it. It is systemic. I was too trusting of some, and I accepted, as accurate, reports that I now know to have been misleading with regard to patient wait times,” he said.

 

1
Text Only
World, nation, state
  • GROUNDED U.S., other countries ban flights to and from Israel

    A Hamas rocket exploded Tuesday near Israel’s main airport, prompting a ban on all flights from the U.S. and many from Europe and Canada as aviation authorities responded to the shock of seeing a civilian jetliner shot down over Ukraine.

    July 23, 2014

  • REPORT: Retaliation by supervisors common at VA

    A pharmacy supervisor at the VA was placed on leave after complaining about errors and delays in delivering medications to patients at a hospital in Palo Alto, California. In Pennsylvania, a doctor was removed from clinical work after complaining that on-call doctors were refusing to go to a VA hospital in Wilkes-Barre.

    July 22, 2014

  • Veteran's Ducks Iraq vet cited for owning 14 therapeutic pet ducks

    An Army veteran who hurt his back during the Iraq War is worried a citation will result in him losing his 14 pet ducks, which he says are therapeutic.

    July 21, 2014 1 Photo

  • Stacked Apartment.jpg New York building shows how mod design stacks up as cool

    In a city piled high with ambitious architecture, a seven-floor structure off the beaten path boasts a distinction of its own: It’s billed as the first multistory, modular-built apartment building to open in the nation’s apartment capital.

    July 21, 2014 1 Photo

  • Scores dead in first major ground battle in Gaza

    The first major ground battle in two weeks of Israel-Hamas fighting exacted a steep price Sunday: It killed 65 Palestinians and 13 Israeli soldiers and forced thousands of terrified Palestinian civilians to flee their neighborhood, reportedly used to launch rockets at Israel and now devastated by the fighting.

    July 21, 2014

  • Traditional lottery games hold their own

    Ohio’s traditional lottery games are mostly doing well despite competition from their electronic counterparts at four racinos.

    July 20, 2014

  • HIV diagnosis rate fell by third in U.S. over decade

    The rate of HIV infections diagnosed in the United States each year fell by one-third over the past decade, a government study finds. Experts celebrated it as hopeful news that the AIDS epidemic may be slowing in the U.S.

    July 20, 2014

  • Suddenly, the sun is eerily quiet: Where did the sunspots go?

    The sun has gone quiet. Almost too quiet.

    July 20, 2014

  • Monitors try to secure Ukraine plane crash site

    International monitors moved gingerly Saturday through fields reeking of the decomposing corpses that fell from a Malaysian airliner shot down over rebel-held eastern Ukraine, trying to secure the sprawling site in hopes that a credible investigation can be conducted.

    July 19, 2014

  • Israeli bulldozers destroy Hamas tunnels in Gaza

     Israeli bulldozers on Saturday demolished more than a dozen tunnels the military said were being used by Hamas gunmen to sneak beneath the southern border of the Jewish state and carry out attacks on its soldiers and civilians.

    July 19, 2014

House Ads
Parade
Magazine

Click HERE to read all your Parade favorites including Hollywood Wire, Celebrity interviews and photo galleries, Food recipes and cooking tips, Games and lots more.
AP Video