Review: VA has 'nationwide' problem

Washington - An independent review of Veterans Administration health centers has determined that government officials falsified records to hide the amount of time former service members have had to wait for medical appointments, calling a crisis that arose in one hospital in Phoenix a "systemic problem nationwide."

The inspector general's report, a 35-page interim document, prompted new calls for VA Secretary Eric Shinseki, a former general and Vietnam veteran, to resign a post he's held since the start of the Obama administration. Those calls from lawmakers included members of Obama's own party, complicating what is already a political challenge for a president who has made veterans issues a legacy-defining priority after a decade of war.

The report found that 1,700 veterans using a Phoenix VA hospital were kept on unofficial wait lists, a practice that helped officials avoid criticism for failing to accommodate former service members in the appropriate amount of time.

A review of 226 veterans seeking appointments at the hospital in 2013 found that 84 percent had to wait more than two weeks to be seen. But officials at the hospital had reported that fewer than half were forced to wait that long, a false account that was then used to help determine eligibility for employee awards and pay raises.

The agency has made it a goal to schedule appointments for veterans seeking medical care within 30 days. But the interim IG report found that in the 226-case sample the average wait for a veteran seeking a first appointment was 115 days, a period officials allegedly tried to hide by placing veterans on "secret lists" until an appointment could be found in the appropriate time frame.

"We are finding that inappropriate scheduling practices are a systemic problem nationwide," the report states. "We have identified multiple types of scheduling practices not in compliance with VHA policy."

The report helps clarify allegations that have swirled around the VA for weeks. White House officials said Obama had been briefed on its findings and found them "extremely troubling."

Reaction among members of Congress was sharper. Several prominent Republicans immediately called for Shinseki's resignation. Among them: Sen. John McCain, R-Ariz., a leading GOP voice on military and foreign affairs; Rep. Jeff Miller, R-Fla., who heads the House Veterans Affairs committee; and Rep. Howard "Buck" McKeon, R-Calif., who leads the House Armed Services Committee.

"Shinseki is a good man who has served his country honorably, but he has failed to get VA's health care system in order despite repeated and frequent warnings from Congress, the Government Accountability Office and the IG," Miller said.

"What's worse, to this day, Shinseki - in both word and deed - appears completely oblivious to the severity of the health-care challenges facing the department."

The American Legion is the only veterans group calling on Shinseki to resign, and others say they are closely monitoring the probe. The Iraq and Afghanistan Veterans of America blasted the administration over the report.

"Today's report makes it painfully clear that the VA does not always have our veterans' backs," IAVA said.

Shinseki expressed outrage at the findings and noted that he launched a new initiative last week to expand capacity at VA clinics and allow more veterans to obtain health care at private health centers.

"I have reviewed the interim report, and the findings are reprehensible to me, to this Department, and to Veterans," Shinseki said in a statement. "I am directing that the Phoenix VA Health Care System (VAHCS) immediately triage each of the 1,700 Veterans identified by the OIG to bring them timely care."

Miller joins a growing list of lawmakers who are asking the Justice Department to launch a formal criminal investigation.

McCain, who is among those on that list, said in a statement, "It is alarming that Secretary Shinseki either wasn't aware of these systemic problems, or wasn't forthcoming in his communications with Congress about them. Either way, it is clear to me that new leadership is needed at the VA."

While several top congressional leaders have said Shinseki should remain in office to help address the sprawling department's problems, a series of Democratic legislators also joined the calls for Shinseki's resignation.

On Wednesday afternoon, Sen. Mark Udall, D-Colo., became the first sitting Democratic senator to call for the resignation. He was soon joined by Sen. John Walsh, D-Mont., Sen. Kay Hagen, D-N.C., Rep. Scott Peters, D-Calif., Rep. Bruce Braley, D-Iowa, Rep. Ron Barber, D-Ariz., and Rep. Tim Ryan, D-Ohio.

At a news conference last week, Obama defended Shinseki but said that it is "a disgrace" if the allegations that dozens of veterans died because of the use of improper scheduling practices are true.

On Wednesday,White House aides stressed that the president believes the issue of improper scheduling must be handled immediately and aggressively, stopping short of defending Shinseki.

"The president found the findings extremely troubling," said White House spokesman Jay Carney. "The secretary has said that VA will fully and aggressively implement the recommendations of the IG. The president agrees with that action and reaffirms that the VA needs to do more to improve veterans' access to care. Our nation's veterans have served our country with honor and courage and they deserve to know they will have the care and support they deserve."

Sen. Bernie Sanders, I-Vt., who leads the Senate Veterans Affairs Committee, called the inspector general's findings "unacceptable" but didn't call for Shinseki to step down. Instead, he urged Shinseki to immediately implement the inspector general's recommendations and review whether the department's goal of seeing patients within 14 days of a request is realistic.

The report did not say definitively whether the extended waits caused veteran deaths.

The inspector general's office did say that "significant delays in access to care negatively impacted the quality of care" at the Phoenix clinic.

The report notes that use of improper scheduling practices is not new among VA facilities and that, since 2005, the inspector general has issued 18 reports identifying scheduling problems, resulting in lengthy wait times and the negative impact on patient care.

In addition to health care delays, the VA has had a long-standing backlog of disability claims, but the department has cut the inventory by more than 44 percent since it reached a high of more than 600,000 cases last year.

The inspector general's office is continuing its review of VA health clinics nationwide. Its report Wednesday noted that the probe includes deploying "rapid response teams" that make unannounced visits to VA medical facilities to address the allegations of inappropriate scheduling practices as well as long-standing ones.

In 2010, a top VA official issued a memo to all of the agency's medical centers listing 17 schemes they were known to be using and warning that the practices would "not be tolerated."


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