Tran­si­tion team told about three au­dits

In­spec­tor frus­trated with ef­forts to fix wait times

The Washington Times Weekly - - Politics - BY JIM MCELHATTON

Pres­i­dent Obama’s tran­si­tion team was warned in 2008 that re­peated au­dits showed the Vet­er­ans Af­fairs Depart­ment was mis­re­port­ing wait times for med­i­cal treat­ment, in­clud­ing one au­dit re­veal­ing de­lays nearly 10 times worse than the depart­ment was of­fi­cially ac­knowl­edg­ing.

The sit­u­a­tion was so bad that the in­spec­tor gen­eral said it stopped try­ing to po­lice the is­sue un­til the VA could prove its in­for­ma­tion was ac­cu­rate — rais­ing a red flag for the tran­si­tion team, ac­cord­ing to documents ob­tained by The Wash­ing­ton Times.

The documents, ob­tained un­der a Free­dom of In­for­ma­tion Act re­quest, show the prob­lem ex­tended back to at least the mid­dle of the Bush ad­min­is­tra­tion but re­mained un­re­solved when Mr. Obama won elec­tion in 2008, and the VA was un­able to say this week whether it ever took any steps to cor­rect the prob­lems.

Ac­cord­ing to the documents, the VA in­spec­tor gen­eral told the Obama tran­si­tion team of three au­dits dat­ing back to 2005 that re­vealed sig­nif­i­cant prob­lems with wait times and sched­ul­ing.

One of those au­dits showed an in­stance in which the depart­ment re­ported 2,900 vet­er­ans waited more than a month for med­i­cal ap­point­ments. The ac­tual fig­ure was closer to 28,000 vet­er­ans, ac­cord­ing to the au­di­tors.

“Through a se­ries of au­dits, the OIG has re­peat­edly demon­strated that [the Vet­er­ans Health Ad­min­is­tra­tion] re­ported wait times could not be re­lied upon and the elec­tronic wait­ing lists were not com­plete,” the in­spec­tor gen­eral’s of­fice for the VA told the Oba­maBi­den tran­si­tion team.

Wait times were one fac­tor used to dole out bonuses to VA ex­ec­u­tives.

The in­spec­tor gen­eral of­fered a num­ber of rec­om­men­da­tions to try to help the depart­ment es­tab­lish ac­cu­rate wait times, in­clud­ing call­ing for test­ing to gauge the times, and tak­ing steps to en­sure “in­for­mal wait­ing lists” weren’t be­ing used. The VA re­jected both rec­om­men­da­tions in May 2008, when the Bush ad­min­is­tra­tion was in of­fice.

VA of­fi­cials on Wed­nes­day de­clined to say whether any of those rec­om­men­da­tions were im­ple­mented.

In­stead, they re­ferred ques­tions to the in­spec­tor gen­eral’s of­fice, which in­ves­ti­gates, con­ducts au­dits and makes rec­om­men­da­tions but does not have the author­ity to en­act the sorts of pol­icy re­forms that its au­di­tors sought nearly a decade ago.

VA of­fi­cials also did not re­spond to ques­tions about why it has taken the depart­ment so long to en­act an “ac­tion plan” that VA Sec­re­tary Eric K. Shin­seki said last week would pro­vide of­fi­cials with more ac­cu­rate data on wait times.

Dozens of VA fa­cil­i­ties now face scru­tiny over whether em­ploy­ees used “se­cret lists” to fal­sify wait time data to cover up long de­lays faced by vet­er­ans, in­clud­ing in Phoenix where as many as 40 vet­er­ans re­port­edly died while wait­ing for care.

With the scan­dal still grow­ing, Mr. Obama held a brief press con­fer­ence Wed­nes­day to as­sure vet­er­ans he is push­ing for quick ac­tion — though he said he is still try­ing to gather the facts.

“What we have to do is find out what ex­actly hap­pened. We have to find out how can we re­al­is­ti­cally cut some of these wait times,” the pres­i­dent said. “There has been a large in­flux of new vet­er­ans com­ing in. We’ve got a pop­u­la­tion of vet­er­ans that is also ag­ing, as part of the baby boom pop­u­la­tion. And we’ve got to make sure that the sched­ul­ing sys­tem, the ac­cess to the sys­tem, that all those things are in sync.”

Con­gres­sional Repub­li­cans have said Mr. Obama should do more than wait for an­swers. They called on him to fire VA em­ploy­ees and do more to gain con­trol of the prob­lem.

“Ev­ery­thing is news to the White House. The vet­er­ans’ prob­lems are news to the White House un­til they hear it through the news me­dia,” said Sen. John Cornyn, Texas Repub­li­can. “Some­body needs to be in charge at the White House, and some­body needs to start tak­ing re­spon­si­bil­ity.”

While not men­tion­ing him by name, the in­spec­tor gen­eral’s tran­si­tion memo ref­er­enced Dr. Michael Kuss­man, as­sis­tant sec­re­tary of health un­der Mr. Bush, who re­jected the rec­om­men­da­tions for polic­ing wait times.

Reached by phone Tues­day, Dr. Kuss­man de­clined to com­ment. He said he did not re­call re­spond­ing to the in­spec­tor gen­eral and de­clined an of­fer to be pro­vided a copy of the memo.

In a 2008 memo, Dr. Kuss­man made no se­cret about his re­ac­tion to the third re­port in as many years into wait time prob­lems. In a let­ter to the in­spec­tor gen­eral, he wrote that the re­port con­tained “mis­lead­ing im­pli­ca­tions and un­founded in­nu­endo.”

Dr. Kuss­man ques­tioned the in­spec­tor gen­eral’s method­ol­ogy and said some prob­lems are in­evitable be­cause sched­ulers are typ­i­cally the new­est and leas­t­ex­pe­ri­enced staff. “Given the cir­cum­stances, er­rors are in­evitable,” he wrote.

While Dr. Kuss­man ac­knowl­edged “lev­els of im­pre­ci­sion in our wait­ing times data,” he added that no­body has been able to iden­tify a more ef­fec­tive way to track and mon­i­tor wait times for al­most 40 mil­lion an­nual ap­point­ments.

The in­spec­tor gen­eral’s of­fice, in a rare pub­lic dis­play re­flect­ing just how con­tentious the wait time is­sue had be­come in­side VA, fired back: “We can only con­clude that VHA’s stated in­ten­tion to cor­rect rec­og­nize and long-stand­ing prob­lems is not sin­cere,” the watch­dog of­fice noted in a 2008 re­port.

The in­spec­tor gen­eral made in­com­ing Obama of­fi­cials aware of the dis­pute.

“Since the re­port in 2005, OIG is­sued re­ports in 2007 and 2008 con­cern­ing these is­sues, and both sub­se­quent re­ports con­firmed that prob­lems and causes as­so­ci­ated with sched­ul­ing, wait­ing times and [elec­tronic wait­ing lists] are sys­temic through­out VHA,” the VA’s of­fice of in­spec­tor gen­eral wrote in a memo to the Obama-Bi­den tran­si­tion team weeks af­ter the 2008 elec­tion.

Among those who helped over­see the work of the tran­si­tion for Vet­er­ans Af­fairs was Mary­land Lt. Gov. Anthony G. Brown, now a Demo­cratic gu­ber­na­to­rial can­di­date.

His cam­paign did not re­spond to a phone mes­sage Wed­nes­day.

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