Obama started first term with knowl­edge of VA prob­lems

The Washington Times Weekly - - Front Page - BY JIM MCELHATTON

The Obama ad­min­is­tra­tion re­ceived clear no­tice more than five years ago that VA med­i­cal fa­cil­i­ties were reporting in­ac­cu­rate wait­ing times and ex­pe­ri­enc­ing sched­ul­ing fail­ures that threat­ened to deny vet­er­ans timely health care — prob­lems that have turned into a grow­ing scan­dal.

Vet­er­ans Af­fairs of­fi­cials warned the Obama-Bi­den tran­si­tion team in the weeks af­ter the 2008 pres­i­den­tial elec­tion that the depart­ment shouldn’t trust the wait times that its fa­cil­i­ties were reporting.

“This is not only a data in­tegrity is­sue in which [Vet­er­ans Health Ad­min­is­tra­tion] re­ports un­re­li­able per­for­mance data; it af­fects qual­ity of care by de­lay­ing — and po­ten­tially deny­ing — de­serv­ing vet­er­ans timely care,” the of­fi­cials wrote.

The brief­ing ma­te­ri­als, ob­tained by The Wash­ing­ton Times through the Free­dom of In­for­ma­tion Act, make clear that the prob­lems ex­isted well be­fore Mr. Obama took of­fice, dat­ing back at least to the Bush ad­min­is­tra­tion. But the ma­te­ri­als raise ques­tions about what ac­tions the depart­ment took since 2009 to rem­edy the prob­lems.

In re­cent months, re­ports have sur­faced about se­cret wait lists at fa­cil­i­ties across the coun­try and, in the case of a Phoenix VA fa­cil­ity, ac­cu­sa­tions that of­fi­cials cooked the books to try to hide long wait times. Some fam­i­lies said vet­er­ans died while on a se­cret wait list at the Phoenix fa­cil­ity.

Last week, Dr. Robert Pet­zel, un­der­sec­re­tary for health in the Depart­ment of Vet­er­ans Af­fairs, re­signed. His boss, Sec­re­tary Eric K. Shin­seki, told Congress he will stay de­spite grow­ing calls for his res­ig­na­tion.

Mr. Shin­seki, a dis­abled vet­eran, has headed the depart­ment since the be­gin­ning of Mr. Obama’s first term, when the VA re­port iden­ti­fied many of the prob­lems.

“Should they have known? Ab­so­lutely, they should have known,” said Deirdre Parke Holleman, ex­ec­u­tive di­rec­tor of the Wash­ing­ton of­fice for the Re­tired En­listed As­so­ci­a­tion, a vet­er­ans group, which has not taken a po­si­tion on whether Mr. Shin­seki should re­sign. “These are prob­lems that should have been dealt with.”

In par­tic­u­lar, the 2008 tran­si­tion re­port re­ferred to a VA in­spec­tor gen­eral rec­om­men­da­tion to test the ac­cu­racy of re­ported wait­ing times.

Such tests, the re­port noted, could prompt ac­tion if re­sults re­veal “ques­tion­able dif­fer­ences” be­tween the dates shown in med­i­cal records and dates in the Vet­er­ans Health Ad­min­is­tra­tion’s sched­ul­ing sys­tem. It’s un­clear whether that rec­om­men­da­tion was adopted be­cause VA of­fi­cials have not re­sponded to re­quest for com­ment.

In Phoenix, of­fi­cials are look­ing into whether as many as 40 vet­er­ans died while wait­ing for treat­ment, with “se­cret wait lists” used to con­ceal the de­lays. Speak­ing in the Repub­li­cans’ weekly ad­dress over the weekend, Sen. John McCain, Ari­zona Repub­li­can, said the scan­dal be­gan in his home state but it has since “gone na­tion­wide.”

“Al­to­gether, sim­i­lar re­ports of lengthy wait­ing lists and other is­sues have sur­faced in at least 10 states,” he said.

Act­ing VA In­spec­tor Gen­eral Richard

J. Grif­fin told Congress last week that his of­fice has opened mul­ti­ple in­ves­ti­ga­tions into “re­ports of ma­nip­u­lated wait­ing times” in Phoenix as at other fa­cil­i­ties.

He said his in­ves­ti­ga­tion also aims to find out whether of­fi­cials in Phoenix pur­posely left off the names of vet­er­ans wait­ing for care on elec­tronic wait­ing lists and, if so, whether any vet­er­ans died be­cause of the de­lays in care.

Prob­lems with elec­tronic wait­ing lists also mer­ited men­tion in the pres­i­den­tial brief­ing re­port.

“Au­dits of out­pa­tient sched­ul­ing and pa­tient wait­ing times com­pleted since 2005 have iden­ti­fied non­com­pli­ance with the poli­cies and pro­ce­dures for sched­ul­ing, in­ac­cu­rate reporting of pa­tient wait­ing times and er­rors in [elec­tronic wait­ing lists],” the brief­ing pa­pers state.

Brief­ing re­ports typ­i­cally are pre­pared by ca­reer federal em­ploy­ees be­fore a change in power, giv­ing in­com­ing ad­min­is­tra­tions de­tailed looks at agency op­er­a­tions. The VA re­port notes that lit­tle was done to ad­dress the prob­lems sur­round­ing sched­ul­ing and wait time ac­cu­racy dur­ing the Ge­orge W. Bush ad­min­is­tra­tion.

“Al­though VHA has rec­og­nized the need to im­prove sched­ul­ing prac­tices and the ac­cu­racy of wait times data, no mean­ing­ful ac­tion has been taken to achieve this goal to­day,” of­fi­cials wrote.

In fact, of­fi­cials added, nine rec­om­men­da­tions aris­ing from in­spec­tor gen­eral au­dits from 2005 to 2007 were not im­ple­mented by 2008 when of­fi­cials pre­pared the re­port for the in­com­ing ad­min­is­tra­tion.

Jim Ni­chol­son, who served as VA sec­re­tary dur­ing the lat­ter half of the Bush ad­min­is­tra­tion, could not be reached for com­ment.

The brief­ing ma­te­ri­als do not re­veal any con­cerns about out­right fraud in ma­nip­u­lat­ing wait­ing times, but they make re­peated ref­er­ences in sum­ma­riz­ing past au­dits and re­views about data ac­cu­racy.

“This re­port and prior re­ports in­di­cate that the prob­lems and causes as­so­ci­ated with sched­ul­ing, wait­ing times and wait lists are sys­temic through­out the VHA,” of­fi­cials told the in­com­ing ad­min­is­tra­tion.

Tes­ti­fy­ing to Congress last week, Mr. Shin­seki said most vet­er­ans are sat­is­fied with their health care, “but we must do more to im­prove the timely ac­cess to that care.”

The Amer­i­can Legion has called on Mr. Shin­seki and Al­li­son Hickey, VA un­der­sec­re­tary for ben­e­fits, to re­sign.

“They are both part of VA’s lead­er­ship prob­lem,” Amer­i­can Legion Com­man­der Dan Dellinger said in a state­ment. “This isn’t per­sonal. VA needs a fun­da­men­tal shift in lead­er­ship if it is to de­feat its sys­tem­atic lack of ac­count­abil­ity.”


“We have to find out how can we re­al­is­ti­cally cut some of these wait times,” Pres­i­dent Obama 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.”

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