VA remains in critical shape, Shulkin says
Problems include appointment wait times, quality of care, aging facilities
The head of the Department of Veterans Affairs in a rare White House briefing Wednesday laid bare the array of problems still plaguing the agency charged with providing health care to nearly 9 million of the nation’s veterans.
VA Secretary David Shulkin provided a candid assessment of the challenges that he and other leaders face in overhauling the department, including providing appointments more quickly. Veterans are waiting 60 days or longer at more than 30 VA facilities across the country, he said, and one in 10 time-sensitive appointments were not booked within time frames recommended by health care providers.
“I’m a doctor and I like to diagnose things, assess them and treat them,” Shulkin said. “Many of these challenges ... have been decades in building, and they span multiple administrations, and this is the time for us to really address these chronic problems that have affected veterans and in many ways have harmed veterans and their families.”
“I’m going to tackle these issue heads on,” he said.
Shulkin ticked off a litany of problems, including with the quality of medical care provided to veterans. He said the agency has identified 14 VA medical centers that provide lower quality care than nearby private sector hospitals. They include three VA medical centers in Tennessee (Memphis, Nashville, and Murfreesboro), two in California (Loma Linda and Fresno), and two in Texas (El Paso and Big Spring).
He said all received one star out of five in the VA’s internal rat- ing system, which the VA released publicly for the first time in December after USA TODAY obtained and published the internal ratings. Other facilities with a one-star ranking include VA hospitals in Detroit; Phoenix; Biloxi, Miss.; Dublin, Ga.; Fayetteville, N.C; White City, Ore.; and Fort Harrison, Mont.
Shulkin said he has dispatched teams to help improve care at those locations. “Veterans shouldn’t have to accept low quality care, and they deserve our very best,” he said.
In the meantime, Shulkin said he wants to streamline the process for veterans to seek treatment in the private sector — though he also outlined problems in programs that allow them to do that.
He said the department’s needlessly complicated bureaucracy has led to the denial of one out of five veteran requests to get VA- sponsored care at non-VA facilities. And when they have been granted, the agency often hasn’t paid the tab for months. Currently, $50 million in bills have been outstanding for six months or longer, Shulkin said.
“Providers are increasingly frustrated with the VA’s ability to get them payments, to the point that some of them are actually leaving our network,” he said. “And that’s obviously working against us.”
Shulkin said veteran claims for disability benefits also are languishing with 90,000 claims pending for six months or longer.
Another area in critical need of improvement is the VA’s infrastructure, he said, adding that hundreds of the agency’s buildings are in disrepair and the price tag to fix them is at least $18 billion.
Shulkin’s revelations marked an unusual strategy for the historically secretive VA — and for the Trump administration — to announce problems proactively rather than react to them after they are leaked to media or revealed publicly through investigations.
Shulkin’s candid assessments come a month after the VA inspector general issued an urgent warning that equipment shortages and dirty sterile areas at the Washington VA Medical Center were placing patients in danger. Internal documents obtained by USA TODAY show VA officials knew about the problems for years, although Shulkin said at the time that he was surprised by the revelations.
Since taking the VA reins in February, Shulkin has pushed for more transparency. He unveiled a web site last month that reveals how care at VA hospitals compares with nearby private-sector hospitals and national averages. The site is accesstocare.va.gov.
On Wednesday, he announced that a White House hotline for VA complaints (855-948-2311) will be running Thursday and fully operational by mid-August.
“Many of these challenges ... have been decades in building.” VA Secretary David Shulkin