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May 29, 2014

Waiting game at VA sites irks pols

WASHINGTON — Patient waiting lists manipulated by Veterans Affairs hospital workers to gain bonuses should “enrage all Americans,” says U.S. Rep. Lou Barletta, among the Valley representatives who are calling for significant reforms in the wake of an inspector general’s scathing report.

The VA hospital scandal, first recognized in Phoenix and expanding daily — it now involves 42 hospitals nationwide — and is worse than originally thought, said U.S. Sen. Bob Casey, a Pennsylvania Democrat.

The investigation, which initially focused on the Phoenix hospital, found systemic problems in the VA’s sprawling nationwide system that provides medical care to about 6.5 million veterans annually.

The interim report confirmed allegations of excessive waiting time for care in Phoenix, with an average 115-day delay for a first appointment for those on the list — 91 days longer than the hospital had reported.

Additionally, the report found that information was manipulated to conceal the length of time patients waited for medical attention. The report also found the problem to be “systemic” and not limited to the Phoenix facility. At least 40 veterans are reported to have died while waiting for treatment.

“Our military volunteers knew when they signed up that there was a chance they would become casualties in a foreign land, but they did not expect to become a statistic once they had returned safely home,” said Barletta, R-11, of Hazleton. “The news out of the VA keeps getting worse, and it should enrage all Americans. These veterans being neglected and ignored have sacrificed so much to protect our freedoms and deserve much more than this from their country.”

Casey agreed.

After reading the report on Wednesday afternoon, he said: “It’s disturbing, and reveals that the wait list problem may be more significant than the initial reports revealed. The administration must immediately undertake significant reforms to ensure veterans receive quality care in a timely manner. It is unacceptable that any veteran should have to wait over 100 days just to get an appointment.

“Our veterans deserve care that honors the sacrifices they’ve made to our nation.”

U.S. Rep. Tom Marino, R-10, Cogan Station, said: “This report further outlines a failure in leadership from the administration and it’s now prudent to bring in outside veteran service organizations that can make actionable recommendations on how to increase the quality of services while this investigation uncovers more facts about what went wrong and why.”

Richard J. Griffin, the VA’s acting inspector general, found that “inappropriate scheduling practices are systemic throughout” the VA’s health facilities nationwide, including 150 hospitals and 820 clinics; 42 centers are under investigation, up from 26.

About 1,700 veterans in need of care were “at risk of being lost or forgotten” after being kept off the official waiting list at the troubled Phoenix veterans hospital, the inspector general report said as the pressure on Secretary Eric Shinseki to resign has increased.

Meanwhile, Shinseki called the inspector general’s findings “reprehensible to me, to this department and to veterans.”

He said he was directing the Phoenix VA to immediately address each of the 1,700 veterans waiting for appointments.

VA guidelines say veterans should be seen within 14 days of their desired date for a primary care appointment. Lawmakers have called that target unrealistic and said basing employee bonuses and pay raises on it is outrageous.

The 14-day waiting period encourages employees to “game” the appointment system in order to collect bonuses based on on-time performance, the inspector general report said.

The inspector general described a process in which schedulers ignored the date that a provider or veteran wanted for an appointment. Instead, the scheduler selected the next available appointment and used that as the purported desired date.

The inspector general’s report said problems identified by investigators were not new. The inspector general’s office has issued 18 reports to George W. Bush and Obama administrations as well as Congress since 2005.

Griffin said investigators’ next steps include determining whether names of veterans awaiting care were purposely omitted from electronic waiting lists and at whose direction and whether any deaths were related to delays in care.

He said investigators at some of the 42 facilities “have identified instances of manipulation of VA data that distort the legitimacy of reported waiting times.” The IG said investigators are making surprise visits, a step that could reduce “the risk of destruction of evidence, manipulation of data, and coaching staff on how to respond to our interview questions.”

Justice Department officials have already been brought into cases where there is evidence of a criminal or civil violation, Griffin said.

Dr. Samuel Foote, a former clinic director for the VA in Phoenix who was the first to bring the allegations to light, said the findings were no surprise.

“Everybody has been gaming the system for a long time,” Foote said in an Associated Press interview. “Phoenix just took it to another level. The magnitude of the problem nationwide is just so huge, so it’s hard for most people to get a grasp on it.”

The Associated Press contributed to this report.

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