WASHINGTON, D.C. (Press Release) – The U.S. Department of Veterans Affairs (VA) on Monday, June 9, released the results from its Nationwide Access Audit, along with facility level patient access data, medical center quality and efficiency data, and mental health provider survey data, for all Veterans health facilities.
Full details made public at VA.gov follow Acting Secretary of Veterans Affairs Sloan Gibson’s commitment last week in Phoenix, Arizona and San Antonio, Texas to provide timely access to quality healthcare Veterans have earned and deserved.
“It is our duty and our privilege to provide Veterans the care they have earned through their service and sacrifice,” said Acting Secretary Gibson. “As the President has said, as Secretary Shinseki said, and as I stated plainly last week, we must work together to fix the unacceptable, systemic problems in accessing VA healthcare.
“Today, we’re providing the details to offer transparency into the scale of our challenges, and of our system itself. I’ll repeat – this data shows the extent of the systemic problems we face, problems that demand immediate actions. As of today, VA has contacted 50,000 Veterans across the country to get them off of wait lists and into clinics. Veterans deserve to have full faith in their VA, and they will keep hearing from us until all our Veterans receive the care they’ve earned.”
Acting Secretary Gibson announced a series of additional actions in response to Monday’s audit findings and data, including:
- Establishing New Patient Satisfaction Measurement Program- Acting Secretary Gibson has directed VHA to immediately begin developing a new patient satisfaction measurement program to provide real-time, robust, location-by-location information on patient satisfaction, to include satisfaction data of those Veterans attempting to access VA healthcare for the first time. This program will be developed with input from Veterans Service Organizations, outside health care organizations, and other entities. This will ensure VA collects an additional set of data – directly from the Veteran’s perspective – to understand how VA is doing throughout the system.
- Holding Senior Leaders Accountable- Where audited sites identify concerns within the parent facility or its affiliated clinics, VA will trigger administrative procedures to ascertain the appropriate follow-on personnel actions for specific individuals.
- Ordering an Immediate VHA Central Office and VISN Office Hiring Freeze- Acting Secretary Gibson has ordered an immediate hiring freeze at the Veterans Health Administration (VHA) central office in Washington D.C. and the 21 VHA Veterans Integrated Service Network (VISN) regional offices, except for critical positions to be approved by the Secretary on a case-by-case basis. This action will begin to remove bureaucratic obstacles and establish responsive, forward leaning leadership.
- Removing 14-Day Scheduling Goal VA is eliminating the 14-day scheduling goal from employee performance contracts- This action will eliminate incentives to engage in inappropriate scheduling practices or behaviors.
- Increasing Transparency by Posting Data Twice-Monthly- At the direction of the Acting Secretary, VHA will post regular updates to the access data released on Monday at the middle and end of each month at VA.gov. Twice-monthly data updates will enhance transparency and provide the most immediate information to Veterans and the public on Veterans access to quality healthcare.
- Initiating an Independent, External Audit of Scheduling Practices- Acting Secretary Gibson has also directed that an independent, external audit of system-wide VHA scheduling practices be performed.
- Sending Additional Frontline Team to Address Phoenix- Following his trip to Phoenix VA Medical Center last week, Acting Secretary Gibson directed a VHA frontline team to travel to Phoenix to immediately address scheduling, access, and resource requirements needed to provide Veterans the timely, quality healthcare they deserve.
- Utilizing High Performing Facilities to Help Those That Need Improvement- VA will formalize a process in which high performing facilities provide direct assistance and share best practices with facilities that require improvement on particular medical center quality and efficiency, also known as SAIL, performance measures.
- Applying Immediate Access Reforms Announced in Phoenix to Most Challenged VA Facilities- Last week, Acting Secretary Gibson announced a series of measures to address healthcare access problems in Phoenix. On Monday, Acting Secretary Gibson announced he’ll apply the same reforms to facilities with the most access problems from the results of the audit, including:
- Hiring Additional Clinical and Patient Support Staff- VA will deploy teams of dedicated human resource employees to accelerate the hiring of additional, needed staff.
- Employing New Staffing Measures- VA’s first goal is to get Veterans off wait lists and into clinics. VA is using temporary staffing measures, along with clinical and administrative support, to ensure these Veterans receive the care they have earned through their service.
- Deploying Mobile Medical Units- VA will send mobile medical units to facilities to immediately provide services to patients and Veterans awaiting care.
- Providing More Care by Modifying Local Contract Operations- VA will modify local contract operations to be able to offer more community-based care to Veterans waiting to be seen by a doctor.
- Removing Senior Leadership- Where appropriate, VA will initiate the process of removing senior leaders. Acting Secretary Gibson is committed to using all authority at VA’s disposal to enforce accountability among senior leaders.
- Suspending Performance Awards- VA has suspended all VHA senior executive performance awards for FY2014.
- Future Travel Over the course of the next several weeks- Acting Secretary Gibson will travel to a series of VA facilities across the country. He will hear directly from Veterans and employees about obstacles to providing timely, quality care and how VA can immediately address them.
National audit and patient access data available at www.va.gov/health/access-audit.asp.
Medical center quality and efficiency (SAIL) and mental health data available at http://www.hospitalcompare.va.gov/.
*
Among Jewish members of the Senate and the House of Representatives, there were these reactions:
Sen. Michael Bennet, D-Colorado: “We cannot relent in pressing the agency to correct these problems. The VA must do better, and soon. It needs to be more responsive, more transparent and more efficient. And it needs to improve its process for building new facilities – like the one in Aurora. Our veterans have earned that. We’ll continue to review the results of this and upcoming reports and will push for major fixes legislatively and administratively.” Since news of systemic problems within the Veterans Health Administration was brought to light, Bennet has urged VA leadership to quickly assess the problems and make the necessary changes to address them. Last month, he joined members of the Colorado delegation in requesting the administration to provide results of the VA’s internal audit relating to Colorado facilities. He also requested that the VA Inspector General include all facilities that serve veterans in Colorado in its ongoing investigation. He also worked with a bipartisan group of senators to urge the administration to accept assistance from technology companies to help fix the broken VA scheduling system.
Sen. Richard Blumenthal, D-Connecticut: “I am disappointed the VA did not release today the location-specific audit information requested by the Connecticut Congressional delegation. Location-specific information is necessary to restore confidence in the veterans appointment scheduling process. I have no confidence in the accuracy of reported wait times that accompany the audit summary released today, as the audit itself found widespread use of inappropriate practices to make wait times appear more favorable. Among the glaring gaps in this audit is the failure to visit and clearly assess the West Haven Facility. While I appreciate the work of VA staff and health care professionals in the wake of the inspector general report, which outlined systemic issues at the Veterans Health Administration, I have no reason to trust these numbers without independent verification and additional context. I would like to know how the VA reached these numbers and the sources it used for them. For example, did the VA simply rely on local officials for these numbers, as it has in the past, or did the department dig deeper and verify them? This question and others should be answered. I can’t have faith in these numbers and give the VA credit for true transparency, until I know where the data came from and how it was compiled.” Blumenthal is a member of the Senate Committee on Veterans’ Affairs.
Rep. Eric Cantor, R-Virginia, the House Majority Leader: “Today’s news that more than 57,000 veterans are still waiting to receive their first appointment through the VA health system is unacceptable. In my home state of Virginia, some wait times are more than 72 days. Our nation’s veterans deserve better. While the President remains silent on what he will do to fix these systemic problems, this week the House will act to provide all veterans with immediate access to the doctors and health care providers closest to them through the private-sector. The House will investigate and move to hold those responsible accountable, but in the meantime we must ensure that our nation’s heroes get the care they need and deserve in a timely fashion.”
Rep. Steve Cohen, D-Tennessee: “Any delay in providing care to the brave men and women who risked their lives for our safety is unacceptable, and I have consistently pushed to give the VA the resources and personnel needed to provide timely care. While the Memphis VA, under the leadership of Director C. Diane Knight, has implemented the recommendations of the VA Inspector General, today’s report is disappointing and underscores that more still needs to be done—not only in Memphis but around the nation—to fulfill our commitment to our veterans. I look forward to fully analyzing this report and I will continue working with President Obama and members of both parties in Congress to fix these problems and make sure that everyone who has served this country in uniform receives timely, high-quality care at the Memphis VA or any other VA Medical Center.”
Rep. Lois Frankel, D-Florida: “The report said that 63,000 patients were waiting to be scheduled for care nationwide, and that 13 percent of VA schedulers reported being instructed to falsify reports about appointment waiting periods. The Palm Beach, Broward and Miami clinics were not included among VA facilities requiring further audit of their scheduling policies. I am pleased to see that none of South Florida’s Hospital veterans’ hospitals or clinics were included in those that require further audit due to questionable scheduling practices. With that said, there needs to be a careful review of all facilities to make sure that they have the policies and resources necessary to give our veterans the care that they have earned and deserve. This means that Congress has to step up to the plate and pay for the wars of recent years. It will also require expanded access to private healthcare providers.”
Sen. Bernard Sanders, I-Vermont, chairman of the Senate Veteran Affairs Committee: “Incompetent administrators and those who have manipulated wait-time data should be dismissed at once. Sen. McCain and I have agreed on legislation to let the VA do just that. It is equally important, however, to understand that the reason certain VA facilities around the country have long wait times is because they lack an adequate number of doctors, nurses and other medical practitioners. The legislation, which I hope will be on the floor in a few days, would help the VA hire – in an expedited manner – the professional staffing that is needed to address long wait times. The legislation also provides that if a veteran is unable to access care in a timely manner, he or she may go outside of the VA to a private doctor, community health center or other facility to get that care.” … Subsequently, on Monday evening, June 9, Sanders and McCain introduced legislation to improve veterans’ access to health care and address serious problems facing the Department of Veterans Affairs. Other original cosponsors were Sens. Jeff Merkley (D-Ore.), Tim Kaine (D-Va.) and Richard Burr (R-N.C.), the ranking Republican on the Senate Veterans’ Affairs Committee. To read the bill, click here. To read a section-by-section summer, click here.
Sen. Ron Wyden, D-Oregon: “Following the release of a new report that revealed vast numbers of Oregon veterans have been unable to access care at the U.S. Department of Veterans Affairs (VA) facilities, Oregon’s Senators Jeff Merkley and Ron Wyden called Monday for renewed accountability and dramatic action to turn around a system they described as failing Oregon’s veterans. The report revealed that both the Portland VA Medical Center and the Roseburg VA Medical Center were among the worst in the nation for waiting times, with more than 6,600 veterans unable to be seen within 90 days. Additionally, the report flagged the two facilities for further investigation, suggesting possible concerns about the handling of data. Other VA facilities serving Oregon vets, including those in Walla Walla and Boise, were also flagged for further investigation.In recent weeks, Senator Merkley has called for new leadership at the national VA and met with local veterans groups and VA officials. “The picture painted by this report is one that is 100% unacceptable for Oregon’s veterans,” said Merkley. “There needs to be immediate and intense action to ensure that veterans get the services they so fully deserve. Moreover, those who are responsible for these failings and any efforts to cover them up should lose their jobs immediately, and there must be further investigation into the possibility that this scandal reflects not just incompetence but wrongdoing. The wait times reported by the VA audit are far worse than what local leadership has told us in recent weeks, which raises substantial questions about whether we can believe anything we hear about what is happening in these facilities and demands explanation. We need vastly improved leadership and a commitment from the highest levels of the Veterans Administration to fix these problems in Oregon, not sweep them under the rug. Our veterans deserve better.” “I am appalled by today’s report that falsified records forced more than 6,600 Oregon veterans to endure unconscionable waiting times to receive the care they’ve earned,” said Wyden. “Those who cooked the books at VA facilities or lied to Congress as it attempted to conduct oversight should be fired immediately and prosecuted to the fullest extent of the law.” A full copy of the report can be found here, and the fact sheet on Pacific Northwest facilities can be found here. Merkley and Wyden have fought for years against the gaming of records at Oregon VA facilities. They fought an effort to downsize the Roseburg VA Medical Center, based on flawed studies that claimed low demand for services there. In 2011 Wyden, Merkley and Rep. Peter DeFazio wrote the VA secretary and succeeded in maintaining emergency room services and expanding telemedicine at the facility, although the VA closed the Intensive Care Unit and other services over the objections of Oregon’s delegation.”
*
Preceding culled from news releases issued by the Veterans Affairs Department and the members of Congress above