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200 veterans die waiting for care as troubled Phoenix VA builds new backlog

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This is not a surprise. Eight years and it's just getting worse.

200 veterans die waiting for care as troubled Phoenix VA builds new backlog

By Stephen Dinan - The Washington Times - Updated: 10:26 p.m. on Tuesday, October 4, 2016
The Phoenix Veterans Affairs office is still improperly canceling veterans’ appointments, has built up a new backlog of cases — and at least one veteran is likely dead because of it, the department’s inspector general said in a new report Tuesday.

Two years after they first sounded the alarm about secret waiting lists leaving veterans struggling for care at the Phoenix VA, investigators said some services have improved, and they cleared the clinic of allegations that top officials ordered staff to cancel appointments.

But confusion and bureaucratic bungling are still prevalent, some veterans are waiting a half-year or longer for treatment, and staff are still canceling appointments for questionable reasons.

More than 200 veterans died while waiting for appointments in 2015, and investigators said at least one veteran would likely have been saved if the clinic had gone ahead with his consultation.

“This patient never received an appointment for a cardiology exam that could have prompted further definitive testing and interventions that could have forestalled his death,” the inspector general said.



VA chief sees Congress letting politics slow vet reforms

Published: September 29, 2016

“I was confirmed 97-to-0,” says Department of Veterans Affairs Secretary Bob McDonald, recalling the Senate vote in July 2014 on his nomination to lead 360,000 VA employees and an aging infrastructure in delivering health care, disability and education benefits, and a host of other services, to millions of veterans.

“And what I sensed was an appetite for, an urging for, somebody with experience transforming large organizations to do that,” adds the retired chief executive officer and board chairman of Proctor & Gamble Co. “While I have seen that, I have seen it sporadically. And right now, perhaps because of the elections upcoming, we’re seeing a hiatus in that kind of thinking.”

In an hourlong interview in his office overlooking the White House, McDonald expands on the surprisingly sharp critique of Congress he delivered a week earlier while testifying on recommendations of the congressionally chartered Commission on Care.

McDonald is upset to see fiscal 2016 expiring with Congress having failed to pass up to two dozen pieces of legislation he labels “essential” for continuing to transform VA to better serve veterans — with faster access to quality health care outside VA, breaking a disgraceful logjam of disability claim appeals, shelving archaic statutes that handcuff staff, and more.

The enthusiasm he felt on Capitol Hill two years ago came amid a patient wait-time scandal that alarmed veterans and demoralized the Veterans Health Administration. It also spurred Congress, nearing a long election-year recess, to swiftly negotiate and pass a flawed Veterans Choice Act, hailed with false promises that would confuse and anger veterans.

McDonald, a top industry executive but also a West Point graduate who graduated Army Ranger School, not only was volunteering to clean up a mess but to transform the entire department, its legacy practices and systems, into a high-performance organization that would put customers — veterans — first.

The transformation is well underway, McDonald says, but it won’t progress at the speed and breadth veterans deserve unless Congress helps. VA needs legislation to streamline and consolidate six separate community-base care programs that VA still must run in addition to the Choice program. It needs authority to repair a broken claims appeal system that has veterans waiting three years for a decision; to lift unnecessary limits on physician work hours; to extend VA authorities to maintain services, such as transportation to facilities in rural areas and for vocational rehabilitation, and to fix provider agreements with long-term care facilities so the hassles of dealing with VA don’t keep enticing these facilities to turn out vets.

These are highlights of a 100 proposals sent to Congress with the VA budget in February, most of which haven’t been voted on by both the House and Senate to become law, McDonald says, despite the continuous pro-veteran rhetoric heard from Republicans holding majorities in both chambers.

McDonald notes that in May the Senate Veterans’ Affairs Committee with bipartisan support cleared an omnibus bill, the Veterans First Act, packed with reforms. Yet no floor vote has been scheduled. A senator or two, it seems, has a hold on the bill, upset over how it would be funded or over how it would keep VA in control of access to non-VA health providers.

Despite that disappointment, McDonald suggests he’s work well with the Senate committee and Chairman Johnny Isakson, R-Ga.

The House, meanwhile, has passed many separate veterans bills that VA doesn’t view as critical. Recently it voted for the appeals process reforms VA wants, but linked it to tougher accountability measure that the administration opposes. The disputed provisions would relax employee job protections so that, at VA alone, staff could be fired or demoted more easily for wrongdoing or poor performance than is possible in other agencies.

Many bills get passed “as demonstrations of a particular ideology [without] bipartisan support,” says McDonald. “As a result, it’s all about legislative jujitsu of can you get the president to agree to something he doesn’t want to agree to, by attaching something good to it.”

McDonald says he realized soon after becoming secretary that veterans’ issues, even priority reforms strongly backed by veteran service organizations, are not free these days of the bitter partisanship that has made Congresses increasingly dysfunctional.

“I perceived that relatively early on,” he says, “particularly when there was this spirit of ‘gotcha!’ If you say the wrong word, the political opposition tries to exploit it in order to embarrass the administration. It wasn’t something I was familiar with in business.”

His harshest critics are Republicans on the House Veterans Affairs Committee. Its chairman, Rep. Jeff Miller of Florida, led lengthy investigations into the patient wait-time scandal and launched many other examinations of VA waste, fraud and abuse since taking the committee gavel in 2011. His staff pumps out a steady stream of press releases focusing on VA corruption.

Miller says McDonald failed in his promise to establish “a climate of accountability” across VA workforce despite his claims of 3,750 staff firings.

McDonald doesn’t mention Miller by name in our interview, but he’s the presumed target of some pointed remarks.

“You’ve got to make a decision in life,” the secretary says. “Are you always going to be pointing out problems, which is easy to do, or are you going to be part of the solution? It’s a copout to be what I call an ‘against’ leader. You know, ‘I can negotiate a better deal’ or ‘you’ve improved access [to health care] but not enough.’ It’s always easy to criticize what someone else has done. But that’s not going to improve things for veterans.”

I asked if, in his opinion, some Republicans don’t want this administration to be able to claim more victories on behalf of veterans. McDonald replies, “Maybe that’s the issue. Maybe that’s the issue.”

He says he hasn’t made that charge to committee leaders.

“But one thing I did say is we’ve got to stop using veterans as political pawns. Veterans are getting very upset about standing behind candidates, being thanked for their service, but then not getting part of the sacred covenant Abraham Lincoln talked about in his second inaugural address.”

If the priority is party politics, McDonald finds irony in the quest, because he was a Republican when nominated, a donor even to prominent GOP candidates from his home state of Ohio, including former House Speaker John Boehner.

“Now I say my political party is the Veterans’ Party,” McDonald says.


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