The Department of Veterans Affairs spent the past two months addressing a scandal that involved cover-ups of treatment delays and alleged retaliation against employees who tried to expose the problems.
The agency’s corrective actions have ranged from leadership changes and a ban on executive bonuses to hiring more medical professionals and seeking help from the private sector to deal with demand.
Below is a summary of what the VA and the Obama administration have done since the scheduling scandal erupted in late April:
The VA inspector general, the VA itself and White House adviser Rob Nabors have all examined the scheduling problems. Additionally, the Office of Special Counsel, a federal watchdog advocate, announced last month that it is investigating allegations of retaliation against dozens of VA employees.
1.) Inspector general’s investigation
A May report from the VA’s independent inspector general confirmed that many of the department’s medical centers had falsified records to hide the amount of time veterans had to wait for medical appointments. It described the crisis a “systemic problem nationwide.”
Official VA data showed that a sampling of 226 patients had waited just 24 days on average for their first primary care appointments, but the actual average was 115 days. The false wait times were used to determine bonuses and employee awards, the IG report said.
2.) Internal VA audit
On June 9, the VA released results from its nationwide audit of scheduling practices, showing that 57,000 patients were still waiting for their first appointments and that about 13 percent of VA schedulers were instructed to falsify appointment-request dates.
The report also said that complex scheduling practices contributed to the problems by creating confusion among clerks and supervisors, and that the VA’s goal of providing appointments within 14 days of any request was unattainable because of the growing demand for care.
3.) Nabors report
Nabors conducted a broad review of the VA health network, reporting back to President Obama on Friday that the system lacks accountability and suffers from a host of other problems, including a “corrosive culture” of employee discontent and management retaliation against whistleblowers.
4.) Office of Special Counsel
The OSC issued a letter to Obama last week saying the agency was reviewing more than 50 complaints of retaliation against whistleblowers and that it had already referred 29 of the cases for further investigation, meaning they had merit.
Acting VA Secretary Sloan Gibson has vowed to stop reprisals against employees who report wrongdoing. “I am deeply disappointed not only in the substantiation of allegations raised by whistleblowers, but also in the failures within VA to take whistleblower complaints seriously,” he said in response to the letter.
Former VA secretary Eric Shinseki — whose legacy includes reducing a longstanding backlog of disability claims, aggressively battling veterans’ homelessness and expanding access to benefits for Agent Orange-related illnesses — resigned in late-May, saying he could not explain the VA’s “systemic, totally unacceptable lack of integrity.”
Before stepping down, Shinseki called for the nationwide audit of VA scheduling practices, in addition to implementing a ban on executive bonuses and removing senior leaders from the Phoenix clinic where investigators first substantiated claims of falsified records.
Obama appointed Gibson to head the VA on an interim basis after Shinseki’s resignation. The new agency head promised during a June 6 news conference to shake up the culture at the VA, saying he would “make dust.”
Last week, VA officials Will Gunn and Robert Jesse stepped down from their positions as the personnel changes continued. Gunn had served as the agency’s general counsel since 2009, and Jesse, who moved down to the department’s medical ranks, was acting undersecretary for the Veterans Health Administration.
Obama on Monday nominated former Procter and Gamble chief executive Bob McDonald to serve as permanent VA secretary.
Since Acting VA Secretary Sloan Gibson took over as temporary chief, the agency has contacted more than 100,000 veterans who were on unofficial wait lists to discuss their medical needs and begin scheduling appointments.
The VA has shifted more than $390 million within its budget to help find care for veterans who have experienced extensive wait times. The money can be used to contract with private-sector hospitals and government clinics that do not belong to the VA. The agency has also deployed “mobile medical units,” essentially clinics on wheels, to help improve access.
The VA has terminated its goal of seeing patients within 14 days of appointment requests. Nabors said in a summary of his findings that the target was “arbitrary, ill-defined and misunderstood,” and that it may have “incentivized inappropriate actions.” He also suggested that it was unrealistic given the VA’s resources and the growing demand for care.
The department has begun posting twice-monthly updates on wait times and other access-to-care data. The goal is to provide the most immediate information to veterans and the public.
Gibson has said repeatedly since becoming interim VA chief that he will not tolerate retaliation against employees who report wrongdoing. He also ordered a comprehensive review of the department’s Office of Medical Inspector, to include its handling of whistleblower complaints. The analysis is expected to be finished next week.