The House committee that has focused on the cover-up of long wait times for service at veterans hospitals will turn its attention to the federal employees who turned back the covers, sometimes risking their careers to do so.
During a Tuesday evening hearing, the House Veterans Affairs Committee will hear from whistleblowers who exposed the fraudulent practices that have become a national scandal.
Also scheduled to appear is the head of the U.S. Office of Special Counsel, whose prepared testimony places in further disrepute the service the Department of Veterans Affairs (VA) provides its patients.
This is another in a long series of hearings called by Chairman Jeff Miller (R-Fla.), who has been leading a probe into VA mismanagement. Revelations prompted by whistleblowers and outrage from members of Congress and veterans led to the resignation of former secretary Eric Shinseki in May.
Miller criticized “the organizational cesspool at VA” in his prepared opening statement.
In her prepared written statement, Special Counsel Carolyn Lerner told the committee that “too often the VA has failed to use the information provided by whistleblowers as an early warning system. Instead, in many cases, the VA has ignored or attempted to minimize problems, allowing serious issues to fester and grow.”
She based some of her remarks on a report Lerner previously provided to President Obama in a letter last month. Her statement undermines the VA’s reputation for providing good service to veterans once they get in the door, though that is often after a long wait.
For example, Lerner told about patient neglect disclosures from a VA psychiatrist whistleblower at a longterm mental health-care facility in Brockton, Mass.
A “veteran was admitted to the facility in 2003, with significant and chronic mental health issues,” she said. “Yet his first comprehensive psychiatric evaluation did not occur until 2011, more than eight years after he was admitted, when he was assessed by the whistleblower. No medication assessments or modifications occurred until the 2011 consultation.”
Also disgraceful, Lerner describes a VA bureaucracy that appears almost unconcerned.
“The VA, and particularly the VA’s Office of the Medical Inspector (OMI), has consistently used a ‘harmless error’ defense, where the department acknowledges problems but claims patient care is unaffected,” she said, quoting her June 23 letter to Obama. “This approach hides the severity of systemic and longstanding problems, and has prevented the VA from taking the steps necessary to improve quality of care for veterans.”
She also said “schedulers were placed on a ‘bad boy’ list if their scheduled appointments were greater than 14 days from the recorded ‘desired dates’ for veterans.”
When patients were not seen within the 14-day target set by management, some workers falsified records or manipulated waiting lists so it would appear that the goal had been met. In some cases, those actions apparently were driven by the desire to get performance awards that were based, at least in part, on the ability to meet the target.
“The manipulation of data to game performance goals is a widespread cancer within the VA,” Miller said.
In testimony submitted to the committee, Katherine L. Mitchell, an internist at the VA hospital in Phoenix, described an agency suffering from an integrity deficit.
“Ethics have never been made an official VA performance measure, and thus do not appear to be a clear administrative goal,” she said. “There seems to be no perceived financial advantage to pursuing ethical conduct. Administrative repercussions are lacking for unethical behaviors that are so routinely practiced among senior executive service employees.”
Of course, federal employees should not need a financial incentive to engage in ethical conduct. But there were financial incentives, in the form of employee performance awards or bonuses, to meet productivity targets.
In his statement, Scott Davis, a program specialist at the Health Eligibility Center (HEC) in Atlanta, complained about “VA’s “reckless waste of federal funds … for the sole purpose of achieving performance goals.”
VA’s “leadership has repeatedly failed to respond to concerns raised by whistleblowers about patient care at VA,” Davis said. “Despite the best efforts of truly committed employees at HEC and the Veteran Health Administration, who have risked their careers to stand up for veterans, management at all levels ignored or retaliated against them for exposing the truth.”
Without responding to specific cases raised by Lerner or the whistleblowers in his prepared statement, James Tuchschmidt, VA’s acting principal deputy undersecretary for health, told the committee that “intimidation or retaliation against whistleblowers … is absolutely unacceptable.
“We all have a responsibility for enforcing appropriate workplace behavior. Protecting employees from reprisal is a moral obligation of VA leaders, a statutory obligation, and a priority for this department,” Tuchschmidt said.
If that’s true now, with the VA under tight scrutiny, the testimony indicates that was not always the case.
Chronicling a long list of VA whistleblower cases, Lerner said “based on the scope and breadth of the complaints OSC has received, it is clear that the workplace culture in many VA facilities is hostile to whistleblowers and actively discourages them from coming forward with what is often critical information.”
It will take more than fine intentions and VA platitudes to fix that.