Testimony from a Tuesday evening congressional hearing cast the troubled Department of Veterans Affairs in even greater disrepute, and undermined the agency’s claim of providing good health care.
The House Veterans’ Affairs Committee that has probed the coverup of long waits at veterans hospitals focused its attention on the federal employees who turned back the covers, sometimes risking their careers to do so.
The committee also heard testimony from the head of the U.S. Office of Special Counsel, who provided shameful examples of patient neglect, after they were hospitalized — indicating this is more than a waiting-list problem.
Instead of heeding truth-tellers, VA retaliated against whistleblowers, according to complaints filed with the Special Counsel, which deals with whistleblowers government-wide.
Tuesday's session was 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 K. Shinseki in May.
Miller criticized “the organizational cesspool at VA.”
In her written remarks, Special Counsel Carolyn Lerner told the committee that “too often VA has failed to use the information provided by whistleblowers as an early warning system. Instead, in many cases VA has ignored or attempted to minimize problems, allowing serious issues to fester and grow.”
In one disturbing example of bad care, Lerner told about patient-neglect disclosures from a VA psychiatrist whistleblower at a long-term 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 described a bureaucracy that appears almost unconcerned.
“VA, and particularly VA’s Office of the Medical Inspector, 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 President Obama. “This approach hides the severity of systemic and long-standing problems, and has prevented 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, records were falsified or manipulated, so it would appear 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 VA,” Miller said.
While reports and surveys indicate patients generally like VA health care once they get it, Lerner’s statement shows the agency cannot rest on laurels in the face of strong criticism.
In testimony submitted to the committee, Katherine L. Mitchell, an internist at 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 inducements, in the form of employee performance awards or bonuses, that provided perverse incentives to meet productivity targets.
Without responding to specific cases raised by Lerner or the whistleblowers, James A. 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,” he said in a prepared statement. “Protecting employees from reprisal is a moral obligation of VA leaders, a statutory obligation, and a priority for this department.”
If that’s true now, with VA under tight scrutiny, the testimony indicates VA has not always met its moral obligation.
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 VA platitudes to fix that.
Words are cheap. Action counts.
Previous columns by Joe Davidson are available at wapo.st/JoeDavidson.