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The Department of Veterans Affairs on Monday shed light on the depth of the VA scheduling scandal and substantiated claims that rank-and-file employees were directed to manipulate records.
The agency said more than 57,000 new patients have waited at least 90 days for their first appointments and that about 13 percent of VA schedulers indicated they were told to falsify appointment-request dates to give the impression that wait times were shorter than they really were.
The information comes from the agency’s internal audit of 731 VA medical centers, which the VA released Monday.
The report said that complicated scheduling practices created confusion among clerks and supervisors, contributing to the problems. It also said the VA’s goal of providing an initial appointment within 14 days of a request was unattainable because of the growing demand for care among veterans.
The report came less than two weeks after the VA inspector general’s office confirmed recent allegations that VA hospitals have falsified appointment records to hide treatment delays. Former VA Secretary Eric Shinseki resigned over the scandal on May 30.
Another 8 percent of scheduling staff used unofficial lists to track patients who had waited at least 90 days for appointments, according to Monday’s report. Those lists kept the most extensive treatment delays off the books.
Employees at 24 sites said they felt “threatened or coerced” to enter incorrect information, the VA said.
The inspector general’s report last month said VA data showed an average wait time of 24 days when the actual rate was 115 days on average, illustrating the effect of manipulating the records.
“This behavior runs counter to VA’s core values,” the report said. “The overarching environment and culture which allowed this state of practice to take root must be confronted head-on.”
Acting VA Secretary Sloan Gibson said in a statement on Monday that the problems “demand immediate action.” He added that veterans deserve to have “full faith in their VA.”
The VA report outlined 16 actions the department has or will take to address the problems, including ending the 14-day goal, contacting patients to get them off wait lists, holding employees and officials accountable for records manipulation, halting new hires at the Veterans Health Administration headquarters in Washington, D.C. and publishing data on wait times twice per month.
A senior VA official said Monday that the department will distribute about $300 million over the next 60 to 90 days to help accelerate care, including through increased hours and by contracting with non-VA health clinics.
He added that the department will spend the next month doing an in-depth examination of staffing levels nationwide to determine whether shortages exist at any VA medical centers.
VA scheduling personnel indicated that the greatest barrier to timely care was lack of appointment slots with providers, followed by troubles living up to the 14-day goal and a shortage of scheduler staffing, according to the report.
The official also said the VA needs to update its scheduling software package, which the department has been using since 1985. “It predates the internet and Blockbuster’s rise and fall,” he said.
Veterans groups said the report underscores the need for serious changes within the VA healthcare system.
“This audit is absolutely infuriating, and underscores the depth of this scandal,” Paul Rieckhoff, chief executive of Iraq and Afghanistan Veterans of America, said in a statement. He added that President Obama needs to be “out-front in reforming the VA.”
American Legion executive director Peter Gaytan said the number show that the VA has “a huge task in front of it.” He added that the Legion is already working with veterans to make sure they understand their options and to help them book appointments with the VA as soon as possible.
Last week, Senate Veterans Affairs Committee Chairman Bernie Sanders (I-Vt.) and Sen. John McCain (R-Ariz.) reached agreement on the terms of a bill to help address some of the underlying problems that led to the treatment delays.
The proposal would allow veterans who experience long wait times to seek care at non-VA medical centers, in addition to providing about $500 million to hire more doctors and nurses and authorizing the VA to lease 26 medical facilities in 18 states.
Also last week, Gibson promised cultural change for the Veterans Health Administration, saying the agency would restore trust in the network “one veteran at a time.”
“I will not be part of some effort to maintain the status quo here,” Gibson said.
He also outlined steps the VA has taken to address its scheduling problems in Phoenix, where some of the initial allegations occurred.
Gibson said the department contacted all veterans who were on unofficial wait lists to help them set up timely appointments, began work to contract with private medical centers, deployed mobile medical units to help with the workload, and removed three senior officials at the Phoenix VA clinic.
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