VA wait-times still erratic, 5 years after 200 veterans died waiting for appointments

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Rep. Jim Banks told his fellow members of Congress and Veterans Administration leadership Wednesday the story of a veteran who needed help, but was failed by the VA. 

An Indiana veteran having a “mental health episode” was found walking down a highway by police, Banks, R-Ind., said. He was returned to the care of his mother, who on advice from a veteran service organization, planned to take him to the local VA hospital.

The VSO called ahead to help expedite and get the veteran help as soon as possible, Banks said. But hospital staff told the VSO it did not have room or a doctor for the veteran. 

The veteran was next taken to the second-closest VA facility, an hour away. But upon arrival, VA “refused to see him due to lack of space.” Police officers in the VA waiting room told staff they had to admit the veteran. VA refused. It took a court order to force the VA to admit the veteran, Banks said.  

It's been five years since whistleblowers uncovered extensive wait times at the Phoenix Veterans Administration Health Care Center and revealed a coverup of wait times across the country that led to more than 200 veterans dying while waiting for an appointment. On Wednesday, VA leaders were again before Congress to discuss the coverup, subsequent scandal and what progress has been made since.

Chairman Rep. Mark Takano, D-Calif., said during the Wednesday hearing of the House Veterans Affairs Committee that he was “alarmed” much of what was brought to light in 2014 “remains today … we simply cannot put veterans at risk while they wait for care.”

“There is no doubt VA has farther to go,” ranking member Rep. Phil Roe, R-Tenn., said.

Takano mentioned recently reported “secret waitlists” revealed by whistleblowers, and which the VA vehemently denies exist. 

In written testimony, Veterans Health Administration Dr. Teresa Boyd seemed to acknowledge those “secret” waitlists and said “no veterans were harmed” while on the waitists and VA is operating with “unprecedented transparency.” When questioned, though, Boyd said "there are no secret waitlists. We don't need to go back and relitigate all of that." 

Takano called those “two very bold statements” and Rep. Chris Pappas, D-N.H., asked why Boyd said in her testimony that an investigation into those lists was “due to recent media reports” and not simply whistleblowers coming forward. 

“It should not take a media story,” Boyd said but did not give specific reasons why the investigation was launched after media reports and not after the initial whistleblower reports

When asked about the Indiana veteran turned away from two separate VA hospitals, Boyd didn’t offer a solution. 

“If it happens one time, it’s one too many,” she said, and asked Bank’s staff to provide her more information on the incident. Boyd said VA has oversight of how patients are treated when they come to VA for help. But Boyd also said the story doesn’t match up to what VA leadership sees when they visit facilities. 

“I have a lot of concern with the story that you just relayed. It doesn’t fit with what we expect and what we see when we go out,” she said. 

The VA has also still not implemented recommendations on wait times from the Government Accountability Office from the time of the scandal five years ago and even before, according to GAO spokeswoman Debra Draper. “It took seven years to close” one of the recommendations, Draper said, and several more are still outstanding. 

In some cases, VA took as long as three months to enroll veterans in health care benefits, but VA did not include those delays in official wait-time tracking for appointments for more than six years, Draper said. 

A constant of the hearing was a lack of understanding of just what “wait time” means for VA, for patients and the frustration over the difference.

Rep. Amata Coleman Radewagen, R-American Somoa, said she and VA Secretary Robert Wilkie are expected to travel back to her district soon and she expects Wilkie “to really get it in the neck” about the definition of wait times from her veterans.

Rep. Julia Brownley, D-Calif., said veterans “erupted in laughter” at wait time statistics offered by VA leadership, because the way VA measures wait times is the “polar opposite” of what veterans think of as their total wait time. 

“Why is it that VA makes it so complicated?” Brownley said. “Why is it that the VA does not measure wait times from the time a veteran calls to the time he or she gets the appointment?”

VA leadership did not have a solid answer for Brownley’s question. 

VA watchdogs and members of Congress also expressed mounting frustration over incomplete, unreliable and at times incorrect wait time data. 

“We continue to be concerned VA has not addressed the unreliability of its (wait-time) data,” Draper said. 

Wednesday’s hearing came just one day after the VA Inspector General released a report about significant barriers to access and delays for veterans seeking mental health care at the Albuquerque, New Mexico VA. VA is supposed to provide same-day mental health care services at all of its facilities. 

But VA leadership did not provide specific solutions for what’s happening in New Mexico or other areas like North Texas, where Rep. Colin Allred, D-Texas, said 40-80 veterans are waiting for beds at VA hospitals every day. 

VA also does not track the wait times for its private health care partners, so veterans have no way of knowing which would be the quickest route to care. 

Roe said he found it “hard to believe” that VA is keeping its promise to schedule same-day appointments for mental health and primary care, citing New Mexico. 

Boyd said VA is providing that same-day care, and 20 percent of its daily appointments are same-day appointments.

Roe countered, saying he expects “to get a call by the end of the day refuting that.” 

Appointment schedulers are among the top 10 highest-turnover positions at VA, Draper said, potentially adding to wait times.

VA leadership multiple times cited “changing the culture” of VA as a solution to wait times. “We have not done a good job in setting up our mid-managers for success,” Boyd said. 

VA leaders argued that a survey shows "veterans are telling us we are moving in the right direction" and that thousands of veterans are getting quicker care through private urgent care clinics under the MISSION Act.

Roe said he believes the work to be done to improve is on “the local level” and “between when I came on this committee in 2009 and now, the VA is doing a much better job.”

Takano agreed there is more work on the horizon for VA.

“This committee will not allow our veterans to be harmed by the same deceptive practices that led to the Phoenix VA scandal,” he said. 

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