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Under scrutiny in the past, VA clinic delay allegations strike a chord

May 8, 2014 at 6:44 PM EDT
Veterans Affairs Secretary Eric Shinseki is pushing back against calls for him to resign after allegations that dozens of patients have died because of delayed treatment at an agency hospital. Shinseki has ordered a nationwide review of access to care at all VA clinics. Jeffrey Brown learns more from Phillip Carter from Center for a New American Security and Brian Skoloff of the Associated Press.
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GWEN IFILL: Veterans Affairs Secretary Eric Shinseki is pushing back against calls for him to resign. This comes after allegations that dozens of patients have died because of delayed treatment at an agency hospital.

Jeffrey Brown reports.

REP. JEFF MILLER, R, Chair, House Committee on Veterans’ Affairs: All those in favor of the motion to issue the subpoena will say aye.

MEN: Aye.

REP. JEFF MILLER: All those opposed, no.

JEFFREY BROWN: The House Veterans Affairs Committee voted overwhelmingly this morning to subpoena communications between Veterans Affairs Secretary Eric Shinseki and his colleagues, the focus, allegations that employees at VA facilities in Phoenix, Arizona, and Fort Collins, Colorado falsified records on delays in treating patients.

A retired doctor in Phoenix who had worked at the hospital came forward with allegations that up to 40 VA patients died while awaiting care.

On Monday, the head of nation’s largest veterans group, the American Legion, called for Shinseki’s resignation.

DANNY DELLINGER, National Commander, The American Legion: There needs to be a change, and that change needs to occur at the top. The administration needs to take steps now. This is long overdue. They should have taken steps months ago.

JEFFREY BROWN: Three Republican senators, including John Cornyn of Texas, quickly joined that call.

SEN. JOHN CORNYN, R, Texas: The president needs to find a new leader to lead this organization out of the wilderness and back to providing the service that our veterans deserve.

JEFFREY BROWN: But House Speaker John Boehner said today the real priority is making it easier for Shinseki to fire people.

REP. JOHN BOEHNER, R, Speaker of the House, Speaker of the House: I’m not ready to join the chorus of people calling for him to step down. The problems at the VA are systemic. And I don’t believe that just changing someone at the top is going to actually get to the solutions that many of us are looking for.

JEFFREY BROWN: Democrats have generally defended the secretary, while demanding improvements in care for the nine million people in the VA medical system.

For his part, Shinseki insists he won’t step down.

He told The Wall Street Journal yesterday: “I serve at the pleasure of the president. I signed on to make some changes. I have work to do.”

The VA inspector general is now investigating the allegations of falsifying records.

And White House spokesman Jay Carney says President Obama is standing by the secretary.

JAY CARNEY, White House Press Secretary: The president remains confident in Secretary Shinseki’s ability to lead the department and to take appropriate action based on the I.G.’s findings.

Pending those findings, Shinseki has now ordered a nationwide review of access to care at all VA clinics.

We invited Veteran Affairs Secretary Shinseki to appear on tonight’s program. He declined.

So, to tell us more about what happened in Phoenix and the wider implications, we turn to Associated Press reporter Brian Skoloff. And Phillip Carter, he’s a senior fellow with the Center for a New American Security. He’s a former Army officer who writes often on issues involving veterans.

Brian Skoloff, let me start with you. Tell us more first about the specific allegations here. The VA was falsifying records of appointments with patients?

BRIAN SKOLOFF, Associated Press: Yes, those are the allegations.

We had a doctor who retired, longtime physician with the VA after about 20 years of service, retired in December, and then came public with these allegations that administrations at the VA hospital had instructed staff to keep this secret waiting list to hid wait times. Sometimes, patients were waiting six to nine months to get in there.

But the wait list was showing that they were getting appointments within two weeks. He also claims that, because of this wait list, up to 40 patients may have died while awaiting this care.

JEFFREY BROWN: Well, explain that, Brian, because the allegations — it doesn’t — it’s not necessarily that 40 people who died because they weren’t seen, but they died during that waiting time.

BRIAN SKOLOFF: Exactly.

And we also have to make perfectly clear here that these are all still allegations. As you noted, the inspector general’s office has investigators here in Phoenix poring over records, interviewing staff, trying to get to the truth.

Right now, what we have is this doctor and two other former VA employees making these claims. And you are exactly correct. The claims are that up to 40 patients may have died while awaiting care.

But, you know, first of all, VA Administration here in Phoenix deny any of these allegations. But they also point out that if there were deaths while patients were awaiting doctor’s appointments, they very well may could have happened from a heart attack, or a car accident, things unrelated to the care that they were seeking.

So, again, the inspector general is down here. And we will have to wait to see what the probe fills up.

JEFFREY BROWN: All right, well, Phil Carter, there is a larger context here, right? The VA has been under pressure and criticized for systemic problems and not keeping up with demand of the wars we have been fighting.

PHILLIP CARTER, Center for a New American Security: That’s right.

These allegations strike a chord, because even though there is widespread patient satisfaction with the VA’s massive hospital system, there are also repeated allegations like this.

And, in fact, the Government Accountability Office, the GAO, substantiated many of these a couple of years ago with a series of reports on how unreliable the VA’s wait time systems were. And that’s been a known problem within the VA that, even though they have known about it, they have not fixed it in the years since.

JEFFREY BROWN: Well, and, in fact, presumably, it is that very thing that may have caused the pressure in Phoenix and other places to falsify the documents, I assume.

PHILLIP CARTER: That’s part of it. And part of it is also the potential linkage between performance incentives and wait times.

That is, if the reported wait times or the targets for those wait times are part of the employment contracts for certain VA officials, they are also very visible metrics of success for VA medical centers. And there is an allegation at least that the VA personnel may have tweaked the stats in order to look better on those measures.

JEFFREY BROWN: So we have allegations in Phoenix, in Fort Collins.

Are you hearing — does it look like we’re going to be hearing about this in other places as well, these practices?

PHILLIP CARTER: There are also reports coming out of Austin and San Antonio.

You have to remember the VA is a massive health care system, 151 hospitals, 800-plus clinics. And so if these conditions existed at the Phoenix Center, which I should say is also home to the second largest veterans community in the country, they may exist in other large facilities or small facilities too.

It is, as Speaker Boehner said, most likely a systemic issue.

JEFFREY BROWN: Well, Brian Skoloff, you said that there in Phoenix, the VA people at the hospital have denied these allegations. Tell us a little bit more about the reaction so far.

BRIAN SKOLOFF: Yes, I mean, a good point was raised there. These allegations are very, very serious.

And they — Dr. Foote, the former VA employee who came out with them first, claims exactly what your guest just said, that the reason the administrators were having these wait times fabricated was so that they could pad their pockets with bonus checks.

Director Sharon Helman, who is the director at the VA health care system here in Phoenix, prior to her being placed on administrative leave last week, told me that she flat-out denies this. She makes roughly $169,000, $170,000 a year. Her bonus last year was about $9,300.

She scoffs at the notion that she would sit back and watch veterans die to make an extra $9,000 in bonus money. Again, though, these are all allegations, but if proven true, they are very serious allegations. But the chief of staff and the hospital administrator vehemently deny that any secret waiting list was created, that they ever told staff to create the secret waiting list, and that staff is really just confused with a changeover from paperwork, actual paperwork, to an electronic waiting list.

But, again, you know, at this point, it is a he said/she said until investigators get to the truth.

JEFFREY BROWN: Well, Phil Carter, at the national level, though, there is a lot of pressure now on General Shinseki.

PHILLIP CARTER: There’s an awful lot of pressure, and a lot of folks are analogizing this now to the Walter Reed scandal from six years ago, where there were reports of terrible living conditions at the Walter Reed Army Medical Center, which is not a VA facility, and those led to the downfall of the Army’s medical leadership as a result.

But folks are trying to figure out here in Washington, where do you fix responsibility within the chain of command? Is it at the secretarial level? Is it below that at the regional level, the hospital level, or down below? And I think that there’s a consensus building, at least — and Speaker Boehner’s comments illustrate that — to wait for the investigation before we fix accountability for these issues.

JEFFREY BROWN: Now, Secretary Shinseki announced this face-to-face audit, right, yesterday at all the facilities across the country. Do we know what that will entail? Do we know how long it will take?

PHILLIP CARTER: No, we don’t know the details of that.

We do know that it was announced earlier in April, and that that was part of the effort to understand how much of an issue this is throughout the VA’s massive health care system — Secretary Shinseki trying to get ahead of the story as much as possible, while also fighting the perception that he is not doing enough.

JEFFREY BROWN: Brian Skoloff, do you have any more on how that is going to work there in Phoenix?

BRIAN SKOLOFF: Well, it could be weeks down here trying to get to the truth of things. But a good point was raised there.

It is no secret that the VA is overwhelmed with veterans seeking care, either from previous wars, more recent wars. There are a lot of veterans seeking care. And they are really swarming these hospitals. Look, the VA has already acknowledged that 23 patients in recent years have died due to delayed care. So there is no — there is no secret that there is an issue with delayed care.

The allegations made here in Phoenix, though, are very serious that there was a cover-up in order for these administrators to make money and get bonus checks. So I guess we will wait and see. But, again, as your guest noted, there’s no secret that the VA has some issues it needs to deal with.

JEFFREY BROWN: All right, Brian Skoloff, Phil Carter, thank you both very much.

PHILLIP CARTER: Thank you.

BRIAN SKOLOFF: Thank you.