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Veterans Affairs ‘scheduling schemes’ spark strong rebuke from Congress

May 29, 2014 at 6:09 PM EST
Calls for VA Secretary Eric Shinseki are mounting in Washington after the inspector general’s interim report on the VA medical center in Phoenix, Arizona, alleged staffers cooked the books to earn bonuses. Lawmakers on both sides, including Sen. John McCain, are calling for a criminal investigation. Hari Sreenivasan gets more detail from Gregg Zoroya of USA Today.
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JUDY WOODRUFF: The storm kept building today over allegations of delayed care and misconduct at Veterans Affairs hospitals, and demands that VA Secretary Eric Shinseki resign or be fired grew ever more intense.

Hari Sreenivasan has that story.

REP. NANCY PELOSI, Minority Leader: This is intolerable. The findings of this report are troubling and grave, of course. They are unacceptable, unconscionable and unworthy of the service of our men and women.

HARI SREENIVASAN: The reaction of House Minority Leader Nancy Pelosi spoke for politicians from both parties today, after an inspector general’s interim report on the VA Medical Center in Phoenix, Arizona. It alleged VA staffers there cooked the books using various ploys to make wait times appear closer to the goal of just 14 days.

In fact, the I.G.’s findings revealed Phoenix-area veterans seeking care had to wait an average of 115 days for a first appointment. And 1,700 veterans were kept off any official waiting list and were at risk of being lost or forgotten. The report didn’t conclude whether long wait times have contributed to any patient deaths, because that part of the investigation is still ongoing.

But the findings struck sparks at a House hearing last night with top department officials. Tennessee Republican Phil Roe charged VA executives in Phoenix gamed the system to earn bonuses for keeping wait times short.

REP. PHIL ROE, R, Tenn.: What I don’t understand is, as a veteran, as a doctor, as a practitioner, how you can stand in a mirror and look at yourself in the mirror and shave in the morning and not throw up, knowing that you have got people out there and they can’t get in, and they’re desperate to get in. And someone who’s making $180,000 a year gets a bonus for not taking care of the veterans. I don’t get that.

HARI SREENIVASAN: And more lawmakers from both sides, including Republican Senator John McCain of Arizona, called for a criminal investigation and for change at the top of the VA.

SEN. JOHN MCCAIN, R, Ariz.: It’s time for Secretary Shinseki to step down. And if Secretary Shinseki doesn’t step down voluntarily, then I call on the president of the United States to relieve him of his duties, to fire him.

HARI SREENIVASAN: Others, including House Speaker John Boehner and Minority Leader Pelosi, stopped short today of going that far. They spoke at separate events.

REP. JOHN BOEHNER, Speaker of the House: The question I ask myself is, is him resigning going to get us to the bottom of the problem? Is it going to help us find out what’s really going on? And the answer I keep getting is no. But the real issue here is that the president is the one who should be held accountable.

REP. NANCY PELOSI: I really do think we have to be careful about thinking that just because you remove the top person means that you have changed the systemic problem that exists in the organization 10 years before Shinseki, or five years at least before Shinseki became the secretary.

HARI SREENIVASAN: For his part, Shinseki answered by insisting he’s already ordered changes. In a USA Today op-ed column, he wrote: “I remain committed to providing the high-quality care and benefits that veterans have earned and deserve. And we will.”

Publicly, at least, the secretary still had support at the White House. Spokesman Jay Carney:

JAY CARNEY, White House Press Secretary: When it comes to the current situation, the inquiries and the investigations and some of the allegations, the president wants to see the results of these reports. And he, as you know, made clear that he believes there ought to be accountability once we establish all the facts.

HARI SREENIVASAN: In the meantime, the inspector general’s investigation has now expanded to 42 VA health centers nationwide.

For more on the growing outrage over veteran health care and what the inspector general at the VA found, we’re joined now to USA Today reporter Gregg Zoroya.

So, Gregg, late this afternoon, there was a closed door meeting with Eric Shinseki and several veterans groups. What do you know of what took place at that meeting?

GREGG ZOROYA, USA Today: Well, I think the key here was to try to tell them how aggressive they’re trying to be to get these veterans in to see doctors more quickly. And they outlined a plan to do just that.

HARI SREENIVASAN: And so what are some of the steps that are in that plan?

GREGG ZOROYA: Well, the key thing they want to do, they say, is to try to reach out. And they have asked all their facilities, identify those people who have been waiting to see doctors longer than they should.

And then they’re going to find work very hard. They’re going to apparently call them repeatedly to see if they can reach these veterans and then get them in either to see a doctor at the hospital if they have the ability to do that, or get them out to a non-VA doctor and get them some care.

HARI SREENIVASAN: And so there is still some division among veterans groups, some who are calling for Shinseki to resign, and others who are saying basically what John Boehner said, is that, does this get to the bottom of it?

GREGG ZOROYA: Right.

I think, though, that, in general, all the groups are extremely concerned. There are those who have called for him to step down. But there’s others who, while they are reserving judgment, are increasingly worried about whether Shinseki can solve this problem.

HARI SREENIVASAN: The other question I had — well, let’s just kind of walk our audience through what the inspector general found.

It basically said that there were almost two sets of lists, that there were some people who were never put on the waiting lists, just to make the numbers look better?

GREGG ZOROYA: Right.

I mean, you have — you have — probably in the Phoenix facility, you had something like 3,000 veterans who were waiting for appointments. But the problem was, it wasn’t just that. It was that within that group, there were veterans who weren’t even on any kind of a list, or were on lists that were unofficial.

And they were being held off of being calculated in the official system, the investigators believe, because it made the results of their performance at the hospital look better. The later they could hold off on putting these people on the official list, perhaps the shorter the wait time reflected in the official record would be.

HARI SREENIVASAN: So the report said that — they called these scheduling schemes, really four different ways that they were cooking the books. Give us some examples.

GREGG ZOROYA: Well, probably the most common one is simply — the way the system is supposed to work is if a veteran needed to see a doctor, they ask the veteran, when do you want to see him? And that’s supposed to be when they schedule the appointment.

They would in some cases kind of guide the veteran through, though. They would ask them — they would tell them, well, we can’t see you until a particular date and then try to see if the veterans would agree to that. And that would be the so-called starting date. That was kind of one way of gaming the system.

There were other much more dramatic ways. In some cases, they would actually tell staffers to go in and fix some of the appointments, change them, so that they would show a shorter wait time and thereby improve some of the overall performance records that were being sent to headquarters in terms of how long it was taking to see these people.

HARI SREENIVASAN: And so this report still doesn’t get to that conclusion on whether or not some of the people that were on these wait lists or ever — never got to seat care that they deserve actually died as a result.

GREGG ZOROYA: Well, they know, I think — that they have indicated that some people did die while they were awaiting care.

The question is whether they — whether their lives were lost as a result of not — of the treatment they didn’t get and whether others who didn’t get the appointments or the diagnosis in time had their health affected. There seems like — they are finding things in this area, but they want to reserve judgment until they have a better look at some death certificates, medical records and a more definitive idea of these people’s health and, in the cases of the death, what led to their death.

HARI SREENIVASAN: So what happens next as this investigation expands to 40-plus more VA facilities?

GREGG ZOROYA: Right.

Well, they want to get through to the issue of the health and whether the health was damaged by these delays. And they also have, as you have noted, an increasing number of facilities they are looking at. They started out with 10, when the secretary first testified about this two weeks ago. It expanded to 26 last week. And they talked about 42 in the report that was released this week.

It’s not clear how far it’s going to go. But one major conclusion that came out of the interim report was that the investigators are certain this is a systemic problem.

HARI SREENIVASAN: Circling back to something we spoke about earlier, it seems that the pressure is mounting on Eric Shinseki to step down, but the public affairs office keeps putting out e-mails saying that he believes he can fix these changes.

What about those veterans organization that you might have talked to or other folks that you talk to? Do they feel like his continued stay here actually compromises the ability to turn things around?

GREGG ZOROYA: The primary theme that I’m hearing from these folks is they just aren’t sure yet. And they’re very concerned.

They want to get to their people. They want to talk about what the VA is trying to do now. The briefing today was an example of that. They are going to take what they were told in terms of the steps that are being taken to get these veterans care as quickly as possible and take this to their members, to their leadership, and try to see how this is unfolding and whether they should take more dramatic steps, whether they should in fact call for him to step down. I think the jury is still out for many of these major veterans groups.

HARI SREENIVASAN: All right, Gregg Zoroya of USA Today, thanks so much.

GREGG ZOROYA: My pleasure.