Management
The VA and the US Government

Huge backlog: 70 percent of VA facilities used alternative wait lists ... VA audit finds more secret wait lists

Burgess COMMENTARY
The so called 'VA scandal' is no such thing ... it is merely another example of a big system in the modern economy that is totally out of control. Worse, the institutional parts of the system that are meant to be doing oversight and stopping things like the misreporting of management information are totally dysfunctional and ineffective.

I was in corporate management for a good number of years, and usually having something to do with the reporting and the management information. Everywhere I worked, we knew what was going on. That is what the management information systems were for. We knew what we needed to know in a very timely way.

By contrast, institutions of government seem to work on a completely different time scale. Over and over again the Inspectors General start to do their work after the scandal has taken hold and it is a media story. The come in too late, and are able to do too little. The system of IG oversight is broken.

There is also a money and budget dimension of most government scandals. In many cases, the amount of money is sufficient, but the process by which the money gets allocated to get the job done does not work.

In the case of the VA situation, it is entirely probable that the system is grossly underfunded and equally possible that the paperwork load is ludicrous, driven by political agendas and solutions dreamed up by lawyers.

This is not a catastrophe that has been created under the current Obama administration, but goes back a very long time. It was Reagan's administration that signed the 'Paperwork Reducation Act' in the 1980s, and for years afterwards government forms came to you with a separate document confirming that the form had been approved under
Peter Burgess

Huge backlog: 70 percent of VA facilities used alternative wait lists System fostered bonuses for executives, created confusion for scheduling staff VA audit finds more secret wait lists An internal audit of the Department of Veterans Affairs released Monday found that 70 percent of facilities had placed patients on a wait list other than the official electronic record. By Jacqueline Klimas-The Washington Times Monday, June 9, 2014 ** FILE ** This April 28, 2014, file photos shows the Phoenix VA Health Care Center in Phoenix. The Veterans Affairs Department says more than 57,000 patients are still waiting for initial medical appointments at VA hospitals and clinics 90 days or more after requesting them. An additional 64,000 who enrolled in the VA health care system over the past 10 years have never had appointments. (AP Photo/Ross D. Franklin, File) Tens of thousands of veterans are stuck in backlogs awaiting care at VA facilities, the department said Monday in a report that confirms employees regularly cooked the books, often under pressure from supervisors, to try to hide long wait times. The audit found that 70 percent of Veterans Affairs facilities surveyed placed patients on alternate wait lists, meaning many of those veterans probably weren’t recorded in the official reports back to headquarters and were used to dole out bonuses to VA executives. SEE ALSO: VA IG subpoenas watchdog group In a report that called the problems plaguing the nation’s largest single health care provider “systemic,” auditors also found a scheduling process that is “overly complicated” and “resulted in high potential to create confusion among scheduling clerks and front-line supervisors.” As a result, more than 57,000 veterans were waiting 90 days or more for an initial appointment. Another 64,000 apparently never got appointments after enrolling. “This audit is absolutely infuriating and underscores the depth of this scandal,” said Paul Rieckhoff, founder of Iraq and Afghanistan Veterans of America. “Our vets demand action and answers.” Richard Griffin, the VA’s acting inspector general, told a Monday evening hearing of the House Veterans’ Affairs Committee that his agency was investigating 69 of its medical facilities for suspected wrongdoing, more than half as many as the 42 that he said were being investigated two weeks ago. The White House said the audit is the beginning of efforts to resolve problems within the VA and that President Obama deserves credit for releasing the details. “The release of today’s data is an indication of the president’s commitment to trying to be transparent about this process,” said White House spokesman Josh Earnest. He said fixing the problems won’t be easy but insisted that Mr. Obama has “never been more dedicated” to the effort. Mr. Earnest said one change already has been made: The VA no longer has a goal of scheduling appointments within 14 days. The spokesman said that goal led to “unintended consequences” such as the secret wait lists. Both chambers of Congress are working on bills that would let veterans who have waited too long for appointments to go instead to private doctors outside of the VA system, with the costs covered by the government. The scandal at the VA emerged last month when a whistleblower reported that at least 40 veterans had died while awaiting care at the Phoenix VA facility and were never placed on the electronic wait lists. A preliminary inspector general report released in late May found 1,700 veterans had been kept off the books at the Phoenix facility and said there were systemic problems of scheduling delays and manipulation of data across the health care system. A final inspector general’s report is expected to be completed this summer. According to the audit released Monday, 8 percent of scheduling staff nationwide used something other than the electronic wait lists, and 70 percent of facilities had at least one alternate list. The audit did not examine whether any of these lists were acceptable under VA policy. Investigators said 13 percent of scheduling staff had been instructed by a supervisor to enter a date other than the veteran’s requested appointment into the “desired date” field, substantiating the claims that employees were cooking the books. “This behavior runs counter to our core values,” the report said. “The overarching environment and culture which allowed this state of practice to take root must be confronted head-on.” The VA allows patients to give a desired appointment date, which may have led to some of the problems. The audit said that practice was “difficult to reconcile against more accepted practices such as negotiating a specific appointment date based on provider availability.” Auditors also questioned the VA’s self-imposed deadline of 14 days to begin providing care. Investigators said the number of doctors or appointment slots may not be sufficient to achieve that goal. Officials have blamed the 14-day deadline and other performance goals for some of the problems. They said some facilities began to treat the deadline as a goal in itself, not as a tool to ensure better care. Former VA Secretary Eric K. Shinseki, who resigned late last month as the internal audit was being prepared, said department executives wouldn’t be getting bonuses this year. A bipartisan group of 21 senators said the matter is more serious than that. Led by Sens. John McCain, Arizona Republican, and Richard Blumenthal, Connecticut Democrat, the senators demanded that the Department of Justice take over a criminal investigation into the situation. “The spreading and growing scale of apparent criminal wrongdoing is fast outpacing the criminal investigative resources of the IG, and the revelations in the interim report only highlight the urgency of involvement by the Department of Justice,” the senators wrote last week in a letter to Attorney General Eric H. Holder Jr. “There is a need for prompt results from the IG — not by August, as the IG has publicly said, but within the next few weeks.” • Dave Boyer contributed to this report. Read more: http://www.washingtontimes.com/news/2014/jun/9/audit-more-57000-await-initial-va-visits/#ixzz34FYXzNvn Follow us: @washtimes on Twitter