Tuesday, June 10, 2014






Moving to the issue of veterans, Erik Wemple (Washington Post) reports:

The Project on Government Oversight (POGO), a Washington-based nonprofit that pushes for “good government reforms,” will fight a May 30 subpoena from the inspector general of the Department of Veterans Affairs (VA) seeking the results of its research into mismanagement at the department. “We never have” complied with such a subpoena, says POGO communications director Joe Newman, who says the group has now dealt with seven demands from federal agencies for records since the early 1990s. “And we have no plans to do that.”

CJ Ciaramella (Washington Free Beacon) adds, "POGO, along with the Iraq and Afghanistan Veterans of America, launched a website on May 15 where whistleblowers within the VA could confidentially report problems. According to POGO, roughly 700 people have submitted tips using the site."  Joe Newman, Director of Communications for the Project On Government Oversight, writes a response to the IG subpoena which includes:

POGO, which has a 33-year history of working with whistleblowers to expose government fraud, waste and abuse, wrote the IG today and refused to provide the records, most of which have come from confidential tips submitted through VAOversight.org.
POGO and the Iraq and Afghanistan Veterans of America (IAVA) launched VAOversight.org on May 15 to offer potential whistleblowers a safe channel to confidentially report abuses in the VA healthcare system, which have been the focus of intense media scrutiny and congressional hearings in recent weeks.
Since the website went live, about 700 people have submitted tips or aired grievances. About 25 percent of those tips have come from current or former VA staffers. POGO is reviewing the information it has received and is looking into many of the claims.
In a letter sent to the IG this morning, POGO said the IG’s subpoena infringes on POGO’s constitutional “freedom of speech, freedom of press, and freedom of association rights as they relate to all whistleblowers and sources.”
Some VA employees who contacted POGO and requested confidentiality said they feared retaliation if their names were divulged. Any of them could have reported their concerns to the VA inspector general. In fact, some of the employees told POGO that they had filed reports with the IG. Some people expressed a lack of confidence in the Office of the Inspector General.
“The Inspector General’s demand stands opposed to POGO’s mission and to good government reform—both of which serve the public interest,” POGO Executive Director Danielle Brian said. “Our focus is squarely on investigating the problems in the VA healthcare system and trying to find some solutions.
“Our mission as a public interest watchdog would be severely damaged if we violated the trust of our sources. We have faced these kinds of threats before and have never wavered. We will not violate the trust whistleblowers have placed in us by revealing their identities to anyone.”

Staying with the topic of veterans, it started as rumors and became much more with whistle-blowers coming forward and CNN reporting.  Yes, we're talking about the VA scandal where veterans were kept waiting for weeks and months despite the claims that all veterans were receiving medical appointments within 14 days of requesting them.  Today the Veterans Affairs Department released the Nationwide Access Aduit results. Among the findings?  "Meeting a 14-day wait-time performance target for new appointments was simply not attainable given the ongoing challenge of finding sufficient provider slots to accommodate a growing demand for services.  Imposing this expectation on the field before ascertaining the resources required and its ensuing broad promulgation represent an organizational leadership failure."

"Represent an organizational leadership failure."

Eric Shinseki resigned as Secretary of the VA two weeks ago.  Even then, some rushed to defend him.  The audit found "an organizational leadership failure."  The would be Shinseki's failure, he headed the Department..

We'll note this from the report and italicized emphasis is from the authors of the report, not me:

Findings indicate that in some cases, pressures were placed on schedulers to utilize inappropriate practices in order to make waiting times (based on desired date, and the waiting lists), appear more favorable.  Such practices are sufficiently pervasive to require VA re-examine its entire performance management system and, in particular, whether current measures and targets for access are realistic or sufficient.

How many sites were cooking the books?

The report notes:

Respondents at 90 clinic sites provided responses indicating they had altered desired dates that had been entered.  In virtually all cases, they indicated they were instructed by supervisors, but many believed the policy of altering dates was coming from facility leadership.  In at least 2 clinics, respondents believed someone else (not a scheduler) was routinely accessing records and changing desired dates in order to improve performance measures. 

  • Establishing New Patient Satisfaction Measurement Program- Acting Secretary Gibson has directed VHA to immediately begin developing a new patient satisfaction measurement program to provide real-time, robust, location-by-location information on patient satisfaction, to include satisfaction data of those Veterans attempting to access VA healthcare for the first time. This program will be developed with input from Veterans Service Organizations, outside health care organizations, and other entities. This will ensure VA collects an additional set of data – directly from the Veteran’s perspective – to understand how VA is doing throughout the system.
  • Holding Senior Leaders Accountable- Where audited sites identify concerns within the parent facility or its affiliated clinics, VA will trigger administrative procedures to ascertain the appropriate follow-on personnel actions for specific individuals.
  • Ordering an Immediate VHA Central Office and VISN Office Hiring Freeze- Acting Secretary Gibson has ordered an immediate hiring freeze at the Veterans Health Administration (VHA) central office in Washington D.C. and the 21 VHA Veterans Integrated Service Network (VISN) regional offices, except for critical positions to be approved by the Secretary on a case-by-case basis. This action will begin to remove bureaucratic obstacles and establish responsive, forward leaning leadership.
  • Removing 14-Day Scheduling Goal VA is eliminating the 14-day scheduling goal from employee performance contracts- This action will eliminate incentives to engage in inappropriate scheduling practices or behaviors.
  • Increasing Transparency by Posting Data Twice-Monthly- At the direction of the Acting Secretary, VHA will post regular updates to the access data released today at the middle and end of each month at VA.gov. Twice-monthly data updates will enhance transparency and provide the most immediate information to Veterans and the public on Veterans access to quality healthcare.
  • Initiating an Independent, External Audit of Scheduling Practices- Acting Secretary Gibson has also directed that an independent, external audit of system-wide VHA scheduling practices be performed.
  • Sending Additional Frontline Team to Address Phoenix- Following his trip to Phoenix VA Medical Center last week, Acting Secretary Gibson directed a VHA frontline team to travel to Phoenix to immediately address scheduling, access, and resource requirements needed to provide Veterans the timely, quality healthcare they deserve.
  • Utilizing High Performing Facilities to Help Those That Need Improvement- VA will formalize a process in which high performing facilities provide direct assistance and share best practices with facilities that require improvement on particular medical center quality and efficiency, also known as SAIL, performance measures.
  • Applying Immediate Access Reforms Announced in Phoenix to Most Challenged VA Facilities- Last week, Acting Secretary Gibson announced a series of measures to address healthcare access problems in Phoenix. Today, Acting Secretary Gibson announced he’ll apply the same reforms to facilities with the most access problems from the results of the audit, including:
  • Hiring Additional Clinical and Patient Support Staff- VA will deploy teams of dedicated human resource employees to accelerate the hiring of additional, needed staff.
  • Employing New Staffing Measures- VA’s first goal is to get Veterans off wait lists and into clinics. VA is using temporary staffing measures, along with clinical and administrative support, to ensure these Veterans receive the care they have earned through their service.
  • Deploying Mobile Medical Units- VA will send mobile medical units to facilities to immediately provide services to patients and Veterans awaiting care.
  • Providing More Care by Modifying Local Contract Operations- VA will modify local contract operations to be able to offer more community-based care to Veterans waiting to be seen by a doctor.
  • Removing Senior Leadership- Where appropriate, VA will initiate the process of removing senior leaders. Acting Secretary Gibson is committed to using all authority at VA’s disposal to enforce accountability among senior leaders.
  • Suspending Performance Awards- VA has suspended all VHA senior executive performance awards for FY2014.
  • Future Travel Over the course of the next several weeks- Acting Secretary Gibson will travel to a series of VA facilities across the country. He will hear directly from Veterans and employees about obstacles to providing timely, quality care and how VA can immediately address them.

CONTACT: Gretchen Andersen (212) 982-9699 or press@iava.org

57,000 Vets Waiting For Appointments, New Vets Infuriated
Audit details how vets across the country wait almost three months for appointments at VA Hospitals
Washington DC (June 9, 2014) – According to a new Department of Veterans Affairs (VA) audit released today, more than 57,000 patients across the country have been waiting almost three months for appointments at VA hospitals and clinics. The audit was released ahead of IAVA CEO and Founder Paul Rieckhoff’s meeting with other leading veterans groups and Acting VA Secretary Sloan Gibson at the VA.
“This audit is absolutely infuriating, and underscores the depth of this scandal,” said Rieckhoff. “Our vets demand action and answers. IAVA again calls on the President to be out-front in reforming the VA and we also encourage members of Congress and the Administration to implement IAVA’s eight-step plan. We would welcome a meeting with the President – the veteran community must hear more from him and be assured that he cares. I look forward to hearing answers from Acting VA Secretary Sloan Gibson this afternoon.”
The audit found that: 
Practices of manipulating wait times were so pervasive, the audit recommended a complete overhaul of VHA's performance management system. 
13 percent of schedulers - and 76 percent of facilities - reported some improper scheduling practices. 
8 percent of schedulers - and 70 percent of facilities - used an alternative to the appropriate waiting lists. 
Last Monday Rieckhoff, joined by IAVA veterans from across the country, unveiled eight steps  the Obama Administration and Congress can take now to restore confidence in the Department of Veterans Affairs. Among the steps are recommendations from IAVA’s 2014 Policy Agenda. IAVA urged Congress and the President to enact all of the recommendations from the plan.
NOTE TO THE MEDIA: IAVA leadership is available for interview. Press can email press@iava.org or call 212-982-9699.
Iraq and Afghanistan Veterans of America (www.IAVA.org) is the nation's first and largest nonpartisan, nonprofit organization representing veterans of Iraq and Afghanistan and has more than 270,000 Member Veterans and civilian supporters nationwide. Celebrating its 10th year anniversary, IAVA recently received the highest rating - four-stars - from Charity Navigator, 
America's largest charity evaluator. 

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RECOMMENDED: "Iraq snapshot"