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Phoenix, AZ's VA health care campus
Phoenix VA Hospital
An interim report released Wednesday by the Inspector General's Office (OIG) of the Veterans Administration has confirmed previous claims of serious delays in scheduling appointments and providing treatment to patients at the VA's Phoenix Health Care System. The report did not, however, go so far as to say that staff at Phoenix had concealed or destroyed records, or that veterans had died because they couldn't get a timely appointment for treatment. Such findings could come later.

The report includes recommendations for change, but notes that getting a handle on the allegations of gross mismanagement and misallocation of resources in Phoenix and elsewhere in the VA system will have to await the completion of a more thorough report.

As a consequence of the allegations against Phoenix, congressional Republicans, who have a record of failing to fund the VA adequately, have called for the resignation of the Veterans Administration chief, General Eric Shinseki, someone picked specifically because of his reputation as a straight talker with demonstrated willingness to buck the system.

Acting Inspector General Richard Griffin noted in the interim report's executive summary that since 2005, his office has issued 18 reports "that identified, at both the national and local levels, deficiencies in scheduling resulting in lengthy waiting times and the negative impact on patient care."

The latest abbreviated interim report concludes likewise, and includes disturbing details:

• At Phoenix, some 1,400 veterans were found to be on the center's electronic waiting list for a primary care appointment. That is, they had an appointment scheduled. But the OIG also found 1,700 veterans seeking an appointment who weren't on an EWL. "Until that happens, the reported wait time for these veterans has not started. Most importantly, these veterans were and continue to be at risk of being forgotten or lost in Phoenix HCS’s convoluted scheduling process."

• Because veterans are not placed as they should be on EWLs, Phoenix leadership
"significantly understated the time new patients waited for their primary care
appointment in their FY 2013 performance appraisal accomplishments, which is one of the factors considered for awards and salary increases."

• In its sample of 226 veterans, the OIG found the Phoenix HCS had reported to the VA for fiscal 2013 that the average wait time was 24 days for a first primary care appointment. Forty-three percent waited more than 14 days, the report said. But the OIG's review found the average wait for these 226 veterans was actually more than four times as long—115 days—with about 84 percent waiting more than 14 days.

• Until it complete additional research, the OIG will not determine whether any veteran died as a result of delayed appointments and treatment h.

There is more to read on this subject below the fold.

The OIG recommended that action be taken immediately to "provide appropriate health care" to the 1,700 veterans not on any waiting list, that all waiting lists at Phoenix be evaluated by the VA to "identify veterans who may be at greatest risk because of a delay in the delivery of health care," that a nationwide review of all veterans on waiting lists be undertaken to ensure that they are seen at an appropriate time, and that a nationwide New Enrollee Appointment Request report be carried out to ensure that new enrollees have been given the treatment they need or are on an electronic waiting list to see medical personnel.

Since President Obama became president, the VA budget has climbed 50 percent from $100 billion to $150 billion. While that may seem adequate to the austerity mongers,  those eligible for veterans' benefits more than doubled from 400,000 to 918,000 in the same period.

While money isn't the only problem at the VA, it certainly plays a role in how we treat health problems of the people sent off to fight our wars.

A big problem with the nation's defense budget is that it doesn't include quite a number of things that it ought to. One exclusion is what it costs to treat veterans, not just those who have already returned home, but the inevitable Veterans of Future Wars. It doesn't matter whether those wars are among the very, very few that are just and necessary or the majority that should never ever happen. We owe the men and women who fight in them the very best health care.

The situation at Phoenix may turn out not to be quite as bad as some have claimed. But the interim report shows that it's bad enough. The previous 18 OIG reports addressing the impact of the VA's recurring delay in treatment have apparently been an excuse by too many people who could do something about it to hit the snooze alarm. It would encouraging if No. 19 would finally wake them up.

Originally posted to Meteor Blades on Wed May 28, 2014 at 12:26 PM PDT.

Also republished by Daily Kos.

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Comment Preferences

  •  of course McCain can afford not to use the VHA (3+ / 0-)
    Recommended by:
    Meteor Blades, LinSea, cactusgal
    Sen. John McCain, an Arizona Republican, told CNN's Wolf Blitzer that inspector general Richard Griffin's initial findings were terrible and said it was "about time" the Justice Department launched its own investigation.
    He also said embattled VA Secretary Eric Shinseki should probably resign, which the Cabinet officer has said he has no plans to do.
    "I haven't said this before, but I think it's time for Gen. Shinseki to move on," McCain said.
    There have been calls from other members of Congress for him to step down over the scandal, but McCain's voice on military matters carries enormous weight considering his experience as a combat veteran, a Vietnam prisoner of war, and his work in the Senate on related issues.

    Warning - some snark may be above‽ (-9.50; -7.03)‽ eState4Column5©2013 "If we appear to seek the unattainable, then let it be known that we do so to avoid the unimaginable." (@eState4Column5)

    by annieli on Wed May 28, 2014 at 12:30:31 PM PDT

  •  need more caregiving & alot less/Republicans (5+ / 0-)

    decent wages don't eliminate jobs. Republicans eliminate jobs; and workers, and prospects, and then excuse it all and call for more austerity. there is no end to their ignorant, arrogant avarice. only political dinosaurs support their treachery.

    by renzo capetti on Wed May 28, 2014 at 12:39:03 PM PDT

  •  Nope. Republicans answer will be "Get Obama". (8+ / 0-)

    There will be NOTHING done to actually FIX it.

    Nothing at all.

    Reid can bring up the bill that was filibustered in February and even have it paid for with food stamp and welfare cuts, and STILL Republicans would block it.

    Because it's Get Obama. It's not about veterans. They can die for all Republicans care about them.

    "Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity." --M. L. King "You can't fix stupid" --Ron White -6.00, -5.18

    by zenbassoon on Wed May 28, 2014 at 12:39:08 PM PDT

  •  I get VA medical care (6+ / 0-)

    Cat 5. Most VA medical care takes place in community clinics rather than VAMCs (hospitals) particularly primary care.

    Is the Phoenix appointment system so centralized that a vet can't call the local clinic?

    In recent years I have tried to use the system as little as possible to make room for the newer vets. They need the care more than I do.

  •  If people have to wait this long... (6+ / 0-)
    the OIG's review found the average wait for these 226 veterans was actually more than four times as long—115 days—with about 84 percent waiting more than 14 days.
    wouldn't that simply suggest a severe shortage of doctors? It doesn't matter how much better you make the scheduling technology if there simply aren't enough appointment slots.
    Or what am I missing?
  •  I think there is major footdragging (3+ / 0-)
    Recommended by:
    Vetwife, cactusgal, DQKennard

    over PTSD and the vast numbers of our troops returning with this issue.

    There are ongoing concerns that the issue is being downplayed, divided and conquered and trying to be avoided without looking like they are avoiding it.

    I have seen reports that suggest doctors or other clinicians in the VA are changing PTSD diagnoses to other things such as personality disorders and totally disqualifying vets from essential treatments.

    At the same time that the Department of Veterans Affairs (VA) made it easier for soldiers to file a post-traumatic stress disorder claim, the agency also made it more difficult to receive such a diagnosis, prompting veterans groups to sue the government over the latter change.

    In 2010, the VA decided veterans no longer needed to provide witnesses to substantiate a claim of PTSD. This move was heralded by veterans’ organizations. But then it was learned that the agency adopted another new rule that states PTSD diagnoses must come from VA doctors, not private physicians.

     - - - - -

    “With the new regulation they could say they don’t have to look at a private examiner now because they have one done by a VA examiner. And the preponderance of evidence then is against the claim.”

    Plus our GOP doesn't want to waste money on the troops unless it is to blow non-white people up or take their oil.

    Legal means "good".
    [41984 | Feb 4, 2005]

    by xxdr zombiexx on Wed May 28, 2014 at 02:09:06 PM PDT

    •  Efficiency as well? (3+ / 0-)
      Recommended by:
      DQKennard, ssgbryan, nio

      I'm pretty sure resourcing is part of it.

      On the other hand, I saw a news article a week or two ago about the Albuquerque VA that said the cardiologists at the VA hospital there saw about 1/4 to 1/5 as many patients per week as did cardiologists at non-VA hospitals in the area.   Now, that doesn't have to mean the doctors are inefficient, it could be other bottlenecks that leave the doctors underworked.  But something seems wrong.

      As someone who has worked for the federal govt myself, I don't want to bash public employees.  But the system really can be crazy.

      In that job, I wanted an ergonomic keyboard as it really makes a difference in hand comfort for me.  TO their credit, my immediate supervisors were fine with that request, and we were only talking about a ~$50 product.

      So....   two months later I got my keyboard, along with a 27 page documentation trail, including signatures from about eight different people in the IT, finance, and contracting chains.  The pages included compliance reports for laws I'd never even heard of.  I did not not get the model I wanted, since that was determined to not be "least cost".  Then again, the actual price the govt paid for what I did get was fully 2x what that same keyboard sold for at the Office Depot a mile away (and nearly 3x the Newegg price).  

      That amount of bureaucratic churn was using pre-approved vendors, for a product already on the "approved equipment" list!  

  •  "Convoluted scheduling system" seems (0+ / 0-)

    to be a damn good place to start for a big ol' fix.

    And hire some more docs/nurses with a commitment of at least 5 years......with a signing bonus if it's too hard to get them to "do for their country" without the dollar signs.

    Listening to the NRA on school safety is like listening to the tobacco companies on cigarette safety. (h/t nightsweat)

    by PsychoSavannah on Wed May 28, 2014 at 02:10:12 PM PDT

    •  I think you would get a better response if (3+ / 0-)

      rather than signing bonus they offered to pay off some or even most of their student loans in exchange for say, 5-10 years of such service.

      You have watched Faux News, now lose 2d10 SAN.

      by Throw The Bums Out on Wed May 28, 2014 at 02:24:08 PM PDT

      [ Parent ]

      •  The vets deserve more than docs just out of their (1+ / 0-)
        Recommended by:

        residency. I sure wouldn't go to someone who's not had a least 5 years of private practice.

        They also need specialists in trauma injuries and mental health.

        While this problems started a long time ago, it's landing in the lap of the Prez. Now that the report is out, immediate action is needed.

        Fire and imprison (if justified) those bastards who shredded documents, etc.

        When we went to war in the middle east, did the legislature pump more money into the VA? Did they allow enough?

        This is also a bureaucratic mess that plays right into the hands of the Rs who say that government is too big and can't do as good a job as the private sector.

        It’s the Supreme Court, stupid! Followed by: It's always the Supreme Court! Progressives will win only when we convince a majority that they, too, are Progressive.

        by auapplemac on Wed May 28, 2014 at 04:41:45 PM PDT

        [ Parent ]

        •  VA Budget (0+ / 0-)

          The VA budget has more than doubled from $75 billion in 2004 to over $150 billion this year for 2014.

          Republicans are arguing we have thrown a ton of money at it and government has still proven to be every bit as incompetent as ever.

          We need to find an effective way to counter that argument as to the low info voter it is effective.

          •  Maybe it's true. On rare occasions the R's have a (1+ / 0-)
            Recommended by:
            John in Cleveland


            Why were VA employees given bonuses based on faulty information. Where was the oversight. These employees actually stole your tax dollars.

            Now that the interim report is out, we should be as incensed as they are.

            It’s the Supreme Court, stupid! Followed by: It's always the Supreme Court! Progressives will win only when we convince a majority that they, too, are Progressive.

            by auapplemac on Wed May 28, 2014 at 05:20:44 PM PDT

            [ Parent ]

          •  The counter is in the fact that the ... (3+ / 0-)
            Recommended by:
            ssgbryan, Bongobanger, Vetwife

            ...caseload has MORE than doubled.

            Don't tell me what you believe, show me what you do and I will tell you what you believe.

            by Meteor Blades on Wed May 28, 2014 at 05:51:34 PM PDT

            [ Parent ]

            •  But with faked waiting times there was no (0+ / 0-)

              evidence that the VA needed more money.

              The key problem here was fraud - people faking data so they could get bonuses.  

              That's just plain old theft.  The people who did it need to be prosecuted.

              Once we have accurate information on wait times, service, etc. then we can see if more money is needed to handle the case load.

    •  you gotta have funding if you're going to hire (2+ / 0-)
      Recommended by:
      Tony Situ, mjd in florida

      adequate #s of care givers

      republicans always support the AUMF for a godless war/always filibuster vet care when they return from that godless war

      AND furthermore, (having nothing to do with your post)... John McCain is the one who should resign.

      "Show up. Pay attention. Tell the truth. And don't be attached to the results." -- Angeles Arrien

      by Sybil Liberty on Wed May 28, 2014 at 02:39:13 PM PDT

      [ Parent ]

  •  This makes me wonder how many veterans (6+ / 0-)

    might have contacted McCain (R) or Flake (R) or AZ representatives like Paul Gosar (R) to report on the VA problems, and what, if anything, THEY did about it.

    All I know is that these same guys didn't do shit during the government shutdown until the horses had already burned up with the barn.

    Time for THEM to resign.

  •  Whistleblowers??? (4+ / 0-)

    As soon as the FOX brought on a so called whistleblower that fully supported the long want of conservatives, to privatize the peoples responsibility the VA for corporate profits off the peoples treasury which would also bring on any fee's that can be legislated for the corporate entities, the jig was up!! Started sounding way too much like what was going on in the agency under the bush!! Files being shredded, the long time if a conservative executive branch ignore the Veterans issues, and much much more, not to mention little extra funding as they waged two more wars and long occupations!!

    Looks like the conservative friends on the inside of their government jobs were working overtime to help the Burr's and Millers as they and company have sought to boot Gen Shinseki since he was appointed, and why, because He and with Help From The Entire Executive Branch are doing what they've refused to do, the country served as well, Build The VA that should always have been, the peoples responsibility:

    The Country that 'Talks the Talk' but rarely 'Walks the Walk', patriotism posers who loves the free wars and ignore any sacrifice as to the long term results from, while ignoring the many issues of Veterans, those that served them, especially as a result of our wars, their representatives leading that ignoring while attacking the under funded VA, decades now and wars from, they control the purse strings of the Country!

    The Fallen Brothers and Sisters and Our Veterans Community are Not a Corporate Marketing Tool Especially on Memorial and Veterans' Days!!!!!!!

    "In fiscal 2013, the VA spent about $4.8 billion, or about one-tenth of its healthcare costs, on private care, often for veterans who live far from VA facilities or veterans in need of care unavailable at a VA facility."

    “Why in 2009 were we still using paper?” VA Assistant Secretary Tommy Sowers “When we came in, there was no plan to change that; we’ve been operating on a six month wait for over a decade.” 27 March 2013

    TX-19 Congressional Candidate Neal Marchbanks - Veteran: 28 March 2014 - "Congress controls the budget for the VA and it is the fault of Congress that the VA does not have enough employees and that the facilities are too small."
    Congress, in Veteran Marchbanks statement, are the people served and who representatives work for, or are supposed to!

    USN All Shore '67-'71 GMG3 Vietnam In Country '70-'71 - Independent**

    "If military action is worth our troops' blood, it should be worth our treasure, too; not just in the abstract, but in the form of a specific ante by every American." -Andrew Rosenthal 10 Feb. 2013

    by jimstaro on Wed May 28, 2014 at 02:37:12 PM PDT

    •  conservative idelogy (2+ / 0-)
      Recommended by:
      ssgbryan, Vetwife

      Sen. Burr, as minority leader on the Senate Veterans' Affairs Committee, when he decides to even attend the hearings of,Is Not A Friend Of Veterans', Never Has Been, but boy howdy does NC love them Defense Dollars which keep it's economy afloat as it attacks education, the unemployed {including unemployed veterans}, the poor and middle classes {including the veterans within}, the health care needs {including veterans and families needing medicaid}, residents and military and veterans needing food stamps, and much more many including the residents who are Veterans'! Nor are the rest of the Conservative's in the Senate. Nor is Rep. Miller, Chairman of the House Veterans' Affairs Committee, he leads as attack prosecutor, for photo ops TV appearances and political scandal creation, in their minds only, his fellow conservatives, who also aren't friends of Veterans and lead in ignoring the many issues especially as to our wars, especially when the testimonies are from VA civil servants, not there to do their jobs and help the Veterans Affairs agency.

      "If military action is worth our troops' blood, it should be worth our treasure, too; not just in the abstract, but in the form of a specific ante by every American." -Andrew Rosenthal 10 Feb. 2013

      by jimstaro on Wed May 28, 2014 at 02:38:15 PM PDT

      [ Parent ]

  •  that's not much longer (0+ / 0-)

    than anywhere to get an initial appointment

  •  Delays in appointments due to system's popularity (1+ / 0-)
    Recommended by:

    The wholly-owned subsidiary of Koch Industries, the GOP, is just licking its chops at the idea of destroying the VA. It is a long-standing example of Single Payer healthcare and its customers/patients like it, warts and all. THAT'S WHY IT'S SO HARD TO GET AN APPOINTMENT! It isn't perfect, there are lots of things to fix, but it is wildly popular w/vets. Again, that's why it's so hard to get an appointment b/c it has lots of repeat business and satisfied customers! Were it not true the place would have no patients and getting an appointment would not be difficult! The GOP needs to destroy any examples of single payer, government run, socialism, whatever you want to call it, or "the peasants" might get ideas about spreading such concepts to other areas of the economy, not the least of which is the for-profit healthcare system the rest of us are saddled with.

  •  The VA is nothing more than Obamacare for our (1+ / 0-)
    Recommended by:

    veterans who have served their country and deserve to have the best care we can give them.

    Take that Republicans.

  •  I just don't get what the big deal is. (1+ / 0-)
    Recommended by:

    If I call for an appointment it usually takes about a month before I can get in.  For dentist?  Two months.  If it is an emergency - sometimes I can get in quicker.

  •  Limbaugh (1+ / 0-)
    Recommended by:

    I heard Limbaugh crowing today that the VA is what we have to look forward to with Obamacare in the future.

    He was also crowing about how the VA budget has more than doubled since 2005, and it is in no better shape now than it was under Shrub.

    In his mind it confirmed that no matter how much money you throw at anything government run incompetence always wins out, and the private sector will have to rush in to save the day from liberal bureaucrats.

    I have seen the doubling budget mentioned in a bunch of conservative outlets now, and it seems they are trying to pre-empt the likely Obama/Democrat argument we haven't properly funded the VA, and that's why this is happening.

    I just know that for every politician involved on both sides this entire episode is shameful, and heads should roll.

    Anyone that willfully signs up to take a bullet for this country should never be subjected to this kind of non-sense. I hope they really drill down and expose everyone involved as they deserve any ridicule that comes their way.

  •  A Lot Of Veterans Are Over 65 Years Of Age (2+ / 0-)
    Recommended by:
    ssgbryan, Bongobanger

    and are on Medicare.  If these veterans could not get an appointment in time to take care of them they should have been able to go to a doctor that takes Medicare.  If you have an urgent problem and can't get an appointment than what should you do?  Go to a doctor somewhere else that you can see faster.  

    "Don't Let Them Catch You With Your Eyes Closed"

    by rssrai on Wed May 28, 2014 at 05:47:05 PM PDT

  •  This appears to be a systemic problem. (0+ / 0-)

    Exclusive: Texas VA Run Like a ‘Crime Syndicate,’ Whistleblower Says
    Lots of administrators gaming the system to get their bonuses & promotions. I expect the General will be firing a bunch of folks immediately.

    Warren is neither a Clintonesque triangulator nor an Obamaesque conciliator. She is a throwback to a more combative progressive tradition, and her candidacy is a test of whether that approach can still appeal to voters.-J. Toobin "New Yorker"

    by chuck utzman on Wed May 28, 2014 at 07:58:27 PM PDT

  •  The republicans have found their fall guy (0+ / 0-)

    including a black eye to the Obama administration.  This is not Obama's fault.  This is not Shinseki's fautl.   This is about two unfunded wars bringing in a multitude of hurt vets.  This is about cutting taxes and vet care and benefits in the midst of war.  This is about the Bush doctrine.  This about no oversight and underfunding pre Obama.   I knew this in 2004 as many other advocates did.   This is about a no no no congress and rewarding failure.  This about the 2014 election and 2016 election and if you think veterans are treated badly now.. just wait till they privatize it and have Corporations and their lobbyist stir up more more to shore up more business for people like Scott.
    A mess?  Yes.. but it is a mess the republicans are to blame for and it stands squarely on this administration's shoulders.   Read my other comments.... I have not waivered .   I hate this has become partisan but dammit we all knew Bush's war was the wrong thing and the exit strategy would be horrendous.  

    It is the people's responsbility to care for those who borne the battle ..not Root and Brown and Halliburton and other private entities...Stand up for this administration and lay the blame where it should be George W Bush's feet and his Bring em on attitude. Good diary MB  

    Just how much Koch do Right Wingers want in their life? . United Veterans of America

    by Vetwife on Thu May 29, 2014 at 05:48:34 AM PDT

    •  This IS Shinseki's fault. (0+ / 0-)

      He is responsible and accountable for the actions of his administrators. The President could not reasonably be expected to know this was going on, but this was Shinseki's fucking job.

      His only fucking job.

      •  This was deeper and broader and IMO (0+ / 0-)

        the fault lies with the republicans... No oversight in their own territories.   I said they laid the blame on the president ...It is not Obama's or Shinseki's fault.  Do you know how people below Shinseki never got info to him... Petzel is a good start !!!!  This is the head of a huge system and where was the outrage when worst was going on under Principi?  

        Just how much Koch do Right Wingers want in their life? . United Veterans of America

        by Vetwife on Thu May 29, 2014 at 07:41:47 AM PDT

        [ Parent ]

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