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Audit: More than 57,000 await first VA appointment

Posted June 9, 2014

— More than 57,000 U.S. military veterans have been waiting 90 days or more for their first VA medical appointments, and an additional 64,000 appear to have fallen through the cracks, never getting appointments after enrolling and requesting them, the Veterans Affairs Department said Monday.

It's not just a backlog problem, the wide-ranging review indicated. Thirteen percent of schedulers in the facility-by-facility report on 731 hospitals and outpatient clinics reported being told by supervisors to falsify appointment schedules to make patient waits appear shorter.

The audit is the first nationwide look at the VA network in the uproar that began with reports two months ago of patients dying while awaiting appointments and of cover-ups at the Phoenix VA center. A preliminary review last month found that long patient waits and falsified records were "systemic" throughout the VA medical network, the nation's largest single health care provider serving nearly 9 million veterans.

"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."

Acting VA Secretary Sloan Gibson said Monday that VA officials have contacted 50,000 veterans across the country to get them off waiting lists and into clinics and are in the process of contacting 40,000 more.

The controversy forced VA Secretary Eric Shinseki to resign May 30. Shinseki took the blame for what he decried as a "lack of integrity" through the network. Legislation is being written in both the House and Senate to allow more veterans, including those enrolled in Medicare or the military's TRICARE program, to get treatment from outside providers if they can't get timely VA appointments. The proposals also would make it easier to fire senior VA regional officials and hospital administrators.

House Speaker John Boehner, R-Ohio, said the report demonstrated that Congress must act immediately.

"The fact that more than 57,000 veterans are still waiting for their first doctor appointment from the VA is a national disgrace," Boehner said.

The new audit said a 14-day agency target for waiting times was "not attainable," given poor planning and a growing demand for VA services. It called the 2011 decision by senior VA officials to set the target, and then base bonuses on meeting it, "an organizational leadership failure."

A previous inspector general's investigation into the troubled Phoenix VA Health Care System found that about 1,700 veterans in need of care were "at risk of being lost or forgotten" after being kept off an official, electronic waiting list.

The report issued Monday offers a broader picture of the overall system. The audit includes interviews with more than 3,772 employees nationwide between May 12 and June 3. Respondents at 14 sites reported having been sanctioned or punished over scheduling practices.

Wait times for new patients far exceeded the 14-day goal, the audit said. For example, the wait time for primary care screening appointment at Baltimore's VA health care center was almost 81 days. At Canandaigua, N.Y., it was 72 days. On the other hand, at Coatesville, Pa., it was only 17 days and in Bedford, Mass., just 12 days. The longest wait was in Honolulu — 145 days.

The VA facility in Fayetteville ranked third nationally, with an average wait time of 83 days for primary care. But it ranked highest in the nation for the percentage of patients who couldn't be seen within 30 days.

The Durham VA Medical Center has the longest wait time for new patients seeking mental health care, at 104 days, and the seventh-longest wait for patients seeking specialized care, at 69 days.

U.S. Sen. Kay Hagan asked that Gibson visit Fayetteville to see the problem firsthand.

"The results of the VA’s report are appalling and disturbing," Hagan said in a statement.

For veterans already in the system, waits were much shorter.

For example, established patients at VA facilities in New Jersey, Connecticut and Battle Creek, Michigan, waited an average of only one day to see health care providers. The longest average wait for veterans already in the system was 30 days, in Fayetteville, North Carolina, a military-heavy region with Fort Bragg Army Base and Pope Air Force Base nearby.

Gibson, the acting VA secretary, said the department is hiring new workers at overburdened clinics and other health care facilities across the nation and is deploying mobile medical units to treat additional veterans.

The VA believes it will need $300 million over the next three months to accelerate medical care for veterans who have been waiting for appointments, a senior agency official said in a conference call with reporters. That effort would include expanding clinics' hours and paying for some veterans to see non-VA providers. The official said he could not say how many additional health providers the VA would need to improve its service.

The report said 112 — or 15 percent — of the 731 VA facilities that auditors visited will require additional investigation, because of indications that data on patients' appointment dates may have been falsified, or that workers may have been instructed to falsify lists, or other problems.

Gibson also has ordered a hiring freeze at the Washington headquarters of the Veterans Health Administration, the VA's health care arm, and at 21 regional administrative offices, except for critical positions personally approved by him.

Boehner said the House would act on legislation this week to allow veterans waiting at least a month for VA appointments to see non-VA doctors, and said the Senate should approve it, too. An emerging bipartisan compromise in the Senate is broader than that, but senators have yet to vote on it.


Associated Press writers Donna Cassata and Alan Fram contributed to this story.

Follow Matthew Daly: https://twitter.com/MatthewDalyWDC


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  • Objective Scientist Jun 9, 2014

    My Dad was in the Army from 1940 - 1945 and was honorably discharged in the summer of 1945 after having fought in Europe... landing on the coast of France and eventually ending up in Germany. He was fortunate and had no on-going health concerns following WWII. Nevertheless, I recall him talking about how "good the health care was for veterans". Was that indeed the case for WWII vets? Any others agree with that? If it was "good" at that time... what has happened? Did it change with subsequent wars or at some other point in time? Regardless... the current state of affairs in veteran health care is absolutely SHAMEFUL? Is not Fort Bragg the largest military base in NC? Even in the country? And veterans in Fayettville wait an average of EIGHTY-THREE days for PRIMARY CARE? Absolutely SHAMEFUL!!! CONGRESS - get off of your blatant partisan derrieres and FIX THIS!!!

  • Bill Mooney Jun 9, 2014
    user avatar

    Burr needs to step up and show some competence. You can't support and fund wars without supporting and funding veteran care.

  • JAT Jun 9, 2014

    I'd like to know if there is a connection between the wait times and the type of care the vet needs and maybe even how bad the issue is when they finally decide to try to get an appt. 14 days is probably an unreasonable and unattainable goal. And if you show up with Stage 4 Lung Cancer, well, there's really not alot they can help you with and why have you left your regular doctor? Obviously, times for those already in the system are incredibly good. Sounds like they're trying to see the ones they can help quickly as fast as they can but some things just take a while, or maybe it's not as critical.

  • LovemyPirates Jun 9, 2014

    Alberteinstein - you should talk with someone who is Canada. They LOVE their one payer health care system. Of course there will be a problem here and there but that happens in the US. A friend of mine was in a really bad car accident. EMS took her to Duke Raleigh and they put her in an ER examination room, tossed the IV bag that had been placed by the EMS onto her lap and walked out, turning off the light as they went. 2 hours later, someone came in to clean the room and found her and asked what she was doing there. The had 2 cracked vertebra. No one ever took responsibility for lack of care.

  • jsmith844 Jun 9, 2014

    Yeah I was forgotten. Went there got all the paperwork together was told they would call to let me know. I called again two weeks later still had nothing. Called again was told for the third time they will call nothing again. Gave up

  • solarcableguy Jun 9, 2014

    View quoted thread

    Most will tell you from experience that the VA hospital in Durham is one of the best VA hospitals in the US.

  • AlbertEinstein Jun 9, 2014

    Unfortunately, many of us DISABLED American Veterans are very much displaced and concerned. Thank goodness we have alternatives in private practice - Tricare (which is also under some budgetary cuts now).

    Somebody please explain to me how any type of government health care can be comparable to private other than cutting cost and patient care? Do not try to snowball somebody that has both.

  • JAT Jun 9, 2014

    I don't get it - my dad had no trouble at all getting in. Are these poeple that keep cancelling their appointments or missing appointments? Do they only want to go to Durham or can they go to some of the other VA places in NC? And alot of times, 90 days is reasonable if it's not an emergency. Try making a new appointment as a new patient at alot of private practices and you'll be waiting longer than that.

  • Allen Kennedy Jun 9, 2014
    user avatar

    Have any of you ever researched the different types of Universal Healthcare available around the world? Have you ever considered that what's being proposed (H.R. 676) is not socialized medicine like the highly underfunded VA? Socialized insurance (like France and Germany's systems) is not the same as the Beveridge model. Please educate yourselves.

    H.R. 676, Improved Medicare for All, would cover everyone at a low payroll cost. It is not socialized medicine.

  • solarcableguy Jun 9, 2014

    View quoted thread

    That goes for all who have governed during these wars. Nice try.