As Scandal Deepens, Senate Stalls on Veterans Health Bill

[Freewill]

Who controls the house? Who controls the Senate? This is the ONLY thing I thing will solve the VA problem, accountability. Apparently the Senate democrats think other wise. Back to the pixie dust and magic wands.

As Scandal Deepens, Senate Stalls on Veterans Health Bill

But although Reid called the House bill “not unreasonable,” Sen. Bernie Sanders, I-Vt., blocked Rubio’s request for immediate action. Instead, Sanders, chairman of the Senate Veteran Affairs Committee, said he would hold a hearing within a few weeks.

The House action “is a sign that members on both sides of the aisle understand the urgent need to restore trust in the scandal-plagued VA,” Hegseth said.

A total of 162 Democrats joined 228 Republicans to pass the three-page bill.

 

[waltky]

Revamped VA bill to be introduced this week...

Bernie Sanders to Introduce Revamped VA Bill This Week
June 2, 2014 – Sen. Bernie Sanders (I-Vt.), chairman of the Senate Veterans Affairs Committee, said Sunday on CBS’s “Face the Nation” a bill to address the “short-term needs” of veterans who face long waits for health care will be introduced on Monday or Tuesday.

“If you ask the veteran's organization today, the American Region, the V.A.V., and the others, and you look at independent surveys, the truth is that when people get into the V.A., the quality of care is good. The problem that we have to address is access to the system and waiting lines,” Sanders said. Sanders’ revamped bill will be introduced on Monday or Tuesday and addresses the “short-term needs” of veterans waiting in long lines, so that they will be able to seek treatment at a private facility, community health center or military bases.

It authorizes emergency funding to hire new doctors and nurses. It also provides scholarships or authorizes loan forgiveness for doctors and nurses who work at the VA, and it gives the Veterans Affairs authority to fire poor-performing executives, the Associated Press reports. The bill does not authorize as broad firing authority as the bill that the House passed but the Senate defeated last month. “But longer term, what we have to do within the V.A. is to make sure that they have the primary care physicians, the nurses, and the staffing they need to provide the quality of care that our veterans deserve in a timely manner,” Sanders said.

Sen. John McCain, who also appeared on “Face the Nation,” said “it’s not just a scheduling problem in the VA. It is as in the words of the inspector general, a ‘systemic problem.’” “And one of the keys to solving this problem, as I campaigned, if I might say, is to give the veteran the flexibility to get the care that he or she needs at the closest and most available place,” McCain added. “There are V.A. facilities that are unique and wonderful, traumatic brain injury, P.T.S.D., prosthesis, war wounds, and they're the best at it. But why should a veteran have to get into a van and ride three hours to get to Phoenix in order to have routine medical care taken care of? Why doesn't that veteran have a card and go to the caregiver that he or she needs and wants?” he said. “And that's the solution to this problem, this flexibility to the veteran to choose their healthcare, just like other people under other healthcare plans are able to do,” McCain added.

Bernie Sanders to Introduce Revamped VA Bill This Week | CNS News

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Amid VA scandal, a call for 'a Marshall Plan for veterans'
June 2, 2014 ~ Veterans from Iraq and Afghanistan came to Washington on Monday to urge sweeping reforms of the scandal-plagued Department of Veterans Affairs and to push priorities for the massive agency’s next chief executive.

They said President Barack Obama and Congress must do more than name and confirm a replacement for Eric Shinseki, the retired four-star general who resigned last week following reports of treatment delays and other problems at VA hospitals across the country. “What we need is a Marshall Plan for veterans,” Paul Rieckhoff, head of Iraq and Afghanistan Veterans of America, told reporters at an outdoor briefing near the U.S. Capitol. “This is a defining moment in American history.” Rieckhoff, who founded the 177,000-member group after having served in Iraq, laid out an ambitious eight-point proposal, starting with the nomination of a new VA leader who served in one of the two post-9/11 wars.

Among other recommendations, the group wants a criminal investigation of VA employees who allegedly falsified data on how long veterans waited to see doctors, plus a nationwide review of all VA hospitals and clinics to see how widespread the problems are. “An unknown number of bad actors have ruined the reputation of the VA,” Rieckhoff said. “Those who have violated America’s sacred trust with our veterans must be rooted out nationwide and held accountable.” The scandal that led to Shinseki’s resignation started at the VA hospital in Phoenix. A probe by the agency’s inspector general found that vets waited an average of 115 days for their first medical appointment, 91 days longer than the hospital reported in its logs. The inspector general investigation has spread to 42 VA health care facilities across the United States suspected of manipulating patient wait-time data in order to conceal treatment delays. The fraudulent bookkeeping helps VA hospital administrators get cash bonuses and pay increases, the inspector general report found. Poor training and outdated computer software also contribute to scheduling problems, Rieckhoff said.

Aaron Mankin, a former Marine Corps corporal who was severely wounded by a bomb blast in Iraq that killed six Marines, said the gratitude Americans express to him must be supplemented by improvements in health care for all former service members. “Everywhere I go, people want to tell me, ‘Thank you for your service.’ ” Mankin said. “They want to hug me, have their picture taken with me. I think the time for saying ‘thanks’ has passed.” Rieckhoff said the new VA chief must be given more power to swiftly remove hospital managers who falsify data. He urged the Democratic-majority Senate to pass the Veterans Affairs Management Accountability Act, which the Republican-ruled House of Representatives approved May 21 by a wide bipartisan margin.

The measure, crafted by Rep. Jeff Miller, R-Fla., would authorize the VA secretary to sidestep civil service rules and merit reviews in order to fire hospital administrators and other senior executives based on performance. “Without the ability to fire poor-performing managers, the next VA secretary will struggle to restore a culture of accountability,” Rieckhoff said. Miller, who chairs the House Veterans Affairs Committee, said Monday that at least 23 veterans have died because of recent delays in obtaining VA medical care. “The only right executives who contributed to the VA scandal have is the right to be shown the door,” Miller wrote in a column published by Time.com.

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[waltky]

Compromise bill worked out to deal with VA waiting list scandal...

VA scandal: Compromise bill reached to reform 'crisis on our hands'
June 5, 2014 ~ It was a hard-fought compromise between Sen. John McCain, R-Ariz., and Sen. Bernie Sanders, I-Vt., who both floated VA reform bills to help solve a widening scandal over patient scheduling abuses and veteran deaths.

The Senate introduced a compromise bill Thursday aimed at reforming the troubled Department of Veterans Affairs. The legislation would streamline executive firings, expand access to outside health care for rural veterans, hire more doctors and nurses, and look at ways to improve VA computer systems. It was a hard-fought compromise between Sen. John McCain, R-Ariz., and Sen. Bernie Sanders, I-Vt., who both floated VA reform bills to help solve a widening scandal over patient scheduling abuses and veteran deaths. Sen. Marco Rubio, R-Fla., who sponsored a bill solely on firing VA executives, said Thursday he also supports the compromise.

Support appears to be building, but the bill must still pass a floor vote in the Senate, which has built a reputation for gridlock. Congress is grappling with how to fix the nation’s largest integrated health system, which serves 6.5 million veterans per year, since the VA scandal broke in April with news that 40 veterans might have died due to a secret wait list kept at a Phoenix hospital. The House passed a bill last month that would give the VA secretary power to fire department executives at will, which supporters say it necessary to clear out an entrenched culture of unaccountability and wrongdoing. “I can fully assure you I am not 100 percent happy with [the compromise bill],” Sanders said. “I would have written a very different bill, [but] right now we have a crisis on our hands, and it is imperative we deal with that crisis.”

Under the bill, VA employees could be fired immediately by the secretary and would stop receiving pay and benefits. They could file an appeal within a week and would have a right to an appeal committee verdict within three weeks. “Under appeal, that person will not receive a salary but that employee will receive due process,” McCain said. A key proposal of McCain’s legislation introduced Tuesday also made it into the compromise bill. Veterans who live more than 40 miles from a VA hospital or clinic and cannot get care within a reasonable time would be allowed to choose where they are treated. The VA already approves some outside care but McCain and Sanders say the bill will make that easier for veterans.

Here is what else the bill includes:

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18 veterans who were on Phoenix wait list died, VA chief confirms
June 5, 2014 — Eighteen veterans died while waiting for medical appointments, the acting Veterans Affairs secretary said during his visit Thursday to a facility that has become the epicenter of a growing and sweeping scandal over inadequate veteran patient care.

Sloan Gibson said the VA had contacted 1,700 veterans kept off an official waiting list at the Phoenix VA facility to schedule their appointments and confirmed that at least 14 of those 18 later contacted the VA for end-of-life care, Gibson said. He said he didn’t know whether this group was part of the 40 patients that VA employees and veterans have said died while waiting for medical care. Gibson said he has asked inspector general officials to get back to him on that matter and to tell him how many of those deaths were associated with delay in patient care.

If that is the case, Gibson said, he would come back to Arizona and “personally apologize to those survivors.” “In far too many instances we have let our veterans down,” Gibson said in a news conference. “They have had to wait too long for the care they deserve and in too many instances we have behaved in ways that are not consistent with our values.” Gibson also said three senior VA leaders in this desert city may soon be fired over allegations of misconduct in patient care and that hospital officials are scrambling to fill more than 300 vacancies as quickly as possible.

He promised to release documents that would provide details about wait times at every facility in the VA. Gibson’s visit came less than a week after VA Secretary Eric K. Shinseki stepped down and the VA Inspector General’s Office released a critical report about the Phoenix VA. The interim report showed a systemic problem in scheduling veterans for health care in a timely manner, which included instances in which Phoenix VA staff falsified records to cover up long waits. Investigators found an average wait of 115 days for a sample of veterans at the facility.

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Feds probing reports of VA whistleblower reprisals
June 5, 2014 WASHINGTON — Federal investigators are looking into 86 cases of government misconduct and alleged whistleblower reprisals within the Department of Veterans Affairs following a nationwide scandal over secret wait lists and veteran deaths.

Of the 86 employees alleging “scheduling improprieties and other potential threats to patient safety,” 37 claim the VA retaliated against them for reporting the abuses and other wrongdoing, according to the U.S. Office of Special Counsel, an independent investigative agency charged with protecting federal employees. It is more evidence of a far-reaching scandal that began in April with whistleblower Sam Foote, a retired VA doctor who helped expose off-the-books patient waiting lists that may have played a part in 40 veteran deaths at a Phoenix VA hospital.

Carolyn N. Lerner, head of the United States Office of Special Counsel (Any relation to Lois?)

Last week, the VA inspector general reported that the patient scheduling abuses are systemic in veteran hospitals and clinics, which serve 6.5 million beneficiaries per year and constitute the largest integrated health care system in the United States. “Receiving candid information about harmful practices from employees will be critical to the VA’s efforts to identify problems and find solutions,” said Carolyn Lerner, head of the OSC, in a released statement. “However, employees will not come forward if they fear retaliation.” One whistleblower was given a 7-day suspension after telling the VA inspector general about improper scheduling and computer coding procedures, according to the OSC.

The employee also claimed the VA lowered a performance evaluation and reassigned him following the report to the IG, OSC said. Another VA employee was temporarily reassigned out of a position and then faced demotion after disclosing the mishandling of money meant for patient care in December, and an employee who reported the unauthorized use of patient restraints faced a 30-day suspension without pay. Last month, the OSC blocked disciplinary action against the employees while it investigates. It did not release the names of employees or location of the facilities. The reports of scheduling wrongdoing and threats to patient safety are under investigation.

Feds probing reports of VA whistleblower reprisals - News - Stripes

 

[waltky]

Yea, I'd say they need to hire more doctors...

VA says more than 57,000 patients are waiting for first visit
June 9`14 ~ The Department of Veterans Affairs on Monday shed light on the depth of the VA scheduling scandal and substantiated claims that rank-and-file employees were directed to manipulate records.

The agency said more than 57,000 new patients have waited at least 90 days for their first appointments — representing 90 percent of all new patients — and that about 13 percent of VA schedulers indicated they were told to falsify appointment-request dates to give the impression that wait times were shorter than they really were. The information comes from the agency’s internal audit of 731 VA medical centers, which the VA released Monday.

The report said that complicated scheduling practices created confusion among clerks and supervisors, contributing to the problems. It also said the VA’s goal of providing an initial appointment within 14 days of a request was unattainable because of the growing demand for care among veterans. The report came less than two weeks after the VA inspector general’s office confirmed recent allegations that VA hospitals have falsified appointment records to hide treatment delays. Former VA Secretary Eric Shinseki resigned over the scandal on May 30.

Acting VA Secretary Sloan Gibson said in a statement on Monday that the problems “demand immediate action.” He added that veterans deserve to have “full faith in their VA.” The VA report outlined 16 actions the department has or will take to address the problems, including ending the 14-day goal, contacting patients to get them off wait lists, holding employees and officials accountable for records manipulation, halting new hires at the Veterans Health Administration headquarters in Washington, D.C. and publishing data on wait times twice per month.

A senior VA official said Monday that the department will distribute about $300 million over the next 60 to 90 days to help accelerate care, including through increased hours and by contracting with non-VA health clinics. He added that the department will spend the next month doing an in-depth examination of staffing levels nationwide to determine whether shortages exist at any VA medical centers. Veterans groups said the report underscores the need for serious changes within the VA healthcare system.

More VA says more than 57,000 patients are waiting for first visit

 

[HenryBHough]

At what point does Obamerica institute a draft for doctors?

 

[waltky]

Coming forward means doctors put their careers on the line...

Veterans Administration Docs: If We Speak Up, We Become A Target
June 12, 2014 -- The primary complaint of health care providers employed by the Department of Veterans Affairs (VA) is retaliation by management - including “sham peer reviews” and even dismissal - for speaking up about serious deficiencies in the VA’s medical system, several VA doctors said during a two-day meeting in Washington on how to improve veterans’ health care.

Dr. Rafael Montecino, a surgeon with the VA in eastern Kansas, complained that “when you try to make things more efficient, the system is working against you. They say that you are creating a hostile environment.” And “when you complain, or you say like ‘You know, this is not the right thing,’ then you become a target and they gang together to get you out of there,” Dr. Montecino added. Other complaints raised by VA physicians included inefficient scheduling systems, a lack of appropriate post-surgical care, lazy VA employees, and having their input ignored by VA management.

The discussion was hosted by the Foundation for Veterans Health Care (FHVC) and the National Association of Veterans Affairs Physicians and Dentists (NAVAPD) at the National Press Club prior to Thursday’s House and Senate hearings. “I mean, you know, I got fired from the VA many times,” Rep. Dan Benishek (R-MI), chairman of the House Committee on Veterans’ Affairs’ Subcommittee on Health who is also a doctor, commiserated with the physicians, dentists, and others talking about retaliation for complaining about substandard conditions in VA medical facilities, “You have to be willing to put your career on the line, frankly,” Benishek told them, recounting that he had been fired by the VA himself for voicing his concerns, but that he was eventually re-hired because of the scarcity of surgeons in his rural area.

The majority of the doctors who testified complained of “sham peer reviews” - a name given to the abuse of a medical peer review process to attack a doctor for personal or other non-medical reasons. “Sham peer reviews are something that we need to look into because they’re destroying the doctors,” Dr. James Martin, a national representative for the American Federation of Government Employees (AFGE) and physician on its National VA Council, told Benishek. ”They’re afraid to come forward because they see what happened to their colleagues. So if there’s some way we could look into these peer reviews that are not being done ethically, that would help us a lot,” Dr. Martin told Benishek.

The congressman replied that that would be a good topic for a congressional hearing, noting that “we need to just fix that at the top.” Montecino said that talking to other doctors across the country has convinced him that the retaliation problem is widespread. At his hospital, he said, “you have the people who are in the leadership over there telling you: 'Don’t work that hard [because] you’re going to make other people look bad. We need to provide the most basic care for homeless kind of patients.' That’s what we’re told.”

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