Revelations from Inspector General reveal culture of fear led to wait time manipulation
The Department of Veteran Affairs Office of the Inspector General has released reports from 49 investigations into whether patient appointment wait times were being manipulated throughout the VA Health Care System.
Sen. Ted Cruz (R-TX) talks to reporters ahead of a rally near Raleigh, North Carolina on March 8, 2016. Cruz is seeking the Republican nomination for president.
The release of the reports has led to additional pressure from Sens. Ted Cruz and John Cornyn of Texas, who together passed an amendment last year requiring VA Secretary Robert McDonald to report to Congress on any corrective measures and share a timeline for remedying the problems, which surfaced first in Phoenix, Arizona in April 2014.
“Veterans in San Antonio deserve better than long waits and barriers to care after selflessly putting their lives on the line to serve this nation,” Sen. Cornyn said in a statement last November.
“Our veterans deserve the very best care our nation can provide,” Cruz said in a statement on the amendment, which became law in December 2015. ” Unfortunately, veterans in South Texas often do not receive timely access to health care.”
Cruz, Cornyn and Texas Gov. Greg Abbott authored a joint letter to McDonald last week asking for an update on the department’s progress in the wake of the reports.
“We remain troubled that the VA continues to fail to provide timely health care to our nation’s veterans, despite receiving enhanced authorities and funding from Congress to hire new employees and address additional problems facing the VA,” the letter reads.
There were 12 investigations into Texas facilities from Dallas to El Paso, all of which can be accessed online through the VA IG website.
“The IG reports indicate that improper training, lack of supervision and non-centralized scheduling are the primary causes of the data manipulation,” the letter reads. “However, some employees reported feeling pressure to change wait times or risk getting fired.”
In their letter, the senators and Abbott call for McDonald to make “more robust use” of his power “to remove any individual from the VA Senior Executive Service whose poor performance or misconduct warrants such removal.”
“These ongoing scheduling problems clearly evidence failures of leadership at senior levels of these Health Care Systems in Texas and, more broadly, within the Veterans Health Administration,” the letter continues.
The investigations were based on complaints filed by employees and former employees. One such investigation into Audie L. Murphy VA Hospital in San Antonio found that schedulers based patient’s desired dates on clinic availability to manipulate the system into recording shorter wait times for care.
While investigators at the Harlingen VA facility found no evidence that employees had been threatened with termination for not following the schedule manipulation policy — as one complainant claimed — the report did note a culture of fear that contributed toward the manipulation of wait times.
“There was evidence that the employees felt pressure from the TVCB Health Care System management official, which led to the manipulating of VistA in order to keep scheduling numbers within standard,” Quentin Aucoin wrote in his report.
Larry Smith, a U.S. Army veteran living in South Texas, said in 2014 that three veterans reportedly died while waiting for treatment at the Harlingen clinic. At least 40 veterans in Phoenix were died while enduring artificial wait times.