24 April 2016

VA report fails to build confidence (Editorial in my own local newspaper, Fort Collins CO)

Note: I reprint this newspaper's editorial because it is about my local VA clinic, in which I,too, was unable to get timely appointments for a series of orthopedic and oncology issues, and instead sought surgeries elsewhere. It has always been on my mind how much VA has saved by not providing my three hip replacements, six neck and back surgeries, two shoulder surgeries, cancer surgery with subsequent radiation and chemo, It has also been on my mind how financially destructive it would have been on the family if I'd not had other insurance options – I would probably have not sought care for several issues. Are today's veterans forced to those hard choices?
The general public may not know that in many situations, a disabled vet isn't permitted VA medical care and other benefits until VA finishes evaluation his/her claim. That can take years, especially if the claim is first denied and forced into a three to five year appeals delay.That's a long wait when one already has cancer or other issues for which care is sought.
                  If you can get an appointment. I couldn't.

APRIL 24, 2016:

New reports published earlier this month show the Fort Collins Veterans Affairs office blamed its scheduling problems on a single manager in the business office who is no longer with the clinic.
Roughly two years ago, the Coloradoan reported the VA office falsified wait times for local veterans seeking medical care.
Fast forward to earlier this month, and spokesperson Samuel House said, "All appropriate action was taken against the employees."
The Editorial Board struggles with this determination for a number of reasons.
First, we know this problem is widespread. A VA inspector general’s report found it was possible that more than 300,000 veterans nationwide died before their applications, which precede appointments, were processed.
Are we to believe that persistent problems across the country, resulting in an unquantifiable number of delays for care, were isolated to a single person in the Fort Collins office?
In May 2014, the Coloradoan reported staff in Fort Collins was manipulating logs to make it look like they were following the VA’s policy of granting appointments within 14 days of the veterans’ desired dates.
Back in March 2013, the Fort Collins clinic “was having problems with scheduling, employee morale and professionalism, and lack of teamwork between the (medical support assistants)," the report from the federal Office of the Medical Inspector stated. To address those issues, employees were transferred between Cheyenne and Fort Collins, according to the OMI report. The transfers to Fort Collins reported that scheduling in Fort Collins was "fixed" by having staff change appointment dates to be within two weeks of the desired appointment date, an agency goal.
In the report released earlier this month, the employee who was let go defended her actions, saying "this had no effect on the veterans because they received the same appointment they otherwise would have received. When asked if she thought this was “gaming” the system she replied, 'yes.'"
Again, it’s difficult to believe that just one person orchestrated all adjustments to veterans appointments, therefore creating just a single responsible party for inappropriate wait times.
We should note here that Cynthia McCormack, director of the Cheyenne Veteran Affairs Medical Center, which oversees services in Fort Collins, retired in 2015 after a federal investigation found the Fort Collins clinic falsified wait time records for veterans seeking care. A whistleblower said she was punished for not “cooking the books” and six employees were ultimately punished in the scandal.
But there is this, too: Any and all audits of the scheduling process, workflow and employees that were conducted were done so internally. In the two years since we first learned wait times were being manipulated, the VA has gotten a new director and folks have been called back to Washington, D.C., to testify. But we’ve heard nothing of an independent investigation, which could root out additional problems and ultimately restore confidence in the organization.Sen. Marco Rubio (R-Fla.) and Rep. Jeff Miller (R-Fla.) have asked the Senate Committee on Veterans Affairs to ensure VA accountability and have introduced legislation that they say does so. This is a step in the right direction. We should continue to encourage our elected leaders to call for change at the VA.
David Shulkin, a physician who took over as undersecretary for health at the VA in June, told USA TODAY the agency has increased capacity to get wait times down.
“We’ve expanded appointments, we have added evening hours and weekend hours, we’ve added 3 million square feet of space, we’ve hired 14,000 new providers,” he said.
And yet any great organization is built on the quality of the people working for it. We are left to wonder if real change has occurred locally.
This “story” is more than two years old. In that time, we’ve not seen sufficient evidence the problem is being addressed. So we’re left to wonder: Is care for Northern Colorado veterans continuing to be adversely impacted?

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