Inspector General Scolds VA VHA for Deceiving Congress & Veterans on Fact Sheet

More scandal added to VA's Year of Scandals. Here...a deliberate deception of the House Veterans Affairs Committee as confirmed by VA's own Inspector General today, and reported in USA Today and other journals. (note: see related C-123 post.) Secretary McDonald personally apologized, stating, "VA has a responsibility to communicate clearly and accurately to Congress, veterans and the American public."

OIG evaluated Veterans Health Administration’s (VHA’s) review of “unresolved” consults and the accuracy of VA’s summary, the National Consult Delay Review Fact Sheet (Fact Sheet), as requested by the Chairman of the House Veterans’ Affairs Committee (HVAC).

Unresolved consults are requests for consultations that are open or active in patients’ electronic health records. In September 2012, VHA initiated a multi-phased review of consults that were unresolved for more than 90 days. By May 2014, the number of unresolved consults had decreased considerably.

However, because VHA did not implement appropriate controls, we found it lacks reasonable assurance that facilities appropriately reviewed and resolved consults; closed consults only after ensuring veterans had received the requested services, when appropriate; and, where consult delays contributed to patient harm, notified patients as required by VHA policy. Our review of the Fact Sheet found several key statements related to the scope and results of VHA’s review of unresolved consults were misleading or incorrect.

These statements were repeated by VHA leaders at meetings with congressional staff and during media events. In July 2014, VHA issued a letter to the Chairman of the HVAC that included information intended to clarify statements in the Fact Sheet.

We recommended that the Interim Under Secretary for Health (1) conduct a systematic assessment of the processes each VA medical facility used to address unresolved consults during VHA's system-wide consult review; (2) ensure that if a medical facility's processes are found to have been inconsistent with VHA guidance on addressing unresolved consults, action is taken to confirm that patients have received appropriate care; and (3) after reviewing the circumstances of any inappropriate resolution of consults, confer with the Office of Human Resources and the Office of General Counsel or other relevant agency to determine the appropriate administrative action to take, if any.

VA IG Changes Story – Delays in Phoenix "CONTRIBUTED" to Patient Deaths

Patient Scheduling Delays: They did, they didn't, and now...they did again.
Remember IOM C-123 Committee: You can trust everything the VA tells you.

By Jim Avila@JimAvilaABC
Serena Marshall@SerenaMarsh
Sep 17, 2014 6:16pm

Delays caused by secret waiting lists “contributed” to deaths at the Phoenix VA earlier this year, an assistant inspector general who helped draft a controversial Inspector General report admitted today under intense questioning by the House Veterans Affairs Committee.
The assertion by Dr. John Daigh comes less than a month after the Office of the Inspector General proclaimed in its official report that it is “unable to conclusively assert that the absence of timely care caused the deaths of these veteran.”
Rep. David Jolly, R-Fla., asked Daigh whether he could “conclusively assert that wait-lists did not contribute to the deaths of veterans?”
“No,” Daigh replied.
When asked whether he’d be “willing to say wait-lists contributed to the deaths,” Daigh responded,  “Yes.”
It was a startling admission, following complaints that the OIG softened the report at the VA’s request.  The sentence about being “unable to conclusively assert that the absence of timely care caused the deaths of these veterans” was not in the first draft of the report and only appeared in the final draft after the VA had a chance to review and comment privately on it.
Daigh also said that while he could not say “the delays caused the deaths,” he also could not say they didn’t.
That caused Jolly to ask him whether such was the case, and why put one assertion in the report but not the other.
“The issue is cause or, of course, a direct relationship, how tight of a relationship do you want? That’s where the difficulty is here,” Daigh said.
Daigh said earlier in the testimony “I’m not clairvoyant. It’s very difficult to know how someone died.”
The acting inspector general, Richard J. Griffin, added “We don’t know how they died or why. Nor do you, I would say that it may have contributed to their death, but we can’t say, conclusively, it caused their death.”
The Inspector General’s Office also suffered severe criticism from two whistle-blowers testifying before the Veterans Affairs committee. Dr. Samuel Foote and Dr. Katherine Mitchell scolded the OIG for downplaying the causation and link between wait times and deaths.
“I would like to use this statement to comment on what I view as the foot-dragging, downplaying and, frankly, inadequacy of the Inspector General’s Office,” Foote said.

VA Resists C-123 Veterans' FOIA for Agent Orange Data

Early last year, LtCol Paul Bailey submitted our formal FOIA (Freedom of Information Act request) to the Veterans Administration, seeking information about how VA officials managed their participation in two meetings with C-123 veterans hosted by Senator Burr's staff in Washington DC. Our request to the Air Force for their materials had been granted earlier. It is our fear that the VA participants approached the question of C-123 dioxin contamination with a mindset of denial, rather than even-handed scientific concern. In went our FOIA as we hoped to learn about how we were treated at the meetings.

Result? $5000 in pushback from the VA as they denied the perfectly valid appeal! To prevent us getting information about ourselves. $5000 to make sure we'd never get it! $5000 to make sure veterans would never learn that VA officials approached our concerns about Agent Orange exposure with a determination not to uncover the truth, but instead to construct any argument necessary to prevent our access to VA medical care and benefits. Our concerns for this FOIA focused on uncovering all the information located by the VA, how they interpreted it, what instructions they gave their officials and whether those instructions were neutral or whether those instructions were to

Government agencies usually can't bury information like this without running up against the FOIA itself, but obviously there are times when the requested information might cause bureaucrats discomfort. This seem to be one of those instances. Solution? Delay. Delay. Delay. Delays then followed by charging prohibitive fees for the information requested! That's the VA solution to keep embarrassing information out of the hands of C-123 veterans.

But we have rights and options, and one was to appeal the VA's pricing and refusal to provide an expedited response. Paul submitted that appeal in May and the GSA took until late November to get around to refusing it..again! They claimed the FOIA law required VA to charge us because only journalistic, educational, and not-for-profit requests can be free. Another free category - information requested is in the public interest and informs the public of how the government operates. VA's Assistant General Counsel Deborah McCallum wrote Paul about her refusal to grant his appeal even though we were fully justified, but she was also required to tell us of a final route for an appeal before going to court: The Office of Government Information Services (OGIS) acts as a final arbiter of our rights to this information - and so we submitted our appeal on behalf of The C-123 Veterans Association on December 24, 2012.

In this last out-of-court appeal, we explained our journalistic presence in the form of blogs, web sites and newsletters, We explained that the public is intensely interested in both Agent Orange and veterans health care. We explained that we have no commercial interest in the requested materials, and that the Air Force honored an identical request, using the same FOIA law and regulations, and that the information is, after all, about US!

 In it, we explained the justification for our FOIA and the reasons its denial were improper. Now...we are waiting once again. The impact: we won't have the data in time for the 15 Jan 2013 briefing we are scheduled to give the Institute of Medicine's Agent Orange committee, but we will have both the VA and the Air Force extensive collections of materials ready to give Congress early in 2013 as we continue our struggle.

So...more waiting, more hoping. Keep the faith!