Forgotten Soldiers: A Look at the VA’s Failures — The Beltway Times

D.C. BELTWAY

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The United States Department of Veterans Affairs has forgotten their soldiers.  Those soldiers faced the horrors of war, looked into the eyes of evil dictators, and escaped the clutches of death.  They are too often homeless and in need of desperate medical care. These people are our veterans- the men and women who have sacrificed greatly for our freedoms here at home. Yet, for years we have neglected to afford them the proper care needed to ensure their well being.

President Donald Trump campaigned hard on a promise to fix the Department of Veterans Affairs.   It is no secret the department has been plagued with corruption over the past several years.

In 2014, the department reeled from a scandal involving secret waiting lists at a Phoenix VA facility.  Officials had masked actual wait times.  The VA gave the perception that veterans were seen at a much faster pace.  In fact approximately 40 veterans died while waiting to be seen for care.

Veterans Affair Secretary Eric Shinseki resigned as a result of the scandal. President Obama replaced him in 2014 with Robert McDonald.  A former executive at Procter and Gamble and a graduate of the United States Military Academy at West Point.  He was charged with fixing the problems within the VA.

However, McDonald was not successful in his efforts.  The VA continued to be plagued with inconsistencies. Recently, the USA Today obtained internal documents pertaining to VA facilities that contain the results of the VA’s internal ranking system.  The rankings are used to give a facility a star rating of 1 to 5 (1 being the worst, 5 being the best).  

The VA compiles these rankings based on a variety of factors- the experience of care based on patient surveys, and the continuity of care and population coverage to name a few.  The VA does not disclose these rankings to the public, and they state that the rankings are used much like private hospitals use internal rankings in order to self measure for improvements.

The findings from these reports are alarming.  For example, Tennessee has four VA facilities within the state.  It ranks 14th in the nation among the veteran population, yet three out of those four facilities had a star ranking of 1. Nashville, Memphis, and Murfreesboro all scored in the bottom 10th percentile in the reports.  This is concerning news for the nearly half a million veterans living in Tennessee.

In Memphis, administrative officials have resigned over a recent series of scandals.  The first involved secret waiting lists much like in Phoenix, AZ.  Another involved a backlog of medical records left unattended.  Patients who sought treatment or testing outside the Memphis VA Hospital may have never had those results put into the VA system.  The average wait time in Tennessee exceeded 60 days, far from the 14 day target set by the VA.

The Murfreesboro facility made recent headlines when Sgt. John Toombs was found hanging in a vacant building, having taken his own life. Sgt. Toombs had been seeking court-ordered drug treatment at the Alvin C. York facility. He was kicked out of that program after nearly 70 days of treatment.  

Toombs served as a member of the Tennessee National Guard and deployed to Afghanistan. He returned home and began to suffer from depression and post-traumatic stress disorder (PTSD).  He had sought help through the VA system. Toombs’ family stated he was released from the program for missing his morning medication and openly criticizing a doctor.  They said he was doing so well in the program and had even helped teach a class. According to his father, Toombs attempted to speak to someone about getting back into the program. He did not get a chance to make his plea a second time.

Toombs posted a video to YouTube the night of his suicide.  In the video, Toombs described his frustration with the VA program.  He stated he was discharged for “trivial reasons, they made an example out of me”.  He goes on to say, “When I asked for help, they opened up a Pandora’s Box inside of me, and they just threw me out like a stray dog in the rain.”  Toombs expressed his thanks for those who had supported him just before the video ended.  His body was discovered the next morning.

Tennessee is just an example of the corruption now embedded into the DNA of the VA. In 2016, officials in Puerto Rico fired an employee after being arrested for armed robbery, but a union representative got the employee reinstated. The union argued that the facility manager was a registered sex offender and another was arrested for drunken driving and possession of pain pills, signifying that corruption within the system was in essence par for the course.

In July 2016, the VA reported that nearly 25,000 veterans in North Carolina, Tennessee, and Virginia were eligible for new tests for traumatic brain injuries.  They attributed a policy confusion to many veterans receiving initial examinations from unqualified specialist, which led to improper diagnoses of many and a lack of compensation for their injuries.

In Cincinnati a local news investigation revealed corruption at a local facility.  Network Director for the Ohio VA, Jack Hetrick resigned amid the scandal.  In addition, acting Chief of Staff Barbara Temeck was reassigned by the VA.  Temeck may face criminal charges after an internal investigation revealed her writing improper prescriptions.  Among those given prescriptions was Hetrick’s wife.

The VA is in dire need of an overhaul- its problems just keep mounting.  These internal reports show higher rates of preventable complications, like infections, and a higher percentage of vets waiting more than 30 days for care.  It is estimated approximately 46,000 veterans wait more than six months for care.

I spoke with Deputy Director Nate Anderson of the Concerned Veterans for America.  The CVA is a project of Americans for Prosperity.  Their goal is to translate the experience, concerns, and hopes unique to veterans and their families into a common vision of freedom.

Beltway Times: Is the VA system failing our veterans?

Nate Anderson: The current system has been failing our veterans for years. Despite years of scandal, crisis, and millions in taxpayer funding, little was done to improve the VA under the Obama administration and Secretary Bob McDonald’s VA leadership. For example, the Phoenix VA was a one-star medical center when news broke in 2014 that their schedulers were using secret wait lists to hide how long veterans were really waiting for appointments. To date, Phoenix is still a one-star facility, according to the VA’s own data. The same applies for facilities in Tennessee that have been under the radar. The fact that Tennessee has three failing VA facilities and nothing has been done to improve them is very telling of the urgent reforms needed by the new administration and incoming VA secretary.

BT:  What is your characterization of this report?

NA: The VA has an obligation to care for and honor the men and women who have served their country, and that includes being completely honest about the quality of care being provided. It shouldn’t take a USA Today investigation to light a fire under VA leadership to be transparent. The VA should not have to come under pressure by the media to disclose what should already be public information – it sends a clear message that the VA has been more interested in its public image rather than fixing the very serious and widespread internal problems. Transparency should be the rule, not the exception.

BT: What you would like to see done by the current administration and the incoming VA Secretary?

NA: CVA is optimistic that incoming VA Secretary, Dr. Shulkin, will make transparency at the VA a number one priority.  CVA has routinely called for more robust auditing and improved data collection at the VA.

BT: Do you feel that privatization should be considered or that VETS should have an option to seek private care?

NA: CVA does not support privatization. In our bipartisan Fixing Veterans Health Care report we clearly state that under our proposal, the VA will remain the guarantor of veterans’ health care. We propose that a government-chartered non-profit within the VA will oversee the distribution of veterans benefits, allowing them choice over where and when to see a doctor. CVA supports the Caring for our Heroes in the 21st Century Act, draft legislation introduced by Rep. Cathy McMorris-Rodgers (R-WA) which would do just that.

BT: You stated your organization’s optimism for Shulkin and the lack of progress under the Obama administration. Shulkin is being criticized by some for being an Obama hold over and having been over the Health Administration aspect of the VA, yet some facilities remain unchanged.  

Can you maybe elaborate on that optimism just a little?

NA: I would say our optimism is cautious optimism. We have not endorsed Shulkin and we will certainly continue to hold him accountable. While Shulkin already holds a leadership position at the VA, as Secretary, he will now have ultimate responsibility over the agency and we are optimistic he will take it in a new direction including making accountability reform an immediate priority.

President Trump nominated David Shulkin – a physician-  last week to head the VA.  If confirmed, Shulkin would be the first non-veteran to hold the position.  He is currently serving as the Under Secretary for Health Administration for the VA, appointed by President Obama in 2015. He is the only carry over from the previous administration.  

Shulkin stated, ‘The VA is a unique national resource that is worth saving and I am committed to doing just that.”  Shulkin did criticise the USA Today’s reporting of the internal rankings report. He called the system an improvement tool and that releasing such information to the public would only serve to deter veterans from seeking care.  “It is essentially a system within the VA to see who’s improving, who’s getting worse, so we can identify them both,” Shulkin said. He vowed that facilities receiving poor ratings would get extra scrutiny and administrators would be replaced if those facilities did not improve.

During his confirmation hearing,Shulkin reiterated that he did not support the privatization of the VA.  President Trump called for private options during his campaign, but Shulkin testified that he had spoken to President Trump and informed him the VA offers care that the the private sector can not.  He said he told the President he would like to see an integrated approach to care by combining good aspects of the VA with community healthcare systems.

A government oversight report recently indicated wait times for new patients ranging from 22-71 days. However, since Shulkin took over as Under Secretary for health, wait times have decreased for urgent care.  Those waiting longer than a month for such care have decreased from 57,000 to just around 600 in a year.  This may just be the glimmer of optimism many are looking for from the Trump administration’s nominee.

These reports show the complexity of problems facing an ever-expanding bureaucracy.  Our veterans have served our country honorably, and they deserve the care and the respect worthy of their sacrifices.  Cautious optimism should accompany a strong resolve to see we afford every veteran the care they need in the United States.