An interim report on the Veterans Affairs Department delivered to President Barack Obama found that the VA’s medical system is hobbled by management with little accountability and a “corrosive culture” that has led to widespread personnel problems.
A summary of the report by White House Deputy Chief of Staff Rob Nabors released today also said the 14-day standard set for scheduling appointments is “arbitrary, ill-defined and misunderstood” and may have motivated personnel at VA facilities to falsify records.
The department must address “significant and chronic systemic failures” and restructure the Veterans Health Administration, which oversees more than 1,700 facilities delivering health care to military veterans, it said.
The department also needs to hire more doctors and other health care professionals, the report concludes.
The White House released the report summary after Nabors delivered it to Obama during a meeting that also included acting VA Secretary Sloan Gibson. Obama asked Nabors to remain in his temporary role assisting the VA.
Former VA secretary Eric Shinseki stepped down May 30 amid a growing scandal over revelations of extended waits for veterans seeking medical appointments and alleged falsification of records regarding those wait times.
An internal VA audit of 731 veterans’ medical facilities released June 9 found more than 120,000 veterans were either waiting for care longer than 90 days or hadn’t received an appointment. The Federal Bureau of Investigation’s Phoenix office is conducting a criminal investigation of the delays.
An earlier review, before Shinseki resigned, found scheduling staff were told to manipulate appointments to cover up wait times at 64 percent of VA facilities.
As part of the effort to speed care to veterans, Nabors’ report suggests convening a panel of health-care experts and industry leaders to develop a set of best practices. It also cautions against using performance measures, such as wait-time data, as a gauge of the quality of care.
Congress is working on legislation that would authorize billions of dollars to shorten long wait times for veterans seeking medical care at Veterans Affairs facilities and to make it easier to fire employees at the agency.
According to the Congressional Budget Office, the Senate version would cost as much as $35 billion over 10 years while the House version would double VA health spending and cost as much as $44 billion over five years. A House-Senate conference committee will resume talks on the measure next month when Congress returns to Washington.
The VA has an influx of patients as about half of the 1.9 million troops discharged after serving in Afghanistan or Iraq return to the U.S. in need of medical care, according to VA data. The department operates the U.S.’s largest integrated health system.