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As Veterans Affairs Secretary Eric Shinseki prepares to testify Thursday before a Senate committee, he will have to explain why problems with the VA appointment system — which include doctoring records to show only acceptable wait times for patients — have endured for a decade.
While issues involving delays in patient care and charges of secret waiting lists have reached a boiling point in the past month, the Government Accountability Office and VA Inspector General have reported on scheduling problems and prolonged wait times for nearly 10 years.
And in December 2012, GAO released the most damning analysis up to that point: a report noting that schedulers at four VA medical centers hid actual wait times, fudged the numbers and backdated appointments to meet timeliness goals set by department headquarters.
Schedulers at VA facilities in Dayton, Ohio; Fort Harrison, Montana; Washington, D.C.; and Los Angeles changed appointment dates to ensure wait times fell within VA standards, side-stepped the electronic appointment monitoring system by recording appointments on paper and omitted patients with backlogged specialty appointments from electronic wait lists, tracking them only on paper.
“A provider at [a] clinic expressed concern that the clinic manager has a tall stack of unscreened consult referrals siting on her desk that no one is addressing,” GAO officials noted.
But while the problems appear to be ongoing and pervasive, they reached crisis level only last month when a retired physician from the Phoenix VA sent letters to CNN and the Arizona Republic alleging that the facility’s off-the-books wait list may have led to the deaths of at least 40 patients.
Since the Phoenix story broke April 23, reports of similar problems have surfaced in San Antonio, Cheyenne, Wyoming, and elsewhere.
Following the release of the GAO report in 2012, VA officials said they concurred with recommendations to improve the system.
GAO analyst Debra Draper said April 9 during testimony in Washington that her office has seen some progress by VA in implementing the GAO recommendations but added that more needs to be done.
She also noted that as of April, VA had 2 million open consults and 450,000 “remain unresolved.”
She warned that there continues to be little oversight over the outstanding medical referrals.
“Oversight of VHA’s consult initiative ... has not included independent verification,” Draper said.
Last Thursday, Shinseki ordered a review of health care access at VA medical centers nationwide — the same day members of the House Veterans’ Affairs Committee subpoenaed all correspondence from top VA leaders regarding alleged secret waiting lists at the Phoenix VA.
Earlier in the week, the American Legion, the largest veterans support organization with 2.4 million members, called for the resignations of Shinseki, Undersecretary for Health Dr. Robert Petzel and Undersecretary for Benefits Allison Hickey.
Three Phoenix VA officials have been put on administrative leave pending a full investigation into the scandal at the facility. An interim chief, Steve Young, was named on Saturday.
Shinseki is scheduled to testify at 10 a.m. Thursday.
Staff writer Leo Shane III contributed to this report.