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Posts tagged ‘care’

Veterans died waiting for care at Phoenix VA hospital

In a recent report, the VA Inspector General’s office (OIG) found that more than 200 veterans have died while waiting for medical care at the Department of Veterans Affairs hospital in Phoenix, just two years after the facility was under severe scrutiny for a scandal in which patient records were altered to hide the length of their waiting period.

It was found that 215 deceased patients had open appointments at the Phoenix facility on the day they died. The report also found that one veteran never received an appointment for a cardiology exam “that could have prompted further definitive testing and interventions that could have forestalled his death.”

Despite two years of reform efforts since the 2014 scandal and the resignation of then-VA Secretary Eric Shinseki, the OIG report found that the Phoenix hospital still has “a high number of open consults because … staff had not scheduled patients’ appointments in a timely manner (or had not rescheduled canceled appointments), a clinic could not find lab results, and staff did not properly link completed appointment notes to the corresponding consults.”

Consults include appointments, lab tests, teleconferencing and other planned patient contacts.

As of July 2016, there reportedly were 38,000 open consults at the Phoenix VA.

The report also found that nearly a quarter of all specialist consultations in 2015 were canceled, in part due to employee confusion stemming from outdated scheduling procedures that were not updated until this past August.

Rep. Jeff Miller, R-Fla., chair of the House Committee on Veterans Affairs, said the report proved that the work environment at the Phoenix VA “is marred by confusion and dysfunction” and the problems won’t be solved “until there are consequences up and down the chain of command.”

Arizona Sens. Jeff Flake and John McCain released a joint statement calling the practices described in the report “unacceptable” and “reprehensible.”

“Today’s report confirms that cultural change at the Phoenix VA is still desperately needed,” McCain and Flake said. “There is no place at the VA for managers and employees to engage in such misconduct.”

The VA released its own statement touting its reform efforts and calling for increased support staffing. According to the department, the Phoenix facility has 39 job openings among the support staff responsible for consultation scheduling.

The Phoenix system enrolls about 85,000 veterans and announced last week the hiring of yet another new director since the 2014 firing of Sharon Helman.

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Trump on Veterans Programs

His recent speech In Virginia was Donald Trump on veterans programs.  It was the latest in a series of prepared remarks aimed at articulating his policy agenda and convincing still-reticent Republicans that he has the discipline and control to mount a credible general election bid against Hillary Clinton.

Trump, the presumptive GOP nominee, was in Virginia Beach, Virginia, not far from the USS Wisconsin in Norfolk, where he first unveiled his plan to reform the Department of Veterans Affairs last October, promising to modernize the system, while minimizing wait times for patients and improving care. “The current state of the Department of Veterans Affairs is absolutely unacceptable,” read the plan that Trump unveiled last fall. “The guiding principle of the Trump plan is ensuring veterans have convenient access to the best quality care.”

Under the plan he unveiled then, eligible veterans would be able to bring their veterans’ identification cards to any private doctor or facility that accepts Medicare and be able to receive immediate treatment. The change, he argued, would help improve wait times and services by adding competition.

“The plan will ensure our veterans get the care they need whenever and wherever they need it,” he said then.

The proposal sounded similar to the Veterans Choice program, a centerpiece of the 2014 VA overhaul, which provides veterans access to federally-paid medical care from local, non-VA doctors — but only if they’ve waited at least 30 days for a VA appointment or live at least 40 miles away from a VA medical center.

A congressional commission report released last week recommended replacing the program with a new, nationwide community care network that would be open to all veterans, regardless of how long they have waited for care or where they live.

Trump had broken with some Republicans who’d called for privatizing the VA in the wake of the 2014 scandal over long wait times for veterans seeking medical care and falsified records by VA employees to cover up the delays.

“Some candidates want to get rid of it, but our veterans need the VA to be there for them and their families,” Trump said at the time.

The VA still has “profound deficiencies” in delivering health care to veterans, according to the Commission on Care report. It concluded the VA delivers high-quality health care, but that it is inconsistent from one site to the next and that problems with access and long wait times remain.

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VA Wait Times Not Fixed Yet

The Department of Veterans Affairs (VA) has not done enough to prevent schedulers from manipulating appointment wait times.  VA wait-time data remains misleading and underestimates how long veterans wait for care, according to a nonpartisan watchdog report. So fixing the VA wait times is still a long way from done.

“Ongoing scheduling problems continue to affect the reliability of wait-time data,” the Government Accountability Office found.

The Piecemeal Approach to American Veterans Aid

The GAO said the VA has taken a “piecemeal approach” to addressing the problems since the wait-time scandal broke in 2014 in Phoenix, where schedulers falsified wait times and at least 40 veterans died awaiting care. But the agency needs to take comprehensive action, the GAO concluded in its audit, which stretched from January 2015 through last month.

Auditors found schedulers at three of the six medical centers they reviewed had improperly changed dates so the VA system falsely showed shorter or zero wait times. In a review of scheduling records for 60 individual veterans at those three centers, they found improper scheduling in 15  — or 25% — of the appointments.

While the system showed average wait times of between four and 28 days in the cases reviewed, the actual averages were between 11 and 48 days. The audit characterized the schedulers’ actions as mistakes rather than deliberate falsification.

“Until a comprehensive scheduling policy is finalized, disseminated, and consistently followed by schedulers, the likelihood for scheduling errors will persist,” the GAO said in its draft report.

The findings bolster recent claims by VA whistle-blowers that schedulers across the country are still falsifying wait times. And they cast doubt on the effectiveness of corrective actions VA officials touted as recently as 10 days ago.

USA TODAY reported April 7 that the VA inspector general found schedulers at 40 VA medical facilities in 19 states and Puerto Rico regularly “zeroed out” veteran wait times and supervisors at seven of those facilities instructed them to do so.

VA Wait Times for Aid and Care

VA officials at the time said many of those probes had been finished more than a year ago and they had already imposed discipline in some cases and instituted refresher training for all schedulers. But local VA officials overseeing five centers told the GAO their own internal audits also found schedulers continuing to enter dates improperly.

The VA, in its response to the GAO report, said it will review the situation and make improvements where necessary by the end of the year.

While we know we can do more to improve our access to American Veterans aid and care, we are aggressively implementing changes in our systems, training and processes to improve access, the statement said.

They claim they are doing everything they can to fix the VA wait times and rebuild the trust of veterans who depend on the VA for care.

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