By Dan Margolies – Kansas News Service/KCUR.org
Almost 1,000 veterans in Missouri, Kansas and Illinois were denied care at non-VA facilities because their wait times were incorrectly reported, an audit released last week concludes.
The report, by the Office of Inspector General for the Veterans Health Administration, found that 18 percent of appointments for new patients at VA facilities in the three states had wait times longer than 30 days. The facilities’ own electronic scheduling systems, however, showed only 10 percent had wait times of more than 30 days.
The inaccurate wait-time data meant that veterans were not identified as eligible for treatment through the VA’s Choice program, which allows veterans who face wait times of more than 30 days, or have to travel more than 40 miles to a VA facility, to seek care at non-VA facilities.
Because wait times were not accurately measured, the inspector general report estimated that staff failed to offer 970 patients the option of receiving care through the Choice program.
The VA came under fire in 2014 amid disclosures that the VA Medical Center in Phoenix had falsified records to conceal long wait times. The scandal prompted a shakeup in the VA health system, including the resignation of Eric K. Shinseki, the secretary of Veterans Affairs. Since then, inspector general reports have found similar problems at other VA facilities across the country.
The new report looked at wait times in the VA region that includes VA facilities in Kansas City, St. Louis, Columbia and Poplar Bluff, Missouri; Wichita, Topeka and Leavenworth, Kansas; and Marion, Illinois. The region is known as VISN 15 (VISN stand for Veterans Integrated Service Network and encompasses VA medical centers and clinics in Missouri, Kansas, Illinois, Indiana and Arkansas).
“The main thing that is most troubling to me is that the through lines and the themes that contributed to the problems we were seeing with wait times at so many of the facilities as far back as 2014 still seem to be in place,” said Charles Hughes, a policy analyst with the conservative-leaning Manhattan Institute who has written about VA wait times.
“I’m not talking about willful manipulation or anything in that vein, but just inconsistent enforcement of the processes that are supposed to be in place,” Hughes said. “Sometimes facility staff doesn’t quite understand what they’re supposed to be doing and the end result is more veterans are waiting longer than the data indicates. And in a lot of cases that can lead to them not getting timely care or being inappropriately not made eligible for the Choice program.”
Kevin T. Arnhold, a spokesman for VISN 15, said in an email that the facilities “appreciate the inspector general’s review and we welcome the oversight because we know it makes us better.”
“And while this report highlighted opportunities for improvement with respect to our wait times, it also validates VISN 15’s efforts to deliver timely health care to Veterans,” he said. “Nevertheless, we are taking this opportunity to redouble our efforts to provide timely, high-quality care to those who have worn the uniform.”
U.S. Sen. Roy Blunt, R-Missouri, said in an email to KCUR that the report “clearly shows there’s more work that needs to be done to ensure wait times are being reported accurately, consults are being managed effectively, and veterans who are eligible for the Choice program are able to get the care they need within 30 days.”
Blunt last year co-sponsored legislation called the Department of Veterans Affairs Accountability and Whistleblower Protection Act, aimed at protecting whistleblowers while making it easier to fire employees at the Department of Veterans Affairs.
The Dwight D. Eisenhower VA Medical Center in Leavenworth also was among the facilities examined in the audit report.
Drew Pusateri, a spokesman for U.S. Sen. Claire McCaskill, D-Missouri, said via email that McCaskill was reviewing the inspector general report “but finds many aspects of the audit concerning and will be demanding additional information from the VA.”
The report follows a similar audit of another VA region last year, which also found facilities failing to maintain accurate data on wait times.
Neither report reviewed the quality of the health care provided at the facilities. Rather, they measured wait times for new patients and the accuracy of the facilities’ wait-time data.
The VA health system comprises 1,700 hospitals and clinics, making it the country’s largest integrated health care system.
The new inspector general report says that “VA data reliability continues to be a high-risk area.”
In addition to finding that 18 percent of appointments for new patients overall had wait times exceeding 30 days, the report also found that the wait times for 38 percent of new mental health or specialty care appointments were inaccurate. The report said the average wait time for the 18 percent cohort was 53 days.
“Staff continued to enter the wrong date in the scheduling system primarily because VISN 15 and facility management did not ensure staff consistently implemented VHA’s scheduling requirements,” the report stated.
“I think a lot of it is just kind of, I don’t want to say incompetence, but misunderstanding or mistakes or just poor performance,” Hughes, of the Manhattan Institute, said.
He added: “It is a little disheartening that we’re into 2018 now and still having a lot of these same issues.”
Dan Margolies is a senior reporter and editor for KCUR. You can reach him on Twitter @DanMargolies.