VA's own audit finds problems beyond Phoenix
An internal audit of access and scheduling practices at the Department of Veterans Affairs paints a grim picture of an agency whose ambitious performance efforts were unattainable and whose government schedulers faced pressures that led to inappropriate practices.
As political pressure from the scandal over veterans' health care grew in recent weeks, attention focused on the internal audit, ordered by the White House and carried out by the Department of Veterans Affairs, to explain what had gone wrong and what needed to be done.
The report was released Friday after Secretary Eric Shinseki resigned.
At his news conference, President Barack Obama said that Shinseki and White House deputy chief of staff Rob Nabors, whom Obama named to investigate questions about the agency, discussed the audit before Shinseki offered to step down to avoid becoming a political distraction.
The audit showed that problems at the VA went beyond isolated complaints at the Phoenix facility.
The audit examined 216 sites and more than 2,100 scheduling staffers and is the first phase of the department's audit of its practices.
Among the findings:
• Appointments at more than 60 percent of the divisions had been changed at least once.
• 13 percent of the scheduling staffers indicated that they had received instructions to enter a date different from the one requested by the patient.
• 7 percent to 8 percent of scheduling staffers indicated that they used something other than the official electronic list, a complaint made by whistle-blowers who charged that some veterans were pushed onto secret waiting lists because their needs could not be handled within the agency's performance target of 14 days.
• The audit found at least one instance of such juggling in 62 percent of the facilities examined.
• Officials are now removing the 14-day target for performance contracts and this year are suspending executive bonuses that are tied to waiting times.
• Officials are writing new scheduling directives to employees.
• Officials need to compare the capacity to deliver services against health care demands to make sure there are adequate resources.
• Accountability for integrity in scheduling should be strengthened with renewed training and coaching of employees.
About the VA
9 million veterans get health care from the VA.
4 million receive compensation for injuries and illnesses incurred from their service.
150 hospitals run by the VA.
800 outpatient clinics in the VA system.