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C.W. Bill Young VA Medical Center to get more scrutiny after audit

The audit found just 3 percent of patients at the C.W. Bill Young VA Medical Center waited more than 30 days for an appointment. At the Haley center in Tampa, it was 5 percent.

DIRK SHADD | Times (2009)

The audit found just 3 percent of patients at the C.W. Bill Young VA Medical Center waited more than 30 days for an appointment. At the Haley center in Tampa, it was 5 percent.

The C.W. Bill Young VA Medical Center will get additional scrutiny after a critical audit of Veterans Affairs wait times released Monday.

That puts the Young VA center on a list that includes more than a third of the nation's biggest VA health care facilities that will undergo further review.

Nationwide, more than 57,000 veterans have been waiting more than 90 days for appointments, the audit found. The VA has yet to say what issues were identified at any one facility.

"At this point, we're unclear at what further review really means," said Jason Dangel, spokesman for the Bay Pines VA Healthcare System, which sees 103,000 veterans a year at its Young VA center at Bay Pines and eight other facilities in a 10-county area. But he said local administrators are ready to move on "any opportunity to improve."

In addition, a community-based outpatient clinic that the Bay Pines VA system runs in Sarasota will be subject to similar analysis.

The audit findings weren't all unfavorable: Just 3 percent of the Young VA center's patients had to wait more than 30 days for an appointment, compared to 4 percent nationwide and 5 percent at the James A. Haley VA Medical Center in Tampa.

But in Florida, the Young VA center was second only to Gainesville for the number of patients — 1,193 — who had requested an appointment during enrollment during the last 10 years but had not had an appointment scheduled. It also had 712 new patients who had to wait more than 90 days for an appointment.

In Tampa, 238 veterans had enrolled at the Haley VA center over the past 10 years without having an appointment scheduled. Of Haley's new patients, 565 could not get an appointment in 90 days or less.

Established patients wait an average two to three days for a primary care appointment at Haley and the Young VA center.

New patients wait longer for primary care appointments: an average of nearly 42 days at Haley and more than 47 days at the Young VA center.

The audit team that visited Bay Pines did not notify local administrators that it found anyone doing anything "intentionally wrong," Dangel said. He said followup steps could include additional training and working to make sure its staff understands definitions and terms used in the scheduling process, which the audit criticized as "overly complicated."

Meanwhile, Dangel said, Bay Pines administrators recognize they have scheduling challenges in areas like dermatology and optometry. As a result, staff has called hundreds of veterans about appointments and, if a slot can't be found sooner, offers them a chance to go to a non-VA health care provider with the agency picking up the tab.

Haley spokeswoman Karen Collins said the audit didn't include surprises but touched on already familiar issues like a policy regarding no-shows, which she said was vague and was something that Haley has been working to make more consistent.

The audit follows a scandal that forced VA Secretary Eric Shinseki to resign and has energized Republicans ahead of this year's mid-term congressional elections. The controversy includes allegations of cover-ups and secret VA waiting lists. It was set off two months ago amid reports that veterans died while waiting for appointments at the VA center in Phoenix.

The audit found "systemic problems" that demand immediate action, acting VA Secretary Sloan Gibson said. After looking at 731 facilities and interviewing more than 3,770 employees, auditors concluded:

• Hitting a 14-day target for new appointments was not attainable, given the slots available. A 2011 decision by top VA officials to set the goal and then base bonuses on meeting it was "an organizational leadership failure." The 14-day goal has been dropped from employee performance plans. Senior executive performance awards have been suspended this year.

• Thirteen percent of scheduling staff interviewed said they had been told to enter a date different from the one a veteran had requested. Auditors found at least one instance of this happening at 76 percent of VA facilities.

• Sometimes schedulers were put under pressure to use inappropriate practices to make waiting times "appear more favorable."

"Such practices are sufficiently pervasive," the audit said, to require the VA to "re-examine its entire performance management system and, in particular, whether current measures and targets for access are realistic or sufficient."

Nationwide nearly 64,000 more who enrolled over the last decade have yet to see a VA doctor.

In response, VA officials have contacted 50,000 veterans across the country to get them off waiting lists, and efforts are under way to contact 40,000 more. The VA also plans to deploy mobile medical units and to use other temporary staffing measures to speed up care to veterans.

Statewide in Florida, the audit found more than 8,500 new patients waiting for appointments more than 90 days after requesting them.

Another 5,000-plus had enrolled at Florida VA facilities in the previous decade but had never had an appointment.

The longest waiting list was at the VA's medical center in Gainesville, with 4,006 new patients having to wait more than 90 days for an appointment. More than 3,000 who enrolled at that facility in the past 10 years had not received appointments.

Florida has 1.6 million veterans, including the nation's largest population of World War II veterans, according to the Florida Department of Veterans Affairs.

Last week, Florida officials sued the VA at the behest of Gov. Rick Scott after state inspectors made unannounced visits to veterans hospitals in Pinellas, Hillsborough, West Palm Beach, Miami, Lake City and Gainesville.

State officials said they made the visits in April and May to investigate allegations that included complaints of long wait times, unsanitary conditions and improper medical care.

VA administrators turned them away and followed up with letters to Tallahassee saying federal facilities are not subject to state laws.

Information from the Associated Press was used in this report.

C.W. Bill Young

VA Medical Center


712 new patients who have waited at least 90 days for first appointment

1,193 veterans who have never gotten an appointment after enrolling and requesting one

48 days average wait time for new primary care patients

James A. Haley

VA Medical Center


565 new patients who have waited at least 90 days for first appointment

238 veterans who have never gotten an appointment after enrolling and requesting one

42 days average wait time for new primary care patients

The worst

in the nation

145 days average wait time for new primary care VA patients in Honolulu

145 days average wait time for new patient specialist care at VA Texas Valley Coastal Bend HCS in Harlingen, Texas

Source: Department

of Veterans Affairs

C.W. Bill Young VA Medical Center to get more scrutiny after audit 06/09/14 [Last modified: Monday, June 9, 2014 11:41pm]
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