A new Veterans Affairs Department effort to shorten wait times for veterans needing health care could include extended hours and overtime at VA health facilities in addition to increased staffing at some VA clinics.
In cases where VA cannot meet demand for timely appointments in-house, the initiative would expand access to care in private health facilities paid for by VA. The VA on May 27 released details of the effort, the “Accelerating Care Initiative,” with officials saying the program was underway with a review of all primary care clinics to determine if they are correctly sized and staffed.
Clinics needing more capacity will be authorized extended hours, to include nights and weekends.
According to a VA release, facilities will:
• Try at least three times to reach patients new to VA care or new to a clinic if their appointment is more than 30 days away or they are on an electronic wait list.
• Assess whether the veteran wants to be seen sooner, and — if resources are available — provide a new appointment.
• Refer veteran to non-VA care if resources are not sufficient.
According to a VA fact sheet, this “surge” will continue for at least 90 days. VA officials did not provide an estimated cost of the initiative but said in fiscal 2014, it already has paid $3.38 billion for health services of 904,714 veterans at non-VA facilities.
Veteran service organizations, while welcoming the efforts, questioned why they came so late.
“They have always had the authority to utilize purchased care, and we don’t think it’s been used very effectively,” said Garry Augustine, executive director of Disabled American Veterans Washington headquarters.
Federal investigators are looking into 86 cases of government misconduct and alleged whistleblower reprisals within the Department of Veterans Affairs following a nationwide scandal over secret wait lists and veteran deaths.
Of the 86 employees alleging “scheduling improprieties and other potential threats to patient safety,” 37 claim the VA retaliated against them for reporting the abuses and other wrongdoing, according to the U.S. Office of Special Counsel, an independent investigative agency charged with protecting federal employees.
It is more evidence of a far-reaching scandal that began in April with whistleblower Sam Foote, a retired VA doctor who helped expose off-the-books patient waiting lists that may have played a part in 40 veteran deaths at a Phoenix VA hospital.
Last week, the VA inspector general reported that the patient scheduling abuses are systemic in veteran hospitals and clinics, which serve 6.5 million beneficiaries per year and constitute the largest integrated health care system in the United States.
“Receiving candid information about harmful practices from employees will be critical to the VA’s efforts to identify problems and find solutions,” said Carolyn Lerner, head of the OSC, in a released statement. “However, employees will not come forward if they fear retaliation.”
• One whistleblower was given a seven-day suspension after telling the VA inspector general about improper scheduling and computer coding procedures, according to the OSC. The employee also claimed the VA lowered a performance evaluation and reassigned him following the report to the IG, OSC said.
• Another VA employee was temporarily reassigned out of a position and then faced demotion after disclosing the mishandling of money meant for patient care in December, and an employee who reported the unauthorized use of patient restraints faced a 30-day suspension without pay.
Last month, the OSC blocked disciplinary action against the employees while it investigates. It did not release the names of employees or location of the facilities. The reports of scheduling wrongdoing and threats to patient safety are under investigation.