The Department of Veterans Affairs is a mess. The Phoenix VA Medical Center is one of its messier entrails, where keeping one (false) waiting list for oversight while another (secret) list for actual use has been implicated in the deaths of as many as 40 neglected veterans.
On April 9, the House Committee on Veterans’ Affairs ordered the VA to preserve the fraudulent scheduling records. Rather than comply, VA lawyers in Washington tipped off the Phoenix managers, and dragged their feet for eight days before complying. Given this wink and nod from HQ, the Phoenix managers went on an orgy of document shredding and file deletion, scrubbing agency files and computers of all evidence of their wrongdoing — except, of course, for the dead veterans’ corpses, which were beyond all mortal intervention at this juncture.
VA Secretary Rick Shinseki’s response? To assert he’s shocked that there was gambling in this fine establishment, or words to that effect — and to “punish” three Senior Executive Service-level payroll patriots with extra paid vacation days until it all blows over.
Department of Veterans Affairs officials were threatened Thursday with a congressional subpoena if they fail to explain the destruction of a secret list of medical appointments at the Phoenix veterans’ hospital and preserve documents for an inspector general’s investigation.
Meanwhile, the agency placed three officials from the Phoenix facility on leave.
Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans’ Affairs, said he is prepared to call an emergency committee meeting to subpoena the information formally if he does not get answers by next week.
Whistleblowers say more than 40 patients died because of delays in treatment while in the Phoenix VA Health Care System.
In a letter sent Thursday to VA Secretary Eric Shinseki, Miller also rebuked the agency for failing to act quickly to preserve documents related to allegations hospital administrators in Phoenix kept two sets of appointment lists to hide large backlogs of medical appointments.
Miller issued a directive at an April 9 hearing that scheduling records at the Phoenix hospital be preserved.
But VA lawyers did not formally issue the preservation order until April 17, eight days later. That order went to, among others, Dr. Sharon Helman, director of the Phoenix VA Medical Center.
“It is extraordinarily disconcerting that more than a week was allowed to pass before any directive was issued to Dr. Helman and her staff to preserve all potential electronic and paper evidence,” Miller said in his letter to Shinseki.
Helman and Phoenix Associate Director Lance Robinson were both placed on administrative leave Thursday by Shinseki, along with a third Phoenix VA employee who was not identified publicly.
The secretary said the three would be on leave until further notice, “based on the request of the independent VA Office of Inspector General, in view of the gravity of the allegations and in the interest of the Inspector General’s ability to conduct a thorough and timely review.”
At least 1,500,000 medical orders including in-process procedures, lab requests, etc. were canceled by the Phoenix VA Medical Center in 2013 to “improve” their reportable backlog statistics, with complete disregard of the veterans whose health those 1.5 million orders bore upon. Three Arizona Congressmen have called for the heads of Sharon Helman and her leadership team, given her depraved indifference to the health of the veterans that come to the hospital — not to mention, her demonstrated dishonesty in the statistics scandal. The problem is not unique to Phoenix, although it’s worst there: LA and Dallas have also dumped pending appointments and procedures to polish their backlog stats.
The scandal came to light when Dr Samuel Foote, a 20-year physician at the facility, resigned and brought Helman’s blackholing of veterans and their records to Congressional attention. Congressman Jeff Miller says of Foote, “He has no axe to grind… I think he tried to bring this to the attention of executives and basically was shunned.”
VA medical facility administrators may not work hard, but they sure think they deserve to be paid well for it. An IG examination of the Providence, Rhode Island medical facility (.pdf) found that the managers at that site were exuberantly generous with bonuses and retention payments.
Our review indicated that the VAMC Providence Director, a Title 5 employee, receives a retention incentive payment equal to 5 percent of salary. In 2009, his salary was $170,435, which resulted in retention incentive payments totaling $8,194. In addition, he received a Senior Executive Service award totaling $14,000 and a performance award totaling $19,000. The total value of the compensation he received in 2009 was $211,629. We found the request for retention incentive payments to the VAMC Providence Director, dated December 19, 2008, did not include an adequately supported supervisory certification that he was likely to leave Federal service absent the retention incentive. Rather, the certification included a generic statement that addressed turnover and attrition rates (mostly due to retirement) within VHA’s senior executive leadership ranks generally, without focusing on the Director’s specific status or circumstances. Given his status and circumstances at the time of the request, we believe it is highly unlikely that he was planning to leave Federal service.
They also noted that he was eminently replaceable, and indeed, had been replaced:
Further, should the VAMC Providence Director decide to leave Federal service, it seems likely that the current Assistant Director or another VHA senior level manager could perform the full range of duties and responsibilities of the Director with minimal training, cost, or disruption of service to the public. In fact, the Assistant Director has been serving as the Acting Facility Director since January 2010 when the VAMC Director was detailed to serve as Acting Director at VAMC West Haven.
Naturally, the Assistant Director was loading up on bonuses, too. But that’s just Providence, right?
When we discussed this case with the VISN 1 [VISN1 is Veterans Integrated System Network 1 — the New England VA region -Ed.] Director… [w]e noted that at least 4 of 7 medical center directors in VISN 1 receive retention incentive payments…. Even though the decision to pay retention incentives was made prior to the VISN Director assuming his role as the director, he signed the supervisory certification attesting the VAMC Providence Director was likely to leave Federal service.
Oh. But wait, wait, it gets better! The Providence facility knew these special pays were rubber-stamped at regional and national HQ, so they didn’t bother to keep any paperwork on more than a third of them, leaving “Christ knows” as about the only conclusion available to the IG investigators trying to figure out why so many VA managers are being paid special-purpose bonuses. And the IG report’s results are based on the 20 cases it reviewed (of which, 17 were being paid inappropriately) — it didn’t look at 52 others, but guesses that they’re probably bad at about the same rate.
Rick Shinseki has pledged to get to the bottom of each of these scandals, a pledge that conflicts with his actions so far. But then again, he pledged to take care of those 40 dead vets, so what’s his word actually worth?
We’ve known Shinseki for 20 years, so we’re not expecting a sudden outbreak of integrity in a man who shucked his off as an inconvenience while climbed the ladder. But is competence too much to ask for?