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April 4 2016

Report: VA Supervisors Intimidating Employees into Lying about Wait Times

Patrice J. Lee

Local Departments of Veterans Affairs are still not doing a good job of serving our veterans and, sadly, it reportedly is the supervisors who are leading the staff to provide bad service and then refuse to tell the truth afterwards.

Investigations into management at VA medical centers in California found that supervisors coached employees on what to tell investigators about wait time manipulation. Staff, according to the findings of the investigation, had been directed to report untrue wait times or suffer consequences and then told to lie about it to investigators. In some instances, supervisors reportedly sat in on the interviews between staff and investigators to ensure staff said what they had been told to say.

The VA is rife with mismanagement and misconduct when it comes to their treatment of veterans. By manipulating recorded wait times for veterans to receive appointments, they appeared to be efficient, while the men and women who served this country languished with sickness leading to the deaths of a few dozen former service members.

Two years after this scandal broke and not enough has changed. VA schedulers are still purposefully changing dates to make it appears as if veterans seeking care have no wait time. They are entering the next available date to a veteran’s desired appointment date. We recently reported on 77 investigations into VA wait time claims and findings. In 38 cases whose findings were released, 21 had improper scheduling.

Now, a new watchdog report finds that in 2014 CA VA management cherry-picked medical support staff to be interviewed than coached them with exactly what to tell investigators. Most of the assistants said they were told to employ the fraudulent tactic of “zeroing out” appointment times – making it appear as if there is no wait. Furthermore, assistants said that if they did not manipulate the wait times, their evaluations and performance would suffer possibly blocking bonuses and promotions.

More specifically, assistants reported the following:

A former lead MSA stated that another MSA was once tasked to change all desired dates that exceeded 14 days.  He recalled having to find a dedicated room/computer so the MSA would not be disturbed while he made these adjustments.  According to the former lead MSA, this instruction came straight from the MAO around November/December 2012. Furthermore, he routinely received emails from the MAO identifying scheduling clerks who needed to adjust their desired dates to reflect a shorter waiting time.  He said that the MAO continued to send these email reports until the waiting times were to his satisfaction, even if that meant the desired dates were altered.  Because he no longer worked for VA at the time of the investigation, he did not have any emails showing the direction by the MAO.

In one heart-wrenching case, we see the direct impact of the wait list manipulation on the life of one veteran:

On June 25, 2014, OIG received information from a VA employee that a veteran had attempted suicide at a CBOC located in San Diego, due to his frustration with his canceled appointments.  OIG staff reviewed the veteran’s historical appointments in VistA, which showed that the veteran’s appointments had been canceled since early 2014, and the desired dates of his rescheduled appointments were captured incorrectly…  Ultimately, the veteran was scheduled in advance to see the provider the following month, but by the time the data was reviewed, the appointment had already been canceled by the clinic. The veteran was not scheduled to see his provider until 1 month later.  The veteran was admitted to the VAMC after his suicide attempt.

When interviewed by OIG staff, the veteran stated he used the cancellation of his appointments as an excuse to act out and attempted to harm himself.  He said he regrets his actions and that he received help and now has follow-up appointments.  He had been seeing the same provider since 2009 and never had an appointment canceled until 2014.  He estimated that his appointments were canceled four times in a row, which triggered his behavior.

Not all supervisors encouraged this behavior. As the Daily Caller reports, some told their staff to report actual times and they suffered blowback:

One manager at a veteran outpatient clinic said she would not instruct her employees to zero out dates, which of course resulted in higher wait times in her area.

“She heard that she was moved out of Primary Care because of this,” the report noted.

She then sent an email showing that 78 percent of veterans had zero wait times, and in that email she stated, “That’s a glaring red flag that the clerks are not entering the true desired date, but instead, they are finding the next available appointment and making the desired date the same as the appointment date instead of asking the patient when they want to be seen.”

 

VA leadership may have changed but this odious behavior seems to have persisted at the mid and junior levels. Until the house is swept clean and guilty held responsible - in this case managers - we shouldn't expect much to change at the VA. Granted this is tricky.

Managers reportedly ordered assistants to do their dirty work. Both are responsible, but managers should shoulder the heavier punishment. However, how do you deal with the assistants? Between their bonus or job versus someone else's doctor's appointment we see which choice they made. It's not at the level of Sophie's choice but workers at Enron who knew the books were cooked and sat quietly are just as responsible.

In the end, our veterans are the ones who suffer and continue to at the hands of bloated, inept, and incapable federal government.

IIndependent Women's Forum is an educational 501(c)(3) dedicated to developing and advancing policies that aren’t just well intended, but actually enhance people’s freedom, choices, and opportunities. IWF is the sister organization of the Independent Women’s Voice.​
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