A Department of Veterans Affairs scheduling clerk has accused VA officials in Austin and San Antonio of manipulating medical appointment data in an attempt to hide long wait times to see doctors and psychiatrists, the American-Statesman has learned.
In communications with the U.S. Office of Special Counsel, a federal investigative body that protects government whistleblowers, the 40-year-old VA employee said he and others were “verbally directed by lead clerks, supervisors, and during training” to ensure that wait times at the Austin VA Outpatient Clinic and the North Central Federal Clinic in San Antonio were “as close to zero days as possible.”
The medical support assistant, who is seeking whistleblower protection and has been advised to remain anonymous by federal investigators, said he and other clerks achieved that by falsely logging patients’ desired appointment dates to sync with appointment openings. That made it appear there was little to no wait time, and ideally less than the department’s goal of 14 days. In reality, the clerk said, wait times for appointments could be as long as three months.
The claims echo recent allegations that VA officials in Arizona and Colorado similarly manipulated wait time data or maintained secret lists to obscure lengthy wait times for medical care. Three top administrators at the VA medical center in Phoenix have since been put on leave and the VA’s inspector general is conducting an investigation into an alleged secret wait list at the facility. A retired doctor at the Phoenix facility told CNN that more than 40 veterans there died while waiting for an appointment.
This week, the American Legion, the nation’s largest veterans service organization, called for the resignation of VA Secretary Eric Shinseki, citing several issues, including wait times for medical care.
When asked to respond to the allegations, local VA officials said in a statement they would review their scheduling practices, but didn’t directly address the claims.
“In light of the charges recently made against the Phoenix VA, (director of the Central Texas Veterans Health Care System Sallie) Houser-Hanfelder has made it clear she does not endorse hidden lists of any kind,” the statement reads. “To ensure the integrity of the health care system, she has directed each service chief to certify they have reviewed each of their sections and scheduling practices to ensure VA scheduling policies are being followed. All staff who schedule appointments have also been instructed to have refresher training to make sure policies are clear and being followed accurately.”
U.S. Sen. John Cornyn, R-Texas, called for emergency hearings after learning of the Texas allegations.
“This is yet another deeply troubling account, and I’m afraid we have not heard the last of gross mismanagement within the VA and deception by VA bureaucrats,” Cornyn said in a statement. “It is time for urgent steps to be taken that match the gravity of this situation.”
He also called for Shinseki to step down.
“It is absolutely disgusting to think that another VA facility would be cooking the books like this, especially in our own community. The House of Representatives is digging into these allegations against the VA from every direction possible and we will get to the bottom of this,” said U.S. Rep. John Carter, R-Round Rock.
The Texas clerk said he saw the scheduling manipulation when he worked at the Austin VA Outpatient Clinic from December 2012 to December 2013 and when he transferred to the San Antonio clinic, where he still works. He said he also saw similar maneuvers at the Waco medical center earlier in 2012.
“If you had any appointments showing over a 14-day waiting period you were given a report the next day to fix it immediately,” said the clerk, a disabled veteran who served in the Army from 2002 to 2011. Fixing it meant recording the requested appointment date closer to the available opening, he added.
The clerk said that scheduling clerks in Austin were also instructed specifically not to use a VA tool called the Electronic Waiting List, which is designed to help veterans waiting for appointments get slots created when other veterans cancel their appointments.
“The failure to use (the electronic waiting list) may also pose a substantial and specific danger to public health, because patients who should be included on the EWL are not receiving more timely appointments when they become available,” according to the clerk’s communications with the Office of Special Counsel.
While the VA’s massive backlogs of disability benefits claims have garnered much attention in recent years, investigators have also increasingly discovered problems with access to VA medical care.
In 2012, the VA inspector general found that the department had vastly overcounted how many veterans were waiting 14 days or less for a mental health evaluation. While the VA claimed a 95 percent rate in meeting the two-week target, investigators found that the real number was 49 percent, with the remaining 51 percent of patients waiting about 50 days for an evaluation.
That same year, a scheduling clerk at a VA medical center in New Hampshire told a Senate committee that staffers there were instructed to obscure wait times for mental health help by using a method similar to that described by the Texas clerk.
“The overriding objective at our facility from top management on down was to meet our numbers,” Nick Tolentino told the committee. “Performance measures are well intended, but are linked to executive pay and bonuses and as a result create incentive to find loopholes that allow facilities to meet its numbers without actually providing services.”
Last week, the House voted to ban bonuses for VA executives, a move opposed by VA leadership. Shinseki has defended the bonus system, saying it is necessary to “attract and retain the best leaders.”
Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans’ Affairs, which is also investigating delays in VA medical care, blasted the VA on Tuesday for not taking better advantage of its authority to send patients who are waiting months for appointments to private medical providers.
“Whether we’re talking about allegations of secret lists, data manipulation or actual lists of interminable waits, the question VA leaders must answer is ‘Why isn’t the department using the tools it has been given – fee-based care being one of them – to ensure veterans receive timely medical care?’” he said.
Reporter Jeremy Schwartz, a member of the Statesman investigative team that produced the “Uncounted Casualties” series on the deaths of veterans, has reported extensively on veterans issues, in addition to filing reports from the wars in Iraq and Afghanistan.