5 Priorities to Fix VA

[longknife]

These make a whole lot of sense to me!

Create a culture of accountability at the Department of Veterans Affairs

Empower employees to speak up about wrongdoings.

The department must be made to answer congressional inquiries in a direct, transparent and timely manner

Increase the efficiency of service delivery and elevate the quality of care provided by the VA system to that found in the private sector.

Increase medical options for our veterans.

The first, in my opinion, is a bit lame. It should be – Make VA employees pay for mismanagement and even bring them up on charges when an investigation deems it appropriate. No more transfers to sweep it under the rug.

Read more @ 5 Priorities to Fix Veterans Affairs

 

[waltky]

Edging him out doesn't solve the problem of too few VA doctors due to the AMA lobby keeping a stranglehold on the number of medical schools in the US...

Shinseki resigns as Veterans Affairs secretary
May 30`14 ~ President Obama announced after his meeting with Shinseki that he accepted his resignation. “With considerable regret, I accepted,” Obama said. “We don’t have time for distractions,” he added.

President Obama will meet with embattled Veterans Affairs Secretary Eric K. Shinseki at the White House Friday morning as calls for him to step down continue to pile up on Capitol Hill. The White House said Obama will meet with Shinseki in the Oval Office at 10:15 a.m to discuss the VA scandals that have drawn widespread criticism from both Democratic and Republican lawmakers.

In an interview with ABC's "Live with Kelly and Michael" that aired Friday morning, Obama vowed to have a "serious conversation" about whether he is equipped to remedy the situation at the VA. "He's going to report back to me on what he's seen. And I'll have a serious conversation with him about whether he thinks that he is prepared and has the capacity to take on the job of fixing it," Obama said. "Because I don't want any veteran to not be getting the kind of services they deserve."​

The meeting will be closed to the press. A wave of lawmakers in both parties has called for Shinseki to step down, following the release this week of an independent review that found VA officials had falsified records to conceal how long some veterans had to wait for medical care.

Shinseki resigns as Veterans Affairs secretary

 

[waltky]

Are they gonna hire more doctors, and if so, why didn't they do it on Shinseki's watch?...

Dressing the VA's wounds: What Obama faces now
31 May`14 WASHINGTON (Reuters) - When U.S. President Barack Obama accepted the resignation on Friday of Veterans Affairs Secretary Eric Shinseki, he said his priority now was fixing the troubled agency whose officials are accused of covering up delays in providing healthcare for U.S. veterans.

That task is monumental. As Obama himself said, the sprawling Veterans Affairs department "has had problems for a very long time," including management problems. The agency's woes have been compounded by the rising demands for services after the return of veterans from Iraq and Afghanistan. Obama noted on Friday that the VA enrolled 2 million new veterans in healthcare under Shinseki's watch. Obama and many Democratic lawmakers say that the increase calls for more doctors and nurses to prevent veterans from having to endure long wait times for care.

But hiring them would require a big funding increase from the U.S. Congress, something that is unlikely to happen given the strong resistance in the Republican-led House of Representatives to spending increases. In February, Senate Republicans blocked a bill by Bernard Sanders, an Independent who caucuses with Democrats and chairs the Senate Veterans Affairs Committee, to expand veterans' benefits. Just two Republican senators voted for it. It would have cost about $21 billion over a decade.

Representative John Culberson, Republican chairman of the House appropriations subcommittee in charge of veterans affairs, said the VA is already "amply funded. The problem has far more to do with bureaucratic rigmarole and civil service inertia than it does with lack of funding.” He noted that the VA has been exempt from automatic spending cuts that were imposed on other agencies starting last year as a result of a budget deal between the two parties. Proposals for broad legislative changes to the VA could also fall victim to gridlock, especially in a midterm election year when both parties are more focused on attacking one another than on striking bipartisan compromises.

On Friday the Obama administration moved to address one management practice that may have given some VA administrators an incentive to falsify records - a bonus system that rewarded officials for shorter wait times. The administration is doing away with all performance bonuses this year for senior VA health executives. To ensure that veterans aren't left waiting for doctor appointments and urgent care, both Republicans and Democrats have suggested offering more patients access to private healthcare services, at least on a temporary basis. Sanders, however, says that would not work in the long term because there are not enough doctors in the private sector either. Obama tapped Deputy VA Secretary Sloan Gibson to serve as acting head of the Veterans Affairs department and has promised to look for a permanent successor to Shinseki.

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[eflatminor]

5 Priorities to Fix VA

Respectfully disagree.

The VA is an example of a Soviet-like system, for which there is NO fixing. No oversight, no leader, no matter how benevolent or intelligent, can make an operation efficient in which there is no competition, no choice, and no consequence for failure. The VA, like any centrally planned monopoly, is doomed to providing sub par service at extraordinary cost.

Good news is there is an easy fix. Scrub the VA and allow vets to choose any private doctor or hospital they like. I agree vets should have taxpayer funded healthcare. That doesn't mean government should operate those healthcare facilities. Give vets choice!

 

[LoneLaugher]

And the fantasy that accountability exists exclusively in the private sector lives on.

Wait times are just as long in just as many facilities in private, for profit healthcare as in the VA system.

Employees in the private sector will, if faced with unattainable goals, fudge numbers. When they are caught, they will be reprimanded or dismissed.....which will also happen in the VA.

The standard of care within the VA system is on par with...or better than that found in the private sector. Especially when it comes to combat related trauma. At issue is access....not quality.

We can so,ve the problem by extending Medicare benefits to vets. Then...after sanity sets in...we can extend them to every American citizen.

The desire for the "anti government" sore losers to establish that government is the root cause of all that ails us.....is transparent and counterproductive.

 

[eflatminor]

The standard of care within the VA system is on par with...or better than that found in the private sector.

 

[LoneLaugher]

The standard of care within the VA system is on par with...or better than that found in the private sector.

[MENTION=9429]AVG-JOE[/MENTION]

Should I bother?

 

[eflatminor]

The standard of care within the VA system is on par with...or better than that found in the private sector.

[MENTION=9429]AVG-JOE[/MENTION]

Should I bother?

No idea what the fuck you're talking about. My advice, lay off the vodka and paint chips...

 

[waltky]

Granny wantin' to know if dey gonna hire more doctors so vets won't have to wait so long?...

Shinseki is out, but Phoenix VA delays leave a haunted trail for some
May 31, 2014 ~ In Arizona, where allegations first surfaced of secret waiting lists at the Phoenix VA and ultimately led to Friday's resignation of Veterans Affairs Secretary Eric K. Shinseki, reaction was swift and pointed.

Shortly after President Obama accepted Shinseki's offer to step down, veterans and their relatives who had experiences with the Phoenix facility said that they expected the departure but that the agency had a long way to go. Sally Barnes-Breen, whose father-in-law died while waiting for a follow-up appointment, said Shinseki’s resignation was not enough. "People are still dying," she said from her home in San Tan Valley, Ariz. Her father-in-law, Thomas Breen, 71, a Navy veteran with a history of bladder cancer, waited two months last fall for a follow-up appointment at the Phoenix VA after discovering blood in his urine. His family finally took him to a private hospital, where he was told he had terminal bladder cancer. He died Nov. 30.

Barnes-Breen said her father-in-law was one of at least 40 veterans who died while waiting for service at that VA medical center, according to hospital employees as well as several members of Congress who have looked into allegations of staff misconduct involving waiting lists. That facility is also the focus of a federal Justice Department investigation over secret waiting lists that allegedly were used to conceal the extent of delayed patient appointments. Barnes-Breen said federal officials need to clean house and hold VA officials accountable for what she called criminal acts. About half an hour north of the Phoenix VA, Edward Laird responded to Friday's news with scorn.

The 76-year-old Navy veteran, who had more than half his nose cut away because of what he described as years of delayed care at the Phoenix VA, said Shinseki's resignation was a step in the right direction. "He didn't do nothing," Laird said. “He should have stood up and taken a few bullets for us." Laird said he'd been watching the news all morning from his home in New River, Ariz. He called Shinseki, a retired four-star general, "collateral damage." "They're not out of the woods yet,” he said of VA officials. "You've got an organization that has too many patients." Barnes-Breen summed it up by pointing out her father-in-law refused to go anywhere else for his care. "He believed and trusted the VA," she said.

Shinseki is out, but Phoenix VA delays leave a haunted trail for some - Veterans - Stripes

See also:

Search for new VA leader should look beyond ex-military, experts say
May 31, 2014 ~ According to Michael Tanner, a senior fellow at the CATO Institute, many retired generals move from the Pentagon to the VA but "we’re not talking about combat or an army. We’re talking about bureaucracy.”

President Barack Obama may want to look beyond the military community for someone with solid management experience to fix the Veterans Administration after retired Gen. Eric Shinseki resigned as head of the troubled department. Shinseki, a decorated Vietnam veteran and former Army chief of staff, stepped down Friday after a preliminary investigation confirmed reports of widespread mismanagement and delays in scheduling appointments for veterans in VA hospitals. Obama praised Shinseki but said the VA "needs new leadership" to address the mounting claims of malfeasance that allowed executives to cash in on bonuses even as veterans with serious health issues languished on secret waiting lists.

The search for that new leadership should be “less about having someone with a military background and more about someone with a management background,” said Michael Tanner, a senior fellow at the CATO Institute. Tanner said many retired generals move from the Pentagon to the VA but "we’re not talking about combat or an army. We’re talking about bureaucracy.” Tanner said veterans can identify with other veterans, but "they’re not dealing with the veterans, ultimately." "They’re dealing with a lot of people who aren’t impressed by how many stars the guy wore,” he said, adding that a better candidate might be someone with solid business credentials, "ideally someone who's helped turn around a company."

Shinseki himself alluded to the problem just before his resignation was announced. In a speech to the National Coalition for Homeless Veterans, Shinseki said he had initially thought the delays in scheduling appointments for veterans were isolated cases. Now, he thinks such delays are systemic and that he was misled by other managers within the VA system. “I can’t explain the lack of integrity among some of the leaders of our health care facilities,” he said. “This is something I rarely encountered during 38 years in uniform.” Phillip Carter, a former Army officer and current director of the military, veterans and society program at the Center for a New American Security, said Obama should “cast a wide net” as he searches for someone capable of repairing the damage. “The next VA secretary should be familiar with the culture of the VA, but that does not mean that he or she needs to be a veteran, let alone a retired general or admiral,” Carter said.

With a department employing more than 312,000 people and a budget of more than $150 billion, any VA secretary must be “very politically astute… capable of balancing competing interests and priorities,” Carter said. John Raughter, spokesman for the American Legion, said the key is to find a reformer, “someone who will make monumental changes to the structure of how the VA is operating now, someone who will hold the administrators accountable if they abuse their customers." He also said the new secretary must change the "culture of fear" that seems to have kept many employees from reporting problems. “It’s going to take a reform-minded individual,” Raughter said. In a written statement, Iraq and Afghanistan Veterans of America urged Obama to choose a new secretary who would make “bold changes and work quickly and aggressively to change the VA system."

The organization also called on the president to look for a veteran of the wars in Iraq or Afghanistan. Dr. Sam Foote, a retired VA doctor who helped expose scheduling abuses in the Phoenix VA, said someone with considerable administrative experience would be ideal, though a top-level hospital administrator would likely have to accept a significant pay cut to take the job. Ex-military commanders would face culture shock, Foote said. They are accustomed to working with trained subordinates who follow orders — habits less widespread in the VA culture, Foote said. “Superman would be good, if he’s available,” Foote said.

Search for new VA leader should look beyond ex-military, experts say - Veterans - Stripes

 

[whitehall]

Democrats think they can throw money at any problem and it will go away on it's own but it ain't about money. Hussein allegedly authorized 25 million in bonuses for VA administrators who thought of creative ways to kill patients. Indict the bastards for manslaughter and eliminate bonuses for all government workers and then appoint people who give a shit instead of political drones.

 

[waltky]

“Having a different secretary is not going to be enough,”...

How the VA fostered a culture of gaming the system
June 2, 2014 ~ About two years ago, Brian Turner took a job as a scheduling clerk at a Veterans Affairs health clinic in Austin, Texas. A few weeks later, he said, a supervisor came by to instruct him how to cook the books.

"The first time I heard it was actually at my desk. They said, 'You gotta zero out the date. The wait time has to be zeroed out,'" Turner recalled in a phone interview. He said "zeroing out" was a trick to fool the VA's own accountability system, which the bosses up in Washington used to monitor how long patients waited to see the doctor. This is how it worked: A patient asked for an appointment on a specific day. Turner found the next available time slot. But, often, it was many days later than the patient had wanted.

Would that later date work? If the patient said yes, Turner canceled the whole process and started over. This time, he typed in that the patient had wanted that later date all along. So now, the official wait time was ... a perfect zero days. It was a lie, of course. But it seemed to be a very important lie, one that the system depended on. "Two to three times a month, you would hear something about it," Turner said — another reminder from supervisors to "zero out." "It wasn't a secret at all." But all this was apparently a secret to Secretary Eric Shinseki, perched 12 levels above Turner in the VA's towering bureaucracy. Somewhere underneath Shinseki — among the undersecretaries and deputy undersecretaries and bosses and sub-bosses — the fact that clerks were cheating the system was lost. On Friday, Shinseki resigned and was replaced by his deputy.

But his departure is unlikely to solve the VA's broader problem — a bureaucracy that had been taught, over time, to hide its problems from Washington. Indeed, as President Barack Obama said, one of the agency's key failings was that bad news did not reach Shinseki's level at all. This is an ironic development: Until recently, the VA had been seen as a Washington success story. In the 1990s, reformers had cut back on its middle management and started using performance data so managers at the top could keep abreast of problems at the bottom.

Then that success began to unravel. As the VA's caseload increased during two wars, the agency grew thick around the middle again. And then, when the people at the bottom started sending in fiction, the people at the top took it as fact. "Shinseki goes up to Capitol Hill, and says, 'I didn't know anything.' I find it perfectly believable," said Paul Light, a professor at New York University who has studied the bureaucracy of the VA and others in Washington. "And that's a real problem." For decades, the VA was a byword for bureaucracy itself, seen as Washington's ultimate paper-pushing, mind-bending hierarchy. That reputation was rooted in the VA's history: It came about because the agency's first leader was an audacious crook.

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See also:

Cultural change critical to rescuing VA, experts say
June 1, 2014 — The country's largest hospital system lost its top two leaders in two weeks, is under fire from powerful politicians and interest groups, and awaits an internal overhaul in the glare of an election-year political spotlight. And the man at the helm — acting Veterans Affairs Secretary Sloan Gibson — just joined the department in February.

“I don't envy him,” Hershel Gober, who twice served as acting VA secretary during President Clinton's second term, told the Tribune-Review. “He's going to have to spend about 20 hours a day there. There is so much he's got to read, so much he's got to understand,” Gober said. As the Department of Veterans Affairs tries to find its way through one of the worst crises in its history, critics inside and outside say nothing less than a cultural change will rescue the embattled agency.

Secretary Eric Shinseki resigned on Friday, two weeks to the day after Undersecretary for Health Robert Petzel retired. Shinseki was forced out by the growing scandal of secret waiting lists at VA hospitals across the country, including one in Pittsburgh that included more than 600 veterans.

But other incidents have shaken the public's confidence in the federal government's second-largest department. At least six veterans died and 16 fell ill during an outbreak of Legionnaires' disease in Pittsburgh from February 2011 to November 2012, to name just one. “Having a different secretary is not going to be enough,” said Sen. Bob Casey Jr., D-Scranton. “There are probably others who have to be removed, and even when you remove them and make changes, the key is going to be the result. Can you reduce — substantially — the backlog? Can you restore confidence?”

Changing the way the VA operates won't be easy, in part because of its size. Its 2,022-page budget lays out more than $150 billion in spending. Its workforce is about the size of Pittsburgh's population.

Start at the top

 

[waltky]

Interim VA chief working to immediately eliminate long treatment delays nationwide...

Interim VA chief cites progress amid new details on secret wait lists
June 4, 2014 ~ Acting Veterans Affairs Secretary Sloan Gibson said Wednesday his department has contacted all 1,700 veterans caught up in a hospital wait-list scandal in Phoenix and is working to immediately eliminate long treatment delays nationwide.

Gibson met with veteran groups and spoke publicly for the first time since taking over from retired Army Gen. Eric Shinseki, who resigned Friday over widespread scheduling abuses at VA hospitals and clinics that have been blamed for 40 veteran deaths in Arizona. But even as Gibson offered reassurances, new details emerged that VA health care facilities in the Midwest also kept 10 off-the-books waiting lists – with two being acknowledged as a health threat to patients.

A VA inspector general report last week found the potentially dangerous patient scheduling abuses were systemic in the department but only listed specific problems at the Phoenix VA hospital, where patients were never added to official wait lists as a way to conceal treatment delays of up to several months. “As the president has directed, we are moving immediately to get veterans off of wait lists and into clinics, and we are taking action to fix the systemic problems that allowed these unacceptable waits to occur,” Gibson said during a White House event Wednesday.

Sloan Gibson, acting secretary of Veterans Affairs, speaks at the White House on June 4, 2014 before first lady Michelle Obama announced a nationwide challenge to local leaders to end veterans homelessness by the end of 2015.

Gibson described the VA efforts during a meeting earlier in the day with the American Legion, AMVETS, Disabled American Veterans, Paralyzed Veterans of America, Veterans of Foreign Wars, and Vietnam Veterans of America. Some of the 1,700 veterans in the IG report declined to provide contact information or were duplicate entries. According to a VA release, Gibson told the groups that by Friday the VA had called the 1,586 veterans the IG found on off-the-books waiting lists kept by staff in Phoenix. “VA identified that roughly 725 veterans of the 1,700 identified by the [inspector general] wanted care within 30 days,” according to the department.

The initial IG report, part of a larger audit of the Phoenix deaths and the VA’s nationwide health care system, found that staff used strategies to make it appear facilities were meeting a VA requirement that veterans receive care within 14 days of their requested schedule date. The wait times were used in employee performance evaluations and related to awards and pay bonuses. A full report is expected to be completed in August.

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[waltky]

Whistleblowers are not to be retaliated against...

VA acting chief: retaliation will not be tolerated
7 June`14 — Investigators said they are examining allegations that supervisors in the veterans' health system retaliated against 37 employees who complained about practices such as falsified records used to cover up months-long delays in scheduling appointments. The acting VA chief said such reprisals would not be tolerated.

"I think that is wrong. It is absolutely unacceptable," Acting Veterans Affairs Secretary Sloan Gibson said Friday. "There have been questions raised about intimidation or even retaliation. There is a law that forbids that, and we'll follow the law," Gibson said at a news conference Friday following a visit to a San Antonio VA facility. His comments came after the Office of Special Counsel said it was looking into possible retaliation against 37 employees of the VA who filed so-called "whistleblower" complaints. The office is an independent watchdog separate from the VA which looks into whistleblower complaints from across the federal government. But one of the 37 who complained of reprisals, Brian Turner, said he is not reassured by Gibson's vow to discipline those who retaliated. Turner, who works at North Central Federal Clinic in San Antonio, said he was intimidated by his supervisors for complaining that scheduling clerks in Austin, San Antonio and Waco were regularly told to enter false information to make it appear that wait times for appointments were far shorter than they really were. "I don't care about what (Gibson) said. I want to see action," Turner told the Associated Press in an interview Friday.

The Office of Special Counsel said it had blocked disciplinary actions against three VA employees who had complained, including one who was suspended for seven days after complaining to the VA's inspector general about improper scheduling. The agency also blocked a 30-day suspension without pay for another VA employee who reported inappropriate use of patient restraints and blocked demotion of a third employee who reported mishandling of patient care funds. The complaints about retaliation against whistleblowers came from 28 VA facilities in 18 states and Puerto Rico, the special counsel's office said Friday. About half the 37 complaints have come in the last two months, or after allegations about treatment delays of up to three months for veterans and secret waiting lists first surfaced. The disclosures have set off a furor in Washington, forcing the resignation of VA Secretary Eric Shinseki last week, and prompting Congress to consider legislation to make it easier for treatment of veterans outside the government-funded VA.

Gibson, who has stepped in as acting secretary, apologized on Friday for the VA's failures and said he is doing everything he can to fix the system. "We have lost an awful lot of trust, and we've got work to do to earn it back," Gibson said. "With veterans, we'll do that one veteran at a time by reaching out to veterans that have been waiting too long (for care) and saying, 'You've been waiting, I want to get you in the clinic. When can you come in?'" Some veterans whose names were kept off the official electronic appointment list have died, and Gibson said on Thursday that he would ask the inspector general to look into 18 more cases of deaths to see if there is any indication they were related to long wait times. The 18 are in addition to 17 deaths reported last month.

The 18 veterans who died were among 1,700 veterans identified in a report last week by the VA's inspector general as being "at risk of being lost or forgotten." The investigation also found broad and deep-seated problems with delays in patient care and manipulation of waiting lists throughout the VA health care system, which provides medical care to about 9 million veterans and family members. Gibson said in San Antonio that he has been in daily contact with Richard Griffin, the VA's acting inspector general, and he expressed confidence that Griffin and his investigators will be able to ferret out the truth, regardless of any attempts to squelch potential whistleblowers. VA whistleblower Turner, a veteran himself who has worked for the VA since 2011 as a medical support assistant, said until the VA's management is restructured and supervisors who were responsible for causing or ignoring the problems are removed, nothing will change and employees who may wish to come forward to report other problems will be discouraged from doing so. "I will not stop. I will not waver in my actions until they make drastic improvements," he said.

VA acting chief: retaliation will not be tolerated

 

[depotoo]

I like what this guy appears to have done in a short time. If he keeps it up, he should be nominated.