Brian Skoloff and Matthew Daly, The Associated Press
10:33 AM, May 29, 2014
PHOENIX (AP) -- Navy veteran Ken Senft turned to the Department of Veterans Affairs for medical care in 2011 after his private insurance grew too costly. It could have been a fatal mistake, he now says.
A few years ago, the 65-year-old had a lesion on his head. He went to a VA clinic near his home outside Phoenix, but he said the doctor told him it could be two years before he might get an appointment with a dermatologist.
So he paid out of pocket to see a private physician. Turns out, he had cancer.
"What if I had waited two years?" Senft said in frustration. "I might be dead."
Senft's story comes amid allegations of delayed care and misconduct at VA facilities across the nation.
A probe of operations at the Phoenix VA Health Care System found that about 1,700 veterans in need of care were "at risk of being lost or forgotten" after being kept off an official waiting list. The investigation, initially focused on the Phoenix hospital, found systemic problems in the VA's sprawling nationwide system, which provides medical care to about 6.5 million veterans annually.
The scathing report by the VA Office of Inspector General released Wednesday increased pressure on VA Secretary Eric Shinseki to resign.
President Barack Obama found the findings "extremely troubling," his spokesman, Jay Carney, said.
"As the president said last week, the VA must not wait for current investigations of VA operations to conclude before taking steps to improve care," Carney said in a statement.
The interim findings confirmed allegations of excessive delayed care in Phoenix, with an average 115-day wait for a first appointment for those on the waiting list. That's nearly five times longer than the Phoenix hospital system had reported to national VA administrators.
"While our work is not complete, we have substantiated that significant delays in access to care negatively impacted the quality of care at this medical facility," Richard J. Griffin, the department's acting inspector general, wrote in the 35-page report. It found that "inappropriate scheduling practices are systemic throughout" some 1,700 VA health facilities nationwide, including 150 hospitals and more than 800 clinics.
Griffin said 42 centers are now under investigation.
"What makes me angry is the fact that there are a lot of veterans who couldn't afford to do what I did, and it would have been too late for them," said Senft, who was wounded during the Vietnam War. "It's just a disappointment when you serve your country and you expect to get good medical care -- and you just don't."
Several Republican lawmakers and a handful of Democrats have called for Shinseki's resignation.
Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, and Sen. John McCain, R-Ariz., also have called for criminal probes.
"I believe that this issue has reached a level that requires the Justice Department involvement. These allegations are not just administrative problems. These are criminal problems," McCain said during a news conference.
Miller said the report confirmed that "wait time schemes and data manipulation are systemic throughout VA and are putting veterans at risk in Phoenix and across the country."
Dr. Samuel Foote, a former clinic director for the VA in Phoenix who was the first to bring the allegations to light, said the findings were no surprise.
"I knew about all of this all along," Foote told The Associated Press. "The only thing I can say is you can't celebrate the fact that vets were being denied care."
Still, Foote said it is good that the VA finally appears to be addressing long-standing problems.
"Everybody has been gaming the system for a long time," he said. "Phoenix just took it to another level. ... The magnitude of the problem nationwide is just so huge, so it's hard for most people to get a grasp on it."
Shinseki called the Inspector General's findings "reprehensible to me, to this department and to veterans." He said he was directing the Phoenix VA to immediately address each of the 1,700 veterans waiting for appointments. The hospital system's director has already been placed on leave amid the probe.
Reports that VA employees have been "cooking the books" have exploded since Foote went public with allegations that management at the VA in Phoenix had instructed staff to keep a secret waiting list to hide delayed care and that as many as 40 patients may have died while waiting for appointments.
Griffin said he's found no evidence so far that any of those deaths were caused by delays.
Lawmakers say the agency's 14-day target for seeing patients seeking appointments is unrealistic, while the Inspector General's report found it encourages employees to "game" the appointment system in order to collect performance bonuses.
The report described a process in which schedulers assigned appointments based on the next available slot, but marked it down as the patient's desired date.
"This results in a false 0-day wait time," the report said.
Thomas Lynch, of the Veterans Health Administration, an arm of the VA, said VA health care quality compares favorably with that in the private sector while also explaining that a bonus system based on meeting the 14-day goal had a negative effect.
"Our performance measures have become our goals, not tools to help us understand where we needed to invest resources," he told the House Veterans Affairs Committee late Wednesday. "We undermined the integrity of our data when we elevated our performance measures to goals."
Griffin said investigators' next steps include determining whether names of veterans awaiting care were purposely omitted from electronic waiting lists and at whose direction and whether any deaths were related to delays in care.
Investigators at some of the 42 facilities "have identified instances of manipulation of VA data that distort the legitimacy of reported waiting times," he said.
Griffin said investigators are making surprise visits, a step that could reduce "the risk of destruction of evidence, manipulation of data, and coaching staff on how to respond to our interview questions."
U.S. Justice Department officials have already been brought into cases where there is evidence of a criminal or civil violation, Griffin said.
Daly reported from Washington. Associated Press writers Lauran Neergaard, Pauline Jelinek and Donna Cassata also contributed to this report from Washington.