VA Watchdog: Phoenix Problems Much Worse Than Thought

About 1,700 veterans in need of care were "at risk of being lost or forgotten" after being kept off the official wait list at the troubled Phoenix veterans hospital, the Veterans Affairs watchdog said Wednesday in a scathing report that increases pressure on VA Secretary Eric Shinseki to resign.

The investigation, initially focused on the Phoenix hospital, found systemic problems at the VA's sprawling system that provides medical care to about 6.5 million veterans each year. The interim report confirmed allegations of excessive waiting time for care in Phoenix, with an average 115-day wait for a first appointment for those on the wait list.

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"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 Griffin, the department's acting inspector general, wrote in the 35-page report. The report found that "inappropriate scheduling practices are systemic throughout" the nationwide VA health care system.

Colorado Sen. Mark Udall on Wednesday became the first Democratic senator to call for Shinseki to leave. "We need new leadership who will demand accountability to fix these problems," Udall said in a statement.

Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, Rep. Howard "Buck" McKeon, R-Calif., chairman of the House Armed Services Committee, and Arizona's two Republican senators, John McCain and Jeff Flake, also called for Shinseki to step down. Miller also said Attorney General Eric Holder should launch a criminal investigation into the VA.

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."

Shinseki called the IG'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.

Griffin said his office has increased the number of VA health care facilities it is investigating to 42 nationwide, up from 26 known to be under investigation as of last week. He 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.

He said investigators at some of the other 42 facilities "have identified instances of manipulation of VA data that distort the legitimacy of reported waiting times."

Justice Department officials have already been brought into cases where there is evidence of a criminal or civil violation, Griffin said.

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 in an interview. "The only thing I can say is you can't celebrate the fact that vets were being denied care."

Foote took issue with the finding by the inspector general that patients had, on average, waited 115 days for their first medical appointment.

"I don't think that number is correct. It was much longer," he said. "It seemed to us to be about six months."

Still, Foote said it is good that the VA finally appears to be addressing some 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."

The report Wednesday said 84 percent of a statistical sample of 226 veterans at the Phoenix hospital waited more than 14 days to get a primary care appointment. VA guidelines say veterans should be seen within 14 days of their desired date for a primary care appointment. A fourth of the 226 received some level of care during the interim, such as in the emergency room or at a walk-in clinic, the report said.

The report said investigators would not be able make any determination about whether long appointment waits resulted in patient deaths until after they analyze medical records, death certificates and autopsy results.

In a related matter, Griffin said investigators have received numerous allegations of mismanagement, inappropriate hiring decisions, sexual harassment and bullying behavior by mid- and senior-level managers at the Phoenix hospital. Investigators were assessing the validity of the complaints and their effect, if any, on patients' access to care, he said.

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