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VA wait times mean some die before getting care

Mar. 15, 2013 - 10:47AM   |  
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Internal Veterans Affairs Department documents show that at least two veterans died last year waiting to see a doctor while others couldn’t get primary care appointments for up to eight months, members of a House oversight and investigations panel said Thursday.

Addressing the ongoing problem of vets who suffer through long waits for appointments at VA hospitals and clinics, House lawmakers joined federal investigators and veterans service organizations in castigating VA on an issue that has endured for more than a decade.

“Evidence shows that many VA facilities, when faced with a backlog of thousands of outstanding or unresolved consultations, decided to administratively close out these requests. Some reasons given included that the request was years old, too much time had elapsed, or the veteran had died,” said Rep. Mike Coffman, R-Colo., chairman of the House Veterans Oversight and Investigations panel.

“This is unacceptable,” said Rep. Ann Kirkpatrick, D-Ariz., the panel’s ranking Democrat. “Veterans deserve timely, accessible health care.”

According to VA, about 49 percent of new patients and 90 percent of established patients are able to see a primary care doctor or specialist within VA’s goal of 14 days, a metric established in 2011.

But the first-time patients who weren’t seen within 14 days waited an average 50 days to schedule initial appointments.

Bad data, fudged numbers

VA actually has no idea how long most patients wait, said Debra Draper, health care director at the government’s watchdog agency, the Government Accountability Office, which looked into the matter in December.

“The bottom line is it is unclear how long veterans are waiting to receive care in VA’s medical facilities because the reported data are unreliable,” Draper told the panel.

She said GAO analysts found that more than half of VA’s 50,000 schedulers did not know how to accurately report the information needed to determine wait times, which includes logging the date a veteran wants to be seen as well as the actual date of the appointment.

Others admitted to changing the desired date so the time aligned with VA’s established goal of 14 days.

“We weren’t specifically told that they were directed by management, however, the current situation provides ample opportunity to change dates to further reflect the results they want to achieve,” Draper said.

She said other issues contribute to the problem, including a scheduling system that is “antiquated, cumbersome and error-prone.”

VA intends to replace the 25-year-old VistA system with a product that would make the process more efficient and allow veterans to use it to schedule medical tests and visits. But that acquisition appears to be years away.

The department also is rolling out new policies for measuring and maintaining wait time information, according to William Schoenhard, deputy undersecretary for health for operations and management. He said new procedures will require schedulers to record the date decided between patients and physician — the “agreed-upon date” — and gauge it against the projected appointment date.

“There will be a recorded time stamp,” Schoenhard told the panel.

A pilot project is underway that should result in reduced wait times in certain areas, he added. Project ARCH (Access Received Closer to Home) allows eligible veterans in five rural areas to see a civilian provider, paid for by the government.

Draper explained that wait time length is important because it measures efficiency and can convey where staffing fails to serve veterans who need it.

Long wait times also are a major roadblock to adequate care, panelists said. Coffman disclosed little about the circumstances surrounding the veterans’ deaths but said “gaming the numbers” is unacceptable.

Roscoe Butler, a field service representative with the American Legion, said the organization’s members are fed up.

“The most frustrating part of the process is when veterans can access the VA system, they really have good things to say about the care they receive. The American Legion believes VA needs to do a better job getting these veterans to that care,” Butler said.

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