An unauthorized waiting list for psychotherapy appointments at Omaha’s VA hospital delayed care for 87 veterans this year and led to the departures of two employees, Department of Veterans Affairs officials said Friday.
Letters addressed to Iowa Sens. Joni Ernst and Chuck Grassley and Nebraska Sen. Ben Sasse — all Republicans — blamed the unauthorized list on “training deficiencies” involving the hospital’s medical support assistants, who were said to be improperly managing the VA’s electronic waiting list following rules changes in 2016.
“The management of these psychotherapy referrals during the spring 2017 time frame was handled poorly and did not meet the standards of our VA Health Care System,” said an unsigned response to questions posed by Sasse.
Separate letters from VA Secretary David Shulkin to the three senators said the affected veterans did receive other types of treatment while their names were on the list, including substance-abuse treatment, inpatient treatment and counseling through primary care or Veteran’s Center clinics.
It did not say whether any of the veterans were told about the delays.
The VA’s response to Sasse also said that although no employees were fired, one employee who was involved retired and another resigned. And it said no bonuses were paid based upon performance data implicated in the investigation of the secret lists.
It also said that an investigation is continuing into whether more lower-ranking employees in the VA’s Nebraska-Western Iowa Health Care System were responsible. That should be completed by the end of the month.
“Appropriate disciplinary action will be taken if warranted,” Shulkin said in his letters.
The unauthorized list came to light following a story published Oct. 15 in The World-Herald, based on redacted documents obtained using the Freedom of Information Act. VA officials declined to answer clarifying questions posed by the newspaper. But the three senators cited that story in letters the following week demanding answers from Shulkin.
The unauthorized waiting list echoed a nationwide scandal in 2014 at the VA Medical Center in Phoenix, which showed that veterans there were dying while waiting months for medical care on lists that were kept secret.
The secret list dodged requirements issued by the VA in July 2016 setting strict rules for establishing and maintaining waiting lists, according to an Aug. 11 memo from the system’s compliance officer to Nebraska-Western Iowa System Director Don Burman. The compliance officer’s audit included two whistleblower complaints made about lists for appointments at the VA’s mental health psychotherapy clinic in Omaha.
In a statement to The World-Herald, Rep. Don Bacon, R-Neb., praised the VA.
“Caring for those ‘who bore the battle’ is one of our most important commitments, and I know this sentiment is shared by the staff at our VA,” Bacon said.
“While proper scheduling procedures were not followed at the Mental Health Clinic, the leadership at our VA found the problem, fixed it, and ensured the same errors were not occurring at other areas of the hospital. I commend the vigilance and quick response of Director Burman and his staff. Our VA receives high marks by those who receive care and we all are dedicated to ensuring this continues.”
Sasse was more critical, saying in a press release that the entire VA needs to explain the concrete steps it will take to prevent a repeat.
“Without the work of local journalists making Freedom of Information Act requests this audit probably would have stayed in the dark, and that speaks volumes about the need for a top-to-bottom culture of transparency and accountability inside this federal bureaucracy,” Sasse said. “This response is just the start and we need to work to make sure that our veterans receive the excellent and timely care they deserve.”
In his letter to Sasse, Shulkin praised significant decreases in the average amount of time it takes for “urgent specialist referrals” for veterans seeking mental health care. In Nebraska and western Iowa, he said, that wait has gone from 23.3 days in 2014 to 1.8 days now. He credited a triage system and the addition of same-day mental health services at all clinics for veterans with the greatest need.
Any veteran who can’t get an appointment within 30 days is eligible to receive care from a private-sector health care provider through the Veterans Choice program, created by Congress in response to the wait-list scandal.
“Our highest priority in VA for access has been to ensure we meet the urgent health care needs of the Veterans whom we service in a timely manner,” Shulkin said.
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