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Letter to Eric Shinseki, Secretary of the US Department of Veterans Affairs - VA Putting Veterans' Lives at Risk


Location: Washington, DC

The Honorable Eric Shinseki
U.S. Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, D.C. 29429

Dear Secretary Shinseki:

America's veterans risked their lives for our nation -- and we are very concerned that the Department of Veteran Affairs is now putting our veterans' lives at risk.

After hearing from constituents in our state and reading media reports, it is clear that veterans across our country are not receiving the care they deserve. Instead, it appears that your Department has spent more time covering its own failures than delivering high quality, prompt care to the men and women who bravely served our country. The reports we have read suggest that your Department has failed to live up to its promised core values of integrity, commitment, advocacy, respect, and excellence.

Today, we are requesting more information specifically regarding scheduling policies at Veterans Administration Medical Centers (VAMC), including Cheyenne VAMC, which violated Veterans Health Administration (VHA) Directive 2010-027. It is our understanding that patients were to be asked for their desired date of an appointment, which was to be recorded regardless of schedule capacity. Further, it is our understanding that the Office of the Medical Investigator had substantiated these violations in December of 2013.

Concerns have been raised that the wide-spread nature of the violations across the VHA system indicates that a concerted effort was made to "game" the wait time reporting data. The Veterans Administration Office of the Inspector General issued report 12-00900-168 on April 23, 2012 which determined that the VHA wait time data was not accurate or reliable. It included 4 recommendations for the Under Secretary of Health. The Under Secretary agreed, and promised to create a working group to address the recommendations and issue a report by July 1, 2012.

The U.S. Government Accountability Office (GAO) issued report GAO-13-130 on December 21, 2012 which also found VHA reported wait times unreliable. The GAO visited 23 clinics in 4 different VAMC's, and noted the failure to properly follow scheduling guidelines. GAO recommended that VHA improve the reliability of its scheduling data by enforcing the scheduling policy and increasing training. The VA agreed with these recommendations, and as of March 22, 2013, stated it was revising scheduling policy and training, and that development of an implementation program was in progress. Report GAO-14-509T, issued by the GAO on April 9, 2014 as follow-up, states that in March of 2013, VHA distributed guidance via memo to all VAMCs clarifying the scheduling policy and requiring all scheduling staff to complete required training.

Further, our offices received a letter from Dr. Cynthia McCormack, Director of the Cheyenne Medical Center on May 2, 2014. Included in this correspondence was a summary of the actions taken by the Cheyenne facility as a consequence of an inquiry from the Office of Medical Inspector regarding scheduling practices at the Ft. Collins Clinic. In this letter, Director McCormack stated, "There was no intent or attempt to manipulate wait times." Yet, just days later, an email surfaced written by an employee of the Cheyenne VA which acknowledged practices that were "gaming the system." It was only after this statement was widely reported in the media that the VA took any disciplinary action against the employee.

We request the Veterans Administration explain why, if guidance on proper scheduling procedures was issued in March of 2013 to all VAMCs, the wait time trend in Ft. Collins actually improved that month. Medical Support Assistants testified to the Office of the Medical Inspector in OSC File Number DI-13-4425 that they received instructions that month from the "business office" to schedule the date of availability as the date of desirability.

We would like to know:
* the names of the individuals responsible for that instruction,
* the instruction provided,
* as well as the named individuals' current status with the Veterans Administration.
* Please further identify the reason disciplinary proceedings were begun against employees only after the media reports discussed the issue.

In addition, we request the following information:

1. The memo distributed to the Cheyenne VAMC in March of 2013 regarding the scheduling policy, and its recipients.

2. The training status of those conducting scheduling for the Cheyenne VAMC on October 1, 2013, as well as their training status on May 14, 2014.

3. The report issued to the Undersecretary of Health on July 1, 2012.

4. The final report issued by the Office of Inspector General you ordered in response to the leaked email regarding the scheduling of patients at Cheyenne VAMC.

5. The number of veterans who were impacted by the scheduling policies at the Cheyenne VAMC.

6. The VA's most recently updated plan to prevent this from reoccurring, the date of its adoption, steps completed and steps still being implemented.

Thank you for your full and fair consideration of these requests. We look forward to receiving your response. Our Veterans deserve the highest level care and commitment from the nation that they have served so nobly.

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