VA Audit Confirms Thousands of Veterans Await VA Care

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WASHINGTON—A VA internal audit found that over 57,000 new veterans have been waiting for more than 90 days or more for an appointment and that another 64,000 veterans who requested an appointment during the enrollment process during the past 10 years have not yet been scheduled for an appointment.

Furthermore, the audit found that 13% of scheduling staff interviewed as part of the audit indicated they received instructions from supervisors or others to enter a date different than what the veteran had requested in the appointment scheduling system.

“This data shows the extent of the systemic problems we face, problems that demand immediate actions. As of today, VA has contacted 50,000 veterans across the country to get them off of wait lists and into clinics. Veterans deserve to have full faith in their VA, and they will keep hearing from us until all our veterans receive the care they’ve earned,” Gibson said in a written statement on June 9th.

The audit was first announced in mid-April. The purpose of the nation-wide Access Audit was “to ensure a full understanding of VA’s policy among scheduling staff, identify any inappropriate scheduling practices used by employees regarding veteran preferences for appointment dates, and review waiting list management,” according to VA.

According to VA, the audit “covered a total of 731 separate points of access, and involved over 3,772 interviews of clinical and administrative staff involved in the scheduling process at VA Medical Centers.”

The VA explained in a fact sheet that it was “immediately redoubling” its efforts to “quickly address delays in veterans’ health care.” In addition, among actions it was taking was to remove the 14-day scheduling goal of patients.

The audit noted that “meeting a 14-day wait-time performance target for new appointments was simply not attainable given the ongoing challenge of finding sufficient provider slots to accommodate a growing demand for services.”

Acting Secretary Gibson also directed VHA to develop a new patient satisfaction measurement program to provide “real-time, robust, location-by-location information on patient satisfaction, to include satisfaction data of those veterans attempting to access VA healthcare for the first time,” according to VA.

Other actions included implementing “an immediate hiring freeze at the Veterans Health Administration (central office in Washington D.C. and the 21 VHA Veterans Integrated Service Network (VISN) regional offices, except for critical positions to be approved by the Secretary on a case-by-case basis.”

“This action will begin to remove bureaucratic obstacles and establish responsive, forward leaning leadership,” according to VA.

Comments (4)

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  1. Sherman Mitchell Harman says:

    Can someone in the Secretary’s office please explain how a hiring freeze in an organization already admitted to be understaffed is going to help the situation.Part of the problem is that many administrators are already doing jobs that should be done by two or more people, which slows hiring credentialing, purchasing, contracting, etc. to a crawl. Also worth asking- how is suspending performance pay for the doctors, midlevel providers,nurses, and psychologists who actually provide care for our veterans supposed to help a system that already has a recruiting and retention problem for frontline healthcare professionals? Just wondering!

  2. Robert D. Udy, LCSW, ACSW, LASUDC says:

    I work at Colorado Springs CBOC and we just don’t have enough SWers to help veterans with Mental Health. I am booked solid out to last week of Sept and first week of Oct. I have had vets say “that is far too long next appt and what is the point.” Can’t answer. I have been a counselor for almost 20 yrs and never had a schedule this long. We have people quitting due to this. Back to Back clients and no time to care for self during the day unless someone in NO SHOW, but I believe it’s because the time to next appt is too far out. I am now looking for a new employment. We have lost SWers and haven’t been getting them back for over 1 yr. Moral is going down. No VA has enough people or facilities to help the Veterans. Now what’s going to happen? Where is the money that Congress believes is enough?

  3. S G says:

    Leave it to the far removed VA big wigs to implement a hiring freeze to solve a problem in which the primary etiology is a work force that’s insufficient and overburded. Sadly this is not suprising.

  4. Denise Feil, MD, MPH says:

    These our my personal opinions and they do not represent the views of the Veteran’s Administration.

    Our local healthcare system frequently seems to lose control over its own budget and its ability to hire staff (and fire, for that matter…). A perfect example of this would be another surprise hiring freeze, like the one described above. Or an act of Congress that results in a budget shortfall. Each time this happens, it destabilizes our healthcare system and requires a period of recovery. It creates chaos and stress on administration and employees. It causes administration to be taxed with shorterm emergency fixes at the expense of longterm healthy stability.

    While this is one major cause of dysfunction, the other cause is the accountability and health of the entire healthcare system. It needs major restructuring. This is no news. There are many national experts who have spent years analyzing it and said so. Staff at all levels are more stressed and have less workplace satisfaction. The system as a whole requires improved efficiency. Human Resources as a department needs to be freed from itself. It has to follow bizarre hiring procedures that prevent hiring a select candidate sometimes for up to a year, it projects no accountability to the local healthcare system, and sometimes it just simply grinds to a halt. Accountability to Veteran patients needs to remain a central core value of our mission. But this mission gets lost in the sometime punitive or chaotic working environment. Transparent and horizontal rather than vertical administrative and clinical supervisory relationships need to be established to improve morale and accountability. This is not the general culture of the VA.

    If the VA and Congress are serious about fixing the VHA, then they need to stop playing around with the budget and enacting hiring freezes. Rather, they need to listen to the many national experts and think tanks on healthcare organizational systems and culture, bring them into the trenches to hear and see what’s going on in real time, and not be afraid to enact a lasting change that might be painful and expensive in the short term, but cost-effective, enduring and healthy in the longterm.

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