Will the Phoenix VA hospitals former director Sharon Helman be held accountable?

[trostberg]

Working in private healthcare most of my life, I am afraid the VA problems with wait times is only the beginning for all of healthcare. That does not excuse the cover ups. My mother was waiting 3 months for an appointment with a specialist when she passes away, a friend of mine was denied access to MRIs even at her primary MDs insistence until her friends took her to the ER one night and she ended up with emergency brain surgery and is now on hospice care. This is the aging population we have been hearing about. Vouchers may be nice but there will be increasing g wait times for everyone I am afraid.

[JamieLynn]

I wonder what the truth is: Per The Economist back in Aug 2006:

• The VA runs the largest integrated health-care system in the country... And by a number of measures, this government-managed health-care program ... is beating the marketplace.
• Medicare, which pays more than $6,500 per patient annually for care by private doctors, could save with the VA's less expensive care, which costs about $5,000 per patient. ...
• For the sixth year in a row, VA hospitals last year scored higher than private facilities on the University of Michigan's American Customer Satisfaction Index... Males 65 years and older receiving VA care had about a 40% lower risk of death than those enrolled in Medicare Advantage, whose care is provided through private health plans or HMOs... Harvard University just gave the VA its Innovations in American Government Award for the agency's work in computerizing patient records.

​Has that much changed in 7 years?

[Guest Pensauncola]

This is not a money issue. The VA budget in 2014 was 161.9 billion dollars with a 3 percent increase for 2015 which means it will be 164,000,000,000 billion dollars next year. There are roughly 26,000,000 million vet in America of which 2,000,000 are retired. If my math is correct (please check me on this) based on a 161.9 billion dollar budget that breaks down to 6,230,769 dollars per year per vet.

 

I don't know how accurate your numbers are, but assuming they are correct I don't follow your math. If there is $161 billion available to 26 million vets, that's $6,300 available per vet. Of course, all vets don't partake of the service.

 

 

I like the solution that has been proposed: Dissolve the VA health care system and give veterans vouchers for private health care. It would cost far less than sustaining the present bloated bureaucracy.

 

VA medical services have always been perceived to be lacking, compared with private medical services, to anyone I've talked with about it. When a vet had options, like private medical insurance from an employer or even Medicare, he/she wouldn't consider dealing with the VA. If we start providing vouchers for all eligible Vets to go to their private doctor/medical facility, there surely would be a rush to apply for the service. I suspect that costs would escalate substantially.

 

I am an example. I presently pay about $4000 a year to participate in an employer subsidized medical insurance program. I am a Vet. If the VA would give me vouchers to go see the same doctors I'm seeing now and paying copays to, I'd apply tomorrow.

[Phaeton10]

I only go to the VA for my meds and dental . All other things I use Medicare as my primary insurance and Tricare as a secondary. I am at 100% and don't like waiting for weeks for an appointment.

[skp51443]

Having a VA type organization makes a lot of sense, how many civilian doctors are familiar with the side effects of Agent Orange or of some of the inoculations tried out on the troops in the last few years? Some of the injuries are also fairly unique to military service and getting to a doctor that has current experience with your problem is far better than trying to get someone up to speed before they make you worse. The psychological issues are also a bit unique and someone specializing in your problem is going to work better than someone used to treating non-military mental issues. Sure offload as much as makes sense to other doctors but keep a core of folks specializing in the hard and rare issues.

 

I greatly dislike the VA system and the administrators that have viewed it as a just a job where they can play power and money games. I'm not fond of the doctors, nurses and support staff that have migrated there because they were unemployable at places with higher standards. The good folks, and there are a lot of them, that stick it out despite the preceding and try to help the wounded and damaged service men and women deserve our respect and support. We dare not stand by and let the whistleblowers be punished for exposing the fraud and deceit that has been rampant in the VA since sometime before dad had problems with them in 1945!

[DJW]

Pensauncola

 

Thanks for correcting my math. I was not sure but knew it seemed like a lot. $6,300 sounds better anyway.

 

Dennis

[skp51443]

Good article, both on the steps leading to this mess and the doctor that reported it.

 

http://www.azcentral.com/longform/news/arizona/investigations/2014/05/31/va-scandal-whistleblower-sam-foote/9830057/

He's also reserved about the OIG findings and the ouster of Shinseki. He said he cannot celebrate being vindicated by official findings that veterans have been damaged by delays in care and fraudulent record-keeping. And he suspects that the former VA secretary is a good man who got duped or overmatched by a monolithic bureaucracy.

 

"I think he had a hard time realizing these people did not have the same moral ethics that he did," Foote added. "But, as they say in the Navy, it happened on his watch."

 

As for reforming the Phoenix VA Health Care System, Foote is less equanimous.

 

"As any good surgeon will tell you," he said, "if you've got cancer, you have to cut it all out or it'll come back and kill you."

[RV_]

Stan,

We do tend to project who we are onto others as I wrote about in that poem "The Bridge." If one is honorable and does not lie, cheat, or steal, they will assume the others around them are the same. Accusing people of being honorable never hurt anybody except the accuser if he or she is honor bound. If a person accuses me of lying and I have never lied to that person, or any others, since no one can read minds we go to the only one we can go to to see how our minds work. It is instinctive but clear; If I am called a liar and do not lie, I know that person is a liar and will in the future. If one calls me a thief, and I never stole from them, they have just told me that, if given a chance, they will steal from me. Some people only have situational ethics. Their ethics is governed solely by who knows, and fear of punishment/getting caught.

 

I totally agree with you Stan. I thought the same thing when I heard his record. But as we both know, not all of any profession or group are honorable. Only the percentages change.

 

But as they said, it happened on his watch. A leadership failure is still a leadership failure regardless of the intent. We know what roads are paved with good intentions.

 

Now they need someone to clean house.

[skp51443]

I'm not sure "someone" is the cure here, nobody placed in charge under the current civil service system rules is going to have the power to do any real housecleaning. One of the reasons they pick a fall guy to head these agencies is to shield the bureaucrats that stay off camera and keep their jobs no matter how bad things get.

If you dig into the civil service mess (I haven't for many years now) you find little surprises, like you catch someone red handed actively sabotaging a government computer and the most you can hope to do to them is a week's suspension. Translated into reality, what you just accomplished was to delay their retirement by one week and make them take an unpaid week off work.

 

Yes Shinseki failed but was anything else a real possibility given what little real power he had? Too bad he didn't resign when he saw what he had been suckered into, at least he'd still have his self respect.

 

Score so far: One outsider, fall guy, gone in disgrace and one bureaucrat retired a couple months early versus nothing really changing, just lots of noise and monkey motion.

 

 

Criminal charges and damage claims by families would be a good start and that can be done outside the civil service system. Inside the system???

[RV_]

Stan,

I know too. I had to take over a failed unit at a base that was 50% or more Civil Service. Even most of the military were "homesteaders who had spent all, or most of a career there, then got out and did civil service there. I was told that they have seen many like me come and go and things were still the "Lackland way." See they said, there was the AF way, the right way, the wrong way, and the Lackland way. I got the changes made in that last year since they moved the Security Police agency that year too. (Our one-button AF Top Cop) But when I was gone, despite the changes that needed to be done getting done, every obstructionist was still there years later and may still be there now. Those of us elsewhere called it Lackland-itis. While there was the first time I heard the term rice bowl, as in "Stay out of my rice bowl." Or "I'd stay out of his or her rice bowl." But I did not do Langley or DC and stayed away from HQ anything except when I was command manager at the Academy for my program.and ran my programs just fine.

 

But still, if the commander in chief called me today, or in 2016 and was a different party, it would make no difference, if asked I would have to try. But it would not be pretty. I was sent to clean house my last three assignments. I did and sometimes it wasn't pretty. One reason I left with a year's retainability, and that much more in retirement pay, was the politics were getting stifling at that level and I wanted no more. It just wasn't fun anymore. You've been there I am sure, or you would likely still be there. Don't get me wrong there are lots of great civil service just like a lot of great uniformed folks. But the bad ones in Civil service don't rotate out usually, unless they want to. At least we could look forward to a bad apple in uniform shipping out or our shipping out first, away from them either way.

 

I believe you might be correct. I just hope not.

[skp51443]

Just so nobody thinks this is forgotten, the Phoenix media is still paying attention. Here are some of the updates for this month (June 2014) since the last post here.

Save reading this for when you have time to cool down afterwards.

http://www.azcentral.com/story/news/arizona/investigations/2014/06/24/phoenix-va-scandal-whistle-blower-kept-deaths-secret/11297965/

A scheduling employee for the Phoenix VA Health Care System disclosed that she was the keeper of a "secret list" of local veterans who waited months for medical care, and she accused others of altering records recently to try to hide the deaths of at least seven veterans awaiting care.

http://www.azcentral.com/story/news/arizona/investigations/2014/06/22/phoenix-va-officials-false-data/11232447/

The Department of Veterans Affairs has consistently ignored whistle-blower warnings about dangerous practices that jeopardize patient safety, according to a scathing letter sent to President Barack Obama by the Office of Special Counsel.
The letter sent Monday by the independent federal investigative agency says the failure of Phoenix VA officials to heed alerts about fraudulent appointment scheduling is part of a "troubling pattern" nationally where the VA investigated and verified complaints but did nothing to correct problems.
"The VA, and particularly the VA's Office of the Medical Inspector, has consistently used a 'harmless error' defense, where the department acknowledges problems but claims patient care is unaffected," says the letter. "This approach has prevented the VA from acknowledging the severity of systemic problems and from taking the necessary steps to provide quality care to veterans."
The letter goes on to say that assertion of "harmless error" in many cases was "unsupportable." It listed numerous instances where employees reported unlawful prescriptions, delayed care, medical negligence and other issues, yet the complaints were simply cast aside after they were confirmed.

http://www.azcentral.com/story/news/politics/2014/06/20/phoenix-va-ousted-exec-keeps-salary-leave/11101981/

The U.S. Department of Veterans Affairs disclosed Friday during a congressional hearing that Sharon Helman, the former Phoenix VA Health Care System administrator placed on leave last month amid a patient-care scandal, continues to receive her full salary — roughly $170,000 annually.
The VA has acknowledged her facility manipulated patient wait-time records to trigger bonuses.
The U.S. House Veterans' Affairs Committee on Friday examined how the VA awards bonuses and whether the criteria used to grant them reward executives who engage in bad behavior or create incentives to falsify information.
The VA also provided records showing the majority of its executives across the county received "outstanding" or "exceeds fully successful" ratings since fiscal 2010. Those ratings were given despite evidence that many were "gaming" the system to show shorter wait times for veterans seeking health care.
Since 2010, $14.5 million has been paid in executive bonuses.

http://www.azcentral.com/story/news/politics/2014/06/20/new-acting-phoenix-va-director-named/11101755/

A new acting director was named for the Phoenix VA Health Care System on Friday, but he won't be in the post for long.
The Department of Veterans Affairs named Glenn Costie, director of the Dayton VA Medical Center in Ohio, as Phoenix's acting director starting in July. Costie will hold the Arizona job only until early November.
He replaces current acting Director Steve Young, who has been in Phoenix for two months.
Phoenix VA spokeswoman Jean Schaefer said the plan is to rotate experienced administrators in and out of Phoenix in the hopes of improving leadership.
"The strategy to provide leadership is to have some seasoned veteran executives rotate through until a permanent director can be named," Schaefer said.

http://www.azcentral.com/story/news/arizona/investigations/2014/06/17/phoenix-va-gave-mil-bonuses-last-years/10653263/

Newly released records show the Phoenix VA Health Care System paid out roughly $10 million in bonuses during the past three years, when some staff manipulated patient wait-time records to trigger bonuses as veterans died awaiting care.
Bonus payouts increased significantly under Sharon Helman, who became director of the Phoenix VA in February 2012. She was placed on administrative leave last month with two other top staff members amid accusations of mismanagement stemming from the bonus scandal. Helman could not be reached, but previously has said she was unaware of fraudulent record-keeping or patient deaths caused by delays.
Records show 4,188 bonuses were paid over the past three fiscal years to more than 2,150 employees, including doctors, nurses, administrators, secretaries and cleaners. Nearly 650 VA employees received a bonus in each of the three years. The VA has about 2,500 employees.

 

More stories:

http://www.azcentral.com/politics/vahealthsystem/

[skp51443]

Running behind today, finally made it to national news and it looks like there is still some interest there too:

 

http://www.washingtontimes.com/news/2014/jun/24/poor-care-va-hospitals-cost-1000-veterans-their-li/

 

The problems at Veterans Affairs extend well beyond long wait lists, with a report Tuesday showing the department is plagued with poor care that has cost up to 1,000 veterans their lives and left taxpayers on the hook for nearly $1 billion in malpractice settlements since the beginning of the wars in Iraq and Afghanistan.

 

http://www.cnn.com/2014/06/23/us/phoenix-va-deaths-new-allegations/index.html

 

Records of dead veterans were changed or physically altered, some even in recent weeks, to hide how many people died while waiting for care at the Phoenix VA hospital, a whistle-blower told CNN in stunning revelations that point to a new coverup in the ongoing VA scandal.
"Deceased" notes on files were removed to make statistics look better, so veterans would not be counted as having died while waiting for care, Pauline DeWenter said.
DeWenter should know. DeWenter is the actual scheduling clerk at the Phoenix VA who said for the better part of a year she was ordered by supervisors to manage and handle the so-called "secret waiting list," where veterans' names of those seeking medical care were often placed, sometimes left for months with no care at all.

 

http://dailycaller.com/2014/06/23/shocker-thedc-uncovers-another-va-medical-center-scandal/

 

A failure to scan outsourced medical records has caused an approximate three- to five-month backlog at the Memphis Veteran Administration Medical Center, The Daily Caller has learned.

TheDC was exclusively given a photo snapped of the medical records room on June 12, 2014. In the photo, hundreds of unprocessed medical records sit idly, causing delays of up to five months.

According to a whistle-blower who wished to remain anonymous because they are still employed by the Memphis VA Medical Center, the medical records room is for entering test results and other medical data that occurs after a patient is outsourced for medical tests or procedures.

 

http://www.progressivestoday.com/veteran-waited-8-years-for-ptsd-treatment-from-va/ (with a video)

 

Veterans are losing the war at home, and the loss is coming at the hands of their own government.

A new audit finds the VA didn’t treat a veteran with PTSD for 8 years while another was in the hospital for 7 YEARS before being treated.

[pjstough]

I like this post from a fellow veteran Rver. http://daily-blog.rv-boondocking-the-good-life.com/2014/06/the-veterans-administration-is-not.html

 

Paul

[skp51443]

Paul, Reading that you'd think that the VA folks haven't lied cheated and let vets die to grab bonus payments.

 

Sure the VA could use more money for patient care but when the staff is raking it off the top with scams that make them look like superstars in providing care how much of the "more" would go to the vets and how much to the crooks?

[strawdog]

Paul, Reading that you'd think that the VA folks haven't lied cheated and let vets die to grab bonus payments.

 

Sure the VA could use more money for patient care but when the staff is raking it off the top with scams that make them look like superstars in providing care how much of the "more" would go to the vets and how much to the crooks?

 

Exactly.... The root cause here is Fraud. Those responsible should be relocated to prison, not just fired.

 

Dave

[RV_]

Agreed Stan and Dave.

Paul I read the article on your friend's blog and agreed with all of it about breaking our promises as a nation to us, the vets of all branches and service times. I got the feeling that he must have been a VA employee or had family working at the VA. However it felt to me to be a preamble to an apologia for the VA folks. How many more doctors and staff could they have hired with the monies nationwide paid out in bonuses?

 

I am personally tired of the SES folks ( Senior Executive Service, http://en.wikipedia.org/wiki/Senior_Executive_Service_(United_States ) and the generals who had the laws changed so that they make more after retirement than their active duty pay, as well as jobs waiting in the SES or private agencies, and not subject to the pay cuts and benefits cuts they allow for the lower ranks officer and enlisted, being allowed off the hook because they are white collar. Look at that link and see what their minimum starting pay is before you think they needed bonuses to be motivated. Herzberg's motivational theories proves in practice that money is a hygiene factor not a motivating factor. The famous (or infamous to some) Hawthorne Experiment with the lights at a WE Plant ( http://en.wikipedia.org/wiki/Hawthorne_Effect )and increases and decreases in productivity according to perceived management interest. Also found was that more money often has the entirely opposite effect and the productivity goes down because they felt peaked.

 

I am sure that thed VA folks who received and/or authorized the bonuses are familiar with Motivation and Hygiene factors, as most of us with even a little college know so well from leadership and management, as well as psychology courses. http://en.wikipedia.org/wiki/Two-factor_theory

 

In 1984 I wrote a song called amazingly enough "1984." A line from it is "The signs have changed, Don't rearrange your truth."

 

Then in my imperfect way I tried to improve on telling the experiences of those of my generation, the Boomers,who were teens and drafted in the mid to late 60's and early 70s, and what we've seen to now. Or at least what I have witnessed.

 

It is called "Boomers" and to me appropriate to the discussion and several other discussions about Vets.

 

Boomers

 

Back when I was still a son

We all laughed and had some fun

Tryin to make a moral stand

Everybody had a hand

 

Other viewpoints also sons

Disagreed and armed with guns

Tryin to make a moral stand

On a foreign patch of land

 

He who would misuse the reigns

Tried to bind us once again

Tryin to make a moral stand

Power shifted from that man

 

The movement made another pass

But foundered in a sea of grass

Tryin to make a moral stand

Tolkien, Cleaver, and Ayn Rand

 

All the leaders claimed no sin

Took their silver went right in

Tryin to make a moral stand?

The money flowed to just their hands.

 

Then the money freely flowed

We thought we’d hit the mother lode

Tryin to make a moral stand

All the speeches had been canned

 

Now that Hair’s begun to gray

The wheel has turned again today

Tryin to make a moral stand

The web is nearly fully manned

 

We forward this and forward that

But never check a single fact

Tryin to make a moral stand

Through a plastic wonderland

 

Some remember days of youth

Still try to find a single truth

Tryin to make a moral stand

Keeping oil that flows from sand

 

It never had a thing to do

With dreams for any Xanadu

Tryin to make a moral stand

Thought we had the upper hand.

 

It started out when I was young

We learned that there’s another tongue

Tryin to make a moral stand

With lyrics from a poets hand

 

It might have come from Medgar Evers

War and all the lives it severs,

Trying to make a moral stand

Never works out as we planned

 

So beware men who make the law

To move the sons toward righteous thought

Tryin to make a moral stand

Is coming back to haunt the land

[Cyberdave]

Stan,

 

Is there any rumblings from the state AG about charging here with manslaughter or the like? It happened in AZ? When a crime was committed on a base it was usually turned over to the local authorities by agreement with Pima county / Tucson PD.

 

Probably a dream...

[skp51443]

Right now the FBI is doing the primary investigation in Phoenix from what I've read. If they do nothing then I'd bet Sheriff Arpio will stick a toe in. Knowing his attitude from past issues the toe will probably go in to the hip! :-)

[strawdog]

Right now the FBI is doing the primary investigation in Phoenix from what I've read. If they do nothing then I'd bet Sheriff Arpio will stick a toe in. Knowing his attitude from past issues the toe will probably go in to the hip! :-)

I don't really see much 'justice' actually coming from one government agency investigating another. On the surface it may appease some, but in the real world it is most likely (shamefully) 'good press'.

 

Dave

[Cyberdave]

Turning Sheriff Joe loose would be interesting to watch.

[bob6801]

I still think if you let the VA be run by Vet's for Vet's you would see a big improvement. No one cares for vets like another vet. We were all NCO's and Officers and can manage anything you throw at us. Give us the VA and in 1 yr everyone will be seen and in 5 yrs. it might even be making a profit. And yes get rid of the Union so we can weed out the dead wood, mostly lazy civilians.

[skp51443]

Far too many vets have forgotten the duty, honor country stuff and are working on a me, me, me basis so I don't think that would be a viable solution although it might help. Real audits, oversight by congress (the cabinet post apparently isn't working out) and a complaint resolution path outside the agency would be the minimum. A way to fire the bureaucrats or at least move them to other agencies would be a big help too.

 

Did you see the articles about the nurse swapping morphine for saline so vets in hospice care got salt water for their pain? Going on for years and no action taken except against the folks reporting it.

[DJW]

I watched the VA hearings last night on C-SPAN. They had the whistleblowers on from AZ, MO, CA and GA. Then they had a panel on from the VA and OSC. Office of Special Counsel. I came away thinking that the OSC process is a joke. The members of the sub-committee could not believe that some folks in the VA still had their jobs. It was very sad but yet not surprising.

 

Dennis

[Cyberdave]

Someone mentioned that the SES (Senior Executive Service) has tremendous influence behind the scenes. Be interesting if Congress would take testimony on their stance of what should be done to the darn lot.

[strawdog]

I still think if you let the VA be run by Vet's for Vet's you would see a big improvement. No one cares for vets like another vet. We were all NCO's and Officers and can manage anything you throw at us. Give us the VA and in 1 yr everyone will be seen and in 5 yrs. it might even be making a profit. And yes get rid of the Union so we can weed out the dead wood, mostly lazy civilians.

There is a real quick fix for the problem..... Start sending politicians, starting at the top, to the VA for their health care..... Another 535 should not overwhelm the system too much!!!!

 

Dave