[humanser] VA Games

Sun Jul 11 17:59:17 UTC 2010

Dear Mary Ann:

Thank you for this article.  The local VA Clinic has had some of these 
issues, but I did not realize that this was a system-wide issue.  Especially 
as our Division is focusing on issues of returning Vets, this story is well 
timed.

Best to you.

JD Townsend, LCSW
Daytona Beach, Florida, Earth, Sol System
Helping the light dependent to see.

----- Original Message ----- 
From: "Mary Ann Rojek" <brightsmile1953 at comcast.net>
To: "Human Services Mailing List" <humanser at nfbnet.org>
Sent: Sunday, July 11, 2010 12:59 AM
Subject: [humanser] VA Games

I received this article on another list and thought it was worth posting.

Mary Ann

Leaked Internal Memo Shows How VA Systematically Screws Over
Wounded Vets
to Maintain Performance Grades
  By Nora Eisenberg, Alterationet
Posted on June 30, 2010, Printed on July 1, 2010
The Veterans Health Administration systematically delays and
denies sick
veterans medical care and masks it with bogus documentation.
That's what
the VA Inspector General and a number of veterans' advocates have
been
claiming since the early days of the Iraq War, when soldiers
returning
from Operation Enduring Freedom began flooding VA facilities.
Now an
internal department memo, posted Wednesday on a watchdog Web
site,
confirms these charges.
  The April 26 memo from William Schoenhard, Deputy
Undersecretary for
Health Operations and Management, alerts supervisors overseeing
scheduling
in the nation's largest health care system that he has learned of
unacceptable practices.  VA facilities have adopted what he calls
"gaming
strategies" in order to "improve scores on various access
measures" by
diminishing patient access to treatment.
  An eight-page attachment identifies 24 "tricks" detected so
far, but
Schoenhard says there may be more.  Using fine-print rules to
cancel
patients' appointments is one of the more sinister strategies
that
Schoenhard describes.  Here, a patient arrives on time for an
appointment
only to be told he has no appointment.  When the patient shows
the employee
his/her appointment form, the employee shows the patient the fine
print on
the form, which says that patients who do not come 10 (sometimes
15)
minutes early to check in risk cancellation.
  In another example of the VA gaming the system, employees enter
into the
computer a later date (often by months) than the doctor has
specified for
a return visit.  Another practice is recording a patient's
initial request
to be treated in a paper log, not the computer system, then
calling them
in months or a full year later (law requires they be seen within
30 days)
and recording that date as their first request to be seen.
  In the block-scheduling strategy, employees book several
patients in the
same time slot for the same doctor or provider, leaving patients
to wait
for hours to be seen, sometimes for something as simple as a
monthly
prescription renewal, which, due to frustration or obligation,
they
sometimes leave without.
  Paul Sullivan, director of the veterans advocacy group,
Veterans for
Common Sense (VCS), told Alterationet he believes Schoenhard's
memo "forces a
key leadership test upon VA Secretary Eric Shinseki" to end the
shenanigans and solve the underlying problems.  "The constant
stream of
hurricane-force flooding of new combat veteran patients from the
wars and
into VA hospitals has totally overwhelmed VA and caused the
improper
gaming," Sullivan said, adding that the memo "reveals how VA
takes the
easy way out."
VA Watchdog editor Larry Scott, who discovered the memo and has
written of
his suspicion of system-wide tricks since 2004, remains
suspicious of the
memo's effect and perhaps its intent.  The detailed explanations
and
illustrations of gaming strategies, Scott wrote on his site,
amount to a
message to employees bto find a better way to hide their sins."
Sullivan
told Alterationet he "hopes VA-BS intent is to end the harmful
practice."
Whatever the intention, VCS is urging Congress to hold an
oversight
hearing on the uncovered memo.  Paul Sullivan wants Congress to
press VA
for a "real plan" to address both the gaming of the system and
the
scarcity of resources the gaming hides.  Congress, he said, needs
to learn
how many veterans over the years have been harmed by the improper
practices; what other practices have been used to hide VA's
severe
staffing problems; when and how VA will retrain all staff on the
proper
use of the appointment system; how VA will hold accountable VA
leaders and
employees who use illegal practices to delay and deny medical
care; and
how many more doctors and medical staff VA will hire and when.
  The problems VA faces from the current wars are staggering.
>From the
Pentagon and VA's own reported data, we know that in addition to
some
4,400 U.S.  troop fatalities, the wars in Iraq and Afghanistan
have been
responsible for some 86,000 casualties, 37,280 wounded in action
and
48,272 medically evacuated due to injury or illness.  As much of
20 percent
of Iraq and Afghanistan veterans (360,000) may have suffered
traumatic
brain injury from IED blasts, according to a DoD estimate issued
last
year.  Every day 18 U.S.  veterans attempt suicide, more than
four times the
national average.  There are 537,099 Iraq and Afghanistan veteran
patients
in the VA system, and thousands more wait as much as a year for
VA
treatment.
  Schoenhard, who recently retired from an administrative career
in private
health care, is new to the VA system, which he joined in
February.  He
alone knows his purpose in providing administrators with the
elaborate
documentation of tricks.  One thing we can be sure of is that VA
has a
scandal on its hands.  How it faces it and underlying problems
could mean
life or death for hundreds of thousands of veterans from current
and past
wars.  According to Sullivan, "another tidal wave" of Vietnam War
veterans
with PTSAID and Agent Orange-related problems is flooding into VA
facilities.  And recent studies on toxic exposure and Gulf War
illness are
causing even more veterans to seek VA health care.
  The revelation of gaming is only one of many scandals plaguing
VA health
care.  Botched prostate surgery, substandard suicide prevention,
reuse of
un-sanitized medical devices--the list goes on.  Tainted
colonoscopy
equipment discovered in 2008 in multiple VA facilities--comwh has
sickened scores of veterans with HIV and hepatitis--continues to
be a
"systemic issue," VA Secretary Eric Shinseki admitted just last
week.
  Using dirty equipment is not an "issue" and ignoring sick
veterans and
faking documents to hide the fact is not a "game" -- these are
crimes.  VA
needs to abandon its alternative virtual universe and dedicate
its time
and ingenuity to actual veterans suffering real injuries and
illness.
  This week, as we wave our flags, watch the sky explode, and
sing of
rockets' glare and America the beautiful, let's not forget the
ugly
rockets, bombs and toxins killing, maiming and sickening invaded
populations and our own young soldiers, who return home to a
brutal health
care bureaucracy fixed above all else on its own survival.
  Nora Eisenberg is the director of the City University of New
York's
fellowship program for emerging scholars.  Her short stories,
essays and
reviews have appeared in such places as Partisan Review, Village
Voice,
the Los Angeles Times and Tikkun.  She is the author of three
novels.  Her
most recent novel, When You Come Home (Curbstone, 2009), explores
the the
1991 Gulf War and Gulf War illness.
  B) 2010 Independent Media Institute.  All rights reserved.

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