VA has 41,500 unfilled medical jobs, forcing vets to costly private care (USA Today)
The Veterans Health Administration has 41,500 job vacancies for doctors, nurses and other medical professionals across its sprawling health care system while it struggles to provide timely medical care for veterans, according to records obtained and analyzed by USA TODAY. The failure to fully staff hospitals is one reason why the Department of Veterans Affairs paid for 1.5 million veterans to see doctors outside the agency in the past year, VA Deputy Secretary Sloan Gibson testified late last month. Those private visits have cost U.S. taxpayers more than $7.7 billion, the VA said. The added expenses have left the VA with a $2.6 billion shortfall this year, prompting VA Secretary Bob McDonald to plead with lawmakers Thursday to quickly pass a bill that would give him flexibility to shift money within the VA budget to cover the gap. Gibson testified before Congress June 26 that the shortfall would not have been so large “if we were fully staffed up.” Neither McDonald nor Gibson told Congress how many medical jobs are unfilled in its 150-hospital system, which funds roughly 210,000 full-time medical positions. Instead, both told lawmakers they have increased medical and non-medical staff by 12,000 in the past year. USA TODAY discovered the 41,500 vacancies as of late June in data obtained through a Freedom of Information Act request. The full- and part-time positions include openings for 5,000 physicians, nearly 12,000 nurses and more than 1,200 psychologists, according to the data. Four locations were short at least 100 doctors: Orlando, Portland, Ore., Baltimore and Salt Lake City. Each of those locations also had at least 100 vacant nursing positions. Portland needed nearly 300 part-time and full-time nurses. Asked this week about this omission from Gibson’s testimony, Janet Murphy, deputy undersecretary for health operations and management, said, “I can’t speak to the deputy’s testimony.” She confirmed the 41,500 vacancies, saying the VA is working hard to recruit and hire more medical professionals. “I will say some of these facilities have too many vacancies and they need to get them filled and we need to help them fill them,” she said. In some places, more than one in five jobs appeared unfilled. For example, according to recent testimony at a House subcommittee meeting on VA hiring practices, 2,020 physician assistants worked for the VA earlier this year. The records show 639 openings for physician assistants — a vacancy rate of 25%.
VA urged to hire new hospital directors for glut of vacancies (KUSA-Denver)
Nearly 25 percent of all VA hospitals are operating without permanent leaders and that contributes to failures in providing care to veterans, according to the chairman of the Senate Veterans Affairs Committee. In a letter to the VA today, Sen. Johnny Isakson, R-GA urged the agency to quickly fill the positions, which include the director of the Denver VA Hospital. The 35 jobs nationwide are either currently vacant or occupied by interim or acting directors. Denver’s VA hospital director Lynette Roff quickly retired in February after a KUSA investigation exposed a secret patient waiting list. Interim Director Carolyn Adams was appointed in April. It is unclear how long it will take to hire a permanent replacement. “Our nation’s veterans have earned and deserve the best health care we can deliver,” Isakson wrote. “Part of providing that high quality care is ensuring there are officials appointed to key leadership positions that are capable and able to oversee and manage the organization.” Isakson notes so many vacancies at the Veterans Health Administration could hinder veterans’ access to health care and that the “lethargy and inaction by VA to fill these key leadership positions is inexcusable.”
Lawmakers reluctantly head toward budget fix for VA (Military Times)
Lawmakers are accusing Veterans Affairs Department officials of creating and concealing an almost $3 billion budget hole that threatens health care for millions, but appear reluctantly willing to move forward on the department’s plans for a quick fix before hospital shutdowns occur. VA officials are warning that without a funding shift by Aug. 1, the department will begin closing clinics, canceling private-care appointments and furloughing staff due to a shortage of usable funds in the fiscal 2015 budget. They propose moving about $3 billion from the new Choice Card program approved by Congress last summer to cover shortfalls in other, separately funded private-care programs — the reason for the shortfall. On Wednesday, VA Secretary Bob McDonald touted that plan to members of the House Veterans Affairs Committee as a commonsense move that must be completed quickly. “My worst nightmare is a veteran going without care because I have money in the wrong pocket,” McDonald said. “I earlier compared the inflexibility we face to having one checking account for gasoline and another for groceries. The inflexibility we’re talking about today is even more puzzling — I can’t spend food money for food.” But lawmakers on both sides of the political aisle called that an oversimplification of the problem, which they see as stemming from poor forecasting and poor management by VA officials. “There’s a lack of trust and transparency, and giving them a blank check is not what we need to do,” said Rep. Jeff Miller, R-Fla., chairman of the veterans committee. “They knew they could come at the last minute and force the committee’s hand, and make us appropriate the dollars to fix their budgeting problems.” Miller said he believes the problems stemming from VA leadership decisions undermine the Choice Card program, put in place in response to long wait times facing veterans at health clinics last year.
Lawmakers: VA hid details as budget crisis loomed (Yahoo! News)
Lawmakers from both parties accused the Department of Veterans Affairs Wednesday of hiding details of a budget crisis that could force the shutdown of some VA hospitals next month. The VA said last week it may shutter hospitals unless Congress closes a $2.5 billion shortfall caused by a sharp increase in demand by veterans for health care, including costly treatments for the deadly hepatitis C virus. Rep. Jeff Miller, R-Fla., the chairman of the House Veterans Affairs committee, said he was shocked at the magnitude of the VA’s problems and outraged that Congress was not notified until nearly 10 months into the budget year. The possible closure of hospitals was not mentioned as recently as last month, when the VA first told Congress about the potential budget shortfall, Miller said. The only indication of the pending crisis was a “cryptic warning” from a VA staffer June 4 about likely overspending, Miller said. “This is not a ‘flying-under-the-radar’ issue, yet I feel that is exactly how VA and the president have treated it in an effort to avoid responsibility,” Miller told VA Secretary Robert McDonald at a hearing Wednesday. “Someone took their eye off the ball here.” Miller called for President Barack Obama to step in personally to ensure the VA’s problems are addressed.
Candidate to head St. Louis VA hospital withdraws from consideration (St. Louis Post-Dispatch)
A month after saying it had a candidate to be permanent head of the St. Louis VA Health Care System, the Veterans Administration confirmed Thursday that the applicant had withdrawn from consideration for the job. That means a two-year trend of temporary directors at the facility continues, further angering members of Congress from the region. The problem filling the job comes amid newly escalating criticism of the Department of Veterans Affairs, a year after revelations about long waits for appointments and poor care in some facilities led to congressional investigations and the replacement of the leadership of the agency that provides health care for the nation’s veterans. Citing recent reports showing even longer wait lines for people seeking medical treatment at VA facilities than a year ago, Sen. Roy Blunt, R-Mo., this week said that the problems at the John Cochran VA Medical Center epitomize the agency’s broader performance. “The VA is not getting better,” Blunt said. “The number of people who are waiting more than 30 days for their first appointment is 50 percent higher than it was a year ago. The Cochran facility in St. Louis is now getting ready for what appears to be its eighth interim director in two years. There is a veterans’ problem that ought to be talked about.” The agency “had previously identified a candidate of the position” to head the St. Louis VA facility, VA spokesman James Hutton told the Post-Dispatch on Thursday. “The individual subsequently withdrew.” The facility in St. Louis serves 46,000 veterans annually. Regional members of Congress this spring wrote to the new VA director, Robert McDonald, expressing frustration at the “revolving door” in St. Louis.
VA chief counterpunches over ‘Community Care’ costs (Montgomery Advertiser)
The Veterans Access, Choice and Accountability Act of 2014, which Congress rushed to pass last summer to address a patient wait-time scandal at dozens of VA hospitals and clinics, spurred VA to broaden access to care. Turns out it did so largely through use of existing and often costly contract authorities and partnerships for non-VA health care with local communities rather than the new, more complex Choice Card plan. The result was seven million new health care appointments for veterans the past year, but also a flood of new enrollees into VA care, an accounting nightmare for health care administrators, and a surprising budget shortfall, which VA officials concede they failed to forecast and which angry lawmakers realize they must repair before going on August recess. VA secretary Bob McDonald came before the Veterans Affairs Committee on Wednesday to explain why VA needs emergency authority to shift $3 billion from an account fenced for the Choice Card program, and use it instead for other burgeoning community care costs, plus a $500 million tab VA faces to buy new wonder drugs for treatment of late-stage Hepatitis C. If denied flexibility to access Choice fund, McDonald said, “We will have no option at the end of July but to defer all remaining non-Choice-care-in-the-community authorizations until October, provide staff furlough notices and notify vendors we cannot pay them as we begin an orderly shutdown of hospitals and clinics across the country.” McDonald issued his blunt warning knowing he had support of the nation’s largest veteran service organizations for the funding shift. VSO leaders had written in the past week to Miller and other chairmen and ranking members of key congressional committees urging swift transfer of funds to avoid any interruption in veterans’ health services. They largely praised McDonald for expanding access to care without regard to cost. McDonald said Congress shares blame for the budget shortfall. It passed the Choice Act promising to reduce veterans’ wait times for care, so McDonald decided to manage his department to address those pressing care requirements rather than manage a hobbled budget. “When you passed the Choice Act you demanded…that we account for care in the community in a different way than we did previously,” McDonald said. “You asked us to centralize that at our business office. I’m sure you did that to keep control of that money and make sure we weren’t spending it for something else, but it helped to exacerbate the situation.” Without medical centers monitoring community care costs, “we lost a lot of intelligence about the obligations that were being made,” added Dr. James Tuchschmidt, VA’s principal deputy under secretary for health. Those regional experts even knew how to use VA’s “clunky” financial management system, he said. “And when we centralized that, maybe we should have anticipated some of the problems. But we didn’t.”
Pittsburgh VA fires two who bound co-worker with duct tape (Pittsburgh Post-Gazette)
Seeking to demonstrate that it can act quickly against problem employees, the Veterans Affairs Pittsburgh Healthcare System on Thursday announced it was firing two employees involved in the harassment of a colleague — including tying him up with duct tape — six weeks ago. The Pittsburgh VA said five other employees received less severe discipline for the incident, which was reported June 11, including one employee who was initially targeted for termination. It did not explain why that employee escaped being fired. “These actions underscore our commitment to promoting a safe and inclusive work environment for all of our employees,” Barbara Forsha, the Pittsburgh VA’s interim director, said in a statement. None of the seven employees has been identified. All can appeal the discipline. The quick action is in contrast to the 2½ years it took the VA to discipline employees for their roles in allowing a Legionnaires’ outbreak to occur at the Pittsburgh VA in 2011 and 2012 that sickened 22 veterans and led to the deaths of six more. It was only earlier this year that former Pittsburgh VA director Terry Wolf was fired for her role in the outbreak, and four additional employees received less severe discipline. Just Tuesday, VA Secretary Robert McDonald cited the quick disciplining in the harassment case to demonstrate how he is trying to change “the culture” of the VA so that “people follow our values.” After the incident occurred in June “we immediately put out a statement that the behavior was unacceptable. We did an investigation and we sought disciplinary action and very quickly you’ll be hearing the outcome of that,” he said at a news conference in conjunction with his visit to Pittsburgh to address the national Veterans of Foreign Wars convention. As a result of the investigation, the Pittsburgh VA said in its statement Thursday that it would require all employees to undergo additional harassment training and that it had “created a new focus group dedicated to encouraging employees to share their experiences, complaints and proposed solutions to workplace issues.”
Salem VA reports show $1.7 million worth of equipment missing in last 5 years (WSLS-Roanoke)
The Salem VA Medical Center has 22,000 pieces of equipment they track every year across multiple buildings on the 225 acre property but a WSLS 10 investigation finds more than $1.7 million of that equipment has recently been reported missing. Medical equipment, big screen TVs and computers. All bought with taxpayer money for the Salem VA Medical Center but a WSLS 10 investigation shows items just like this more than $1.7 million dollars worth of equipment were reported lost in the last five years. “It’s more of a management situation, that they know what’s going on. It’s just things aren’t being done about it,” said a VA employee who didn’t want to be identified fearing retailiation or losing his job. He says no one is being held accountable. Big ticket items reported missing. In 2012, a $26,555 lighting assembly, auditorium and stage reported lost. In 2013, a $75,700 portable ultra sound unit gone. “Sometimes there’s a priority to look for it and sometimes there’s not a priority to look for it,” said the employee. WSLS’s eight month-investigation into hundreds of pages of documents shows of the more than 1,100 individual items reported lost only 198 were ever reported found. Nearly one thousand items worth more than $1.3 million written off the books. Your tax dollars lost. How does this happen? “There’s quite a few things that are on these areas that are not locked properly or locked correctly,” said the employee.
Marine recruiters told to call cops if armed citizens show up (Marine Corps Times)
After four Marines and a sailor were killed by a lone gunman last week, armed civilians have volunteered to stand guard at military recruiting stations around the country — but troops are being warned to keep their distance and alert law enforcement of their presence. In a memo published Tuesday that was obtained by Marine Corps Times, Lt. Gen. Mark Brilakis, the head of Marine Corps Recruiting Command, advised troops not to support the “armed citizen” volunteers in any way. “These citizens’ presence, while well intentioned, will be counterproductive to our recruiting operations,” Brilakis wrote. Maj. Garron Garn, a spokesman for MCRC, confirmed the authenticity of the memo. “We are concerned for the safety of not only our Marines, but the public as a whole, and while most armed citizens have the best intentions at heart, it is not unrealistic to assume a possible incident like a negligent discharge may occur,” he said in a statement provided to Marine Corps Times. “Additionally, we are concerned that armed citizens may detract interested individuals from entering our offices, which ultimately negatively effects our recruiting mission. We ask that these concerned citizens show their support in other ways that are less impactful on our mission attainment.” If armed volunteers appear in the vicinity of any Marine Corps offices, Brilakis wrote in his memo, Marines should immediately call local law enforcement to deal with them. “Inform [law enforcement officers] that the Marine Corps did not request nor do we support [armed citizens] being in proximity of our facilities,” he wrote.