WASHINGTON — The Department of Veterans Affairs has not done enough to prevent schedulers from manipulating appointment wait times, and wait-time data remains misleading and underestimates how long veterans wait for care, according to a nonpartisan watchdog report released Monday.
“Ongoing scheduling problems continue to affect the reliability of wait-time data,” the Government Accountability Office found.
The GAO said the VA has taken a “piecemeal approach” to addressing the problems since the wait-time scandal broke in 2014 in Phoenix, where schedulers falsified wait times and at least 40 veterans died awaiting care. But the agency needs to take comprehensive action, the GAO concluded in its audit, which stretched from January 2015 through last month.
Auditors found schedulers at three of the six medical centers they reviewed had improperly changed dates so the VA system falsely showed shorter or zero wait times. In a review of scheduling records for 60 individual veterans at those three centers, they found improper scheduling in 15 — or 25% — of the appointments.
While the system showed average wait times of between four and 28 days in the cases reviewed, the actual averages were between 11 and 48 days. The audit characterized the schedulers' actions as mistakes rather than deliberate falsification.
“Until a comprehensive scheduling policy is finalized, disseminated, and consistently followed by schedulers, the likelihood for scheduling errors will persist,” the GAO said in its draft report.
The findings bolster recent claims by VA whistle-blowers that schedulers across the country are still falsifying wait times. And they cast doubt on the effectiveness of corrective actions VA officials touted as recently as 10 days ago.
USA TODAY reported April 7 that the VA inspector general found schedulers at 40 VA medical facilities in 19 states and Puerto Rico regularly “zeroed out” veteran wait times and supervisors at seven of those facilities instructed them to do so.
VA officials at the time said many of those probes had been finished more than a year ago and they had already imposed discipline in some cases and instituted refresher training for all schedulers.
White House Press Secretary Josh Earnest acknowledged Monday the pace of reform has been slow, but that President Obama has made the issue a priority and the administration is making progress.
“There is no denying that the problems that the VA has encountered for more than a decade now have been deeply entrenched,” he said. “ We have made important progress in ensuring that veterans are getting the benefits that they have so richly earned. That said, work remains to be done.”
In response to the new GAO report, VA spokeswoman Walinda West issued a statement saying the agency "agreed with its conclusions" but adding that it has "built a strong system of checks and balances to detect scheduling errors and potential manipulation since the GAO findings."
The VA said it also is working on a new national scheduling directive and is in the process of testing and deploying a new scheduling program to make it easier to book appointments.
That's not good enough for Rep. Jeff Miller, R-Fla., chairman of the House Veterans' Affairs Committee, who has been pushing the VA to do more to hold employees accountable.
“This report proves what we’ve long known: wait-time manipulation continues at VA and the department’s wait-time rhetoric doesn’t match up with the reality of veterans’ experiences," Miller said. "But given the fact that VA has successfully fired just four people for wait-time manipulation while letting the bulk of those behind its nationwide delays-in-care scandal off with no discipline or weak slaps on the wrist, I am not at all surprised these problems persist."
The GAO audit focused on primary care for newly enrolled veterans and said its findings should not be generalized, but it did not limit its conclusions to those patients. Auditors selected six centers with varying sizes and geographic locations for their sample. They are in Leeds, Mass.; Nashville, Tenn.; Fayetteville, N.C.; Charleston, S.C.; Leavenworth, Kan.; and San Diego, Calif. The GAO did not identify which three locations showed false wait times.
Local VA officials overseeing five of the six centers told the GAO their own internal audits also found schedulers continuing to enter dates improperly. At one of the medical centers — the GAO didn’t say which one — an audit of 1,200 appointments between January and June 2015 found scheduling problems with 205 of them.
The local VA officials blamed national VA officials for confusing directions about changes to scheduling policies that had been “ineffective and may be contributing to continued scheduling errors,” the GAO report states.
The VA, in its response to the report, said it will review the situation and make improvements where necessary by the end of the year.
“While we know we can do more to improve our access to care, we are aggressively implementing changes in our systems, training and processes to improve access," the statement said. "We are doing everything we can to rebuild the trust of our veterans who depend on VA for care.”