UPDATE: Congressional sources say the Veterans Affairs inspector general provided the draft report of its Phoenix investigation to the House Veterans’ Affairs Committee late Thursday. No other details are available.
A draft report that could show whether top officials at the Department of Veterans Affairs pressured the agency’s inspector general to soften its damning assessment of patient deaths at a Phoenix hospital is being withheld from a congressional oversight committee, the Washington Examiner has learned.
Richard Griffin, acting inspector general at the veterans’ agency, is refusing to turn over the draft version, which was submitted to top VA officials for comment prior to the publication of the final version on Aug. 26.
Catherine Gromek, spokeswoman for the IG, confirmed Thursday the draft version of the report is being withheld, adding that is the office’s normal practice. That could change, she said.
“The first request we did decline to provide in keeping with our practices,” Gromek said. “I don’t think we’re at the total refusal level at this point in time.”
Inspectors general are independent watchdogs within federal departments. Draft inspection reports are normally provided to agency administrators for comments, which can lead to revisions between the drafts and final versions that are made public.
The VA inspector general’s final report confirmed the widespread use of inappropriate practices to hide unacceptable delays in care at the Phoenix hospital. It also found 20 patients died after unacceptable delays or substandard care. But it concluded no deaths could be directly attributed to those delays.
“While the case reviews in this report document poor quality of care, we are unable to conclusively assert that the absence of timely quality care caused the deaths of these veterans,” the final version of the report said.
Allegations that waiting lists were being falsified in Phoenix publicly surfaced in April. Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans’ Affairs, disclosed at a committee hearing that a whistleblower claimed secret waiting lists were being kept at the Phoenix facility and as many as 40 patients died waiting for treatment.
Miller directed the IG to fully investigate the complaints.
The whistleblower was later revealed to be Dr. Sam Foote, a former doctor at the Phoenix VA hospital. Foote had initially gone to the inspector general in October 2013 with allegations that patient appointment schedules were being falsified.
After several months without resolution by the IG, Foote took his charges to Miller’s committee.
Foote told the Examiner Thursday he went to the House committee February because the IG did not seem to be taking his allegations seriously.
“They were ducking it all the way,” he said of the early stages of the IG’s investigation. “Nothing was changing in Phoenix. My assumption was they were just going to bury this and never act on it,” Foote said of his decision to take his charges to Congress.
The IG’s handling of Foote’s allegations between his initial complaint and Miller’s revelations were questioned by Rep. Mike Coffman, R-Colo., chairman of the House Veterans Affairs subcommittee on oversight and investigations, in an Aug. 19, 2014, letter to Griffin.
Coffman told the Examiner late Thursday that he remains concerned
“It’s disappointing that it appears the culture of the VA isn’t changing,” Coffman said. “I have serious concerns about the independence of the inspector general and the IG’s most recent stonewalling only heightens those suspicions. The American people deserve to know the truth.”
Coffman raised similar concerns in his Aug. 19 letter to the IG.
Though the final report had not been released, Coffman specifically asked Griffin to describe the steps the IG took to investigate Foote’s allegations between the time he initially raised them in late 2013 and their disclosure by Miller in April.
“Please explain, in detail, the progress of the investigation from that original disclosure up to the request by the committee for the OIG to open an investigation in April 2014,” Coffman said in his letter.
Coffman also questioned the standard the IG would use to determine whether delays caused patient deaths. Rather than the “conclusively assert” language that was ultimately used in the final report, Coffman noted in his letter to Griffin that the standard normally used by VA in making those assessments is “more likely than not.”
“The VA uses a greater than 50% or ‘more likely than not’ standard for determining service connected conditions,” Coffman noted in his letter to Griffin.
“It is not necessary for your office to conclude to a 100 percent certainty, an unrealistic standard that is not that used by VA and will assuredly overlook Veterans who more than likely died from delays in care,” Coffman said. “Did someone within VA attempt to persuade the OIG not to use the greater than 50% standard?”
Coffman also sought a copy of the draft report on the Phoenix investigation.
Griffin responded three days later. He did not describe what IG investigators did prior to Miller’s disclosure of the allegations or address what standard would be used to determine if deaths were caused by delays. Griffin did indicate the draft report would not be turned over to the House committee.
“The deliberative nature of the draft report review and comment process is consistent with the principle of inspectors general as independent and objective units of government and long-standing OIG practice,” Griffin said in his Aug. 22 response.
“I can assure you that minimal changes were made to the draft report following receipt of the VA’s comments and that changes were made solely for the purposes of clarity, and in no way altered the substance of the report,” Griffin added.
Gromek said Thursday that the initial allegations from Foote were sent to the IG’s Office of Healthcare Inspections. After Miller raised the issue in April, the IG expanded the probe to include its offices of audits and investigation.
Gromek did not immediately know how much information about what it later called “systemic” falsification of appointment records had been discovered by the IG prior to Miller’s announcement.
As to providing a copy of the draft report, Gromek said if it is released to the committee it would be for the purposes of congressional oversight, and should not be disclosed publicly.
