A year and a half after concerns about falsified patient waiting lists at Department of Veterans Affairs clinics were first aired during a congressional hearing, the VA continues to suffer from many of the same systemic problems.
Veterans are still dying while they wait for care in Phoenix, the epicenter of the scandal that drew national attention to the agency.
Few employees have been removed — or even punished — for their role in covering up long delays in care at VA hospitals across the country.
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And officials have done little to curb the waste, fraud and abuse that too often hampers well-intentioned VA efforts, such as an unfinished facility in Denver that somehow ballooned more than $1 billion over-budget.
It’s a trend that has thrust the VA — once a little-noticed bureaucracy — into the center of the 2016 debate as candidates on both sides of the aisle attempt to assign blame for the agency’s failures.
Jeb Bush, who released a detailed plan to reform the VA this summer, said the VA struggles to serve veterans because it is “too big and too insular.”
Hillary Clinton suggested the failure lies with Republicans, accusing lawmakers of exaggerating the scandal for political purposes.
Most observers agree the agency faces two major hurdles to improving its services for a growing number of veterans: a lack of accountability and a lack of transparency.
Until the VA holds officials responsible for misconduct, and is open about the process, critics argue the agency will continue to fall short of its mission.
Accountability
Secret waitlists at 110 VA facilities across the country concealed the long stretches of time veterans were waiting just to see a doctor.
At the VA hospital in Phoenix, Ariz., where whistleblowers first drew attention to the fake lists, dozens of veterans died as they waited for their appointments.
But few at the Phoenix facility have faced any sort of punishment for covering up delays that were later linked to at least 35 deaths.
In fact, two of the central figures in the scandal —Brad Curry and Lance Robinson— are still on paid leave from the VA while the agency continues an ill-defined investigation into their conduct.
The VA did not return a request for comment as to why the two employees have remained on leave since May of last year.
While the scandal forced VA Secretary Eric Shinseki to resign at the end of May 2014, two days after an inspector general report confirmed whistleblower allegations of a massive cover-up in Phoenix, only three employees throughout the agency have been fired as a result of the scandal.
Just 24 employees have been recommended for disciplinary action, with many receiving lighter punishments than initially proposed.
John Cooper, spokesman for Concerned Veterans for America, told the Washington Examiner the VA has made “cosmetic changes” in lieu of real reform.
“VA leadership is not fundamentally serious about holding those involved in the wait list manipulation accountable, which incentivizes similar behavior in the future,” Cooper said.
Many have criticized Robert McDonald, who replaced Shinseki as head of the VA last summer, for his failure to rid the agency of officials who participated in the scandal.
Rep. Jeff Miller, chairman of the House VA Committee, wrote in an op-ed Tuesday that the VA likely struggles to attract high-quality employees because of its “notorious aversion to accountability.”
“Until the VA rids itself of those who engage in scandalous behavior, the department will always be mired in scandal,” Miller said. “But unfortunately, indefensible civil service rules that put the job security of failing VA bureaucrats ahead of the safety of the veterans they are charged with serving are prolonging the agency’s problems indefinitely.”
A September letter from the Office of Special Counsel, which handles whistleblower cases across the federal government, criticized the VA for failing to provide “an adequate justification” as to why no employees at the Phoenix facility had not faced punishment.
The letter cited as an example a West Virginia VA manager who bugged a conference room where investigators were conducting interviews with staff, then lied to investigators when confronted about his attempts to keep tabs on the probe of poor patient care.
OSC said the manipulation had a “chilling effect” on witnesses who were afraid to talk for fear of retaliation from the manager, who apparently confronted a witness after he or she spoke with investigators.
Despite the evidence, the manager received nothing more than “written counseling”
An Alabama doctor “copied and pasted” records for hundreds of patients, including notes about their symptoms and treatment plans, instead of actually updating their charts, according to the OSC.
“An investigation confirmed that the pulmonologist copied and pasted 1,241 separate patient records,” the letter said. “Yet the physician received only a reprimand.”
A reprimand is the lowest level of punishment a VA employee can face.
A bill that would give VA leadership more authority to remove VA officials for misconduct has stalled in the Senate, with Democrats arguing the bill unfairly targets VA staff over other federal employees.
Senate Majority Leader Mitch McConnell’s office did not respond to a request for comment as to whether he plans to bring the accountability bill to the floor for a vote.
Transparency
While the VA is far from the only agency that struggles with a lack of candor, it has failed to answer questions about why employees have escaped responsibility for abusing the system, among other issues.
“[W]e need to demonstrate the kind of transparency that builds trust,” the VA wrote last year in a 47-page plan to improve the agency called the “Blueprint for Excellence.”
Before he was unanimously confirmed by the Senate in July 2014, McDonald promised to bring transparency to the agency, something he has repeated throughout his time as VA secretary.
But Congress still has trouble keeping tabs on the VA’s activities.
For example, the House VA Committee is still waiting for an answer to 143 different requests for information from the VA. At least one request has languished at the agency for nearly three years.
Eighty-nine such requests have been outstanding for more than two months.
Andrea Dickerson, spokeswoman for the American Legion, said leadership and policies vary greatly among different VA facilities, preventing directives from trickling down to employees who work with veterans.
“That’s not to say that front line VA employees are not treating veterans well, it just means that the incentive to be a good employee and value the veteran … has more to do with the values already possessed by the employee,” Dickerson told the Examiner.
McDonald has been less than forthcoming about how the agency has handled staff that covered up wait times.
Late last week, the VA secretary told an audience at the National Press Club that 300 VA employees had been slated for punishment for their role in the scandal.
However, just two dozen employees had actually been recommended for disciplinary action, raising new questions about the veracity of the VA’s statements on its effort to reform the VA.
The VA came under fire once again this summer when officials declined to inform Congress about the largest budget shortfall in the agency’s history until just weeks before the gaps would have prompted the VA to close hospitals.
Lawmakers railed against the VA for concealing the budget holes in a seeming effort to force Congress to approve more funding.
