Senators agree on how to bolster VA hospitals

Acting Secretary of Veterans Affairs Sloan Gibson speaks Thursday in Phoenix where he made his first visit since taking over the agency amid an investigation that found 1,700 veterans were kept off the official waiting list for care at the troubled Arizona hospital.

Acting Secretary of Veterans Affairs Sloan Gibson speaks Thursday in Phoenix where he made his first visit since taking over the agency amid an investigation that found 1,700 veterans were kept off the official waiting list for care at the troubled Arizona hospital.

Friday, June 6, 2014

WASHINGTON -- U.S. veterans hospitals would be able to hire more doctors and nurses under a plan announced by bipartisan Senate negotiators in an effort to reduce the long waits for thousands of military veterans seeking care.

"We have a crisis on our hands," Sen. Bernie Sanders, a Vermont independent and chairman of the Senate Veterans' Affairs Committee, said on the Senate floor Thursday. "We have learned that in many parts of this country -- not all parts, but many parts -- veterans cannot get the timely care that they need."

The plan, negotiated with Republican Sen. John McCain of Arizona, would allow construction of 26 medical facilities in 18 states and provide $500 million for hiring doctors and nurses, Sanders said.

The proposal, costing more than $1.5 billion, also would make it easier to fire senior Department of Veterans Affairs health officials for poor performance, he said. They would be allowed to appeal.

Lawmakers are facing political pressure to eliminate long delays at many VA hospitals for veterans seeking doctor's appointments. At least 40 veterans died while awaiting care in Phoenix, House Veterans' Affairs Committee Chairman Jeff Miller, R-Fla., has said, citing a retired doctor from the area.

An inspector general's report on May 28 found systemic mismanagement, treatment delays and falsified records throughout hospitals that treat 8.3 million veterans. Veterans Affairs Secretary Eric Shinseki resigned two days later.

"We are talking about a system that must be fixed. It's urgent that it be fixed," McCain said Thursday.

Sanders and McCain said Senate Majority Leader Harry Reid, D-Nev., has promised a vote as soon as possible on the measure. The chamber has no more votes scheduled this week because a group of senators was heading to Normandy for the 70th anniversary of the D-Day landings.

If the Senate passes the bill, lawmakers could open negotiations with the House, which has passed several similar measures, McCain said.

Under the proposal, veterans who live at least 40 miles from VA medical facilities or can't schedule a medical appointment within about two weeks would receive "choice" cards to seek non-VA care, McCain said. That care would be confined to doctors who accept Medicare or Tricare, which provides health benefits to some retired military personnel.

In addition, veterans would receive in-state college tuition regardless of where they live after being discharged from the military. The tuition benefits also would be given to spouses of those who die in the line of duty, Sanders said.

At the Phoenix VA hospital, an official list showed that veterans waited 24 days for their first primary-care appointment, while a more complete list -- which was kept secret -- showed the average waiting time was 115 days, according to the inspector general's report.

"This isn't a scheduling problem," McCain said on the Senate floor. "These are systemic problems that need to be addressed."

"Every single day that goes by, a veteran is deprived of the care that he or she has earned serving this country," said McCain, who asked colleagues to set aside their usual partisan bickering and act on the VA legislation swiftly.

"We have, for all intents and purposes, in some ways betrayed the brave men and women who are willing to go out and sacrifice for the well-being and freedom of the rest of us," he said.

President Barack Obama has said the VA, which spends $160 billion annually, needs a new health-information system and may need more doctors and nurses.

The bipartisan Senate plan emerged as the U.S. Office of Special Counsel announced it is investigating allegations of reprisals against 37 VA whistle-blowers, including some who reported improper scheduling of veterans.

Whistle-blowers who have complained about reprisals work at VA facilities involving 19 states, but the Office of Special Counsel, an independent federal investigative agency, declined to name the facilities.

"Receiving candid information about harmful practices from employees will be critical to the VA's efforts to identify problems and find solutions," said Special Counsel Carolyn Lerner. "However, employees will not come forward if they fear retaliation."

In the meantime, members of Congress stepped up efforts to find out about problems at VA facilities in their own states.

U.S. Sen. Roy Blunt's office said Thursday that the VA hospital in Kansas City, Mo., maintained a secret waiting list containing the names of 37 veterans -- all of them heart patients.

The Kansas City VA Medical Center confirmed the list hours after the Missouri Republican sent a letter asking whether the secret list existed. The medical center said in a statement that it is reviewing capacity at the hospital and its community clinics in an effort to expedite care.

"No Veteran should have to wait for the quality health care they have earned and deserve," the statement read. "This is our top priority."

In addition to questioning whether the list existed, Blunt's letter to Kent Hill, director of the Kansas City VA hospital, questioned why the facility failed to notify members of Congress once it learned of the list and asked what actions were taken in response.

"These so-called 'unauthorized wait lists' for America's heroes are simply unacceptable and will not be tolerated," Blunt said in a statement. "I'm going to do everything I can to ensure this stops immediately. Our veterans should not be forced to wait for care."

Senators were told earlier this week that 108 veterans in the six states overseen by the VA's Heartland network had waits for care of more than 90 days, including several in Missouri.

On Thursday, Republican senators sent a letter to acting VA Secretary Sloan Gibson seeking answers about the other reports of unauthorized wait lists at VA facilities in the Midwest.

Gibson was visiting the Phoenix VA on Thursday. He said 18 veterans who were kept off official Veterans Affairs waiting lists in the Phoenix area have died, but he said he does not know whether the deaths were related to having to wait a long time to see a doctor.

Gibson said the 18 veterans were among 1,700 in the Phoenix area who a report found were not on official hospital waiting lists. He also said he was not sure whether the 18 veterans were among the 40 veterans a retired doctor claimed may have died while awaiting treatment in the Phoenix area.

Gibson, who took over the VA temporarily last Friday after Shinseki resigned, said the agency will make changes to improve care for veterans, including using more purchased care especially in rural areas.

Meanwhile, Obama's choice to be the top health official in the Veterans Affairs Department withdrew his nomination Thursday, saying he feared his confirmation would spark a prolonged political battle.

Jeffrey Murawsky, health-care chief for the VA's Chicago-based regional office, was nominated last month to be the department's new undersecretary for health care, replacing Robert Petzel, who resigned under pressure.

Murawsky now oversees seven VA hospitals and 30 clinics in Illinois, Indiana, Wisconsin and Michigan, including one in suburban Chicago where there are allegations that its staff also used secret lists to conceal long patient waiting times. Murawsky was a doctor at the hospital and remains on its staff.

Murawsky said his withdrawal was "in consideration of recent events, but most importantly in the best interests of serving our nation's veterans."

The White House said Murawsky feared a prolonged fight over his confirmation, adding that he believed that the role was too important not to be filled quickly.

Obama accepted Murawsky's withdrawal and will move quickly to find a replacement, the White House statement said. The VA is required by law to convene a commission to seek and review candidates for the position, which oversees the Veterans Health Administration.

Robert Jesse, Petzel's chief deputy, has served as acting undersecretary since Petzel resigned May 16.

Information for this article was contributed by Michael C. Bender of Bloomberg News; by Richard Simon of the Los Angeles Times; and by Terry Tang, Bill Draper, Jim Salter, Matthew Daly and Donna Cassata of The Associated Press.

A Section on 06/06/2014