WASHINGTON — For more than four hours Wednesday night, House lawmakers hammered VA officials to turn over internal documents on off-the-books wait lists related to veteran deaths at a Phoenix hospital.
Earlier Wednesday, an interim Department of Veterans Affairs inspector general investigation found inappropriate scheduling practices such as those in Phoenix are “systemic” in the nationwide veterans’ health care system, adding fuel to what was already set to be a very tense hearing on Capitol Hill.
The IG announced it found that 1,700 veterans — 54 percent — who were waiting for primary care at the Phoenix VA hospital had not actually been added to official electronic waiting lists. By not adding the patients to the waiting list, the staff at the hospital significantly understated wait times and boosted job performance evaluations, which were connected to employee awards and salary increases, the IG reported.
The House Veterans’ Affairs Committee said Wednesday it has tried for weeks to obtain emails and other documents from the VA after issuing a subpoena May 8 and charged that the VA was still improperly withholding some records related to wait lists and veteran deaths at the Phoenix hospital.
“Why wouldn’t you turn over the documents ... just tell the truth?” asked Rep. Phil Roe, R-Tenn. “In my mind, I am thinking right now, ‘They’re hiding something from me,’ and I have no reason to think you are not.”
Three VA executives, including Assistant Deputy Under Secretary for Health for Clinical Operations Thomas Lynch, who flew to Phoenix to conduct initial investigations in April, told the lawmakers that four off-the-books lists were used and destroyed at the facility between 2012 and 2013.
The VA provided the committee 5,500 pages of documents following a May 8 subpoena but said Wednesday that some documents were withheld by VA legal counsel under attorney-client privilege, angering committee members.
Rep. Jeff Miller, R-Fla., scoffed at that, saying he thought the VA was still stonewalling, and pointing out that the VA missed a May 19 deadline to provide all correspondence related to the facility waiting lists and deaths.
He said the agency was using attorney-client privilege inappropriately, and had not provided other internal documents clearly covered by the House subpoena, including VA executives’ notes taken during an earlier hearing.
“Until the VA understands that we are deadly serious,” Miller said, “you can expect us to be over your shoulder every single day.”
Miller continued to press the three officials, saying the VA has still not filled 110 committee requests for information, some of which are related to Phoenix.
Assistant Secretary for Congressional and Legislative Affairs Joan Mooney said the VA’s office of legislative affairs is working with the committee and over past five years has responded to about 100,000 requests for information.
“Ma’am, veterans died. Get us the answers, please!” Miller said.
“I understand that, Mr. Chairman, and I will look into getting you that request,” she said.
“That’s what you said three months ago!” Miller responded. “This has been going on since January.”
Between late 2012 and mid-2013, Lynch said the hospital had created a “work product” with its electronic scheduling software that listed patients whose appointments had been canceled. He said the lists were used to keep track of those who needed to be rescheduled and denied that the list was kept secret.
“Once the rescheduling has occurred, the list is no longer necessary, so it is appropriately destroyed because it does contain patient identifiable information,” such as social security numbers, Lynch testified.
In addition to that electronic temporary record, the VA had created three other lists that included new enrollee requests for an appointment, requests for consultations from the emergency room and requests for appointments made through the VA telephone hot line, he said.
Lynch said all 1,700 veterans who had requested care but had not been added to the VA waiting list would be contacted by Friday and offered covered health care outside the agency health system.
The VA also will reach out to veterans affected by inappropriate scheduling at other facilities and make the same offer, he said.
The VA is engulfed by a scandal that began in April at Phoenix. Similar reports have surfaced in at least 10 other states, angering veterans and triggering a string of bills in Congress aimed at punishing alleged VA wrongdoing.
The IG examined a sample of 226 veterans at the Phoenix facility and found they waited 115 days, on average, for their first primary-care appointment. The IG said it is also looking into allegations of improper hiring practices, sexual harassment and bullying at the Arizona facility.
Meanwhile, its investigation has expanded to various other VA facilities, which constitute the largest integrated health care system in the United States, serving 200,000 veterans each day.
“To date, we have ongoing or scheduled work at 42 VA medical facilities and have identified instances of manipulation of VA data that distort the legitimacy of reported waiting times,” said the interim report, which was issued after urging from Congress. A final report is expected by August.
But the ongoing investigation and VA testimony failed to satisfy House lawmakers that enough is being done.
At the House hearing, Rep. Jackie Walorski, R-Ind., said after two hours of testimony she learned little from the VA executives about who was responsible for the inappropriate hospital scheduling that may be linked to veteran deaths.
“Dr. Lynch, does the buck stop with you on these deaths? Are you responsible?” Walorski asked.
“I don’t know if it does but I consider myself responsible,” Lynch said.
Mooney and VA Congressional Relations Officer Michael Huff did not directly answer Walorski’s pointed question.
“Yes, I am responsible for ensuring our focus at this point … our focus remains on caring for our veterans,” Mooney said.
Huff said, “I am a staff level congressional relations officer who is a civil servant and also a veteran. I am not a supervisor, I’m a staff level federal employee and I do the best job I can.”