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Veterans: Report validates wait-time allegations at Houston VA

By ST. JOHN BARNED-SMITH AND SAMANTHA KETTERER | Houston Chronicle (Tribune News Service) | Published: June 23, 2016

After moving to Houston two years ago, Bora Chang finally started receiving overdue medical treatment for injuries incurred during a decade of military service and a rocket attack in Iraq.

Doctors here finally diagnosed her bone and joint problems, and she began the process of addressing them. But then, earlier this year, schedulers at the Veteran Affairs Medical Center in Houston began canceling her physical therapy appointments, often haphazardly and without warning, she said.

Chang eventually gave up and sought out privately the health care she had hoped to get from the VA.
"I would rather pay a couple hundred dollars to be served by my chiropractor so I could function and work, than go to the VA," said Chang, 31, a Katy, Texas, resident who works at a local nonprofit.

Chang's complaint echoes that of other local veterans, who have previously raised concerns about the problems obtaining timely appointments at the Michael E. DeBakey VA Medical Center or its outlying clinics.
They -- and local veterans' advocates -- say their concerns were vindicated by a report from the VA's Office of Inspector General released this week that found local VA officials were manipulating scheduling in a way that obscured the long wait times for appointments.

"If they're doing it to me, they're doing it to everyone else," Chang said Wednesday.

Software problems

Local VA officials claim that no veterans were harmed because of the data manipulation or scheduling delays, and attribute the problems in part to complex and antiquated scheduling software. Since investigators uncovered the problems, the local VA has instituted monthly scheduling audits, increased staffing, retrained schedulers and increased training for new hires, said Maureen Dyman, a spokeswoman for the DeBakey Medical Center.

Problems with appointment scheduling and delays made headlines in 2014 and 2015 after revelations that dozens of veterans in Arizona died waiting for treatment while medical staff covered up the lengthy wait times.
At the Houston VA facilities, investigators found that two former scheduling supervisors and the current director of two Community Based Outpatient Clinics in Houston had instructed staff to record appointment changes as if patients had canceled, even when the VA initiated the change, according to the report released Monday.
The changes altered the way patient wait times were calculated and made it appear that patients were getting appointments much more quickly than they were.

Investigators spent 10 months investigating the situation at the Houston VA, focusing mostly on scheduling data from 2014 and 2015.

At the Houston facilities investigators reviewed 373 appointments recorded as canceled by patients, finding that 223 had been incorrectly labeled as cancellations initiated by patients. Investigators also found problems with scheduling data from as recently as February 2016. VA officials said that occurred when officials at an outlying patient clinic had to cover for providers at another clinic nearby. The staff would ask patients if they wanted to have their appointments at the second facility, and if the patients declined, would code the appointment as a patient cancellation.

"We all hope our investigation leads to concrete changes at the medical center and increased efficiency to help those veterans that have served our country," said Mike Nacincik, an OIG spokesman.

Town hall meeting

Other local VA officials addressed the report Wednesday at a town hall meeting with veterans.

Chris Sandles, interim medical center director at the DeBakey Medical Center, said that after the investigation was conducted, the center identified gaps in their training that contributed to the scheduling issues.

"This wasn't something we were aware of prior to the IG coming in to talk to us," Sandles said. "This wasn't intentional, nothing was malicious."

Still, meeting attendees and other local veterans complained of abrupt cancellations, often without any clear reason why.

Veteran Francisco Rodriguez, 69, said he once drove from Corpus Christi to Houston for an appointment, only to find out it was canceled.

"No one had the courtesy to tell me," he said. "We're not treated with any kind of respect."

Rodriguez, who experiences back pain, said he's had appointments canceled more than once, although it hasn't happened for at least a year. One time, he said, he called in to check on his appointment and was told he'd cancelled it himself.

"I knew I had an appointment and I had not received a letter," Rodriguez said. "I called in. They told me, 'No, you canceled your appointment.' I said, 'No, I did not.'"

Rodriguez said he was left wondering why the VA couldn't keep his appointments.

"It taught me a lesson that I can't depend on the VA when I need emergency services," he said.

Half a dozen other veterans shared similar experiences in interviews with the Houston Chronicle.

Lack of accountability

Local veterans groups, meanwhile, said the lack of accountability ends up hurting veterans.

"This happens all the time," said a local veterans advocate who asked not to be identified because he often works with the VA.

"Veterans were promised to be taken care of," he said. "In the end, are they?"

Peyton Lumpkin, the newly installed president of the Texas Veterans of Foreign Wars, credited local VA doctors with providing excellent medical treatment but said he is troubled by revelations in the report.

"Care delayed is care denied," he said. "And people die over this."

Congressional leaders have also expressed serious concerns.

"More than two years after the department was rocked by a nationwide delays-in-care scandal, VA's wait-time rhetoric still doesn't match the reality of veterans' experiences," said U.S. Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans' Affairs.

"And unfortunately, this sad fact is unlikely to change anytime soon," he said. "That's because at one VA facility after another -- including Houston -- the department is often relying on the very same people who caused the scandal to fix it. ... Until VA starts putting veterans' customer service before the job-security of misbehaving employees, the department will continue to lurch from one scandal to another, and veterans will continue to pay the price."

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