'The VA is two-faced.' Whistleblowers say managers are trying to silence them on veteran care
By DONOVAN SLACK | USA Today | Published: June 22, 2019
WASHINGTON (Tribune News Service) — Three Veterans Affairs health care professionals who reported patient care issues say the agency continues to try to silence them, jeopardizing veterans and undercutting a key Trump promise of whistleblower protection.
They work at different sites – in the Phoenix area, Baltimore, and Iowa City, Iowa – yet the VA response has been similar. All were stripped of assigned patient-care and oversight duties, and they suspect VA managers are retaliating against them for speaking out, and sidelining them to prevent them from discovering or disclosing any more problems with veteran health care.
In exclusive interviews with USA TODAY, their assertions contradict proclamations by agency leaders and President Donald Trump that VA employees who disclose wrongdoing at the agency are being celebrated and not scorned.
"The VA is two-faced: What it says it does and what it actually does are two entirely different things," said Katherine Mitchell, a physician who reported shortfalls in care at the Phoenix VA that earned her a federal "Public Servant of the Year Award" in 2014.
Mitchell is scheduled to testify at a congressional hearing Tuesday examining the treatment of whistleblowers at the VA. She will be joined by Iowa City CT technologist Jeffrey Dettbarn, who blew the whistle on mass-cancellations of diagnostic test orders, and Baltimore VA psychologist Minu Aghevli, who reported veterans had been removed improperly from wait lists for opioid-addiction treatment.
Mitchell said the retaliation against her and others who speak out sends a signal to other employees to keep their mouths shut and "jeopardizes the health and safety of every veteran in the system."
"Whistleblowers who are brave enough to report problems serve as a vital safety net for veterans," she said. "If people can't identify problems, veterans will suffer and die. That's what it boils down to."
Trump's accountability order
Trump signed an executive order creating a VA Office of Accountability and Whistleblower Protection and then a law making it permanent in 2017. Early reviews were promising – within several months, the office had delayed disciplinary actions against 70 VA employees who disclosed alleged wrongdoing.
But the VA inspector general has since launched a wide-ranging investigation of the office's handling of whistleblower cases and reports of problems.
The Government Accountability Office issued a report last July that said the office allowed officials accused of wrongdoing or retaliation to be involved in investigations of the accusations – calling into question their independence and findings. And leadership at the office has turned over multiple times, causing confusion and disruption.
In response to inquiries from USA TODAY, VA spokesman Randall Noller issued a statement Wednesday saying the agency "welcomes the inspector general's oversight."
"For the last several months, we've been cooperating closely with the IG on its assessment and encouraging the office to release its report as soon as possible," he said.
An assistant secretary who took over the office in January, Tamara Bonzanto, plans to use its findings as a "roadmap" for improving office operations, Noller said. In the meantime, she has been "working on a number of key improvements."
"These include providing timelier resolutions, more responsive recommendations and enhancing communications with whistleblowers," he said.
Noller declined to say what policies are in place to ensure the office doesn't allow managers accused of wrongdoing or retaliation to be involved in investigating the accusations. Noller also declined to comment on assertions made by Aghevli, Dettbarn and Mitchell, citing federal privacy laws.
Whistleblower advocates say they haven't seen much difference in recent years. Jacqueline Garrick, founder of non-profit peer-support group Whistleblowers of America, said more than 190 VA employees have contacted her since 2017, complaining about retaliation for speaking out about problems at the agency, most about how veterans are treated.
She said those who have gone to the Trump-created whistleblower protection office for help said the office's employees turned around and investigated them instead, launching "counter accusations and further retaliation."
She said Bonzanto told her in February she planned to "reset" the office's operations. Still, Garrick said, "I haven't seen any real sign of that."
She and other advocates also are slated to testify before Congress Tuesday at the hearing before the House VA Committee's Subcommittee on Oversight and Investigations examining whistleblower concerns.
Backlogs and lists
In Iowa City, Dettbarn noticed something was awry in 2017 when patients showed up to get CT scans but orders for the tests had been cancelled in the computer system.
He reported the problems to administrators, who later admitted they had been mass-cancelling diagnostic test orders as part of a national effort to clear out a backlog of out-dated or duplicate orders.
Weeks after Dettbarn reported his concerns that orders had been cancelled without contacting patients or a medical review to determine if veterans still needed the tests, he was removed from his job and then transferred to another position, pending an investigation – of him.
He said he has been spending all day every day making copies and doing other paperwork ever since, nearly two years later. Dettbarn went to the whistleblower protection office for help, but said he didn't hear back for months on end. "As far as I know, I'm still under investigation," he said.
He wants to go back to caring for patients, and he worries about being away from the diagnostic clinic for so long.
"There's nobody there to watch out for the veterans," he said. "They've got everybody else scared to say anything. Who's taking care of those patients?"
In Baltimore, Aghevli began reporting problems with wait lists five years ago, at the same time a national scandal unfolded about VA wait times following revelations that veterans died while they waited for care at the VA hospital in Phoenix.
Aghevli, coordinator of the opioid-addiction treatment program at the VA Maryland Health Care System, reported being pressured by supervisors to remove veterans from a wait list for treatment and schedule them in an "imaginary clinic" so the list would appear shorter.
"Suddenly our wait list went from being well over 100 to being minimal, I mean, well under 20," she said.
A review of her allegations by the VA inspector general later concluded veterans were removed from the list and placed in "non-count" status, even though they still wanted opioid-addiction treatment at the Baltimore VA.
But Aghevli said she quickly became "unpopular" with supervisors who turned around in the ensuing years and investigated her repeatedly, tried to transfer her, and threatened to shut down her program – which serves roughly 400 veterans. She said they excluded her from meetings, changed her hours, and at one point, detailed her to clerical duties.
Through it all, she continued to report patient care problems when she came across them – including improper discharges, short-staffing and medication issues – to her supervisors, to the inspector general and to members of Congress.
"If I see somebody not getting adequate treatment, or not getting treatment that's clinically indicated, I will speak up about it," Aghevli said.
But she said she is still being retaliated against. In April, Baltimore VA officials once again moved her out of her job to a data entry post and stripped her of her clinical privileges, pending investigation. Aghevli said the reason they gave was that she had visited a veteran patient in a non-VA hospital after he had suffered a health crisis, a situation that ostensibly could give rise to charges she was practicing at a hospital where she didn't work.
Aghevli called the explanation "nonsensical." She is going public with her story for the first time. "I just am not sure what else to do," she said.
She wants protections for whistleblowers expanded and strengthened. "I would like other people to not go through this," she said. "It's been really awful."
Noller, the VA spokesman, declined to comment on her case as well as Dettbarn's and Mitchell's unless they signed waivers of their rights under federal privacy laws. Mitchell and Dettbarn declined, fearing further retaliation.
Aghevli's lawyer, Kevin Owen, agreed on the condition the waiver be negotiated with VA general counsel. He said Friday that agency lawyers had not contacted him.
'I will not back down'
In Gilbert, Arizona, Mitchell has endured more subtle retaliation.
After she reported poor training and inadequate triage at the emergency room at the Phoenix VA, she reached an agreement with VA officials to move to a new job assessing health care quality and efficiency at facilities in the region.
"I was hoping to improve patient care on a wider scale," said Mitchell, who was a nurse before becoming a doctor.
But she said that, with very few exceptions, she hasn't been allowed to perform those oversight duties. Mitchell has had to resort to helping veterans "under the table" – in some cases, receiving reports confidentially from VA employees, taking it upon herself to investigate, and then writing reports to regional administrators.
They included flagging poor care provided by a neurologist who was later removed, a facility's failure to biopsy a potentially cancerous skin lesion and radiation oncology treatments delayed by short-staffing.
"They were not happy," she said of administrators, but they didn't stop her and facilities appeared to take actions to address the problems. Still, she said, VA employees told her they were "actively being discouraged from talking" to her.
Since 2018, Mitchell has been in charge of implementing an initiative to complement medical care with yoga, acupuncture and other methods to improve veterans' health.
"They don't want me involved in any patient safety problems – any problem of any significance, they want to keep me away from it," she said.
Mitchell has asked another federal agency that helps whistleblowers for help, the Office of Special Counsel, and is speaking out again about problems in the meantime that she says are jeopardizing veterans.
"As a physician, nurse, and basically as a human being, I will not back down if someone's health or safety is being threatened," she said.
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The VA's Assistant Secretary for Accountability and Whistleblower Protection Tamara Bonzanto prepares to testify at the start of a Senate Committee on Veterans' Affairs hearing on Wednesday, Sept. 5, 2018, on Capitol Hill in Washington.
CARLOS BONGIOANNI/STARS AND STRIPES