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Audit Reveals Vast Scale Of VA Waitlist Issues


From NPR News, this is ALL THINGS CONSIDERED. I'm Audie Cornish.


And I'm Melissa Block. More than 57,000 veterans are waiting too long for care at the VA. That's the conclusion of a new internal audit released today. It also found that dozens of hospitals have been falsifying data about how long veterans wait for an appointment. A scandal over wait times forced the resignation of VA Secretary Eric Shinseki. And today, the department concluded that its goal to see patients within 14 days is impossible to meet and will be scrapped.

NPR's Quil Lawrence has been reporting on this, and he joins us now. Quil, let's start with those numbers. Fifty-seven thousand vets waiting more than 90 days for an appointment. That sounds like a big number. Can you put it in some context for us?

QUIL LAWRENCE, BYLINE: Sure - and the VA's the country's largest health care system. They see something like 85 million outpatient visits each year. So that number, 57,000, is about 1 percent of the number they are scheduled at any given time. Now that's no comfort to those 57,000 veterans who were waiting for care, but this scandal's really more about the VA lying about how quickly they were seeing patients.

BLOCK: And that's another finding in today's audit, which is that some VA schedulers - the people who make the appointments for vets - said that they felt pressure from their bosses to fake the times on these wait lists. How widespread was that problem?

LAWRENCE: Thirteen percent of the people interviewed for the audits said that they'd been told at some point to make it look like they were seeing people within the 14 day target, when the real wait was three months or more.

This audit covered 731 VA facilities, and in three quarters of them, this was going on. A small number of staff even said that they felt threatened to mess with these numbers and even sanctioned if they didn't.

BLOCK: Quil, we mentioned that the VA has now - abandoning the goal of seeing vets within 14 days. Why is it doing that?

LAWRENCE: Well, the whole point of this 14 day goal was to get a handle on this problem. The issue of long waits at the VA is a decade old at least. And the former secretary - now former secretary of the VA, Eric Shinseki - he tried to put a metric on it, and he set this target of let's try to see people within 14 days, but the goal, according to this VA audit, was impossible to meet. So instead of trying to meet the goal, some VA hospital officials just thought as an incentive to change the numbers so that they could say they were seeing people within 14 days and get their annual performance bonuses, and that's basically the scandal. The VA scrapped that goal so there's no longer a reason to cheat. They also canceled all the bonuses for the Veterans Health Administration this year.

BLOCK: What's at the root of this problem, Quil? Why is it that the VA can't see veterans, or at least this percentage of veterans, in a more timely manner?

LAWRENCE: The number one answer on the audit was that they just didn't have the doctors and nurses with time available. So demand has gone up 50 percent in the past three years for patient visits, and the VA has hundreds of vacancies for primary care doctors. But a senior official today also pointed out that the scheduling program - the software that they have the VA - it dates back to 198, that's before the Internet.

BLOCK: So is the VA doing anything to fix these problems that you've mentioned?

LAWRENCE: Yeah, they said today that they're allocating $300 million to get immediate care to these vets who've been waiting. That could be overtime for VA staff, but also vouchers for private care if they need it. They said that getting these veterans care - the ones who've been waiting - is their top priority. But I should add that this is outpatient care, it's not emergency care. And there's still an investigation into whether some of the veterans who may have died on these waiting lists - if they died because they were waiting on these waiting lists. Some of them were actually getting end-of-life care.

BLOCK: OK. NPR's Quil Lawrence who covers Veterans Affairs for us. Quil, thanks so much.

LAWRENCE: Thank you. Transcript provided by NPR, Copyright NPR.

Quil Lawrence is a New York-based correspondent for NPR News, covering veterans' issues nationwide. He won a Robert F. Kennedy Award for his coverage of American veterans and a Gracie Award for coverage of female combat veterans. In 2019 Iraq and Afghanistan Veterans of America honored Quil with its IAVA Salutes Award for Leadership in Journalism.
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