Even the Department of Veterans Affairs cannot trust its own numbers on delivering health care and processing disability claims, the acting secretary of the agency said as he asked for $17.6 billion in new funding Wednesday.
Sloan Gibson repeatedly acknowledged during a Senate Veterans' Affairs Committee hearing that serious problems with “data integrity” have been revealed though a series of investigations into falsified patient wait times at VA medical facilities.
Gibson also acknowledged similar concerns about the reliability of agency numbers that track backlogs and errors in claims for disability benefits, which were challenged recently in reports from the agency's inspector general and the Government Accountability Office.
“We understand the seriousness of the problems we face,” Gibson told the Senate committee. “We own them. We are taking decisive action to begin to resolve them.”
Gibson became acting VA secretary in May, when the former head of the agency, Eric Shinseki, resigned under intense pressure amid revelations that medical appointment lists were being falsified to hide long wait times.
The inspector general has confirmed the “systemic” use of phony appointment lists and other tricks to make it appear patients were being seen within agency time limits so top managers could meet their performance goals and qualify for merit bonuses.
The ongoing investigation by the IG, which began with reports of a secret appointment list used to hide delays in Phoenix, has now been broadened to encompass at least 77 facilities nationwide.
Gibson listed a series of failures that have shattered his agency’s credibility with Congress, the public and veterans.
|At this point I would say no, I can't trust those numbers.|
Patients are waiting too long for care, Gibson said.
Manipulation of medical appointment lists to hide delays was “widespread, including deliberate acts to falsify scheduling data,” he said.
“As a consequence of all these failures, the trust that is the foundation of all we do has eroded,” Gibson said. “We will have to earn that trust back through deliberate and decisive action.”
To fix those problems, Gibson said he has focused on getting patients off of wait lists and into clinics. In the last two months, VA has referred more than 543,000 veterans to private medical providers, an increase of about 91,000 from a comparable period last year, he said.
Administrators who falsified data will be disciplined, Gibson said, adding he expects to receive recommendations for the first round of disciplinary actions by the end of the week.
Gibson also said he has made it clear whistleblowers who expose agency impropriety will be protected, and managers who retaliate against them will be disciplined.
The new money Gibson is asking for will be used through the 2017 fiscal year to hire additional doctors and expand space to treat patients, thousands of whom have been left without care on phony waiting lists, Gibson said.
About $10 billion would go toward hiring 10,000 new medical professionals, including 1,500 doctors. It also will be used in the short term to pay for care from private doctors to clear out backlogs uncovered since the scandal over phony wait lists emerged in April.
Another $6 billion is needed for new medical facilities, Gibson said.
There are currently about 2,000 positions for health care workers that are funded but unfilled at VA, including about 400 vacancies for doctors.
The Government Accountability Office also said in a recent audit that cost overruns at four major construction projects total $1.5 billion, and they are, on average, 35 months behind schedule.
The VA's current-year budget is about $154 billion. The budget request for next fiscal year, which begins in October, would raise that by $10 billion.
The additional $17.6 billion would be a stop-gap measure to make up critical shortfalls in care that have been identified in ongoing investigations, and begin correcting shortfalls in staff and facilities that led to the backlogs, Gibson said.
While most of the hearing focused on health care, Sen. Richard Burr, R-N.C., also questioned VA's assertion that it is dramatically reducing the backlog of disability claims from veterans seeking compensation for service-related medical conditions.
During a House hearing Monday, Linda Halliday, assistant VA inspector general, said she did not trust the agency's numbers on processing times or accuracy.
Recent investigations have found instances of data manipulation, such as entering newer dates on old claims to make it appear they were processed more quickly, Halliday said.
When asked whether she trusted VA’s statistics showing a 55 percent reduction of older claims in the last year, Halliday replied, “At this point I would say no, I can’t trust those numbers.”
What incensed Burr was a press release issued the next day in which VA officials continued to repeat the statistic and claimed an accuracy rate of more than 90 percent.
“How does publicizing suspect data increase the integrity and the trust?” Burr asked.
Gibson said improvement in processing disability claims has been “amazing” but acknowledged there are problems with the statistics that were identified by outside investigators.
“There is room to improve there, I got it,” Gibson said. “We’ve got to restore trust. We need to make sure the data integrity is there. But I’m not going to pull back from standing by that department and the good work that’s been done.”
That didn’t satisfy Burr.
“It strikes me that you could have testimony like we had Monday night and yet turn around and put out a press release still stating the same numbers the next day, when every one of the investigators found that those numbers couldn’t be trusted,” Burr said.