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A message to veterans from the Secretary of Veterans Affairs

A message to veterans from the Secretary of Veterans Affairs

Department of Veterans Affairs Secretary Eric Shinseki issued a statement Thursday to America's veterans regarding allegations of performance breakdowns in the VA health-care system that have been blamed for preventable patient deaths. The statement is as follows:

Fellow Veterans and Family Members,

After 38 years in The Army, I am now honored and privileged to serve as your Secretary of Veterans Affairs (VA).  VA remains committed to providing the high quality benefits you have earned and deserve.

Allegations of VA employees’ misconduct have surfaced over the last several weeks, beginning with scheduling delays at the Phoenix VA Health Care System. As I testified before Congress on May 15, I take any allegations about patient safety or employee misconduct very seriously.  The reports of Veterans’ negative experiences while seeking VA care are of great personal concern to me. I fully agree with President Obama’s statement on May 21, 2014: “If these allegations prove to be true, it is dishonorable, it is disgraceful . . . .”

In response to these allegations at the Phoenix VA Medical Center and a number of other facilities, the VA Office of Inspector General is conducting a comprehensive, independent review.  In addition to the IG’s independent review, I ordered the Veterans Health Administration (VHA) to conduct a nationwide audit of all other major VA healthcare facilities to ensure understanding of, and compliance with, our appointment policy.  That audit is being conducted now by more than two hundred senior VHA staff.  All teams are independent of the facilities they are visiting.  You and your families deserve to have full faith in your VA, and we intend to earn it every day.

As President Obama made clear to the American people May 21, 2014, “Every single day, there are people working in the VA who do outstanding work and put everything they’ve got into making sure that our Veterans get the care, benefits, and services that they need.”  I echo that praise and commend the hard work and dedication of the vast majority of our VA employees, many of whom are Veterans themselves.  Every year, dedicated employees are prepared to provide care for over 8.9 million Veterans enrolled in VA healthcare.  Every day, VHA conducts approximately 236,000 outpatient healthcare appointments—about 85 million last year.

Since 2009, we have enrolled two million more Veterans in high-quality VA healthcare, reduced Veterans’ homelessness by 24 percent, and provided Post-9/11 GI Bill educational benefits to more than one million student Veterans and eligible family members.  We have opened up new presumptives for Veterans to receive long overdue care for exposure to Agent Orange, for combat-related PTS-D, and for Gulf War illnesses.  And, we have decreased the disability claims backlog by over 50 percent in the last 14 months.  We will meet our goal of eliminating the claims backlog in 2015.

Every VA medical facility is accredited by The Joint Commission, an independent, non-profit organization that ensures the quality of U.S. healthcare through intensive evaluation of more than 20,000 healthcare organizations.  In 2012, The Joint Commission, recognized 19 VA hospitals as top performers, and that number increased to 32 in 2013.

Since 2004, the American Customer Satisfaction Index (ACSI) survey has consistently shown that, on average, Veterans who use VA healthcare award our hospitals and clinics a higher customer satisfaction score than patients give private sector hospitals.  When asked if they would use a VA medical center the next time they need inpatient or outpatient care, 96 percent and 95 percent of Veterans, respectively, indicated they would.  Veterans across the Nation are receiving quality care from VA.  We must encourage other Veterans to seek it.

Notwithstanding these accomplishments, VA will do even better.  If any allegations under review are substantiated, we will act.

As we approach our observance of Memorial Day and its special significance to our Nation, VA is re-doubling its efforts, with integrity and compassion, to earn your trust.

As President Obama said, Veterans have “done their duty, and they ask nothing more than that this country does ours—that we uphold our sacred trust to all who have served.”

And, we will.

More in Veterans Health Center

 

MDCapps

May 30, 2014 - 8:41am

These issue's have been known and reported years ago. Yet nothing was done! Time to bring in new leadership.

Amy H

May 29, 2014 - 6:03pm

With all due respect, Mr. Shinseki, you let similar stuff happen at Walter Reed when I was stationed there in the two years before your retirement from the Army. It's time for you to retire and stop double-dipping - and let someone who's actually worked with veterans take over.

Ted V. Miller

May 29, 2014 - 1:48pm

72 year old Vietnam Veteran. I have received excellent and prompt care from the VA health system. The problem with the health care system as far as I can see is mid management, not at the top.

David Dean

May 27, 2014 - 5:05pm

Let's not lose focus here. The real issue is undue delays in veterans receiving health care, not the political "scandal" of a few mid-level administrators cheating the 14 day appointment tracking. They should all be fired no ifs, ands or buts. While some politicians moan and wail about the local scandals, many of them voted against the recent bill to in improve veterans' benefits (to include new VA clinics). Their stated reasons for voting against it were 1; they weren't allowed to amend it to include new sanctions on Iran, and 2;it would cost $27 billion that they simply refused to pay for. The VA has more demand than ever between baby boomers retiring (without health insurance) and returning Gulf/Iraq/Afghanistan vets. VA Primary care appointments are up 20%, but the number of doctors to see them is only up 9%. The VA needs BOTH more resources and better accounting. Personally, I have been very impressed with the care I recieve, but not the wait times. I had my new doctor spend 55 minutes straight with me just last week going over my blood work and medical history. I have NEVER had a private doctor spend even 30 minutes with me even when I was there for a serious condition. Private doctors run from room-to-room simply so they can bill for a ridiculous number of 'visits" each day. They are in a race to get their first million, then ten million, and on and on...

DaMadOne

May 27, 2014 - 10:33pm

Glad to hear you found a good Dr at VA and not afraid to do lab work. Not sure of your age or disabilities if you have any but you may notice a change in that as you get older. As far as the private practice Dr not spending 30 mins with you in the private practice you can always go to a different Dr. It's like I always have said and it applies to both VA and private practice Dr's is that there are both good and bad in both the VA and private practice. I also agree with you with regards to the politicians as in regards to both parties it happened during their watch and not just with the current administration. Speaking of which I checked one of the vacancy posting websites and VA currently has more then 1000 vacancies in different medical professions. There is more cheating then just a few administrators and tracking appointments let alone only doing in house surveys from people using VA health care. There's also the rationing of care in the form of lab work and other things as well as problems with the procurement system. I do know who ever holds the office of secretary will not be able to make adequate decisions if all of the info they are fed is inaccurate or sugar coated. Not sure how many left the VA medical system and refuse to go back but I think the secretary should hear from them. There is also the issue of patients that complained being pushed to the side as well as employees that tried to change things for the better and bring to management's attention as well. Everyone points to the VA as a single payer system and forgets there is another one that does seem to work pretty well. The second system I am referring to is the dod medical system. I know there are also bad stories here and there but my personal experience is that is where I received the best treatment ever both as a military brat and active duty. The difference between DOD and VA is DOD eliminates the bad actors and can reassign the specialties where the demand is needed most. Not sure when you came off active duty but it wasn't that long ago that retired vets were treated at active military posts.

Highly Upset

May 27, 2014 - 3:08pm

This should have NEVER happened in the first place! All I see when I watch TV are politicians from the president on through congress wearing flag pins. That's a load of BS. There's not one of us out here in the veteran ranks who give a CRAP about who is wearing a darn flag pin! We did our duty for king and country and now they treat us like 4th class garbage? No way man! No way! It's like they all go brain-dead up there in Washington. Every veteran should have high-quality medical care, access to free or greatly discounted prescription medication (No matter how much money we make today. I don't recall the recruiter asking ME how much money I made when I enlisted. Why does it matter now?)

Edward Peruta

May 24, 2014 - 11:22am

IN THE APPEAL OF C REDACTED REDACTED DOCKET NO. 11-21 722 ) DATE 4 APR 2014 ) ) On appeal from the Department of Veterans Affairs Medical Center in VA Connecticut Health Care System THE ISSUE Whether the October 15, 2009, denial of eligibility for a fee basis medical identification card was proper. REPRESENTATION Veteran represented by: Rachel M. Baird, attorney WITNESS AT HEARlNG ON APPEAL The Veteran ATTORNEY FOR THE BOARD Laura E. Collins, Associate Counsel IN THE APPEAL OF C REDACTED REDACTED INTRODUCTION The Veteran had active service from August 1966 to August 1969, including service in the Republic of Vietnam, for which he earned a Combat Action Ribbon. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a decision of the Department of Veterans Affairs (VA) Connecticut Health Care System (HCS). On October 15, 2009, the HCS discontinued the Veteran's fee basis outpatient identification card. In July 2012, the Veteran testified before the undersigned Veterans Law Judge sitting at the Central Office in Washington, D.C. A transcript is of record. FINDINGS OF FACT 1. The Board has jurisdiction to review the October 15, 2009, decision by HCS. 2. The Veteran was originally granted fee basis outpatient treatment due to "other extenuating circumstances for hardship;" namely increased agitation, anxiety, and anger when visiting VA facilities. 3. A psychiatrist has reported and the record shows that since the original grant of fee basis eligibility, V A has not been capable of providing the care or service required due to these extenuating circumstances. 4. The October 15, 2009, denial of eligibility for a fee basis medical identification card was improper. CONCLUSION OF LAW The criteria for restoration of a fee basis medical identification card are met, effective October 15,2009. 38 U.S.C.A. §§ I I 54(a), 1703,5107 (West 2002 & Supp. 2013); 38 C.F.R. §§ 3.102,17.52 (2013). - 2 - IN THE APPEAL OF C REDACTED REDACTED REASONS AND BASES FOR FINDINGS AND CONCLUSION When V A facilities or other government facilities are not capable of furnishing economical hospital care or medical services because of geographic inaccessibility or because they are not capable of furnishing care or services required, V A may contract with non-VA facilities to provide the appropriate care. 38 U.S.C.A. § 1703 (West 2002); 38 C.F.R. § 17.52 (2009). In Meakin v. West, 11 Vet. App. 183 (1998), the United States Court of Appeals for Veterans Claims (Court) determined that the Board had jurisdiction to review a determination by a VA Medical Center that denied eligibility for fee basis outpatient treatment for service-connected disabilities. The Court noted that in determining whether a claimant would be eligible for fee basis outpatient medical care, a claimant must be a veteran seeking treatment for a service-connected disability, and VA facilities must be either (1) geographically inaccessible or (2) not capable of providing the care or services that the claimant requires. The Court stated that with regard to the latter factor, the determination of whether a VA facility is capable of furnishing specific care or services does not involve a medical determination, nor does it involve the question of the "need for and appropriateness of specific types of medical care and treatment," as contemplated by 38 C.F .R. § 20.10l. Meakin, II Vet. App. at 187. Thus, as a general matter, the Board may eview a claim for eligibility for a fee basis medical identification card that would authorize payment for medical services for outpatient treatment outside the VA healthcare system. Service connection is currently in effect for: posttraumatic stress disorder (PTSD) rated 100 percent disabling; coronary artery disease rated 30 percent disabling; residuals of rotator cuff injury to the right shoulder rated 10 percent disabling; tinnitus rated 10 percent disabling; and hearing loss of the left ear rated noncompensably disabling. As he is seeking fee-basis service for all of his service connected disabilities and his PTSD disability is rated 100 percent disabling, he meets the criteria for receiving fee basis medical services. 38 C.F.R. § 17.52(a). The fact that HCS facilities are geographically accessible is uncontested. - 3 - IN THE APPEAL OF C REDACTED REDACTED Consequently, the Board must determine whether the HCS is capable of providing the medical treatment the Veteran needs. 38 C.F.R. § 17.52(a). The Veteran was originally granted fee basis psychiatric care based on an October 1986 referral. That referral states that the services are justified by "other extenuating circumstances for hardship" and specifies, "Veteran is 100 percent service-connected for PTSD. He becomes [highly] agitated, [with increased] anxiety, and [increased] anger when at the VA Hospital." The Veteran was originally granted fee basis care for all other service-connected disabilities based on a December 1990 referral. That referral is also based on extenuating circumstances for hardship, listing three reasons: "in-house patient management situation (behavioral)," "patient becomes extremely tense coming into VA hospital," and "cannot deal with coming in to hospital." The physician signing the referral recommended and approved "any and all medical not just PTSD." (Emphasis in original. ) The Veteran remained eligible for and used the fee basis medical identification card until he was notified in June 2010 that it had "expired" on October 15,2009. He contends that the extenuating circumstances for which the fee basis card were granted are unchanged, and a medical opinion from psychologist Dr. Johnson supports this contention. Dr. Johnson was a psychologist at the West Haven VA Medical Center (part of the HCS) for 17 years, but did not have any knowledge of or interactions with the Veteran during that time. He later treated the Veteran as a private psychologist from September 2004 to April 2005. Based on a thorough psychological evaluation conducted in June 2012, a review of the Veteran's medical records, his own treatment of the Veteran, and his background, Dr. Johnson opined that the Veteran has lost any semblance of trust in the VA, based largely on a traumatic combat experience in Vietnam and then expanded over the years as he conflicted with VA personnel. There is no way, ever, that he will accept services at V A facilities and doing so will create tremendous stress for him. If there was ever a Veteran I have met who requires fee basis, it is this one. Denying him fee basis will be detrimental to his health. - 4 - IN THE APPEAL OF C REDACTED REDACTED (Emphasis added.) Dr. Johnson recommended that the Veteran be given fee basis status for "any and all medical conditions that he would normally be qualified for as a Veteran." Dr. Johnson's report is consistent with the evidence of record, which shows a long history of a hostile relationship between the Veteran and VA and documents the Veteran's mistrust of VA. There is no evidence that these extenuating circumstances have changed since October 1986 or December 1990. There is no evidence of record in conflict with Dr. Johnson's report or the Veteran's lay evidence in this regard. The claims file reflects that no solution has been found to the lack of trust issue. As such, the Board finds that since the original grants of fee basis treatment in October 1986 and December 1990, VA has not been capable of providing the care or service required. Accordingly, the October 15, 2009, denial of eligibility for a fee basis medical identification card was improper. Therefore, the Veteran is eligible for and entitled to a fee basis medical identification card for any and all medical treatment for which he would normally be qualified as a Veteran. ORDER Restoration of entitlement to a fee basis medical identification card is granted. MICHAEL E. KILCOYNE Veterans Law Judge, Board of Veterans’ Appeals - 5 -

AC

May 23, 2014 - 10:54pm

They need to put someone who was an enlisted man when he was in the service. Put a retired Chief Master Sergeant or a Gunnery Sergeant as VA Secretary and they WILL kick ass and get things done. After all, it was, and is, the enlisted man who knows how to get things done.

ginbailey

May 23, 2014 - 2:29pm

its not only pheonex here in mi. it took only 2 days to get in to see doc but only blood test taken.The isues I went in for was told to be quiet and that is all for today.Next appointment eleven months.so I deal with this pain for 11 more months.My out of va doc wont touch the problem for fear of backlash.What are we to do go get x-ray and go tio pt O.K but nobody writes a referral.So do I guess what to do or suffer 11 months and do it all over again

Kevin Blackshear

May 23, 2014 - 1:33pm

Gen. Shinseki is now just another pompous, arrogant, beaurocratic windbag. He's shown no leadership during his entire tenure as SecVA. And then it takes 27 days for the Obama administration to even acknowledge there is a problem! I've been retired from the Navy for over 10 years, and the access to and the quality of healthcare from the VA had gotten worse and worse. Especially if you are NOT an OIF/OEF veteran. This is why I have switched to TriCare Prime and receive my care at SAMMC in San Antonio. We have been very impressed with the care and service there. Congress needs to hold the ENTIRE Veterans Administration accountable for this egregious scandal, the better question would be: who needs to go to jail over this?

cowboyup

May 23, 2014 - 2:37pm

I'm an OIF Veteran Kevin. Trust me, we are not getting 1st class treatment. In fact Sir, I'm actually going in for a Cancer screening outside the Tucson VA who should had done this 2 years ago. Clinical Staff treating me as if I've been branded like cattle. I have a recorded message from one of their nurses two weeks ago that will make you sick to your stomach on how they talk to me. Its disgusting. I have written Shinseki several times in the last 5 years about appointments, their treatment of Myself as a Veteran, how the ratings board was caught lying to me on the phone and two weeks later to my D.A.V. Representative. I have never, ever got one response. Nor any response from American Legion who are now my P.O.A.'s and have already told me to seek out another organization for help. Yes, American Legion Rep. has already told me to seek help some where else. You see Kevin it's everyone....not just some.

irishbob

May 29, 2014 - 6:53pm

Hi cowboyup,you need to get in touch with the national HQ for the legion,I can tell you from experience that,I have had nothing but good results from my branch of the legion,the VA lost my records 3 times,and then denied me services,because they lost my records,I turned to the legion,and they went after them,along with my Congressman,sorry to hear that you are having trouble brother,and welcome home.

SGT John T

May 29, 2014 - 11:43pm

Thanks Irshbob, I actually wrote 3 letters to Commander Dellinger and he has never responded back. My A.L. Rep. told me last month to go look for help somewhere else when I caught him lying to me. So as much as I would like to get Anyone at this point to help me. I'm stuck with American Legion as my P.O.A's. As an OIF Veteran I hung up the phone with my A.L. Rep. I felt hopeless, knocked down hard, and I felt like I just didn't even want to exist. However if it wasn't for my awesome wife/caregiver I probably would had done something stupid. Veterans are treated like cattle and then branded for being a rightful voice. But, we are the good ole boys when were out there in combat zones. Get hurt, your screwed. How sad to be told by an American Legion Rep. to go find someone else to help me. Theres another problem us Veterans are dealing with besides health care.

concerned veteran

May 22, 2014 - 11:12pm

Near the VA near me, myself along with other veterans are being given blood tests in our appointment logs...so I'm wondering if these are being counted as appointments for the purposes of counting a appointment for veterans? There is also a chart check labeled in the appointment log but it doesn't require the veteran to be at the location, was told it's simply for the nurse to check the charts. Seems shady to me. Thoughts?

Jo Sissel

May 25, 2014 - 11:33am

Lab/blood work appointments are 'nc' non count and do not count as a provider appointment.

ginbailey

May 23, 2014 - 2:31pm

your right brother they do a blood test and ignore the problem your in for hopping you will just not come back that's why appointments are set for a year follow up

cowboyup

May 22, 2014 - 11:27pm

Never thought about that. But your right, it does count as an appointment. Once your card is swiped your at an appointment.. Maybe this is how their hiding appointments. Glad you mentioned this concerned Veteran. I have a few people in the Tucson VA who want to keep their jobs yet they will give me information as needed pertaining to my issues only of course. Thank You. HOOAH!!!!!!

Jo Sissel

May 25, 2014 - 11:39am

No Cowboyup the lab appointments are NOT considered appointments, they are 'nc' non count appointments. Been in the system 27 years as a nurse and know the "rules". Unfortunately, I hear what you are saying. You are welcome to contact me privately on FB. mamajo,

cowboyup

May 25, 2014 - 8:38pm

Well Jo Sissel according to what I have been going through lately with this VA I'm not sure who to believe anymore. It's disgusting at times. However, there are real good nurses in the system. But when an Administrator starts getting involved in the quality of care in a negative way. Thats where it hurts me. When I am oredered to come in by a clinical nurse to do "Labs" . That is considered an appointment or I'm not getting my medications according to them. You should hear some of these messages this nurse leaves on my cell phone. I worked the VA myself on Surgical Floor and would never ever talk to a Veteran the way I'm talked at. Everyone once to call the code green on patients only because they have no clue what the hell these, (WE) have gone though. Were branded when voicefull. Yet all we want is someone to listen.....seriously stop, and listen. You will be surprised how quickly things settle by just that. I have a Cancer Screening on the 4th of next month which should had been done by the VA 2 years ago. Yet my wife put her foot down and said enough is enough and now seeing a specialist in Tucson. But thank You Jo. I bet your a great nurse....27 years is a good thing.

DaMadOne

May 22, 2014 - 7:32pm

My god the man still does not get it. He now sees the info he was getting with regard to delay times was skewed and inaccurate as heck. Take note: Since 2004, the American Customer Satisfaction Index (ACSI) survey has consistently shown that, on average, Veterans who use VA healthcare award our hospitals and clinics a higher customer satisfaction score than patients give private sector hospitals. He basing his opinion on only those that are using the system. Those surveys are conducted onsite with people that are using the system yet he's made no effort to contact the ones that got out of the system and refuse to go back. Of the 9 years when I was going on a regular basis I was never asked about filing any sort of survey. No more needs to be said.

cowboyup

May 22, 2014 - 7:02pm

Seriously !!!! ??? HAHAHAHAHa......Decreased the Disability Ratings Back Log by 50% my ass. I've been back and fourth with the Phoenix Ratings High Brass Official's since 2008 on a service connected Apnea. They have been paying me as a single Veteran knowing I'm married. I have recorded conversations of high brass in Phoenix Ratings office telling me they have all documents in their data and will get it processed. Two weeks later while in D.A.V. the same guy told my Rep he didn't have anything in his data. I also have recordings of a call center employee telling me "because I have 5 volumes of medical records, no one in the Phoenix Ratings Office ever bothered to dig that deep so they denied you". If the VA Secretary would read his letters I had sent him for the last 5 years he would know exactly what the hell I'm talking about. Thank You For Your Service Letters is all I fricking get from Phoenix. How dare you say all is going better with the wait times. And switching to "Provisional Ratings" is going to hurt all Veterans. But I bet you won't tell them why, so I will. Ok Veterans/Brother's and Sisters. Lets say your claim is rated at 10% now your not happy and begin sending in more information they request. It goes through the "Provisional Rating Scale" Now your approved and are getting 60%. Here is the what the Veterans Administration will not tell you. If for some reason can't get other documentation or your provisional rating is up for another decision, The VA Raters can lower your rating after paying you 60% for ....lets say 3 years. Guess what? The Veterans are stuck with a bill at 50% and it will come out of your 10% until its paid off. Now, is this what you would call "Fair Ratings'? Or a cheap washout by Mr. Secretary trying to make it look like backlogs are getting caught up. However, Its all a big lie, scandal, and all these people see are right through you, when they use to look at us and truly be grateful for our sacrifices. God Help Our Veterans. God Help Our Current, and Future Soldiers. I think I'm now ready to give all I have to the media. I'm tired, getting sicker by the day knowing were all dying just waiting for benefits. And Fair Ratings. The Veterans Administration should really change their Motto.

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