VA watchdog sits on wait-time investigation reports for months

WASHINGTON — After the Veterans Affairs wait-time scandal erupted nearly two years ago, the department's chief watchdog investigated 73 VA facilities across the country and found scheduling problems in 51 cases.

But that watchdog — the VA's inspector general — still has not released reports with the findings of those investigations to Congress or the public.

As a result, it’s impossible to tell which medical centers had problems, how serious those problems were, or whether they led to the deaths of any veterans. The inspector general has said only that they range from simple rule violations to deliberate fraud.

In Delaware, the inspector general found cases of improper scheduling at the Wilmington VA that led to disciplinary action months ago. But Democratic Rep. John Carney said he's still trying to figure out exactly what went on at the facility.

“I’m outraged that we still haven’t received the inspector general’s report,” he told USA TODAY last week. “The investigation began almost two years ago and we can’t address the problems when we don’t know the full picture.”
After repeated inquiries and a Freedom of Information Act request from USA TODAY, the inspector general's office said it will release the reports “shortly.”

Catherine Gromek, a spokeswoman for the office, did not say why the investigative reports were shared only with the VA but suggested the inspector general did not want to disrupt potential disciplinary actions by the VA.

But that doesn’t explain dozens of cases in which the VA says no discipline was imposed.

Acting Inspector General Linda Halliday pledged greater transparency after former interim Inspector General Richard Griffin stepped down in July amid criticism of secrecy. USA TODAY had found the office had withheld from the public the results of 140 health-care investigations, including cases in which veterans were harmed or died.
In one case, the inspector general failed to release a report about potentially dangerous prescriptions being doled out at a VA hospital in Wisconsin in 2014. VA officials didn't fix the problem, and five months after the report was completed, veteran Marine Jason Simcakoski, 35, died from a fatal mixture of drugs prescribed at the hospital. The VA didn't correct the prescribing practices until his death became public last year.

“The only way that the VA will do anything is if there’s media attention and public pressure," his widow, Heather Fluty Simcakoski, said last week. She said she's “appalled” the wait-time reports still haven’t been released.

In December, President Obama signed legislation requiring the VA inspector general to release investigative reports within three days of completion.

But it's been months — in some cases possibly more than a year — since the VA wait-time reports were completed. Gromek, the inspector general’s spokeswoman, refused to say when the reports were finished. According to congressional testimony, all were completed before Dec. 9.
Gromek said the new law applies only to "issued" reports that include recommendations based on the findings.

“The reports of (wait-time) investigation are not issued and do not make a recommendation or suggest a corrective action,” she said. “We transfer our findings to VA’s Office of Accountability and Review (OAR) for any administrative action they deem appropriate.”

She said Halliday has always intended to release the reports, and her office is now scrubbing personal information from them.

“This is an extensive, meticulous, and time-consuming process,” she said. “Once we are satisfied that we have met these obligations, we will finalize and issue the work product and release it publicly.”

Sen. Tammy Baldwin, D-Wis., who co-authored the legislation requiring release within three days, said that’s “unacceptable.”

“There is a bipartisan commitment in Congress to fix problems at the VA, but we need better transparency from the Office of Inspector General,” she said.

Rep. Jeff Miller, R-Fla., chairman of the House Veterans' Affairs Committee, said that when the inspector general’s office completes a report, it should be released to the public without delay.

“VA’s challenges will only fester if they are kept shrouded in secrecy,” he said.
Federal law requires the inspector general's office to independently investigate fraud, waste and mismanagement within the VA and to keep Congress — and therefore the public — “fully and currently informed” about its findings.

VA officials asked the inspector general in June 2014 to investigate 111 medical facilities where an audit — conducted after the wait-time scandal at the Phoenix VA — found potential scheduling manipulation. Those facilities, located in 37 states and Puerto Rico, range from small outpatient clinics to large hospitals.

In August 2014, the inspector general released a report on the Phoenix facility, where at least 40 veterans died awaiting care. That report noted instances of wait-time manipulation the inspector general was finding elsewhere, including cases of VA staffers keeping paper wait lists or inputting the next available appointment dates as “desired” dates so the system would show no wait time.