Thursday, August 27, 2009

$70 million project but veterans still waited

When I write/talk about what went on over the last eight years, how there are some people in this country deciding they didn't want to talk about it, I have been deadly serious. This should have never, ever gotten as bad as it did and it wouldn't have if everyone in this country actually acted like adults, valued truth over spin and maybe spent some time tuning into CSPAN to actually find out what was really going on.

Now think of this. All this money allocated, veterans wait even longer and who was in charge when all of this was happening? Read this and if your blood is not boiling, then keep reading.

Report: No oversight for $70M program at VA

By Kimberly Hefling - The Associated Press
Posted : Thursday Aug 27, 2009 17:22:40 EDT

WASHINGTON — The inspector general for the Veterans Affairs Department says that agency managers were aware of serious problems with a $70 million project to replace its hospital appointment system several years before the VA dropped the program.

The VA announced the project in 2000 after complaints from veterans about long waits to make appointments. It was halted this year.

The inspector general says that managers didn't take timely and appropriate action to address problems, even as millions more were put into the program.

VA Secretary Eric Shinseki has since ordered improvements in the VA's information technology management. But the IG says that the VA still needs more qualified staff.

But 2003 there was still a huge problem going on.

H.R. 3094, the “Veterans Timely Access to Health Care Act”
H.R. 3094 would establish standards of access to care within the VA health system. Under the provisions of this legislation, the VA will be required to provide a primary care appointment to veterans seeking health care within 30 days of a request for an appointment. If a VA facility is unable to meet the 30-day standard for a veteran, then the VA must make an appointment for that veteran with a non-VA provider, thereby contracting out the health care service. The legislation also requires the Secretary of the VA to report to Congress each quarter of a fiscal year on the efforts of the VA health system to meet this 30-day access standard.

Access is indeed a critical concern of PVA. The number of veterans seeking health care from the VA in recent years has risen dramatically. Since 1995, the number of veterans enrolled in the VA has risen from approximately 2.9 million to more than 5 million. Despite the Secretary’s decision to close enrollment of Category 8 veterans earlier this year, the numbers of enrolled veterans only continues to increase as we begin adding new veterans from the war in Iraq and Afghanistan.

Unfortunately, VA health-care resources do not meet the increased demand for services and the system is unable to absorb this significant increase. With tens of thousands of veterans on a waiting list, waiting at least six months or more for care, VA has now reached capacity at many health-care facilities and closed enrollment to new patients at many hospitals and clinics. Additionally, VA has placed a moratorium on all marketing and outreach activities to veterans and determined there is a need to give the most severely service-connected disabled veterans a priority for care.

To ensure that all service-connected disabled veterans, and all other enrolled veterans, are able to access the system in a timely manner, it is imperative that our government provide an adequate health-care budget to enable VA to serve the needs of veterans nationwide. Access standards without sufficient funding are standards in name only. PVA is concerned that contracting health care services to private facilities when access standards are not met is not an appropriate enforcement mechanism for ensuring access to care. As we stated with regard to H.R. 2379, paying for contract care out of an already inadequate VA health care appropriation draws even more resources away from the funds needed to pay for VA’s core services. Likewise, contracting out to private providers will leave the VA with the difficult task of ensuring that veterans seeking treatment at non-VA facilities are receiving quality health care. We do think that access standards are important, but we believe that the answer to providing timely care is in providing sufficient funding in the first place in order to negate the impetus driving health care rationing. For these reasons, PVA cannot support H.R. 3094.

PVA appreciates the efforts of this Committee to ensure that veterans receive timely access to care. However, we must emphasize that the VA will continue to struggle to provide timely access without adequate funding provided by this Congress. We look forward to working with this Committee to ensure that veterans not only receive timely access to care, but high quality care as well.
PVA would like to thank you for the opportunity to testify today. I would be happy to answer any questions that you might have.
read more here
Oh but that's not all. While some people in this country were fully supporting their elected just because they said they supported and cared about veterans, this is what was going on.

This was from 2005.

Snapshot of How VA Budget Shortfall is Hurting Veterans’

Access to Safe and Timely Care across the Nation

The VA claims that by shifting funds dedicated to replace old equipment and conduct maintenance the department can address its budget shortfall and meet veterans’ demand for timely, high–quality health care. The following snapshots from across the nation reflect the stark reality of the budget shortfall on veterans’ access to safe, high quality care.

The 3 surgical operating rooms at the White River Junction VAMC in Vermont had to be closed on June 27 because the heating, ventilation, and air conditioning system was broken and had not been repaired due to the siphoning of maintenance funds to cover the budget shortfall.

The VAMC in San Antonio could not provide a paraplegic veteran with a special machine to help clean a chronic wound because the facility did not have the equipment dollars.

The VAMC in Lebanon, Pennsylvania, closed its Geriatric Evaluation and Management Unit which does extensive case management to help elderly veterans increase their functioning and remain at home.

The Community Based Outpatient Clinics (CBOCs) needed to meet veterans’ increased demand for care in the North Florida/South Georgia VA Healthcare System have been delayed due to fiscal constraints. The Gainesville facility has made progress in reducing its wait lists, but as of April there were nearly 700 service-connected veterans waiting for more than 30 days for an appointment.

VA Medical Centers in VISN 16, which includes Arkansas, Oklahoma, Mississippi and Louisiana and part of Texas, have stopped scheduling appointments for many veterans who are eligible for care, pending available resources.

Even though the VA Palo Alto, California, Health Care System has used $3 million in capital funds for operating needs, as of March 1 more than 1,000 new patients had to wait more than 30 days for a primary care appointment. A third of these new patients had to wait more than 3 months. More than 5,000 patients had to wait more than 30 days for a specialty care appointment. Roughly 1,400 had to wait more than 3 months.

The replacement of the fire alarm system at the Loma Linda VAMC in California won’t be done this year because the facility is using most of its capital funds to cover operating expenses.

The White River Junction VAMC in Vermont struggling with a $525,000 shortfall in its prosthetics budget.

Because the FY 2005 budget is inadequate, the facility has not been allowed to hire 3 additional mental health care staff and 3 additional Registered Nurses for the ICU. Nurses in the ICU have been forced to work double shifts, which this Committee has found to be an unsafe patient practice.

Even though the San Diego VAMC expects to exceed its goal in medical care cost collections, it will divert $3.5 million of non-recurring maintenance funds to partially cover operating expenses, and has delayed filling 131 vacant positions for 3 months. The facility has a waiting list for patients of 750 veterans.

Because the Iowa City VAMC had to shift maintenance funds and equipment funds to cover a FY 2004 million shortfall of $3.2 million in medical care expenses in FY 2004, the facility is facing severe infrastructure problems and a larger shortfall of $6.8 million in FY 2005 that puts patient care and safety at risk. The facility wanted to spend $950,000 in non-recurring maintenance funds last year to prevent a mechanical failure of the electrical switcher, which would close the facility, but was required to use those funds to cover a budget shortfall in medical care last year. As a result in FY 2005, the VA must divert $1.5 million of medical care funds to maintain the key electrical switchgear for the hospital.

Recently, a motor failed on a hospital bed, which the VA planned to replace but couldn’t because of the shortfall, causing a fire with the patient on the bed. Fortunately the patient was able to get out of the bed safely, but the facility was forced to expend $700,000 of medical care dollars to replace all the beds, which thanks to the diligence of VA staff lasted 7 years beyond their life expectancy. The facility could not use capital funds to replace the very old beds because the money had already been siphoned off to cover medical care.

To bring the shortfall down to $6.2 million the facility has delayed hiring staff for 4 months. The deliberate short staffing of nurses on the psychiatric ward – as a means to correct the budget shortfall -- has forced the VA to cut the beds available for treatment in half.

As a result of cost cutting measures to make up for the shortfall in FY 2005, the Portland, Oregon, VAMC is delaying all non-emergent surgery by at least six months. For example, veterans in need of knee replacement surgery won’t be treated because of the budget shortfall.

Since FY 2002, the Portland VAMC has had to use its equipment and non-recurring maintenance funds to cover medical care expenses. For FY 2005 the facility needed $13 million for medical and clinical equipment but only received $2 million.

The facility is reducing staff as a cost-cutting measure and is now short at least 150 hospital staff, including nurses, physicians, and social workers. As a result of budget cuts for staffing, the VA has cut the number of medical beds available to care for veterans.

Veterans in need of outpatient psychiatric treatment at the Portland facility are on a waiting list because of the budget shortfall.

The Biloxi, Mississippi, VAMC has diverted maintenance dollars to meet operating expenses for the past two years but the facility will not be able to balance its budget without reducing staffing levels at a time when the Gulf Coast Veterans Health Care System has approximately 100 new veterans seeking enrollment each week.

Fifty percent of all the veterans receiving home health care through the San Antonio VAMC will now have to fend for themselves. This cost-cutting measure means that some 250 veterans, including those with spinal cord injuries, will no longer be provided this care.

The VA Connecticut Healthcare System is facing a major budgetary challenge of sending veterans to non-VA facilities for hospitalizations because the VA has a shortage of beds to care for veterans and staff.

Due to the budget shortfall, the VA facility in Bay Pines, Florida, has been forced to put veterans who have a service-connected illness or disability rating of less than 50% on a waiting list for primary care appointments. As of late April, some 7,000 veterans will be waiting longer than 30 days for a primary care appointment.

Prepared by the Democratic staff of the House Veterans’ Affairs Committee

Now put it all together and then try to remember a time when you heard about any of this on cable TV show you watch or the talk radio show you listen to. They thought you'd never find out. So are you finally getting the message that all of these false outrages are cover ups from people that just don't care about veterans but do care about power? As bad as these reports are, it only got worse. Do you still want to defend Republicans or Democrats no matter what they've done or do you now plan on defending veterans?

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