No systemic misconduct at Puget Sound VA, local director says

VA Puget Sound Director Michael Murphy said Friday there are no signs of systemic misconduct at the region’s veterans health care facilities, despite data released in July that indicated one-third of Lakewood and Seattle VA hospital schedulers surveyed in an audit were instructed to falsify records about veteran wait times.

At a press conference with U.S. Sen. Patty Murray of Washington, Murphy said an inspector general review hasn’t identified any wrongdoing.

“We have a lot to do here, but generally speaking I have no reason to believe that anyone was told here to misrepresent data,” Murphy said.

He explained the discrepancy between the inspector general review and a Veterans Health Administration audit done this spring. The auditors examined VA hospitals and clinics and surveyed agency staff about whether they were asked to change wait times and keep wait lists off the books.

But Murphy said the survey didn’t specifically ask whether schedulers were told by supervisors to manipulate records; it asked whether schedulers were requested to use a date other than a veteran’s original requested date for a medical appointment. That could include changing an appointment at the request of a patient or a doctor.

Without speaking to schedulers, Murphy said, it’s hard to know the context in which they answered the question.

Regardless, the VA Puget Sound has put the spotlight on schedulers since news broke about VA scheduling irregularities in other parts of the country, he said.

Murphy said he and other VA senior staff have met with schedulers regularly to “create an environment where employees feel psychologically safe” and comfortable reporting any violations of policy.

The Puget Sound VA is not currently meeting a number of performance measures, including the national standard for seeing new patients.

The VA’s expectation is that 99 percent of patients receive care within two weeks of request for an appointment. Locally, the wait time for new primary-care patients is 40 days; for established patients, it is eight days.

Even so, the Puget Sound region has seen a reduction in the number of veterans waiting for primary care appointments. In December, more than 1,500 veterans had to wait three months or more for service. That number is now 86, Murphy said.

Murray, a senior member of the Senate Veterans’ Affairs Committee, said Friday she’s encouraged by the work being done locally to reduce wait times, but added that veterans often need more than just primary care. As wait times decrease in that area, they are likely to increase again as people are referred to specialists, she said.

“The nation, unlike during the Vietnam War, is really behind making sure we take care of our veterans,” she said.

The best way to do that in the Puget Sound region is to increase staff and add space, Murphy said.

He highlighted the work of American Lake staff in Lakewood, saying the South Sound is home to the fastest-growing population of veterans seeking care in the region.

For the last year and a half, American Lake staff have offered extended clinic hours by opening on Saturdays to decrease wait times. Staff there also have volunteered to work overtime, and additional support staff have been hired, Murphy said.

“I give the staff a huge amount of credit because they are the ones that have largely shouldered the burden,” he said.

Murray’s meeting with Murphy and her tour of the Puget Sound campus Friday was the latest attempt to address hard questions about the VA system.

A national audit was launched this year amid allegations that VA hospitals in Arizona and Colorado manipulated data on how long patients waited to see doctors. Some officials suggested “secret waiting lists” were maintained outside normal VA record-keeping systems.

Congress passed a bill at the end of July to help veterans avoid long waits for health care and fix other problems at the Department of Veterans Affairs. Part of the $16.3 billion measure will enable some veterans — including those living more than 40 miles from a VA facility — to receive care from private-sector doctors.

Murray pushed for the 40-mile radius to help veterans in Washington who live in remote areas such as the San Juan Islands.

The bill also included funding to hire more physicians and open more clinics.

The results of the national wait-time audit last month surprised Washington state lawmakers and appeared to contradict statements from top VA officials who previously said Northwest hospitals did not have serious problems with wait-time data being manipulated.

At 33.3 percent, the percentage of VA Puget Sound staffers surveyed who reportedly were told to change the data is far higher than the national average of 13 percent.

Murphy said he didn’t know how many Puget Sound VA employees were surveyed, but it was “not a large number.”