Acting Secretary Gibson Outlines Problems, Actions Taken, and Budget Resources Needed to Ensure Access to Care

In testimony before the Senate Committee on Veterans’ Affairs, Acting Secretary of Veterans Affairs Sloan D. Gibson outlined serious problems regarding access to healthcare and key actions the Department of Veterans Affairs (VA) has taken to get Veterans off wait lists and into clinics.

 “The trust that is the foundation of all we do – the trust of the Veterans we serve and the trust of the American people and their elected representatives –has eroded,” said Acting Secretary Gibson.  “We have to earn that trust back through deliberate and decisive action, and by creating an open and transparent approach for dealing with our stakeholders to better serve Veterans.”

Gibson discussed six key priorities to begin restoring trust: 

1. Get Veterans off wait lists and into clinics; 
2. Fix systemic scheduling problems; 
3. Address cultural issues;
4. Hold people accountable where willful misconduct or management negligence are documented;
5. Establish regular and ongoing disclosures of information; and,
6. Quantify the resources needed to consistently deliver timely, high-quality healthcare.

Gibson testified that VA needs approximately $17.6 billion in additional resources to meet current demand for the remainder of FY 2014 through FY 2017.  This funding would address challenges such as clinical staff, space, information technology, and benefits processing necessary to provide timely, high-quality care and benefits.

“We understand the seriousness of the problems we face.  We own them.  We are taking decisive action to begin to resolve them,” said Gibson.  “We can turn these challenges into the greatest opportunity for improvement in the history of the department.”

Gibson also outlined actions that VA is taking now in order to address problems with access to VA healthcare, including:

• The Veterans Health Administration (VHA) has reached out to over 160,000 Veterans to get them off wait lists and into clinics.  VHA has also made over 543,000 referrals for Veterans to receive care in the private sector – 91,000 more than in the comparable period a year ago.
• VHA facilities are adding more clinic hours, aggressively recruiting to fill physician vacancies, deploying mobile medical units, using temporary staffing resources, and expanding the use of private sector care.
• VA is moving rapidly to augment and improve its existing scheduling system while simultaneously pursuing the purchase of a “commercial off-the-shelf” state-of-the-art system. 
• Gibson has directed Medical Center and Network Directors to conduct monthly inspections, in person, of their clinics to assess the state of scheduling practices and to identify any related obstacles to timely care for Veterans.  To date, over 1,100 of these visits have been conducted.
• Gibson has directed a comprehensive external audit of scheduling practices across the entire VHA system.  
• Gibson has personally visited ten VA Medical Centers in the last six weeks to hear directly from the field on the actions being taken to get Veterans off wait lists and into clinics, and he will continue to make site visits.
• The inappropriate 14-day access measure has been removed from all individual employee performance plans to eliminate any motive for inappropriate scheduling practices.  In the course of completing this task, over 13,000 performance plans were amended.
• Where willful misconduct or management negligence is documented, appropriate personnel actions will be taken, including cases of whistleblower retaliation. 
• Gibson froze VHA Central Office and VISN Office headquarters hiring – as a first step to ensure all employees are working to support those delivering care directly to Veterans.
• VHA has dispatched teams to provide direct assistance to facilities requiring the most improvement, including a large team on the ground, right now, in Phoenix.
• All VHA senior executive performance awards for fiscal year 2014 have been suspended. 
• VHA is expanding use of private-sector care to improve access. 

• Gibson sent a message to all 341,000 VA employees – and has reiterated during every visit to VA facilities – that whistleblowers will be protected, and that he will not tolerate retaliation against whistleblowers. 

• Gibson has conducted over a dozen meetings and calls with senior representatives of Veteran and Military Service Organizations (VSOs/MSOs) and other stakeholder groups to solicit their ideas for improving access and restoring trust.
• Gibson has made a number of personnel announcements in recent weeks, including: Dr. Carolyn Clancy as interim Under Secretary for Health; Dr. Jonathan Perlin, a former Under Secretary for Health, on temporary assignment as Senior Advisor to the Secretary; Dr. Gerard Cox as Interim Director of the Office of Medical Inspector (OMI); and Ms. Leigh Bradley as Special Counsel to the Secretary.
• As VA completes reviews, fact-finding, and other investigations, the department is beginning to initiate personnel actions to hold those accountable who committed wrongdoing or were negligent in discharging their management responsibilities.