Changes at the VA in Alabama

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Changes at the VA in Alabama
| published August 28, 2014 |

By Earl Perkins
Thursday Review features editor

We might be seeing a light at the end of the tunnel concerning the Department of Veterans Affairs fiasco that has gripped our nation since early this year, according to U.S. Representative Martha Roby and U.S. Senator Richard Shelby of Alabama.

New leadership has been installed at the troubled Central Alabama Veterans Health Care System (CAVHCS), which hopefully means incompetence and malfeasance associated with VA facilities in the south and nationwide could become a thing of the past, at least if Alabama’s changes are a harbinger of other divisions.

Director James Talton and Chief of Staff Dr. Cliff Robinson have been removed from their positions in the wake of a letter from Shelby and Roby to VA Secretary Robert McDonald outlining numerous problems at area facilities.

“Leadership starts at the top, and this change in senior management at CAVHCS was sorely needed,” Roby said in the letter. “I applaud the VA for taking decisive action. Our local system is infested with a culture of complacency when it should in fact be home to a culture of excellence. Congress gave the Secretary the tools he needs to hold people accountable and make improvements in care, and we will expect him to use those tools.”

“We’ve worked very hard to fully understand the problems at CAVHCS,” Roby added, “and I think this move is a step toward finding solutions—but it is only one step. We’ll continue to work with the VA to hold bad actors responsible, support positive changes, and ensure that we get the best care possible to our veterans.”

Congress passed legislation in July that was designed to address issues associated with VA's medical-care backlog and system-wide management problems.

The law expands the Patient Centered Community Care (PC3) program, allocating more funding to hire additional doctors, while hopefully increasing accountability by authorizing the firing or demotion of Senior Executive Service employees for poor performance and allowing more veterans to seek care from non-VA providers.

“When I met with Secretary Robert McDonald last month prior to his confirmation,” Shelby said, “he assured me that he would act expeditiously to address my and Congresswoman Martha Roby’s concerns about the inexcusable mismanagement of the Central Alabama Veterans Health Care System. His action today in replacing the two top officials in Montgomery who presided over such mistreatment is a promising sign that he is serious about addressing the many problems at the VA across the country, and particularly in Montgomery.”

Robin Jackson, Ph.D., has agreed to become acting medical center Director at CAVHCS, and Srinivas Ginjupalli, M.D., becomes acting Chief of Staff. Jackson comes from VA Southeast Network in Duluth, Georgia, where he is deputy network director, while Ginjupalli has served as deputy chief of staff at Montgomery-based CAVHCS. For several months, Roby's office has researched allegations of mismanagement, negligence and cover-up within Central Alabama’s system. In June, two senior members of her staff were dispatched to interview whistleblowers troubled by the system's shortcomings.

“I want to thank all those who had the courage to step forward and provide my office with information regarding the problems at CAVHCS,” Roby said. “I know that there has been real fear of retaliation, which makes these individual's willingness to expose wrongdoing so admirable.”

Numerous problems were uncovered during the investigation, according to the Montgomery Advertiser. One of the most shocking discoveries was that at least 900 unread patient x-ray tests were somehow "lost" until recently, with many showing malignancies. The VA regional chief medical officer had evidently instructed staff to doctor reports, removing references to problems with the lost x-rays.

The probe claims a VA pulmonologist manipulated more than 1,200 patient records. Administrators were apprised of the situation, and evidently failed to discipline the individual. He was then caught doing the same thing again, but instead of being fired was given a "satisfactory performance" review.

CAVHCS couldn't even pay its bills in a timely fashion, preventing local non-VA hospitals from assisting with increased patient demands. Also, more than 441 staff positions have remained unfilled throughout the area, with only 38 job openings being posted on VA's website, according to the Montgomery Advertiser.

E-mail records show the area VA Director was alerted to concerns about patient scheduling discrepancies more than eight months before action was taken. More than 57 percent of CAVHCS staffers surveyed claim they received "instruction" from those in a leadership capacity to manipulate patient wait times, according to a VA "Access Audit."

Probably the most preposterous story includes a CAVHCS worker taking a recovering veteran patient off-campus to a crack house to buy him illegal drugs, then extorting VA payments to pay for vehicles and a prostitute. The best part is that the worker fraudulently claimed overtime pay for the "activities," before being caught and found guilty of the violations. Of course, the worker is still employed by CAVHCS more than a year after the alleged incidents.

An excerpt from the July letter to Secretary McDonald reads as follows:

“Reports regarding the treatment of veterans in Alabama are dire and appalling. While we have yet to see a comprehensive account of the allegations, it is our understanding that the Central Alabama Veterans Health Care System (CAVHCS) has the eighth longest average wait times in the nation for veterans to receive care, even with its recorded manipulated recordkeeping. Whistleblowers allege that veterans’ x-rays have been lost, which may have in turn led to cancer and other life-threatening conditions going untreated. The leadership of the CAVHCS is alleged to have tolerated or encouraged whistleblower intimidation and retaliation, which possibly continued and exacerbated the abuse. To date, we do not believe that proper action has been taken to mitigate these allegations. Instead of swiftly working to fix the serious problems at the CAVHCS, all reports suggest that its leaders are focused on dodging blame and personal cost rather than serving veterans and providing the care and treatment promised. We have lost trust in the leadership at the CAVHCS.”

Related Thursday Review articles:

Support the VA, Support Your Local Crack House; Earl Perkins; Thursday Review; August 19, 2014.

Truth & Lies at the VA; Earl Perkins; Thursday Review features editor; Thursday Review; July 24, 2014.