June 9, 2014 at 11:52 pm

Red flags raised at 3 VA medical sites in Michigan

James Smith, 71, gets emotional as he talks last month about injuries he received in the Navy from 1963 to 1967 and the problems he has had with the VA hospital. (Charles V. Tines / The Detroit News)

Washington— Three Department of Veterans Affairs medical sites in Michigan were among more than 110 facilities nationwide that were flagged for further investigation of patient wait times in a new audit of the beleaguered health care system released Monday.

Among the 20 veterans health care sites visited in Michigan, the VA Ann Arbor Healthcare System and two smaller outpatient clinics in Lansing and Muskegon were identified by investigators for more review.

Officials will do follow-up investigations at the Michigan sites because of the responses given to auditors by “front line” staffers regarding the timing to schedule appointments for veterans seeking health care. The review didn’t include the exact reasons for the additional scrutiny.

The VA audited 731 veterans hospitals and clinics nationwide, and targeted 112 for follow-up in the first state-by-state review of VA facilities since problems of long wait times and secret waiting lists were exposed at the Phoenix VA. The issues culminated last month with the resignation of Veterans Affairs Secretary Eric Shinseki.

The review found more than 57,000 veterans nationwide, including nearly 1,500 in Michigan, were waiting 90 days or more to schedule their first appointment. Nearly 64,000 more veterans, including more than 1,600 in Michigan, had enrolled in the health care system in the last 10 years but have never seen a doctor despite an appointment request.

Ray Moore, state commander of the American Legion Department of Michigan, said he’s not aware of any unique problems at the three flagged Michigan facilities but hopes the attention will bring more awareness to the veterans.

“We as a people need to stand up and ensure we’re giving them the expected benefits those veterans have earned,” said Moore, who added the VA health care staff members in Michigan are doing their best given their resources.

Sites unclear on problems

The VA in Ann Arbor said its mission is to provide exceptional health care and isn’t sure why the hospital was flagged. The audit, however, showed that the Ann Arbor VA had a lower scheduling rate than its counterparts in Detroit, Saginaw and Battle Creek, which were at or above the nationwide average of 96 percent and not cited for additional review.

“Although we do not know the reason for the follow-up visits or who will be conducting them, we will work in full cooperation with the audit team to address any issues they may have,” said Derek D. Atkinson, spokesman for the VA Ann Arbor Healthcare System.

A spokesman for the Lansing and Muskegon outpatient clinics also said while it’s unclear what issues were raised, the facility is committed to improving access to care.

“We embrace the need for change, but we are confident our staff works tirelessly to provide the best care possible to our veterans,” said Damian McGee, public affairs officer at the VA Medical Center in Battle Creek. “If the review should find systematic changes need to be made, we will embrace those changes.”

Overall, the VA audit found a complicated scheduling process resulting in confusion among scheduling clerks. It concluded a 14-day wait target for new appointments was not attainable given growing demand for services and lack of planning.

Thirteen percent of scheduling staff interviewed said they received instruction from superiors to falsify veterans’ preferred scheduling date in the system to make waits appear shorter.

The average waits for a primary care appointment at Michigan facilities were much shorter than the biggest offenders nationally.

In Detroit, the average wait for new patients is about 31 days and in Ann Arbor is nearly 30 days. Honolulu has an average of 145 days, the longest in the country, according to the report.

But the local numbers still well exceeded the department’s goal of a 14-day window for new patients.

Five percent or 2,576 of Ann Arbor’s appointments took more than 30 days, compared with Detroit’s 2 percent or 662 appointments, according to the report.

Existing patients don’t have to wait as long. For a primary care appointment, it’s a two-day wait in Ann Arbor and less than a day in Detroit on average.

Detroit VA pleased

The director of Detroit’s VA was pleased with the audit’s findings at its Detroit hospital and two outpatient clinics of Yale and Pontiac.

“The (audit) teams were impressed with our processes and our staff,” said Dr. Pamela Reeves, director of the Detroit VA Healthcare System. “I am happy to report that 98 percent of all veterans are seen within 30 days of their request for an appointment in our facility.”

U.S. Rep. Dan Benishek, R-Crystal Falls, said he’s skeptical of the VA’s internal audit figures. The VA has painted a rosier picture of the problems in the past about the secret waiting lists at a VA facility in Phoenix, he said, adding he’ll await an independent review.

“We have to get the inspector general report and see what they have to say,” said Benishek, the only Michigan member on the House Veterans’ Affairs Committee. “There’s more to be seen here.”

U.S. Sen. Carl Levin, D-Detroit, quickly fired off a letter to the VA inquiring why the three facilities in Michigan were flagged for further view.

Four veterans in Michigan’s delegation said Monday the findings about the care for fellow veterans were unacceptable.

The audit shows the VA “is failing to meet its main responsibility — delivering accessible, quality health care,” said U.S. Rep. Gary Peters, D-Bloomfield Township, and a former U.S. Navy Reserve lieutenant commander. U.S. Rep. Mike Rogers, R-Howell, a former U.S. Army officer, said the problems go beyond Shinseki to senior and middle-level leadership: “People need to be held accountable.”

U.S. Reps. John Dingell, D-Dearborn, and Kerry Bentivolio, R-Milford, said they are monitoring the situation in Ann Arbor.

“It’s outrageous that the men and women who honorably served our country aren’t receiving the care and respect they deserve,” said Bentivolio, noting the VA at one point lost all of his medical records. “Based upon my personal experience with the VA, I’m not surprised.”

Dingell, one of two remaining World War II veterans in Congress, said the need for additional review at Ann Arbor “is deeply concerning.” He said he hopes the scrutiny will help fix the flawed VA system.

“We must also see to it that the department is receiving proper funding from Congress to do all it can,” Dingell said.

The VA pledged additional reforms Monday and started contacting more than 90,000 veterans to speed up access to care, even if it means going to a non-VA clinic.