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Never Forget

Reprinted from PN/Paraplegia News January 2015

PVA members should be cautiously optimistic about the changes in the VA.

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After a doctor in Phoenix blew the whistle on the Department of Veterans Affairs (VA) hospital there, the Office of Inspector General (OIG) discovered scheduling practices not conforming to Veterans Health Administration (VHA) policy.

This resulted in significant delays in access to care and negatively impacted the quality of care for veterans. This follows an OIG investigation into VA prosthetics, where it found financial mismanagement, inefficient procurement policies and warehousing of excessive inventories costing taxpayers millions of dollars. Unsurprisingly, several of the discoveries involved activities some insist were criminal.

Before I continue with this sobering characterization of a federal agency in disrepair, I need to point out that the VA is filled with well-intentioned professionals who care deeply for veterans. But, even those with the best intentions were no match for the inefficiencies, creeping standards and lack of leadership.

While Paralyzed Veterans of America (PVA) sought to establish a partnership with the VA, we inevitably became the bane of the VA’s existence once it became clear nothing would change without provocation. Even then, our efforts to improve the system were rebuffed.

Our site visit reports languished within a chain of bureaucrats who had no interest in hearing another story about staffing shortages, waiting lists and delayed prosthetic orders.

This brings me to a recent and stark example of the VA’s failure to do the right thing. In 2010, my physical therapist evaluated my need for a device to improve my cardiovascular system and selected a Krankcycle stationary bike.

My treating physician endorsed it and the order was forwarded to VA prosthetics.

I assumed a purchase order would get authorized and I’d have the Krankcycle in about 30–45 days.

It turns out my purchase would get approved, but not by VA prosthetics. Rather, it was granted upon appeal by the Board of Veterans Appeals after nearly four years!

Despite having complete medical justification from two competent experts who actually treated me, my request would pass through the hands of a VA employee, over 1,000 miles away, who ignored the law and denied the request.

I didn’t find this acceptable and neither did the PVA staff who prevailed on my behalf after four years of legal briefs and representing me before a veteran law judge. The bottom line is a single VA employee failing to do her job properly cost PVA and the VA thousands of dollars for a piece of equipment that retails for $1,700.

As president, I know this happens to many PVA members under more critical circumstances. If it can happen to me, it can happen to anyone. If the law was ambiguous I might be less critical, but the law is clear. It provides that a prescription written by a competent expert is sufficient to authorize purchase of prosthetics and the VA can’t deny it based on cost.

VA Chief of Staff Sloan Gibson told Congress, ‘‘As a consequence of all these failures, 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.’’

We can’t let VA fail because it’s the only health care system that delivers comprehensive spinal-cord injury and disease care. Additionally, Congress must provide the resources so the VA is appropriately funded and adequately staffed, that all claims decision makers are fully trained and held accountable for their errors, and the agency is competently managed. Period!

PVA members should be cautiously optimistic. VA Secretary Robert McDonald believes he can turn things around stating, “I think the reason some employees fail to live up to our high care values is that oftentimes in large organizations the measures within the organization, the inertia within the organization, tends to blind people from the ultimate goal of the organization. At Veterans Affairs, our ultimate goal is to serve the veteran. That is the only reason we exist.”

You can rest assured PVA will never let the VA forget why it exists.

 

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