In remarks at the VFW’s 115th Annual Convention, which took place in St. Louis, Mo., this week, Acting Secretary of Veterans Affairs Sloan D. Gibson said that though “the Department of Veterans Affairs is in the midst of its most serious crisis in more than a generation … [the VA] has before it perhaps its greatest opportunity to enhance care for veterans in its history.” In front of a gathered audience of VFW members, Gibson spoke frankly about how the VA plans to tackle the challenges ahead.
According to the acting secretary, the faults that have been revealed over the past several months—such as extended wait times for care, improper scheduling practices, and a lack of accountability for managers who hid poor performance or punished employees who pointed out wrongdoing—can be sorted into three categories: business process problems, leadership problems, and resource problems.
This breakdown allows for the department to set priorities moving forward, Gibson said. The first priority is process initiatives: “using available resources to get veterans off wait lists and into clinics, while also fixing our scheduling system. Second, but simultaneously, are changes of leadership—addressing VA’s cultural issues, holding people accountable for willful misconduct or management negligence, and creating an environment of openness and transparency. Third, the resource challenge—making a compelling case for the resources needed to consistently deliver timely, high-quality healthcare.”
Gibson also drew attention to the actions that the VA has already taken, including making over 571,000 referrals for veterans care, resulting in 700,000 additional appointments; adding more clinic hours and staffing resources at health care facilities; updating their scheduling system, including an independent audit of scheduling practices; mandated in-person site visits; and developing a more robust system for measuring patient satisfaction.
In recounting the differences he saw on his visits to Phoenix and San Antonio medical centers, Gibson noted that as he visited the excellent San Antonio facility, “everywhere I looked I realized that, but for leadership, that could have been Phoenix. But for leadership. Since those visits, I’ve challenged VA leaders to explain to me the difference between Phoenix and San Antonio. I have yet to hear an explanation that doesn’t boil down to one thing—leadership—leaders failing to take ownership of the problems, both large and small, facing their employees.”
To counter this problem, Gibson said, VHA Central Office and VISN Office headquarters hiring has been frozen, VHA senior executive performance awards for FY14 have been suspended, and the VA had made public care quality statistics, including progress updates on decreasing wait times and the results of their field access audit. Accountability is crucial, he emphasized. “At VA, we depend on the service of employees and leaders who place the interests of veterans above and beyond self-interest. Accountability, delivering results, and honesty are also key to serving our veterans. Those who have not performed and have not delivered results honestly will be held accountable. Where willful misconduct or management negligence is documented, appropriate personnel actions will be taken—this also applies to whistleblower retaliation. We will not tolerate retaliation against whistleblowers.”
In order to secure the high quality of leadership necessary to transform the harmful elements of the VA’s culture, several new leadership appointments have been announced, perhaps most notably the nomination of Robert A. McDonald as the next Secretary of Veterans Affairs, whose strong leadership, management skills, and moral compass were praised by Gibson.
Moving forward, Gibson said, “The greatest risk to veterans over the intermediate to long-term is that additional resources are provided only to support increased purchased care in the community and not to materially remedy the historic shortfall in internal VA capacity. Such an outcome would leave VA even more poorly positioned to meet future demand.” In order to prevent this and remain ready to provide quality care to the increasing number of veterans who require it, Congress must allow the VA the funding to invest in resources such as additional clinical staff and IT support to build their internal capacity to meet demand.
Gibson’s sentiments were echoed by other speakers at the conference, including Vice President Joe Biden, who stated in his remarks that veterans “deserve the best from our government ... and we’re determined that you get it.” Along these lines, he also urged Congress to “stop fooling around” and act quickly to confirm McDonald and approve legislation to reform the department. There are many things to be done for the country to meet its “one sacred obligation” to care for veterans, he acknowledged, but as he thanked the VFW and other veterans organizations for their input, he vowed, “Know this: we will not rest until it gets fixed.” ♦