This is the fourth post of a seven-part blog series that chronicles and attempts to dissect and explain the recent and growing issues and challenges negatively affecting the U.S. Department of Veterans Affairs.
Perhaps the single issue that has most hurt VA’s credibility has been the accuracy of its data, on both the VHA and VBA sides.
For example, in VHA, “Auditors found at least one appointment scheduler at 109 VA medical centers who said wait times for veterans had been falsified, according to a USA TODAY analysis of internal VA survey data made public Tuesday. To keep evidence of delayed care out of VA’s official electronic tracking system, secret lists were maintained at 110 facilities, the analysis shows.”
Meanwhile, with respect to VBA, on July 14, 2014, the House Veterans Affairs Committee held a hearing with VBA officials to examine charges it had manipulated its claims processing statistics to give the impression that its huge backlog was declining.
The hearing was called in part because of a new report by VA’s Office of Inspector General that found VBA employees had improperly subtracted cases from its count of pending claims. They had also inappropriately paid benefits and misplaced or lost paperwork related to claims, etc. in order to reduce its claims backlog.
At the hearing, Jeff Miller, R-Fla., and chairman of the Committee, told VBA’s Undersecretary that: “I don’t believe anybody at the table is telling the truth from the VA.”
The point is that as long as VA provides inaccurate information, it will not know what it is dealing with. As a result, it will be unable to properly address its problems.
Interestingly, in the late 1990s, VBA’s Undersecretary made data accuracy a high priority, believing that Congress had historically underfunded VBA because it had given the misimpression that it was doing better than it really was. He emphasized all of VBA’s work in his reporting, not just pending ratings. That tact gave a much more accurate picture of VBA’s workload.
He also established an online Data Integrity Report that identified stations that had a disproportionate number of questionable end products. In my view, such an approach should be reinstituted.
Part of the problem with data accuracy in both VBA and VHA appears to stem from the fact that people in VA’s Central Office were unaware of the extent of the problem. This suggests that VA has a serious flaw in its management information and review systems. A healthy organization should have picked up these problems way before it came to the attention of Congress and the media.
I recommend that VA address this issue in the following ways:
1) Ensure that every facility has an internal quality review system that reviews the accuracy of its data.
2) Schedule periodic independent on-site reviews of VA facilities and examine the same issue.
3) Establish an on-line program that identifies questionable or out-of-line actions by VA offices.
4) Conduct customer surveys that compare the experiences of veterans to the data reported by VA and addresses any inconsistencies.
5) Encourage whistleblowers to report improper actions, but verify the accuracy of their allegations as whistleblowers sometimes have their own agenda.
6) Take appropriate action against individuals who manipulate the data.
Moving on, I do not claim to be an expert on VA’s technology, especially within VHA. However, as I understand it, a big part of the scheduling and access problem was due to the poor electronic scheduling system that was in place. It was cumbersome and difficult to use, even confusing. For years, VHA had tried unsuccessfully to replace it.
I also understand that many of the “secret lists” may have been comprised of manual lists that employees used to keep track of veterans so they could get them into earlier appointments as the existing system wouldn’t allow it. Framed differently, many of the manual lists may have been “workarounds” of the system in order to help expedite scheduling rather than cover up long-waiting times. The good news here is that VA is procuring new technology to fix this problem.
VBA has also struggled with inadequate technology for decades. That has certainly had a negative impact on its ability to process claims. Fortunately, a number of its technological improvements are starting to pay dividends, such as the Veterans Benefits Management System, whereby VBA is scanning many paper documents at a time, digitizing and storing the records, and moving VA towards a digital environment.
About Stewart Liff
Stewart Liff is an HR and visual performance management expert and leading author on managing and transforming government agencies, as well as president of Stewart Liff & Associates. He is also the author of a new book 98 Opportunities for Improving Management in Government, as well as Managing Government Employees and co-author of A Team of Leader and Seeing is Believing.
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Gregg Zoroya and Meghan Hoyer, Audit: VA manipulated vets’ appointment records, The Federal Times, July 29, 2014
VA Office of the Inspector General, Veterans Benefits Administration: Review of the Special Initiative To Process Rating Claims Pending Over 2 Years, July 14, 2014