Letter to the Honorable Robert McDonald, Secretary of the Department of Veterans Affairs - Cornyn Presses VA Secretary to Address Long Wait Times at Houston VA

Letter

Dear Secretary McDonald:

I write today to express my deep concern over the new report from the VA Inspector General (IG) regarding Houston-area veterans' medical wait-times and continued data manipulation by VA employees, dated June 20, 2016. The IG substantiated that three Houston VA officials in positions of responsibility instructed their staff to erroneously record veterans' appointment cancellations. These officials included two previous VA scheduling supervisors and one current director of a VA Community-Based Outpatient Clinic. "These issues have continued despite the Veterans Health Administration (VHA) having identified similar issues during a May and June 2014 system-wide review of access," the IG wrote in its report.

Regrettably, Houston is not the only place in which veterans are still experiencing these types of failures. On April 19, 2016, the Government Accountability Office (GAO) published a report on access to care for newly enrolled veterans at a half-dozen other VA medical centers. The GAO found that nearly one out of every six veterans was "unable to access primary care because VA medical center staff did not schedule appointments for these veterans in accordance with VHA policy." In testimony before the House VA Committee, the director of GAO's health care team pointed out that this report "found many of the same problems as we have previously reported. . . . To date, we have seen, at best, little progress by the VA in addressing the issues."

In fact, these wait-time fiascos and the underlying problems have been allowed to occur at the VA for more than 15 years. The GAO official also testified that, "since 2000 and particularly over the past five years, we have consistently reported on the VA's failure to ensure veterans timely access to health care." At the same hearing, the VA's Assistant IG for Audits and Evaluations (Designee), commented that his IG office had been raising concerns about medical wait-times for more than 10 years. He also said the IG continues to see the VA's own data as unreliable, which of course makes it harder to diagnose and solve the problem.

The manipulation of wait-time data seems to have been standard operating procedure within the VA for years, well before the nationwide VA wait-time scandal two years ago. Today, the VA's excuses for it include inadequate staff training and complex but outdated scheduling software. Those factors may account for some of the problems, but they should have been addressed long ago. Moreover, no amount of staff training or software upgrades represent solutions when the problem is an employee who lacks personal integrity and is deliberately manipulating data out of a desire to hide embarrassing statistics. Such employees simply need to be fired.

Robert Gates, former Secretary of Defense and former Director of the Central Intelligence Agency, writes in his recent book, A Passion for Leadership, about having to fire numerous federal employees who were "not up to the job to which he or she had been assigned." He continues: "The cost of leaving such people in place is just too high. Replacing them is a challenge peculiar to leaders charged with reform. Performance that might be tolerable in maintaining the status quo won't do in a time for transformative change."

Clearly, the VA is an institution that requires transformative change, and I remain hopeful that you will succeed in driving that change. However, doing so will require excising from the VA employee rolls the bad actors and poor performers who have created the wait-time scandals and other significant problems. To date, only a small number of VA employees nationwide have been held accountable for wait-time data manipulation. And, in the limited instances when they have been held to account, the process has been glacial in its speed. To help address these problems, I am cosponsoring the Department of Veterans Affairs Accountability Act of 2015, and it is my hope that this legislation, which the House of Representatives has already passed, can be enacted this year.

I request the opportunity to meet with you in my Senate office to discuss the Houston wait-time issue, the broader VA accountability problem, and other areas in which we might be able to work together to improve the quality of life for those who have worn our nation's military uniform. When we meet, I would appreciate information on the following:

How you intend to fix the problems in the Houston area, as revealed by the IG.

What impediments currently exist to the implementation of a robust system of accountability for VA employees at all levels.

What additional statutory authorities or other support you require to eliminate those impediments; and
How the Veterans Choice program could be made permanent, expanded, and otherwise improved to drastically reduce wait-times for our veterans, like those impacted by the problems in Houston, and give them additional flexibility to receive timely health care.

It is past time to fix the VA medical appointment process and to hold accountable those employees who have violated the trust of our nation's veterans. Thank you for your prompt attention to this critical issue and for your continuing service to your fellow veterans.

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