- Associated Press - Thursday, June 5, 2014

DES MOINES, Iowa (AP) - Some patients at Veterans Affairs medical centers in Iowa and Nebraska are on waiting lists for appointments, but a regional spokeswoman says facility administrators have not yet seen evidence of secret lists like those uncovered in other states.

Regional VA spokeswoman Sharyl Schaepe said Thursday that Iowa and Nebraska facilities were included in a federal investigation of specific sites.

Last week, the VA released a summary of 216 site-specific audits that showed widespread falsification of waiting list records and unreported treatment delays at VA facilities nationwide.

“We do not expect to have any deficiencies, but that review is continuing,” said Schaepe, a spokeswoman for a VA region that includes Iowa, Nebraska and parts of eight other states.

Schaepe said patients are sometimes placed on official waiting lists because of a lack of clinic space and providers.

The VA did not reveal any information about conditions at individual sites. The department is also declining to release numbers from its official, sanctioned waiting list without a formal Freedom of Information Act request.

Some of the official lists, obtained by The Associated Press through the states’ congressional delegations, show that 156 new patients were waiting for an appointment in the Nebraska-Western Iowa Health Care System as of May 1. The Iowa City VA Health Care System had 27 patients on its list, including seven who have been listed for more than 120 days. The VA Central Iowa Health Care System in Des Moines had 52 patients on the list, and the Sioux Falls VA Health Care System - which serves northwest Iowa - listed 100 patients.

Schaepe said those the numbers fluctuate daily. The list shows new patients who request an appointment within 90 days, but can’t be scheduled because clinics don’t have the available capacity.

If no appointment is available, patients are placed on the list immediately and are notified when one becomes available. In cases where treatment is needed more urgently, Schaepe said a health care facility can send a patient to another VA facility or an outside provider for treatment at the VA’s expense.

The VA is conducting a system-wide investigation after it was found that the Phoenix VA Health Care System had about 1,700 veterans in need of care on secret waiting lists, and another that had 1,400 waited over 90 days for primary care appointments. The scandal led to the resignation last week of Veterans Affairs Secretary Eric Shinseki.

Members of Iowa’s congressional delegation say they’re looking into whether the state’s Veterans Affairs facilities faced problems like those that surfaced in other Midwestern facilities. The Department of Veterans Affairs says it maintained 10 such “secret watch lists” of veterans needing care at facilities in Kansas, Missouri, Illinois and Indiana. An official at a Kansas facility said the lists were created by staff that lacked training and understanding VA procedures.

U.S. Sen. Chuck Grassley of Iowa, a Republican, said his office has asked the Department of Veterans Affairs whether any secret lists existed in Iowa facilities.

Grassley’s office provided The Associated Press with the official, sanctioned waiting list for the Iowa City VA Health Care System as of May 1. Grassley, who called for stronger oversight of the VA before the scandal broke, said he was concerned that the problems within the system could be widespread.

He pointed to a U.S. Inspector General’s report released in March, which found leadership problems in the VA Central Iowa Health Care System, which contributed to high nursing staff turnover.

“We’ve got to change the culture of these bureaucracies,” he said.

U.S. Rep. Dave Loebsack, an Iowa Democrat, met with VA officials in Iowa City this week, and said he left feeling assured that the long waits for an appointment weren’t as severe as in other facilities. But Loebsack said the wait times could be shortened with funding for more staff and clinic space.

“If we have to clean house more in management, whether in a particular VA administration or higher up, that’s what we’ll do,” Loebsack said. “But at this point it’s too early to know just how widespread it is.”

Will Ackerman, public affairs officer for the VA Nebraska-Western Iowa Health Care System, said the Veterans Hospital in Omaha and eight other facilities within the two-state system are in midst of being audited as part of an effort to ensure that veterans are getting timely medical care.

“The outcome of those audits will be announced nationally,” Ackerman said. “But, obviously, it’s important to us that we’re getting out veterans care in a timely manner.”

Asked whether the audits have discovered any secret waiting lists in Nebraska or Iowa VA facilities, Ackerman said, “I’m not aware that there’s any list other than the official waiting list.”

Ackerman said he’s been forbidden to reveal the number of patients on the Nebraska-Western Iowa system’s extended waiting list without a formal Freedom of Information Act request.

However, the office of Nebraska Republican Rep. Lee Terry of Omaha provided numbers to The Associated Press showing 156 patients on the system’s waiting list as of May 1. That included 87 patients waiting for care at the Lincoln VA medical center and 64 at the hospital in Omaha.

“What we are doing is actually calling every patient on this extended waiting list that we have to see if they … need an appointment or, if they have a scheduled appointment, if they need care sooner,” Ackerman said.

In situations where facilities are unable to provide timely care for veterans, Ackerman said, those patients are being sent to non-VA care providers, paid for by the VA.


Beck reported from Omaha, Nebraska.

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