The embattled Veterans Affairs Department, now ranked by a government watchdog as among the most troubled federal agencies, is reminding employees in a memo why they should care about their work.
The document circulating among employees is titled the “I CARE Quick Reference” sheet, and it spells out the desired core values of the VA: integrity, commitment, advocacy, respect and excellence. The memo says the VA is “a model of unrivaled excellence due to employees who are empowered, trusted by their leaders, and respected for their competence and dedication.”
But after a year in which VA officials were accused of keeping secret waiting lists and concealing delayed care for veterans, some agency employees and veterans are questioning the “I CARE” program as a cosmetic effort that will do little to improve services.
“Management has made a mockery of it,” said one VA employee, who asked not to be named for fear of retaliation.
The head of a veterans group said veterans and active-duty service members are still waiting for “real, meaningful change” in the VA’s quality and promptness of health care services.
“Adopting a catchy acronym and circulating a checklist is not enough,” said Pete Hegseth, CEO of Concerned Veterans for America. “It’s easy to put on an ‘I CARE’ pin, but it doesn’t matter unless you actually demonstrate that care through your actions and the results you deliver. That’s what veterans, military members and their families are looking for: real results, not a slogan.”
But a spokesman for the Veterans of Foreign Wars said the memo could be useful and called it “a good example of getting people to sing the same tune by providing the same sheet of music.”
“The reference sheets leave little doubt about the direction VA leadership is headed, which for employees means either get with the program or get out,” said VFW spokesman Joe Davis. “The VFW wants the VA to identify and fix what’s broken, to hold employees appropriately accountable, and to help restore the faith of veterans in their VA.”
VA Secretary Robert McDonald, tapped by President Obama last year to revamp the embattled agency, said in a statement on the agency’s website that the “I CARE” principles “focus our minds on our mission of caring and thereby guide our actions toward service to others.”
“These values define our culture and strengthen our dedication to those we serve,” Mr. McDonald said.
But the VA culture was responsible for the agency’s addition last week to the Government Accountability Office’s “high-risk list” of troubled federal programs. The GAO said it has “serious concerns” about VA management and oversight of its health care system and found “inadequate training for VA staff.”
The watchdog agency’s report noted that Congress approved $15 billion last year to address rising demand for veterans’ health care, including increased use of non-VA health care providers.
“Coordination of care between VA and non-VA providers is critical,” the GAO report said. “Without it, there is increased risk of unfavorable health outcomes for veterans. The quality of care may be adversely affected if important clinical information is not promptly communicated between VA and non-VA providers.”
Mr. McDonald said he wanted the agency on the high-risk list to shine a light on problems and what officials are doing to fix them. In an effort to increase accountability, Mr. McDonald said Sunday, the department fired 900 employees under his leadership.
“We’re not where we need to be yet, I’m not saying that. What I’m saying is we’re making progress,” he said on “Meet the Press.”
Mr. McDonald encountered opposition last week from House Veterans’ Affairs Committee Chairman Jeff Miller, Florida Republican, to an administration proposal to cut some funding from the $10 billion VA Choice Card program. Mr. McDonald said he wants greater flexibility to expand services.
About 24,000 veterans have made appointments for private care since the Choice Card program was enacted last summer. Mr. Miller said any extra money in the program should be used to make sure other veterans can enroll.
The VA’s nationwide system of 150 medical centers and more than 800 community-based outpatient clinics has faced growing demand in the past decade, largely because of the wars in Iraq and Afghanistan. The GAO said enrollment in the VA health care system increased from 6.8 million veterans in fiscal year 2002 to 8.9 million veterans in fiscal year 2013, and outpatient medical appointments increased by about 85 percent over that period.
Congress more than doubled the VA’s annual health care budget over that period, from $23 billion in 2002 to $55.5 billion in fiscal 2013.
“Despite these substantial budget increases, for more than a decade there have been numerous reports — by GAO, VA’s Office of the Inspector General, and others — of VA facilities failing to provide timely health care,” the GAO report said.
Mr. Hegseth said veterans’ patience with Mr. McDonald is growing thin.
“The VA reform bill signed into law last August provided Secretary McDonald with the authority he needed to hold failing senior executives accountable and expand patient choice for veterans to allow them access to the care they need, but he has been consistently resistant to dismissing failing executives and now is even seeking to undermine funding for the choice provision — despite his promises to bring changes to the VA,” Mr. Hegseth said. “When Secretary McDonald was nominated by President Obama, we said we were cautiously optimistic about his nomination. In retrospect, it’s clear that the caution was warranted but the optimism was not.”
Mr. Davis, of the VFW, said more patience is required to let proposed reforms take hold.
“This crisis in access and confidence is still less than a year old,” Mr. Davis said. “The VA is a very large but decentralized organization, which means it can’t turn on a dime like the military can. Just as it took awhile for all the past problems to reach critical mass, it may take even longer for the VA to properly identify all that’s broken before the healing can begin.”
• Jacqueline Klimas contributed to this report.