US Veterans Affairs head announces restructuring, firings

The secretary of Veterans Affairs (VA) on Monday announced a restructuring plan at the department that includes firings and “expanded public-private partnerships” at the agency for military veteran benefits. Robert McDonald was nominated to head the VA three months ago in the wake of a scandal over long wait times for medical treatment at facilities run by the beleaguered agency.

McDonald, a former Procter & Gamble CEO, was tapped by President Barack Obama to head the VA following the resignation of Eric Shinseki a month earlier. Whistleblowers at the VA hospital in Phoenix, Arizona, had charged that delays in treatment had been responsible for at least 40 preventable deaths. The Senate confirmed McDonald’s nomination in July.

In a CNN interview on Monday, McDonald said the VA had taken “disciplinary action” against 5,600 employees in the last year over the long wait times and their cover-up. In an appearance on CBS’s “60 Minutes” aired Sunday, he said that 35 VA staffers would be losing their jobs in the near future and that another 1,000 workers may be fired, because they “violated our values.” It has not been revealed what sections of employees face the axe.

According to the VA, more than 100 investigations of department facilities have been undertaken by the VA’s Office of the Inspector General, the FBI, the Department of Justice and other agencies since the scandal broke. According to regulations at the government-run agency, McDonald must build a case against each person slated for discipline, and a judge must approve each firing.

So far, the only senior leader fired has been James Talton, the director of the central Alabama VA, where scheduling problems contributed to treatment delays. McDonald told CNN that the VA is in the process of taking “disciplinary action” against 40 senior officials.

Processes to terminate four other VA senior officials are reportedly under way. Two of these officials, Deputy Chief Procurement Officer Susan Taylor and Dublin, Georgia, VA director John Goldman, have retired with their pensions intact. Sharon Helman, director of the Phoenix VA hospital where more than 3,500 veterans were on “secret” waiting lists for appointments, and Terry Gerigk Wolf, director of the Pittsburgh VA, have been placed on administrative leave with pay since May and June, respectively.

McDonald mapped out a four-point restructuring plan for the VA in a message to employees posted on the agency’s web site on Monday. First, he said the agency would establish “a new VA-wide customer service organization” to improve customer service for veterans led by a “Chief Customer Service Office” who would report to him. The VA is also establishing a “single regional framework” for facilities to “enhance customer service.”

Data released by the VA last week showed that more than 10 percent of veterans were still waiting at least 30 days for appointments. The situation remains dire in Philadelphia, San Diego, Tampa and Gainesville, Florida, where more than 1,000 appointments booked by veterans have wait times of about four months or longer.

A $16 billion bill to overhaul the VA signed into law by President Obama in August included a provision allowing veterans who live 40 miles or more from a VHA (Veterans Health Administration) facility, or who must wait longer than 30 days for an appointment, to seek alternate care in a private facility. The first batch of “choice cards” facilitating this change were mailed out to veterans earlier this month. The final two components of McDonald’s restructuring plan involve changes that will further open up VA services to privatization.

The VA secretary’s overhaul establishes a national network of “Community Veteran Advisory Councils” to coordinate better service delivery to veterans. These councils would “coordinate Veteran-related issues with local, state and community partners, as well as VA employees.” The implication is that a portion of veterans’ services will be contracted out to the private sector. Finally, McDonald said the agency is “looking at options used in the private sector to enhance our rapid delivery of services.”

A review of the VA health system delivered to Obama in June by then acting VA secretary Sloan Gibson noted the need for additional resources at the VHA—primary care physicians, specialty care physicians, administrators and support staff, and physical space—due to “an increased number of female veterans, a surge in mental health needs, an increase in the special needs of younger veterans returning from Iraq and Afghanistan, and specific needs associated with older veterans.”

The scandal at the VA—leading to Obama’s signing of the bipartisan bill in August and the present restructuring of the agency by McDonald—was an expression of the social catastrophe facing US veterans and the VA’s inability to deal with it. More than half of the 2.6 million soldiers dispatched to the wars in Iraq and Afghanistan struggle with physical or mental health problems stemming from their deployment, according to a recent Washington Post /Kaiser Family Foundation Poll.

VHA primary care appointments have increased by 50 percent in the past three years, while the staff of primary care doctors has grown by only 9 percent. McDonald said on “60 Minutes” that he plans to hire about 28,000 medical professionals to work at VHA hospitals and clinics nationwide, including about 2,500 mental health professionals. It is unclear how or when this new influx of staffing will begin to handle the overwhelming patient load.

What is clear is that the Obama administration with bipartisan support in Congress is exploiting the crisis at the VA as a wedge to open up the vast, government-run agency to privatization. “Choice cards” and “expanded public-private partnerships” are aimed at allowing for-profit insurance companies and health care providers to gain access to the lucrative veterans health care market at the expense of veterans’ care.