Congress Is Getting Tougher on the VA

Congress Is Getting Tougher on the VA

The Wall Street Journal

By MICHAEL M. PHILLIPS and BEN KESLING

Feb. 9, 2014

http://online.wsj.com/news/articles/SB10001424052702304450904579371382766771434?mod=WSJ_hp_LEFTTopStories&mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424052702304450904579371382766771434.html%3Fmod%3DWSJ_hp_LEFTTopStories



Congress is poised to tighten its leash on the Department of Veterans
Affairs over its response to what lawmakers say are management and
medical errors, just as VA facilities are flooded with a new
generation of injured troops.

In a rare show of bipartisanship, top members of the congressional
committees that oversee the VA are increasingly frustrated with agency
in the wake of incidents ranging from a patient's death after an
altercation with a nursing assistant in Louisiana to a deadly outbreak
of Legionnaires' disease in Pennsylvania. Lawmakers say these episodes
reflect a lack of accountability at the 1,700 VA hospitals, clinics
and other facilities.

Congress now appears likely to impose legislative penalties on the VA.
The House last week unanimously passed a bill that included a
five-year ban on bonuses for senior VA executives. The Senate is
considering less severe restrictions on performance pay.

The chairman of the House Veterans' Affairs Committee, Rep. Jeff
Miller (R., Fla.), says he plans to introduce a measure this week that
would make it easier to fire or demote hospital directors and other
executives whose performance falls short.

"VA needs to more directly and explicitly measure each leader's
contribution," said Rep. Mike Michaud of Maine, the top Democrat on
the House VA committee. "If they do not, they will never be able to
truly hold themselves accountable to veterans, or the American
taxpayer."

The VA cares for 8.75 million patients, from nonagenarian World War II
veterans to teenagers with brain injuries from Afghanistan.
Vietnam-era vets are now heavy VA users.

In some ways, the agency is politically inviolate. Since the 2000
fiscal year, its budget has tripled to $148 billion in the current
fiscal year, with no serious talk of cuts despite general concern
about government deficits. But that windfall and the influx of wounded
vets have also drawn increased congressional scrutiny of the agency's
performance.

The dispute has taken a testy turn in recent weeks, with Mr. Miller
and VA Secretary Eric Shinseki swapping comments about VA
accountability practices. In a Jan. 31 letter to Mr. Miller, the
secretary defended the agency's bonus and dismissal practices, even
going so far as to explain bonuses given to particular employees.
"Results, or lack thereof, for which employees and executives are
responsible and accountable, are factors when evaluating performance,"
wrote Mr. Shinseki, a former Army general.

Mr. Miller shot back on Friday: "It's becoming more apparent by the
day that there seems to be just two types of people who think VA is
properly holding its leaders accountable: VA executives who have
received huge performance bonuses year after year despite failing in
their jobs and those who work in VA's central office."

Lawmakers complain the VA hasn't responded to more than 100
congressional requests for information, some more than a year old. "It
almost feels as if they see their job as holding back" information,
said Rep. Mike Coffman (R., Colo.), who is pushing to give the Army
Corps of Engineers oversight of three troubled VA construction
projects.

VA officials say they have answered more than 85,000 information
requests in the past four years, including letters, demands for
congressional testimony and questions for the record. They say the
agency has spent less on bonuses than allowed by law.

"Any adverse incident for a veteran within our care is one too many,"
said VA spokesman Drew Brookie. "When an incident occurs in our system
we aggressively identify, correct and work to prevent additional
risks. We conduct a thorough review to understand what happened,
prevent similar incidents in the future, hold those responsible
accountable consistent with due process under the law, and share
lessons learned across the system."

Sen. Bernie Sanders, a Vermont independent who chairs the Senate VA
oversight committee and is one of the agency's biggest allies on
Capitol Hill, says most veterans are satisfied with VA care. "If you
do an investigation of any given [civilian] hospital on any given day
you're going to see negative things coming out," Mr. Sanders said in
an interview.

He, however, expressed some concern about the VA's response when
things go wrong. "When people are doing a bad job we don't want them
staying in the job; when they do a good job we want to see them
rewarded," Mr. Sanders said. "I'm not going to tell you that's always
the case with the VA."

Among the incidents that have become friction points between lawmakers
and the VA:

A nursing assistant allegedly killed a 70-year-old patient in an
altercation at a VA hospital in Alexandria, La. VA officials deemed
the death accidental. The local coroner, a former police detective,
thought otherwise and set in motion steps that led to manslaughter
charges. The nursing assistant pleaded not guilty. His attorney didn't
respond to requests for comment. The VA said it couldn't comment on a
continuing investigation.

The VA inspector general reported the VA system in Pittsburgh didn't
follow standard procedures in managing plumbing systems, leading to an
outbreak of Legionnaires' disease that sickened at least 21 and
contributed to the death of five. In September, the commission that
accredits hospitals said the Pittsburgh VA hadn't adequately mapped
its plumbing system to identify areas at high risk. The VA says
Pittsburgh's water-safety regimen is "now one of the most rigorous" in
the industry. The hospital director has received performance bonuses
and remains in her job. The VA had no further comment on the
Pittsburgh system, and a representative for the facility didn't
respond to requests for comment.

The inspector general found the director of the Augusta, Ga., VA
hospital guilty of "abuse of authority" for having hired a favored
congressional aide. Other problems beset the hospital: It received
only a "conditional accreditation" from its inspection authority, and
a backlog of gastrointestinal exams led to worsened sickness in at
least seven patients. Three of those have since died, perhaps as a
result of those aggravated illnesses, according to the VA's Mr.
Brookie.

The director was briefly removed from her post but was soon put in
charge of another VA hospital. She retired in the fall and didn't
respond to requests for comment. The VA has hired new staff and
cleared up the Augusta backlog, Mr. Brookie said.

Veterans' groups are monitoring the scrap between the agency and the
Hill. Joe Davis, spokesman for the Veterans of Foreign Wars, praised
Congress for taking its oversight responsibility seriously. But he
worries that measures such as banning bonuses might drive talent from
the VA's ranks and into the often more-lucrative private sector. "The
one thing we can't do is penalize everybody for the faults of a few,"
said Mr. Davis.

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Curt Cashour

House Committee on Veterans' Affairs

curt.cashour@mail.house.gov

202.225.3527

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Sean Eagan

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