St. Petersburg, Florida -- 10 Investigates is getting a hold of results from a national audit of Veteran Affairs facilities. The audit was prompted after allegations of veteran patients waiting too long for treatment.
The results show some VA medical centers are in need of further investigation including C.W. Bill Young VA Medical Center, formerly Bay Pines.
The C.W. Bill Young VA Medical Center has been flagged with over 1,000 new patients signing up online and seeking an appointment through their online enrollment process but never scheduling an appointment for them.
The average time frame for scheduling an appointment at the facility was about 47 days days, and that number is nearly 15 days longer than was originally reported by the facility.
A spokesperson for the Young VA Center tells 10 Investigates:
"As you are aware, U.S. Department of Veterans Affairs released results from its Nationwide Access Audit, along with facility level patient access data, quality and efficiency data, and mental health provider survey data, for all Veterans health facilities including the Bay Pines VA Healthcare System. This release of information reiterates VA's commitment to transparency and promise to provide timely access to quality health care Veterans have earned and deserve.
As part of our ongoing work to improve access to care in direct support of VA's Accelerating Access to Care Initiative, we have been and continue to execute immediate, sweeping actions to improve problems identified regarding access to care in order to better serve Veterans.
We recognize that timely access to care is essential to positive outcomes and remain committed to improving access across our healthcare system as the Veteran population continues to grow. Across the Bay Pines VA Healthcare System, we continue extended hours of operation at our larger sites, review those waiting for care and alternatives to providing care in VA, examine physician productivity, improve our scheduling capabilities, and provide telehealth and in home care where appropriate."
The 1,193 patients included in the report are part of what we call the New Enrollee Appointment Request (NEAR) list. This list is generated primarily through the VA health care benefits online enrollment process. When an individual completes an application for health care benefits, he or she is asked if they would like an appointment. If the patient is eligible to receive care through VA and indicates a desire for a medical appointment, the medical center contacts the Veteran to fulfill the request. The 1,193 patients listed on the report are those who were not contacted through the NEAR process. This does not mean that these individuals could not obtain appointments using other scheduling methods available (i.e. calling the facility directly). NEAR is only one process used to identify patients who would like an appointment through VA. It is also important to mention that all patients who request appointments during the enrollment process are automatically added to the NEAR list, regardless of eligibility. Some only want to enroll but do not wish to pursue care. Only after eligibility is determined would a patient be contacted about an appointment. Those who are not eligible are removed from the list. For those remaining on the list, we continue to review and validate if these patients still require care. If so, they will be scheduled as appropriate. Please note that we have added additional new patient appointment within primary care to support timely access.
At the time of release, the national report identified 712 patients on our Electronic Waiting List (EWL). The data was pulled nationally on May 15, 2014. Patients are added to the EWL when their appointments are scheduled out greater than 90 days. This includes primary care, specialty care and mental health patients who do not have urgent or emergent needs. For Veterans who need same day access, it is available through the Emergency Department and an Urgent Care clinic at the C.W. Bill Young VA Medical Center, Urgent Care at the Lee County Healthcare Center in Cape Coral, as well as walk in opportunities at our Community Based Outpatient Clinics (CBOCS) in Bradenton, Naples, Palm Harbor, Port Charlotte, Sarasota, Sebring, and St. Petersburg. My HealtheVet secure messaging via the Internet and telephone contacts are also available with healthcare providers. To decrease the EWL and provide more timely access, we are proactively reaching out to patients and providing options for more timely appointments within our system. We are also providing options for Veterans to seek authorized care in the community when we do not have capacity for timely access.
Supporting care in the community is not a new practice. From FY12 to FY13, Bay Pines' community care expenditures increased 11 percent to $78,633,135, and this year, we anticipate a five percent growth in Non-VA care costs. Cost is not a factor in the decision to coordinate care in the community for a Veteran. Routine reviews of patient needs are completed to ensure those in need of expedited care receive it."
As a result of the audit, the VA is eliminating this 14-day scheduling goal for new patients in an effort to eliminate employee incentive to engage in inappropriate scheduling practices, as was uncovered in some facilities.
Rep. Gus Bilirakis, vice-chairman of the House Committee on Veterans Affairs, participated in a hearing with representatives from the Government Accountability Office (GAO), Inspector General's office (IG), and the VA and questioned policies regarding patient "no shows" and cancellations of appointments.
The audit revealed that many VA facility patient schedulers have been sending notices in the mail to patients with dates and times of appointments without communicating with the patient directly.