Fla. lawmakers deride VA for problems but counsel caution on overhaul

About 20 lawmakers from both sides of the aisle took testimony from veterans groups and from an official of the VA’s Florida health operations.

06/12/2014 5:39 PM

06/12/2014 5:41 PM

A bipartisan collection of Florida lawmakers piled on the Department of Veterans Affairs on Thursday in a special delegation meeting — although one of the most common refrains heard was some variation of “the VA does many things well.”

About 20 congressional members from both sides of the aisle took testimony from veterans groups and from an official of the VA’s Florida health operations. The VA has been caught in a scandal over scheduling practices that hid how long veterans actually waited to see their doctors.

The scandal already has claimed the VA secretary, who resigned two weeks ago, and it escalated recently with a VA audit that found widespread scheduling abuses and data falsification. There also is an FBI investigation into those practices.

U.S. Rep. Jeff Miller, a Republican from the northwest corner of Florida, sat in on the Florida delegation meeting for a bit before leaving for a separate hearing of the House Veterans’ Affairs Committee, of which he is chairman.

He applauded the news of the FBI investigation.

“I believe there is criminal activity involved in what has taken place,” Miller said. “Anytime somebody manipulates federal records for their own personal gain, or to the detriment of the veteran, that’s criminal. I will also tell you that anytime somebody comes to Congress and lies to Congress, that’s a crime.”

He added: “This is not going away. It shouldn’t go away. Americans deserve an answer and veterans deserve nothing less than the truth, and they deserve nothing less than the benefits that they have earned by wearing the uniform of this nation.”

Miller also has inquired about the chief of staff for the Miami VA Healthcare System, Vincent DeGennaro, a colon and rectal surgeon who surrendered his New York medical license in 2009 after Florida’s medical board censured and fined DeGennaro for failing to meet professional standards in the case of a patient who died under his care at a Fort Lauderdale hospital.

During a hearing Monday of the House Veterans’ Affairs Committee, Miller bluntly asked why DeGennaro had not been fired.

“Why is this doctor still at the Miami VA Medical Center? And how is it he remains the chief of staff of a major regional healthcare facility?’’ Miller asked Philip Matkovsky, a top VA official.

Matkovsky promised to respond to the committee, but had not done so as of Thursday, said Miller.

“ This is not at all surprising and is typical of an organization that has become a case study in how to stonewall the press, the public and Congress,” said Miller. “Make no mistake, however: we will pursue this matter until department leaders provide a clear explanation of precisely why they feel someone who has been effectively banned from practicing medicine by a state medical board is qualified to serve in a senior leadership position at a major VA hospital.”

Miami VA officials have said that DeGennaro was vetted by the Professional Standards Board before being appointed chief of staff in 2011. DeGennaro earned more than $327,000 in 2013, according to a federal database on government salaries.

Florida is home to more veterans than any state but California and Texas, as well as several individual congressional districts that rank among the top 20 of all House districts in veteran population.

The Thursday meeting, run like a typical congressional hearing, was led by Reps. Vern Buchanan, a Republican from Sarasota, and Alcee Hastings, a Democrat from Miramar.

Buchanan called the VA audit released earlier this week “extremely disturbing” and “a disgrace unworthy of America.”

Even so, several representatives and witnesses said that, despite its problems, the VA is appreciated and defended by many of its users.

Rep. Joe Garcia, a Democrat from Miami, said, “I find that most veterans like their VA, and they want to keep the integrity of that system. . . . As hard as I sometimes push ‘Do you want private health care?’ – that’s not what they want.”

That sentiment reflects the complexity of the VA and its current scandal.

The VA is a massive system, with 151 medical centers, 820 community clinics, 300 Vet Centers that offer counseling, and a range of other rehabilitation, residential and other care centers.

For veterans who do get into the system – because of their disability levels, prison-of-war status, income or other factors – there is widespread satisfaction. The American Customer Satisfaction Index, a national survey run by an independent organization that allows comparisons over time and among different sectors of the economy, regularly asks veterans about their experience and the VA generally ranks as high or higher than private-sector hospitals.

At the same time, there are growing patient loads in parts of the country, which contributed to the scheduling shenanigans at the heart of the scandal. With overbooked medical clinics, schedulers gamed the system to make their internal numbers look good.

For veterans, they are left to work the system as best they can.

Robert McGuire, president of the Florida statewide chapter of the Korean War Veterans Association, told the Florida delegation that he uses the VA system for some of his care, his Medicare coverage for other aspects, and private doctors for still more. Taken together, he feels he has excellent care — but not because the VA itself provides it.

“You can tell all the good stories you want to about the VA, and I love ’em – I love ’em because what they do well they do very well,” McGuire said. “But what they don’t do is timely medical care.”

That’s why he said the VA system needs to better integrate its coverage options with Medicare or other supplements. The VA, he said, is a “piecemeal medical system” and can’t be relied on for the range of care necessary.

“If I want to see a private doctor I see him today. If I want to see a VA doctor, I see him in two months,” he said.

McGuire, who is 79 years old and from the Daytona area, asked the Florida delegation to consider whether they would rebuild the system the VA now has if they had the opportunity to do so.

“Is what you have today what you would create? Hell, no!” he said. “You wouldn’t touch it. It doesn’t work. It won’t work and it never will as long as you keep tweaking and twisting little tiny pieces.”

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