WASHINGTON — New patients wait more than seven weeks to get a primary care appointment at the Veterans Affairs health facilities in New Orleans — although overall, 98 percent of all patients there obtained an appointment within 30 days, according to an audit released Monday by the federal Department of Veterans Affairs.
The report is the latest prompted by the ongoing VA scandal, initially sparked by revelations of long waiting times and falsified appointments lists at the Phoenix VA hospital. Reports of similar problems in other VA hospitals have fed the growing national uproar, which prompted the resignation of VA Secretary Eric Shinseki on May 30.
The audit looked at the status of appointments on May 15 and included thousands of interviews with VA employees in May and June.
Among the findings in Louisiana:
- New primary care patients waited an average of 51.85 days for an appointment in New Orleans, 33.21 days in Alexandria and 43.79 days in Shreveport.
- Established primary care patients waited an average of 1.52 days in New Orleans, 3.9 days in Alexandria and 3.32 days in Shreveport.
- Waits for new specialty care patients average 45 to 55 days at all three facilities, and for new mental health patients, 27 to 33 days. For established patients, waits in all categories were less than four days, except for 12.73 days for specialty care in Alexandria.
At the New Orleans facilities, the rate of the 44,001 total appointments scheduled more than 30 days out was 2 percent, among the lowest reported for the 10 hospitals in the VA region that includes all or parts of Louisiana, Mississippi, Arkansas, Texas and Oklahoma. The 1 percent rate in Shreveport tied with Houston for the lowest; the 8 percent in Alexandria was the highest.
The VA flagged all three Louisiana hospitals and the VA clinic in Baton Rouge for further review.
Since Hurricane Katrina knocked out the central VA hospital in New Orleans in 2005, the agency has provided service for that area through eight community-based clinics in New Orleans, Slidell, Hammond, St. John the Baptist Parish, Houma, Franklin, Bogalusa and Baton Rouge.
Construction is underway on a massive new central facility near Canal Street and Interstate 10. Building costs are estimated at just under $1 billion, with another $700 million for equipment, furnishings and other expenses. The VA hopes to open the hospital in 2016.
Nationwide, the VA network — the largest single health care system in the United States — counted more than 6 million appointments on May 15. In addition, more than 57,000 veterans were waiting for appointments to be scheduled. More than 63,000 veterans who signed up with the VA system in the last 10 years have never seen a VA doctor or care provider, a group the agency plans to reach out to.
Based on employee interviews, the audit said, 13 percent of the staff members who scheduled appointments said they were told by supervisors or others to manipulate the scheduling system by entering a requested date different than the one the patient actually asked for. Also, 8 percent of the schedulers said they used unofficial appointment lists — in some cases, under pressure to make waiting times look better.
The audit said the VA’s stated goal of achieving a 14-day average wait time is “not attainable,” in light of the growing demand for services and inadequate marshaling of resources to provide them.
The longest average wait time for new primary care patients was 145 days, in Honolulu.
The audit surveyed 731 facilities. The VA operates 150 hospitals and 820 clinics nationwide, treating 9 million patients.
In response to the scandal, senior U.S. senators last week agreed on a bipartisan VA bill. The measure, which awaits action by the full Senate and House, authorizes the VA to lease space for 26 delayed medical clinics in 18 states, including ones in Lafayette and Lake Charles.
Plans for the clinics were cast in doubt when congressional budget officials adopted a new, higher-cost formula for estimating lease expenses. A 2013 House-approved bill to authorize the leases fell victim to procedural wrangling in the Senate early this year.
Authorization of the leases puts them on the VA’s to-do list but does not provide money for them. That would require separate legislation.
The 26 clinics have been designated by the VA in its budget requests as necessary to satisfy unmet needs for veterans’ medical care. The VA operates a small clinic in Lafayette now and has set up a mobile clinic in Lake Charles, but neither is considered sufficient by the agency.
The bill also would allow veterans to get government-subsidized care from private doctors enrolled as providers for Medicare, military TRICARE or other government health care programs, if those veterans experience waits of 30 days or more for VA appointments or live at least 40 miles from a VA hospital or clinic.
It also would let the VA immediately fire as many as 450 senior regional executives and hospital administrators for poor performance. That resembles a measure passed last month by the House but includes a 28-day appeal process omitted by the House legislation.
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