Rebuilding trust at VA Medical Center

Moderated by Tom Sabulis

The Atlanta VA Medical Center in Decatur has come under intense scrutiny from Congress in recent months, after a federal audit linked three patient deaths in the hospital’s mental health unit to pervasive mismanagement. Today, the center’s newly installed director writes about her first steps to rebuild trust on the job. Senator Johnny Isakson, R-GA, writes about the ongling battle to stem military suicides.

Commenting is open.

Building new support

By Leslie Wiggins

The Atlanta VA Medical Center is one of the fastest-growing VA facilities in the nation, expected to serve close to 90,000 individual veterans this year. I believe we owe every one of these veterans a debt of gratitude and appreciation that we can never adequately repay. As the new medical center director, I will do all that I can to ensure they receive the best care in America.

One of my primary goals is for the Atlanta VA to promote an environment that fosters physical and psychological safety for the veterans we serve, and for the employees who are committed to serving them.

Since taking over as director on May 20, my primary focus has been on strengthening our mental health program. We have made significant progress so far. We have:

• Reduced appointment wait times of 14 days or more by nearly 11 percent.

• Embedded VA-licensed clinical social workers at all contract mental health facilities to improve communications between referring VA clinicians, receiving contract providers and veterans.

• Reduced the number of contract mental health facilities from 26 to 5 to enhance our ability to track and monitor patients receiving care outside the Medical Center.

• Implemented a secure database tracking system for veterans referred to mental health contract providers.

• Strengthened policies governing visitation, patient observation, urine drug screening collection and control of hazardous items at the inpatient mental health unit.

• Developed plans for interactive group sessions and classes individually tailored for inpatients and focused on their recovery.

Veterans can be assured of our ongoing commitment to provide high-quality care. Although the Atlanta VA has faced some recent challenges, I want veterans to know that we are committed to serving them with the level of excellence they deserve.

Soon after my arrival, I also began meeting with many of the stakeholders who partner with the Atlanta VA. To date, I have conducted six town hall meetings with employees, two meetings with Veteran Service Organizations (VSOs) and two meetings with my Veterans Advisory Board, which is composed of 25 senior VSO leaders.

Similarly, I have met with U.S. Rep. David Scott on two occasions, and with Reps. John Lewis and Phil Gingrey. I have also addressed the Disabled American Veterans, Veterans of Foreign Wars and the American Legion. I will continue to engage all of our stakeholders to promote public trust, transparency, participation and collaboration.

I would like to extend my personal appreciation and gratitude to all veterans, and vow to always be a strong advocate for them in the future. On behalf of the Atlanta VA Medical Center, a special thank-you to those who have worn the uniform and dedicated their lives to the cause of freedom.

Leslie Wiggins is director of the Atlanta VA Medical Center.

Keeping promises to service members

By Johnny Isakson

Each day, 22 veterans in this country commit suicide; that’s about 8,000 each year. Jaws drop, as they should, when I share this very sad and alarming statistic with others. It is clear that our country has a problem and that we must do a better job caring for our troops and veterans, especially when it comes to mental health care.

I frequently hear from veterans and their family members from across Georgia about the problems they face, from long waits for a VA disability claim decision, to difficulty finding civilian employment, to limited access to quality mental health care. As a member of the Senate Veterans Affairs Committee, I know these problems are not confined to just the state of Georgia but exist across the country.

Recent reports from the VA Inspector General have highlighted problems at the Atlanta VA Medical Center. The reports link three suicides to mismanagement at the hospital, and that is both tragic and heartbreaking.

While I believe the VA is committed to addressing this issue, I have asked the VA to take the necessary steps to maximize its resources to prevent more suicides and reverse this alarming trend.

Though the VA and the hospital have responded in some capacity and have taken steps to fix this unacceptable mismanagement, we must be vigilant and follow up thoroughly. We also must know whether similar incidents are happening elsewhere around the country. To that end, I have worked with the committee to schedule an Aug. 7 field hearing in Atlanta to address the issues at the Atlanta VA Medical Center, as well as to discuss how mental health care must be a part of a comprehensive approach to caring for veterans.

I hope this field hearing will not only demonstrate the hospital has executed a plan to address its failures outlined in the Inspector General report, but will expose best practices for providing care to our veterans so we can stem the tide of suicides.

For example, one important part of the solution is community partners. I encourage the VA to continue to work with private mental health providers, service organizations and wounded-warrior groups across the country. When veterans return home, these local partners help the VA better meet the needs of veterans as they transition to civilian life.

One recent report highlighted that several veterans “fell through the cracks” because of a failure to follow through in each case. I am dedicated to ensuring no veteran falls through the cracks when seeking the care that veteran earned.

This hearing is critically important, as we expect to see more than 1 million service members transition from active duty to veteran status in the next few years from the wars in Iraq and Afghanistan.

We must see to it that the Department of Veterans Affairs lives up to the promises we have made to our service members and veterans who have shown such bravery in the face of tyranny around the world.

Johnny Isakson, a Republican, represents Georgia in the U.S. Senate.

19 comments Add your comment

Bernie

July 11th, 2013
5:08 pm

Senator Isakson seems you speak with forked Tongue. “Republicans Seek To Cut Benefits for Disabled Veterans” There was this pledge from the Republican Party to Cut veterans Benefits in 2010 & 2011.

Surely such an idea has not changed, but delayed until after 2014 and 2016 when it is SAFER!

Bernie

July 11th, 2013
5:39 pm

Ms. Leslie Wiggins Welcome to Atlanta!

May Your Leadership Breathe a Breath of Fresh Air, throughout every Hallway and Stairway on Clairmont Road. We Have Needed You for a Very Long Time.

USC-69

July 11th, 2013
6:44 pm

Welcome Ms. Wiggins. I can see that you have been busy. There were many calls from legislators to fire people. As Bernie points out, much of the problem in the Veterans Administration (particularly the busy Atlanta V.A. Medical Center) Is the failure of these very legislators to provide adequate funding. Yes, there are many federal employees working the system there. During the Gingrich-Clinton Government shutdown of 1995-96, the halls of the hospital emptied but patient care continued. Who were all these apparently unnecessary bureaucrats? Also, you completely fail to mention your second most important source of support – Emory University School of Medicine. Currently, each full time physician should have a faculty appointment there and meet the academic standards of a highly rated medical school. In addition, many medical students, interns, and residents are charged with the care of patients and must be properly supervised and instructed. My last advice is to strengthen this tie (the V.A. hospital is on the grounds of the Emory University President’s Residence) and attend to the multiple patient care complaints that have been received previously by the Dean’s Office of that institution.

InfraredGuy

July 11th, 2013
10:28 pm

I say she should follow the usual Federal model and that’s when the guilty are found, they should get early retirement and placed in another Federal job or just paid to do ” HOME ” work.

SAWB

July 12th, 2013
12:02 am

Curious what Obamacare is going to look like? Well, no need to look any further than Atlanta’s VA Hospital with layer upon layer of bloated bureaucracy. Get accustomed to the frustration of dealing with multiple unnecessary bureaucrats with lifetime employment who are never held accountable for their actions.

While I am certain that there are many very committed and capable healthcare professionals working there I am also certain there are way too many layers of bureaucracy. The best solution for our veterans is to provide them with healthcare vouchers that can be used at private healthcare providers, but alas the central planners will never allow it.

Bernie

July 12th, 2013
11:45 am

SAWB @ 12:02 am – The same comments about OBAMACARE were said of the introduction and implementation of Medicare. Those on the Right railed that it will bring Socialized Medicine and Government take over of Healthcare in America. Those assertions have been PROVEN,FALSE and UNTRUE! Medicare has proven beyond a shadow of doubt to be an asset for Seniors and the Disabled unlike No other Federal Program in History. A success that has continued to this very day over the past decades.

Problems arise for such plans when issues of Health Fraud to the tune of Billions are stolen. Just as the Physician visit to your Mothers Home being Billed as an OFFICE VISIT as stated by YOU, previously. That is where the REAL problems of inefficient Healthcare is to be be found. Your being Silent as a Church Mouse and proudly bragging such act was committed with regularity with this Physician, is just as COMPLICIT in the ACT itself.

Stopping Healthcare FRAUD will save BILLIONS annually in Tax Dollars, is where the real problems of Healthcare resides, not in its so called layered bloated bureaucracy. When Health Fraud is discovered, found or suspected it should be reported. Health Fraud steals from all of US, even our Veterans.

Jesus Christ Crushes NWO, DBMs

July 12th, 2013
12:44 pm

As evidenced in African Americans today, the most severe threat to the mental health of veterans is the realization that they have been criminally misguided by those in command or leadership, and that kind of chicanery is reinforced by government/society after their service is completed. And they come to realize that there is no accountability. Here are a couple of examples.

No honest person believes that by and large, African Americans are in a better position than they were 50 years ago in the South. Yet the government and their chosen black leaders etc create the illusion of progress e.g. Presidential Medals of Freedom awarded to civil rights leaders, Trumpet Wards, high salaried black entertainers/athletes, and First “black” President. All of this is promoted as prima facie evidence of progress in Black America.

Similarly, veterans return to the civilian world and discover that politicians have not been forthcoming. Many have learned via alternative media about the complicity of our government in 911 etc which initiated their involvement in the middle-east wars. Last but not least, veterans soon realize they are unable to receive meaningful service from the Veteran’s Administration. And the solution is as evidenced by Leslie Wiggins, a little window-dressing is applied at the top, people are reassured, but no one is criminally held accountable.

No honest person should be surprised at the flourishing level of suicide among Veterans and African Americans. When citizens discover via alternative media and other credible sources that many of our leaders are criminals, and are complicit in forcing us to live in a fantasy world, the unfortunate ones come to believe that there is no remedy and lose all hope.

Amen?

SAWB

July 12th, 2013
12:47 pm

First, I mentioned that my Mother’s Doctor visited her at home and did not charge her for that visit. I did make the statement that he billed the insurance company, but truthfully I don’t know if he billed Medicare, her Medicare supplemental or if he simply absorbed the cost. The only reason I even brought this up was to refute another hyperbolic statement that you made that when doctors make house calls they require payment during this visit. So, going forward I would prefer that you leave my Mother out of our debates.

Secondly, while Medicare does provide some level of care many people are forced to buy supplemental plans to cover the shortfalls in coverage. While current recipients are sort of stuck where they are going forward we should consider more efficient ways of delivering services. A better idea would be to modify the tax code to encourage young people in the establishment of healthcare savings accounts and the purchase of individual healthcare plans from private insures.

Thirdly, it’s difficult for me to understand how anyone with just a cursory knowledge of the problems associated with the VA can ignore the bureaucratic mess they have become. The VA has many dedicated healthcare professionals and I am by no means disparaging them. However, shifting at least some of the burden to the private sector can only improve the level of care and remove some of the burden from the system.

Bernie

July 12th, 2013
1:41 pm

SAWB @ 12:47 pm – This is your previous comment -SAWB – July 6th, 2013 @11:15 pm – “My Mother’s Doctor makes house calls he actually allocates two afternoons each week to visit patients at home, in hospitals or other facilities. The one time he visited my Mother he simply billed it as an office visit and his staff filed the claim with the insurance company.”

A Physician Billing Medicare a office visit charge for your loved ones Home visit is GOOD?

This is exactly where the waste of healthcare dollars are to be found. The statement made that doctors make house calls they require payment during their visit is True and Factual inquire with any Physician and it is NOT a hyperbolic statement .

There typical response would be “are YOU NUTS? of course we expect to be paid at the time of service on Home visits unless pre-arranged. Surely the cost would be significantly higher if billing is required.

Bernie

July 12th, 2013
1:47 pm

correction:

SAWB @ 12:47 pm – This is your previous comment -SAWB – July 6th, 2013 @11:15 pm – “My Mother’s Doctor makes house calls he actually allocates two afternoons each week to visit patients at home, in hospitals or other facilities. The one time he visited my Mother he simply billed it as an office visit and his staff filed the claim with the insurance company.”

A Physician Billing Medicare a office visit charge for your loved ones Home visit is GOOD?

This is exactly where the waste of healthcare dollars are to be found. The statement made that doctors make house calls they require payment during their visit is True and Factual inquire with any Physician and it is NOT a hyperbolic statement .

Their typical response would be “are YOU NUTS? of course we expect to be paid at the time of service on Home visits unless pre-arranged. Surely the cost would be significantly higher if billing is required.

MrLiberty

July 12th, 2013
3:03 pm

Government central planning has never worked. It cannot ever work as there is no price/value structure that is essential to the proper allocation of resources. The VA has been a joke from the beginning. Face it soldiers, the warfare state only sees you as a means to its end of empire building and resource acquisition for the corporatist fascist state we have in this country (and have had for over 100 years). We don’t fight wars for the defense of this nation (no country has attacked us since 1941 and they were absolutely provoked into that attack). We don’t fight wars to defend liberties or freedoms as the only enemies who are destroying them are in Washington D.C. and the capitals of each state. We destroy nations so that banksters, building contractors (like Haliburton), and weapons manufacturers can get filthy rich in the aftermath. Isakson is a liar. If he or anyone else in Congress really truly cared about those that volunteer to serve, they would stop voting to send them to far away countries that never threatened us to be injured and die for nothing.

Jack ®

July 12th, 2013
4:56 pm

Never fails: Spoon in a measure of racial and anti-American fat in the frying pan and sit back and listen to it sizzle.

Wes Barker

July 12th, 2013
8:35 pm

I have a son who spent 14 years in the Navy as a Psych Tech and another 1.5 years in the Navy Reserves as a Psych Tech. He has applied for positions with this Atlanta V.A. Medical Center and yet hasn’t been ask to interview for all the positions that are open with them. This Medical Center needs all the help it can get to help Veterans who have PDST or just mental problems in general. He left the Navy with honors and they don’t want to hirer someone with his experience. It make me wonder if he was a black Navy corpsman would he have already been hired. Is reverse discrimination go on or dose it just look like it. This is just another problem at this VA Medical Center.

Bernie

July 12th, 2013
9:14 pm

Wes Barker @ 8:35 pm – I am not sure where and how that comment about being Black would give your son preferential treatment. Especially on my last visit the majority of the Patients and staff that was visible looked like you. Mostly White Males!

Maybe your Psych Son is selecting the Race block as Black on his Job application and that is why he is being DENIED! did that one ever occur to you? Blacks have a far greater difficulty in the Navy of becoming a PSYCH Tech, so if you find one, that would be a very RARE find.

I know, for I am a Navy Veteran myself!

Allow the Free Market

July 12th, 2013
9:21 pm

Bernie – Your assertion that Medicare has been great for seniors ignores the fact that thanks to Medicare nearly 50% of all dollars spent on medical care in this country pass through the hands of the Federal Government. There is no greater contributor to the massively rising costs of healthcare in this country than that fact and that fact alone. Everyone looks at the high costs and says “thank god for Medicare” but fails to look at the corellation and causation that government bureaucratic central planning has on runaway costs in everything government touches. If the government wasn’t able to print money out of thin air (thus stealing value and purchasing power from everyone in society) to pay for this boondoggle, it would have gone bankrupt even sooner than it has. Go to usdebtclock(dot) org and see for yourself. Medicare is estimated to have over $86 Trillion in unfunded liabilities on its broken back. That is hardly a measure of success. The new prescription drug benefit (a small government intervention in comparison to Obamacare) has nearly $22 Trillion and it is barely a decade old. Sorry Bernie, but Keynesian smoke and mirrors can’t paper over an atrocity as big as Medicare.

Bernie

July 12th, 2013
9:43 pm

Allow the Free Market @ 9:21 pm – I have yet to see One republican or tea Party member cut Up their Medicare card and return it to HHS. Saying No thanks this is a cost too much to bear for the country. I will forgo this benefit.

Even Nancy Reagan whose Husband Ronnie, was one of the most vocal voices of dissent about the implementation of Medicare is benefiting from this very program this day. I would say when your time comes, you too will expect the same benefit as the millions of seniors all across this Great Nation.

wwoodwo

July 13th, 2013
7:49 am

I am a Vietnam-era noncombat veteran. I should say that the hands-off veterans benefits were pretty good, and I made full use of them. But whenever I had some direct contact with the VA, it just made my blood boil. The last time I went, years and years ago, I realized that if I ever went again, I would be leaving in a police care. Looking back, I’m still not sure whether it was because the VA was a nearly unmovable bureaucracy, or because it represented something. I sense this same undercurrent whenever folks are interviewed about the VA.
PS: the article was not meant to engender a debate about Medicare. That part of this comment field is disrespectful, and pretty maddening, as it simply ignores what the article is about: veterans. It is about veterans, wounded or not, and our sense of caring for their transition to a regular life.

Corey

July 13th, 2013
9:57 am

Could it be that the public sector is much more accessible by the press than private sector entities? The private sector can simply threaten to fire whistle blowers and lock the doors when a news van pulls up out front, but public sector entities are open to the general public. Thus, more eyes, more scrutiny, more oversight. Everyone has a say, and it snowballs as the cameras roll. I’m not saying improvements can’t be made at the VA, but with a sudden boom in patients returning from two simultaneous wars, plus aging Vietnam ear vets coupled with peacetime vets injured on active duty and retired vets; mistakes will be made. My personal experience with the VA has been very good. Visit on any given weekday. It’s open to the general public. The activity there is dizzying.

Veteran Hospital Worker

July 13th, 2013
11:55 am

Ms. Wiggins,

As a worker at the Atlanta VA, I can honestly state that I take great pride in taking care of our Veterans. The management over the years has become more focussed on data and performance measures and have separated themselves from most front line workers. Many areas don’t have regular staff meetings and managers stay behind locked office doors. Workers fear managers because the only time they show up is when their necks are on the line and there has been an incident that gets reported. Workers are often blamed for problems that are systemic.
Please require management at all levels to make rounds more often and get to know workers at all levels.