VA manipulated mental health care data, lawmaker says

The Veterans Affairs Department manipulated its data to show 95 percent of patients who sought mental health care received an appointment within 14 days, when in fact 94,000 new veteran patients in 2011 had to wait an average of 50 days for an appointment, Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee charged at a hearing today.

Miller also blasted VA for trying to head off an inspector general report on veterans’ access to health care released on April 23 with a pre-emptive announcement on April 19 that it planned to hire 1,900 mental health personnel. Miller said he was concerned by the “timing and implications” of the announcement ahead of the release of the IG report, which detailed wait times for care and shortages of mental health professionals. Miller called VA’s personnel announcement a “quick fix, cookie-cutter solution to a very serious multifaceted problem.”

The IG said 1.2 million veterans had to wait longer than 14 days for a mental health care appointment. “Although we based our analysis on dates documented in VHA’s medical records, we have less confidence in the integrity of this date because providers at three of the four medical centers we visited told us they requested a desired date of care based on their schedule availability. VHA data showed that 98 percent received timely care for treatment.”

Dr. Robert Petzel, VA undersecretary of health, told the hearing that the Veterans Health Administration and the IG calculated wait times differently. VHA requires schedulers to ask veterans when they want to be seen for a new appointment. This is referred to as the “desired date” in VA’s scheduling system. Auditors with the Office of the Inspector General assessed wait time based on when the appointment was actually entered, or what is known as the “create date” entry. Petzel said the difference skewed the results.

Linda Halliday, assistant inspector general for audits and evaluations, told the hearing that she had concerns about the “integrity” of VHA data on wait times, reinforcing conclusions in the report that the agency “does not have a reliable and accurate method of determining whether they are providing patients with timely access to mental health care.”

VA Secretary Eric Shinseki told the hearing that the department’s 20-year-old scheduling system contributes to the long wait times. Dr. John Daigh, assistant inspector general for health care inspections, agreed and testified that problems with several VA software project over the past years have contributed to mental health appointment scheduling problems. In 2009, VA canceled a new scheduling system eight years into development.

Shinseki, who disputed the IG report’s findings, said the department’s provision of mental health care services needs to be assessed more broadly than only by appointment timelines with mental health professionals. He said VA’s 800 community-based outpatient clinics and 300 vet centers also provide mental health care as well as a growing telemental health operation. Petzel said VA provided telemental health care to 150,000 veterans in 2011.

Tuesday’s hearing came the day after the 9th U.S. Circuit Court of Appeals in San Francisco overturned a District Court decision in May 2011 that VA had to beef up its mental health care for veterans. The decision stemmed from a suit brought by Veterans for Common Sense in 2007. The Appeals Court ruled that Congress or the president -- not the courts -- has the final say on such care. Judge Jay Bybee wrote in his opinion, “As much as we may wish for expeditious improvement in the way the VA handles mental health care and service-related disability compensation, we cannot exceed our jurisdiction to accomplish it.”