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Associated Press
FILE - In this March 14, 2013, file photo, Rob Nabors, President Barack Obama's deputy chief of staff. Obama is dispatching Nabor, one of his closest White House advisers to oversee an investigation of the troubled Department of Veterans Affairs. (AP Photo/J. Scott Applewhite, File)

Obama aide to oversee VA review

Associated Press
FILE - Veteran Mark Howey waits to ask a question as Sen. John McCain speaks during a forum with veterans regarding lapses in care at the Phoenix Veterans Affairs hospital, on Friday, May 9, 2014, in Phoenix. Grieving family members of dead veterans have joined politicians from both parties in loud protests over VA care. (AP Photo/Matt York)

– President Barack Obama is dispatching one of his closest White House advisers to oversee a review of the beleaguered Veterans Affairs Department as the agency grapples with allegations of treatment delays and preventable deaths at a Phoenix veterans hospital.

White House deputy chief of staff Rob Nabors will be temporarily assigned to the VA to work on a review focused on policies for patient safety rules and the scheduling of patient appointments, officials said Wednesday. The move signals Obama’s growing concern over problems at the department, particularly recent reports that hospital administrators in Phoenix kept an off-the-books list to conceal long wait times as 40 veterans died waiting to get an appointment. Similar problems have since been reported in other states.

The allegations have sparked a firestorm inside the VA and on Capitol Hill. The American Legion and some congressional Republicans have called for the resignation of Veterans Affairs Secretary Eric Shinseki, who is scheduled to testify before a Senate committee Thursday.

“While we get to the bottom of what happened in Phoenix, it’s clear the VA needs to do more to ensure quality care for our veterans,” Obama said in a statement. “I’m grateful that Rob, one of my most trusted advisers, has agreed to work with Secretary Shinseki to help the team at this important moment.”

Obama ordered the patient policy review after the Phoenix allegations became public. But officials said Shinseki requested more help with the review, leading Obama’s chief of staff, Denis McDonough, to tap Nabors for the assignment.

The move is similar to the action the White House took last year when it assigned longtime Obama aide Jeffrey Zients to take over management of the troubled HealthCare.gov website from officials at the Health and Human Services Department. HHS Secretary Kathleen Sebelius later resigned her post.

“We are glad the president took this first step to ensure the White House is involved in solving this crisis at the VA,” said Tom Tarantino, the chief policy officer of Iraq and Afghanistan Veterans of America. “We need bold reform to establish a culture of accountability throughout the VA system and hope that Mr. Nabors’ presence will help ensure that this type of failure never happens again.”

Despite calls for Shinseki to step down, the White House insists that Obama continues to have confidence in the secretary, a retired four-star Army general. Shinseki said he welcomed Nabors’ help in ensuring veterans have access to timely, quality health care.

“If allegations about manipulation of appointment scheduling are true, they are completely unacceptable – to veterans, to me and to our dedicated VA employees,” Shinseki said.

Though Nabors has kept a low public profile, he is one of Obama’s closest advisers and has played key roles in the president’s fiscal battles with congressional Republicans. Nabors, the son of an Army veteran, was appointed deputy chief of staff following Obama’s re-election and previously served as the president’s chief congressional liaison and deputy budget director.

The VA operates the largest integrated health care system in the country, with more than 300,000 fulltime employees and nearly 9 million veterans enrolled for care. But the agency has struggled with the influx of new veterans entering the VA system as the wars in Iraq and Afghanistan come to a close.

The allegations against the Phoenix hospital have been particularly troubling. Former hospital employees contend that up to 40 patients died while waiting to see a doctor and that the hospital kept a secret list of patients waiting for appointments to hide the treatment delays.

VA facilities in South Carolina, Florida, Pennsylvania, Georgia and Washington state have also been linked to delays in patient care or poor oversight. An internal probe of a Colorado clinic found that staff had been instructed to falsify records to cover up delayed care at a Fort Collins facility.

The VA has acknowledged that 23 patients have died because of problems related to care since 1999, according to an ongoing nationwide internal VA review, which showed that delays often occur when a doctor refers a patient to another physician, such as a specialist. During the same time period of the deaths, more than 250 million of these consults were requested.

The review Nabors will oversee is separate from an inspector general’s investigation into the Phoenix allegations that is already underway. Three executives at the hospital have been placed on leave while the allegations are being investigated.

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Follow Julie Pace at http://twitter.com/jpaceDC

Secret lists, deaths: Claims roil Veterans Affairs

BRIAN SKOLOFF -- PHOENIX – A team of federal investigators swept into Phoenix last month amid allegations of a disturbing cover-up at the veterans hospital.

Their goal: to unravel the truth behind a secret waiting list supposedly maintained to hide lengthy delays for sick veterans, making it appear as if they were seeing doctors sooner when some may have waited months and died in the meantime.

The claims, which so far have not been proved, have thrown the U.S. Department of Veterans Affairs into turmoil. Politicians have called for resignations, congressional inquiries are underway, and VA Secretary Eric Shinseki is appearing before a Senate committee in Washington this week.

And it’s only the beginning. Shinseki has ordered an audit of every VA facility nationwide and similar claims of waiting-list manipulations have cropped up in other states. As the election-year talk surrounding the debate rages, here is a look at some key facts about the issue:

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HOW DID THE ALLEGATIONS COME TO LIGHT?

A former clinic director for the VA in Phoenix started sending letters to the VA Office of Inspector General in December, complaining about systematic problems with delays in care.

“The time is now. The place is Phoenix, Arizona where a message needs to be sent loud and clear to VA administrators and bureaucrats alike that the murder of our veterans for cash bonuses and career advancement will no longer be tolerated,” wrote Dr. Samuel Foote, who retired after spending nearly 25 years with the VA.

Foote later took his claims to the media, then to Republican Rep. Jeff Miller, chairman of the House Veterans’ Affairs Committee, who announced the allegations at an April hearing.

Foote says up to 40 veterans may have died while awaiting treatment at the Phoenix hospital and that staff, at the instruction of administrators, kept a secret list of patients waiting for appointments to hide delays in care. He believes administrators kept the off-the-books list to impress their bosses and get bonuses.

“If you died on that list, they could just cross your name off and there was no trace that you’d ever been to the Phoenix VA,” Foote told The Associated Press. “As if you never existed. You’re just gone.”

Since Foote’s revelations, two more former Phoenix VA employees have made the same claims.

But some question their motives. One employee, who first raised the concerns publicly a few weeks ago, was fired last year and has a pending wrongful termination lawsuit against the hospital. Before he retired, Foote was reprimanded repeatedly for taking off nearly every Friday, according to internal emails he provided the AP.

He said the reprimands were unfair and that he was overworked and had every right to take the days off. Managers said it looked bad for a clinic director to work just four days a week.

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WHAT IS THE VA’S RESPONSE?

Phoenix administrators vehemently deny the allegations. The VA announced recently it found no evidence to substantiate the claims after an internal probe.

The Phoenix hospital’s director, Sharon Helman, scoffed at the notion that she would direct staff to create a secret list and watch patients die in order to pad her pockets.

“To think that any of us would do anything like that to harm any veteran for any financial reasons is very, very disturbing,” Helman told the AP hours before placed on leave while the Inspector General’s Office investigates. She has been provided with police protection after receiving numerous death threats.

Last year, Helman was awarded a $9,345 bonus in addition to her $169,000 annual salary.

Helman and hospital Chief of Staff Dr. Darren Deering, who remains in his job, said Foote and others have not provided names of any of the 40 patients or any documentation of a secret list. Foote, who would not provide that information to AP, said he obtained it through other employees at the VA. He won’t say who.

Helman and Deering also speculated that if up to 40 patients did indeed die while awaiting doctor’s appointments, some may have died from car accidents or heart attacks or other ailments unrelated to their care at the Phoenix VA facilities.

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THE FAMILIES

Grieving family members of dead veterans have joined politicians from both parties in protests over VA care. Several of them shared the stage with Sen. John McCain last week at a town hall meeting.

Many are appalled to think that their loved one might have been on a secret list while waiting to see a doctor.

Sally Barnes-Breen said her 71-year-old father-in-law, a Navy veteran, died while awaiting an appointment at the Phoenix VA. Thomas Francis Breen had bladder cancer and died Nov. 30.

Barnes-Breen said she took him into the Phoenix hospital with blood in his urine in September. He was examined, she said, and sent home, told they would get a call for an appointment to see a primary care physician within a week.

But the days came and went and the phone never rang. She said she followed up repeatedly, but no one responded.

“They left him to die,” Barnes-Breen said during a recent interview while cradling a wooden box containing her father-in-law’s ashes.

In early December, a few weeks after Breen died, Barnes-Breen said she finally got a call from the hospital with an available appointment.

“I said, `Well, you’re a little too late,”’ she said.

VA administrators in Phoenix declined to discuss Breen’s case, citing privacy laws.

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WHAT IS THE OVERALL STATE OF THE VA?

The VA operates the largest integrated health care system in the country, with more than 300,000 fulltime employees and nearly 9 million veterans enrolled for care.

The Phoenix claims are the latest to come to light as VA hospitals and clinics around the country struggle to handle the enormous volume. VA facilities in South Carolina, Florida, Pennsylvania, Georgia and Washington state have been linked to delays in patient care or poor oversight. An internal probe of a Colorado clinic found that staff had been instructed to falsify records to cover up delayed care at a Fort Collins facility.

The VA has acknowledged that 23 patients have died because of problems related to care since 1999, according to an ongoing nationwide internal VA review, which showed that delays often occur when a doctor refers a patient to another physician, such as a specialist. During the same time period of the deaths, more than 250 million of these consults were requested.

The White House said the VA has made tremendous progress in reducing case backlogs, but that they need to be completely eliminated. President Barack Obama has said he remains confident in Shinseki’s leadership.

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