Cheating, Lying and Fraud—Will Restructuring Save the Scandal-Plagued VA?
Policy + Politics

Cheating, Lying and Fraud—Will Restructuring Save the Scandal-Plagued VA?

One of the more intriguing questions as the nation honors its veterans is whether Robert A. McDonald, the new Secretary of the Veterans Affairs Department, will be able to revolutionize his beleaguered agency in the two years left of the Obama administration.

Others have tried and failed miserably. But on Monday the former corporate executive from Procter & Gamble unveiled a four-step plan he’s hoping will help put an end to gross inefficiencies and the bureaucratic insensitivity and wrongdoing that contributed to the deaths of veterans who were denied timely medical treatment.

Related: McDonald’s VA ‘To-Do List’ Includes 6 Urgent Fixes

In what he described as the “largest restructuring in the department’s history,” McDonald outlined his plan in a memo to his 300,000 employees throughout the country. The plan includes these actions:

  • Establish a new department-wide customer service organization to ensure the delivery of top-level service to veterans, headed by a chief customer service officer. “The mission of the new office will be to drive VA culture and practices to understand and respond to the expectations of our veteran customers,” McDonald said.
  • Create a single regional framework to simplify internal coordination, facilitate partnering and enhance customer service. Veterans will “more easily [be able to] navigate VA without having to understand our inner structure,” he said.
  • Establish a national network of community veteran advisory councils to coordinate better service delivery with local, state and community partners. 
  • Identify opportunities for realigning internal business processes into a “shared services model” to improve efficiency and reduce costs. The VA will also explore techniques used in the private sector to enhance delivery of services.

Related: 7 of the Most Outrageous Abuses at VA Medical Centers 

McDonald, 61, who spent 30 years as an employee and later chief executive of Proctor & Gamble, the consumer products behemoth, is trying to impose business models on a sprawling, unruly government bureaucracy to improve services, establish better accountability and provide veterans in need of care with a simplified way of making appointments and getting help. Until recently, just making an appointment to see a doctor or have medical tests performed has been a nightmare for many veterans.

“We’re calling [the new plan] ‘My VA’ because that’s what we want veterans to think about it,” McDonald said in an interview yesterday with CNN. “We want them to think of our department as embracing them and giving them a warm hug, a place they can go to get the care that they need, as a department that is totally veteran-centric, looking for only one outcome – which is good outcomes for veterans.”

• With more than 300,000 employees serving about 9 million veterans, the scandal-plagued VA is in the throes of a major upheaval with just two years left in the Obama administration.

• Will McDonald, a former Procter & Gamble CEO, be able to apply disciplined business principles to a vast and sprawling federal bureaucracy whose 2015 total budget, as requested by President Obama, is $163.9 billion, which includes $68.3 in discretionary resources and $95.6 billion in mandatory funding?

While some of his  proposals seem sketchy, McDonald appears to be trying to mount a coordinated campaign to simultaneously overhaul the troubled department while investigating and punishing those responsible for the long waiting lists that denied needed health care and contributed to some deaths.

The scandal first erupted April 30 when CNN reported that at least 40 U.S. veterans had died while awaiting care at the Phoenix, Arizona, VA medical center. The controversy ultimately triggered investigations by Congress, the White House, and the Justice Department, and led to the resignation of VA Secretary Eric K. Shinseki on May 30. 

Related: Is Bob McDonald Really the Right Guy to Lead the VA?   

McDonald said yesterday that at least 35 VA employees are facing disciplinary action, with as many as 1,000 to follow. The VA already has taken “disciplinary action” against 5,600 employees in the past year, and said more firings will follow.   

"We are acting aggressively, expeditiously, and consistent with the law," McDonald told CNN in advance of Veterans Day. But even with additional administrative authority granted the VA secretary to speed up the dismissal of officials and employees found guilty of wrongdoing, the government personnel process is still cumbersome and time consuming.

For example, Sharon Helman, director of the Phoenix VA health center where more than 3,500 veterans were confirmed to have been waiting for inordinately long periods of time for appointments on “secret” lists, and the director of the Pittsburgh VA, Terry Gerigk Wolf, have both been relieved of their duties but kept on the government payroll since May and June, respectively, according to CNN.

Asked why it was taking so long to dismiss these and other officials, McDonald said that legislation approved by Congress last summer in response to the scandal did little more than shorten the time in which employees could appeal their dismissals.

Related: VA Bill Means a New $50 Billion Entitlement

In response to criticism from some lawmakers who have said it’s taking him too long to dismiss incompetent or negligent employees, McDonald said, “If Congress wants me to follow a different procedure, they’ve got to pass a different law. The only thing the new law did was it took the appeal time and cut it in half.”

Since assuming the post three months ago, McDonald said he has made 42 inspections of VA operations in 22 cities, visited eight medical schools, and had conversations with thousands of employees and veterans. “I’ve learned a lot – we’ve had teams of people around the organization, from the bottom to the top of the organization, working on this reorganization.”

President Obama signed a bill into law in August that provided $16 billion to hire more VA doctors and nurses, open mobile clinics and enable some vets to obtain private medical care by using “choice cards.”

McDonald told CBS' 60 Minutes in an interview that aired Sunday that he plans to hire about 28,000 medical professionals to join the agency’s hospitals and clinics, including about 2,500 mental health professionals.

Related: The $1,000 Pill That Could Cripple the VA’s Budget

But whether all the new plans will make a big difference remains to be seen. Paul Rieckhoff, founder and executive director of Iraq and Afghanistan Veterans for America, praised McDonald for bringing a fresh focus on patient care to the VA, but complained that many government-level changes have not yet reached veterans in local communities.

“It is a good step forward, but it is only one of a marathon of steps that are going to be required to turn this around,” Rieckhoff told The New York Times. “Having a plan is easy in Washington; executing that plan is the hard part.”

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