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VA News

VA Secretary Misled Senators During Confirmation

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Robert Wilkie 002

 

Veterans Affairs Secretary Robert Wilkie “gave inaccurate answers to senators during his confirmation process about pro-Confederate speeches he delivered in 2009,” CNN reports.

“In response to questions about remarks he made at Confederate memorial events, Wilkie downplayed his participation in a June 2009 event at the Confederate memorial in Arlington National Cemetery as simply introducing a keynote speaker. He also said he didn’t have copies of remarks because he had not delivered a speech to such groups in ’15 to 20 years.'”

“But Wilkie’s comments stand in contradiction to what his spokesman told CNN’s KFile team last week, when he confirmed that Wilkie delivered a speech extolling the legacy of Robert E. Lee at that June 2009 ceremony at the Confederate memorial. The speech was the same one that he gave to another group in December 2009, which was also published in the Confederate Veteran magazine.”

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Report: Nearly half of Veterans had dermatology appointments delayed at Pensacola VA clinic

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Pensacola Delayed Appts

 

Nearly half of patients needing dermatology consults through the Veteran Affairs' Joint Ambulatory Care Center in Pensacola did not see a dermatologist within the recommended amount of time, according to a recent government inspector's report.

The Department of Veterans Affairs Office of Inspector General's report was released Monday and covered the government's 2017 fiscal year, which ran from Oct. 1, 2016, to Sept. 30, 2017.

Officials with the Biloxi, Mississippi-based Gulf Coast Veterans Health Care System and the Department of Veterans Affairs in Washington did not immediately respond to requests for comment.

The 23-page report by Dr. John Daigh, the VA's assistant inspector general for health care inspections, was prompted by a Pensacola-area Veteran's complaint about not being assigned a new primary care provider for a year after the Veteran's physician left the VA system. The complaint also stated the issue caused delays in receiving dermatology care.

The investigation found 540 out of 1,170 Veterans who sought dermatology consults from the Pensacola clinic in 2017 fiscal year were delayed in receiving appointments.

The Veteran whose complaint promoted the investigation was actually without a primary care provider for nine months, a violation of VA policy, the investigation found.

"(The Veteran) remained assigned to a provider who was no longer employed by the system," the report stated.

Because of the error, the Veteran's dermatology treatment was also delayed, the reported stated.

The case led to further investigations of other requests for dermatology consults.

"The (Office of Inspector General determined that scheduling delays occurred in 46 percent of the (Joint Ambulatory Care Center) dermatology consults initiated during fiscal year 2017, which did not meet the (Veterans Health Administration) goal for patients to have an appointment within 30 days of sending or ordering provider's clinically indicated date," the report stated.

But none of the delays caused Veterans to experience "adverse clinical outcomes," the report stated.

The report included the following recommendations to the Gulf Coast Veterans Health Care System: ensure patients are assigned primary care providers, monitor the scheduling of dermatology appointments and ensure managers review staffing levels of schedulers.

U.S. Rep. Matt Gaetz, who has pushed for changes within the troubled Veteran's Affairs system, did not immediately respond to requests for comments on the issue. In a January town hall in Pensacola, Gaetz heard from dozens of Veterans concerned about VA health care issues.

Diego Echeverri of the Veterans advocacy group Concerned Veterans for America attended the Gaetz town hall and said Tuesday he was disappointed in the inspector general report about the Pensacola clinic.

“It’s unfortunate we continue to hear of instances of Veterans not being able to get the care they need due to being forced into an overburdened system. This reinforces the need for fundamental reforms to how and where Veterans can get the care they need — when and where they need it," Echeverri said in an emailed.

Despite the report's findings, Marine Corps Veteran Ed Rouse said he was pleased with the overall care he receives at the Pensacola clinic. Rouse is among thousands of area Veterans who rely on the clinic for their medical needs.

"If I had to grade them on scale of one to 10, I'd give them an eight," Rouse said. "I go there all there time and I have no complaints, but I have no really serious health issues."

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VA mismanaged police force, costing millions of dollars and leaving security gaps, investigators say

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Mismanaged Police

 

WASHINGTON – The Department of Veterans Affairs failed to properly manage thousands of VA police officers who patrol its medical centers across the country, resulting in short-staffing and millions in overtime charged to taxpayers, as well as missed opportunities to ensure staff and Veteran patients are protected, federal investigators found.

The VA inspector general determined that national and regional VA security officials did not conduct required inspections for months to make sure firearm records were up to date, security plans were adequate and oversight of critical incidents was conducted appropriately.    

At headquarters, three of the six VA police officials responsible for doing the inspections were reassigned last year to provide security for the secretary and deputy secretary.

“The governance problems stemmed from confusion about police program roles and authority and a lack of a centralized management or clearly designated staff within (Veterans Health Administration) to manage and oversee the police program,” an investigation report released Thursday says.

The inspection delays – on average 10 months across nearly 100 medical centers – occurred even after reviews found problems with VA police departments. In Chicago, for example, inspectors identified concerns about VA police officers not consistently advising suspects of their rights during arrests, but inspectors didn’t follow up for nearly a year to ensure the concerns were addressed.

James Byrne, acting deputy VA secretary, concurred with the inspector general’s findings and said VA officials will work with the IG to “make improvements to security and law enforcement programs and maintain the public’s trust.”

VA employs nearly 4,000 officers at 139 medical centers who play a critical role in securing property, preventing and investigating crimes and often intervening to help patients or staff during potentially dangerous incidents.

The inspector general found medical center directors managed their individual police forces with minimal oversight from regional and national police officials.

A national operations official technically responsible for overseeing agency police operations told investigators that responsibility fell to a different official. That official, the director of the Office of Security and Law Enforcement, told investigators that the office “did not have awareness of, or control over, local police activities.”

The lack of oversight in some cases allowed problems with police to continue for years without being addressed. In Seattle, for example, an inspection in 2016 found the police chief at the medical center did not do required supervisory checks on officers or complete security assessments. The inspector general found those same problems had been identified during inspections in 2012, 2013 and 2014.

“Without an improved governance structure, VA will lack assurance that healthcare environments are safe and secure, and that the program operates effectively and efficiently,” the inspector general concluded.

Other federal police forces have centralized offices to provide greater oversight, including the National Park Service and the Department of Homeland Security’s Federal Protective Service.

The VA’s local approach meant staffing models are all over the place, investigators found. The VA started to develop some in 2016 but hadn’t finished as of September this year.

Short-staffing in recent years forced some medical centers to borrow officers from other VA hospitals and cost taxpayers more than $26 million in overtime last year alone.  

VA staff told investigators “factors contributing to recruitment and retention challenges included obtaining local facility approval to hire police officers due to changes in facility management, as well as competing priorities in hiring healthcare staff.”

The inspector general recommended the VA institute hiring and staffing strategies to help stem the shortages and evaluate the need for more centralized oversight of VA police.

VA officials said they would follow the recommendations and have fixes in place by September.

“Ensuring medical facilities nationwide are safe and secure environments for patients, visitors and employees is of the utmost importance to VA,” Byrne, the acting deputy VA secretary, wrote.

It’s not the first time VA police have been flagged for problems. About 30 years ago, the inspector general found more than half of VA’s officers were either unqualified, unsuited or both for the job, and nearly two dozen had criminal convictions.

In January, the Government Accountability Office found the VA did not collect and assess security data across its hospitals that could provide critical information about deficiencies or trends.

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Trump loyalist at VA forced out after collecting pay but doing little work

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The Trump administration has forced out a senior White House political appointee at the Department of Veterans Affairs who spent months on the federal payroll doing little to no work.

Peter O’Rourke’s departure marks an unceremonious fall for a Trump loyalist once seen as a rising star at VA, where he nonetheless had a rocky tenure, first leading a high-profile office handling whistleblower complaints, next as chief of staff and then, for two months, as the agency’s acting secretary.

Since August he has held the nebulous role of senior adviser, with an uncertain portfolio and a senior executive salary as high as $161,000. VA Secretary Robert Wilkie asked for his resignation Friday, O’Rourke said.

O’Rourke said in an interview that he remains “very supportive of the president and the agenda of the Trump administration” and would like to rejoin the administration.

“I’d be more than happy to serve again,” he said. “It doesn’t appear there is a request at this time.” He said he “does not hold any grudges.”

Asked why he was getting paid not to work, O’Rourke said he was “available for anything the secretary asked me to do” and acknowledged that “there were times I didn’t have a lot to do.”

Spokesmen for the White House and VA did not respond to requests for comment.

While he did not serve in roles that required Senate confirmation, O’Rourke, a former press lead for Trump’s presidential campaign, wielded huge influence. But his star faded following clashes with lawmakers, VA’s inspector general and other agency officials.

O’Rourke was a central figure during a tumultuous period from which VA has not yet fully recovered, when infighting at its senior levels threatened the president’s agenda for Veterans. When Wilkie arrived in late July, he tried to sideline O’Rourke, according to people familiar with the matter.

When Trump would not fire him, O’Rourke became a senior adviser to the secretary after turning down at least one low-profile job Wilkie offered, people close to VA said. But O’Rourke was rarely in his office at VA headquarters in Washington, according to four people with knowledge of the arrangement, and by last week White House officials had grown concerned that O’Rourke was getting paid but not working, creating a perception problem in a corner of the government where the president has promised greater accountability.

“I don’t think he has any actual responsibilities at work,” one senior administration official said of O’Rourke days before he left.

O’Rourke joins a group of senior administration officials who were forced to exit after their ethics or management style raised questions about their effectiveness. Nowhere in the government has Trump’s pledge to “drain the swamp” of ineffective bureaucrats and poor performers been on display more than at VA, which has pushed out thousands of low-level employees and dozens more senior career civil servants.

“You say you’ve been cleaning up VA, but this guy’s been getting paid to sit on his couch,” said Paul Rieckhoff, founder and chief executive of Iraq and Afghanistan Veterans of America and a frequent critic of VA’s leadership under Trump.

“Was O’Rourke exempt from this new accountability bill?” Rieckhoff said, referring to legislation Congress passed last year that clears a fast path to firing poor-performing civil servants at VA. “Taxpayers are owed an answer.”

It’s common for federal employees to be placed on paid administrative leave when an agency investigates allegations of misconduct against them. O’Rourke, though criticized by colleagues and lawmakers, was not under investigation for any wrongdoing.

O’Rourke’s standing in the administration was buoyed by a controversial trio of unofficial advisers to the president who are members of Trump’s Mar-a-Lago Club in Palm Beach, Fla. The men have exerted huge influence at VA since Trump took office, steering policies and procurements on everything from information technology to mental health care.

As his power and portfolio at VA grew, particularly during the president’s failed nomination of White House physician Ronny L. Jackson to run the agency, O’Rourke was in regular contact with the group, dubbed the “Mar-a-Lago crowd” by agency insiders: Marvel Entertainment Chairman Ike Perlmutter, Palm Beach physician Bruce Moskowitz and attorney Marc Sherman.

Perlmutter, the group’s de facto leader, did not immediately respond to a request for comment.

O’Rourke made regular trips to Mar-a-Lago for meetings with them after Trump fired his first secretary, David Shulkin, amid a highly publicized power struggle with O’Rourke and other political appointees at the agency. He helped the group deepen its involvement in the agency’s day-to-day operations, according to multiple former VA officials and others close to the agency.

After Wilkie assumed power and began to appoint his own leadership team, Perlmutter contacted Trump and advised him to find O’Rourke another job in his administration, telling the president his loyalty should be rewarded, according to two people familiar with the conversation. The White House Personnel Office was tasked with finding him a job at another agency that would suit his background in business development. But that didn’t happen. Instead, O’Rourke was in limbo for more than four months at taxpayers’ expense.

Sen. Patty Murray (D-Wash.), who serves on the Senate Veterans’ Affairs Committee, said she was disturbed to learn of the arrangement to keep O’Rourke on the payroll while he did not work.

“The VA’s mission is and always has been to serve Veterans, not dole out political favors,” Murray said in an email. “I was deeply concerned by Mr. O’Rourke’s time at VA, where as Acting Secretary he made a number of questionable decisions and personnel changes that were suspect at best.”

The committee’s Republican chairman, Sen. Johnny Isakson (Ga.), declined to comment.

A former Air Force logistics officer, O’Rourke was embroiled in controversy at VA almost from the start. His leadership of the Office of Accountability and Whistleblower Protection, created days after Trump took office, has held to account few of the senior managers it was designed to target, and whistleblowers who came forward to report misconduct complain of retaliation.

O’Rourke’s supporters blamed the White House Personnel Office for allowing him to flounder. They say he was dedicated to Trump’s agenda for Veterans.

O’Rourke drew unfavorable reviews on Capitol Hill from members of both parties after a dispute with VA’s inspector general, who was denied records he sought from the accountability office. A Washington Post report on O’Rourke’s efforts to purge civil servants and some political appointees whom he and others installed by Trump deemed unsupportive of the president’s agenda drew calls for an investigation by Congress.

His relationship with Wilkie was contentious from the start. The new secretary tried several times to have him fired, according to VA and White House officials. Wilkie complained about him to White House officials, telling them he could not bring calm and restore the sense of mission and morale at VA that lawmakers on Capitol Hill demanded if O’Rourke stayed on.

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Veterans are calling for more oversight as the Governor searches for new Veterans affairs director

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Military Relief Fund

 

Military Family Relief Fund under scrutiny

INDIANAPOLIS — Veteran whistleblowers are calling for sweeping change at the Indiana Department of Veterans Affairs, the Veterans’ Affairs Commission, and how the state handles the Military Family Relief Fund.

On Friday, IDVA director Jim Brown submitted his resignation to Governor Eric Holcomb, citing his last day as December 28.

Although Brown did not give a reason for his resignation, his departure notice comes just weeks after a Call 6 investigation that found Brown approved his own IDVA employees to receive benefits from the Military Family Relief Fund, some exceeding the $2,500 limit.

“I was surprised that the resignation happened as quickly as it did, but I wasn’t surprised in that it was something that was needed,” said Lisa Wilken, an Air Force Veteran and Veteran advocate who first raised concerns about the Military Family Relief Fund to Call 6 Investigates right before Veterans Day .

When you purchase a Veteran license plate or a Support the Troops plate, a chunk of that money goes into the Military Family Relief Fund.

The Indiana Department of Veterans Affairs administers the fund, and it says on their website that Veterans and their families can get up to $2,500, “Grants up to $2,500 may be awarded. The qualified individual or family member can receive up to $2,500 one time from the Family Relief Fund.”

Wilken and Veteran Will Henry blew the whistle on the fund after uncovering documents that showed IDVA employees received help while the state agency denied other Veterans.

“He abused the program for his own will,” said Henry. “He pushed his colleagues to the front of the line. It’s a bitter pill to swallow.”

Since 2016, IDVA has denied 799 applications to the Military Family Relief Fund and approved 3,971.

“I think it was an exercise in poor judgment,” said Wilken. “It was an unethical practice.”

Veterans say Brown’s resignation is just the tip of the iceberg, and that the state needs to do a full investigation into the Military Family Relief Fund.

“Veterans just want more answers at this point,” said Henry. “I am worried that this is a systemic issue.”

The State Board of Accounts is looking into the Military Family Relief Fund as part of their ongoing state audit.

Veterans have asked the Indiana Inspector General to investigate, but the IG does not disclose information about the existence of an investigation until the ethics commission finds probable cause, a prosecutor files charges or a final report is issued.

Governor Mike Pence appointed Brown in 2013.

Now, it’s up to Governor Eric Holcomb to appoint a new IDVA director.

Call 6 Investigates caught up with Holcomb at a public event on Monday, and he said he did not ask for Brown to resign.

“I was waiting on an audit to be presented to me, and it is forthcoming, but in the mean time it was his decision,” said Holcomb. “He just thought it was time. He has served his nation and state and felt it was time.”

Holcomb said the audits should help determine if the Military Family Relief Fund needs additional oversight.

“We are going to learn a lot from this, and the data will inform us on next steps to take,” said Holcomb. “Now starts the search for who will replace him and I look forward to that next chapter.”

Veterans are working with state lawmakers to put the $2,500 cap into Indiana law.

“The rules are the rules, but we need to put it into law so it can’t happen in the future,” said Wilken.

Wilken and Henry said the Governor’s office needs to look at the rest of IDVA’s leadership and the Indiana Veterans’ Affairs Commission, a seven-member panel appointed by the Governor.

“The funds need to have more oversight,” said Wilken.

According to their website, the Indiana Veterans’ Affairs Commission manages the Military Family Relief Fund.

Commission member Rep. Karlee Macer (D-Indianapolis) has raised concerns following our Call 6 Investigation.

“Veterans and taxpayers alike have put their faith in the Legislature and the IDVA to ensure that our Veterans are cared for in a fair and consistent manner,” said Macer. “By giving preferential treatment and an inside track to department employees, not only has the IDVA broken the trust of our Veterans, but they have grossly mismanaged a fund dedicated to making sure that those most in need of these funds are able to receive them. Downplaying this and passing blame are simply unacceptable.”

The commission’s next meeting is scheduled for January 11.

Call 6 Investigates has requested an interview with Brown, but we have not yet heard back.

Source

GAO finds VA contractors not meeting timeliness, accuracy standards on exams

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WASHINGTON — The Department of Veterans Affairs doesn’t have the tools to track whether private-sector medical providers are accurately giving exams that help determine whether Veterans are eligible for VA benefits, a government watchdog agency found.

Disability compensation exams are key in determining whether Veterans have injuries or illnesses connected to their military service and deserve compensation. Because of legislation passed in 2014 that allows the VA to outsource more services, an increasing number of Veterans are receiving their exams outside of the agency.

The Government Accountability Office reported last week that the VA lacks the data to determine whether the private-sector providers are meeting standards for quality, timeliness and accuracy. Based on analysis by the GAO, the contractors are falling short with the exams.

“As VA continues to rely on contracted examiners, it is important that the agency is well positioned to carry out effective oversight of contractors to help ensure that Veterans receive high-quality and timely exams,” the GAO report states.

The report is expected to be the subject of a House subcommittee hearing Thursday.

Rep. Phil Roe, R-Tenn., the chairman of the House Committee on Veterans’ Affairs, asked the GAO to conduct the investigation.

“If Congress is without data on the quality and timeliness of these examinations, we have no way of knowing if this is wise use of taxpayer funds,” Roe said Friday in a statement. “I remain just as committed as I was when I first became chairman to ensuring that Veterans are receiving timely and quality examinations and that taxpayer money is well spent.”

The VA awarded contracts in 2016 to five private firms to conduct the exams, totaling up to $6.8 billion for five years. The firms are: VetFed Resources, Inc., in Alexandria, Va.; Logistics Health Inc., in La Crosse, Wisc.; Medical Support Los Angeles in Pasadena, Calif.; QTC Medical Services, Inc., in Diamond Bar, Calif., and Veterans Evaluation Services, Inc., in Houston, Texas.

When awarding the contracts, then-VA Secretary Robert McDonald said it was good news for Veterans who were waiting for the VA to determine whether they were eligible for VA benefits – a process that can take years.

“For these Veterans, we want the process to be smoother – from beginning to end,” McDonald said in a statement at the time.

The GAO focused its investigation on 2017, when contractors conducted 767,000 disability compensation medical exams – about half of the total exams that year. The cost of the exams by contractors totaled $765 million.

The VA set standards for the outside contractors to meet, including for 92 percent of exam reports to contain no errors. In the first half of 2017, only one contractor met that target, the GAO found.

Most contractors fell into the “unsatisfactory performance” category, meaning 10 percent or more of their reports contained errors. The worst-performing contractor had errors in 38 percent of their exam reports.

The VA doesn’t have data for the second half of 2017, but the agency said it hired more staff to review the quality of the reports.

The department had even less information about how quickly the exams are being performed. Contractors are supposed to send their exam reports to the VA within 20 days after they accept a Veteran’s exam request. The VA lacked the tools to determine whether they met that mark.

Using VA data, the GAO investigators themselves analyzed the timeliness of 646,005 exams that contractors completed between February 2017 and January 2018. Of those exams, 306,479 – just more than half – were completed within 20 days. Twelve percent, 69,748 claims, took 40 days – double the targeted time.

Contractors gave various reasons for the delays, including severe weather, Veterans’ availability and challenges finding medical specialists in rural areas.

As of June 2018, there were more than 87,000 exams pending with contractors. Of those exams, 37,077 had already lapsed beyond the 20-day target, the GAO reported.

“Tracking these exams is important because a large volume of such exams could ultimately increase the amount of time Veterans have to wait for their claims to be processed,” the report states.

The GAO made four recommendations to better track and analyze the contractors’ performance. Investigators also recommended the VA improve its training for the providers who conduct disability compensation exams.

In response to the report, VA Secretary Robert Wilkie wrote the VA was developing a new system to capture and analyze data from the exams, which is expected to be completed by the end of the year.

The department is also trying to hire employees who could implement a new training plan for outside medical providers.

The House subcommittee on disability assistance and memorial affairs is scheduled to meet at 10:30 a.m. Thursday to discuss the report.

“It is time to delve into the details,” Roe said.

Source

Indiana Veterans affairs head resigns after grants scrutiny

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Indiana VA

 

INDIANAPOLIS — The leader of Indiana’s Veterans affairs agency resigned Friday following reports that he had awarded money to Veterans who worked under him at the agency that was intended to go to Veterans struggling to make ends meet.

Gov. Eric Holcomb accepted James Brown’s resignation as director of the Indiana Department of Veterans' Affairs, and in a statement he praised the decorated Vietnam Veteran, who had led the agency since 2013.

"Sgt. Maj. Brown is a good man with a distinguished service record," Holcomb said. "I am grateful for his longstanding service to our state and country."

Brown’s resignation came a week after reports surfaced questioning the agency’s administration of Indiana’s Military Family Relief Fund, which was created in 2007.

The fund, which is financed primarily with fees from sales of Veteran license plates and "Support Our Troops" plates, grants money to Veterans to help them pay for food, housing, utilities, medical services and transportation.

The Indianapolis Star reported that at least 11 agency employees who are Veterans — and many of whom make $40,000 to $50,000 a year — have collectively received about $40,000 in recent years from the fund. One employee received $1,100 for new tires. Another employee’s application was approved the day it was submitted, even though Veterans facing homelessness and job losses were required to wait weeks or months for assistance.

The newspaper also reported that while Veterans not employed by the state agency who sought funding faced multiple requests for additional information about their requests, documents showed that Veterans who are agency employees faced few such hurdles.

Indiana’s Veterans Commission approved draft rules Oct. 5 for the fund, but plans to make more changes before submitting a final version to the state Attorney General’s Office for legal review.

The Indianapolis Star reported that had those draft rules been adopted years ago, Veterans' Affairs employees likely would have been precluded from receiving funds. While the proposed rules do not explicitly prohibit agency employees from receiving money, income limitations based on federal poverty guidelines probably would.

WRTV-TV reported that while Veterans and their families can get up to $2,500 in funding, records showed that grants of more than $2,500 were awarded to both employees of the agency and the fund itself. It also reported that two Veterans had raised concerns in February about the fund’s administration.

Most Veterans also were strictly held to a $2,500 lifetime cap on aid, but at least four of Brown's employees who are Veterans received more than that, including the manager of the program, who dipped into the fund multiple times.

Most of the grants in question were awarded during a period of 2 ½ years when Veterans affairs officials hadn't adopted rules governing the $1.7 million program.

Brown, who approved the grants, defended his actions, arguing that his employees had a right to the money just as any other Veteran did.

"There is no great tragedy here," he told the Star last week. "No laws have been broken."

The State Board of Accounts is now conducting an audit of the program.

Holcomb, who re-appointed Brown in 2016 as the agency's director and is ultimately responsible for the agency, has said little about the questionable spending. As recently as Tuesday, he would only say that he is awaiting the results of the audit.

Brown was originally appointed to lead the agency in 2013 by Vice President Mike Pence, who was then Indiana’s governor.

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Veterans Affairs rulers had sway over contracting and budgeting

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Newly released emails about the three Trump associates who secretly steered the Department of Veterans Affairs show how deeply the trio was involved in some of the agency’s most consequential matters, most notably a multibillion-dollar effort to overhaul electronic health records for millions of Veterans.

Marvel Entertainment chairman Ike Perlmutter, West Palm Beach physician Bruce Moskowitz and lawyer Marc Sherman — part of the president’s circle at his Mar-a-Lago resort in Florida — reviewed a confidential draft of a $10 billion government contract for the electronic-records project, even though they lack any relevant expertise.

In preparing the contract, the agency consulted more than 40 outside experts, such as hospital executives, according to the records, which were released under the Freedom of Information Act. The Mar-a-Lago trio were listed among those experts. Perlmutter, a comic book tycoon, appears on the list between representatives from the University of Washington Medical Center, Intermountain Healthcare and Johns Hopkins University.

But none of the three men has served in the U.S. military or elsewhere in government, and none of them has expertise in health information technology or federal contracting.

The list is one of hundreds of newly released documents about the so-called Mar-a-Lago Crowd’s sway over VA policy and personnel decisions. The records show them editing the budget for a government program, weighing in on job candidates and being treated as having decision-making authority on policy initiatives.

In a June 2017 email, a VA official identified Perlmutter alongside then-VA Secretary David Shulkin as “top principles [sic].” In another message, Moskowitz named himself, Perlmutter and Sherman to an “executive committee.”

Since the role of the troika was exposed by ProPublica in August, lawmakers have called their influence “wildly inappropriate” and “textbook corruption and cronyism.” A liberal Veterans group sued to block them under a Watergate-era sunshine law on advisory committees. House Democrats and the nonpartisan Government Accountability Office said they would investigate.

VA Secretary Robert Wilkie has repeatedly distanced himself from the trio. His spokesman, Curt Cashour, blamed previous leaders. “Although his predecessors may have done things differently, Sec. Wilkie has been clear about how he does business,” Cashour said in a statement. “No one from outside the administration dictates VA policies or decisions — that’s up to Sec. Wilkie and President Trump. Period.”

But that posture carries risk for Wilkie; his predecessor was fired after losing favor with the Mar-a-Lago Crowd.

A representative of Perlmutter, Moskowitz and Sherman declined to comment, as did Shulkin and the White House.

Before they could review the government contract in March 2018, Perlmutter, Sherman and Moskowitz had to sign non-disclosure agreements, according to the newly released records. Sherman edited the agreement to allow him, Perlmutter and Moskowitz to discuss the details with one another and with the president or other administration officials, according to the emails.

The newly released emails also detail Moskowitz’s effort to get the VA and Apple to adapt his app. As a VA IT official described it in a May 2017 email, “We are utilizing the native iOS mobile app, Emergency Medical Center Tracker, that Dr. Moskowitz developed.”

VA health officials offered their own ideas for how a collaboration with Apple could benefit Veterans, such as working on credentialing, data exchange and analytics, and suicide prevention research. But Moskowitz rejected the VA doctors’ ideas in favor of his own. “These are good areas but not the emergency ones which my group of experts have identified,” he said in a May 2017 email. “I sent an email to outline the recommendations.”

Darin Selnick, a VA official who previously signed onto a 2016 proposal to dismantle the agency’s government-run health service, agreed with Moskowitz’s low estimation of the VA doctors’ input. “The VA staff has limited knowledge and experience, which is why you and the” academic medical centers “are so important to help the VA move forward,” Selnick wrote.

Selnick, who is now a special adviser to Wilkie, was the point person working with Moskowitz on the app, the emails show. “I like you are the implementer for VA,” he told Moskowitz in March 2017.

When Selnick said the VA’s information technology division could start working on the app, Moskowitz replied, “We need our specialist.” He then connected Selnick with his son Aaron, and Selnick introduced Aaron Moskowitz to Apple. (Aaron Moskowitz’s name is redacted from the emails, but his involvement was confirmed by four people familiar with the matter. He didn’t respond to a request for comment.)

VA officials identified major problems with the app’s usability and functionality. “Some of the code needs to be refactored and even rebuilt,” the IT official said in the May email.

Nevertheless, Moskowitz’s son Aaron joined a June 2017 conference call with executives from top medical systems and from Apple, including CEO Tim Cook. Moskowitz wanted the app discussed for five to seven minutes, according to the emails. After the call, Moskowitz named his son as one of the project’s “mid-level project managers.”

In preparation for the conference call, Apple employees and medical experts circulated a memo that assessed Moskowitz’s proposals, which were identified as coming from “the VA and the White House.” In the memo, Apple’s experts pushed back on Moskowitz’s app, saying that the VA’s website already offered a similar tool and that the national databases needed to make the app accurate didn’t exist. Instead, the memo encouraged pursuing a different idea (giving Veterans a way to store their health data on their cellphones), which it said would “achieve the greatest benefit for our Veterans in the shortest amount of time.”

Apple spokesman Josh Rosenstock didn’t answer requests for comment.

Months later, Moskowitz fumed that the Apple partnership didn’t go his way. “We had an excellent group assembled on the call with Tim Cook,” he said in a March 2018 email. “The VA dropped all contact and proceeded on its own. So now we have a product of limited value.”

Moskowitz also used his influence at the VA to get the agency to convene a meeting on registries for medical devices. Moskowitz started a foundation (whose board included Perlmutter’s wife) that lobbied medical institutions to start such registries so patients could be notified of recalls. Aaron Moskowitz drew a $60,000 salary as the foundation’s director, according to tax filings.

The VA already had a system to notify patients within 10 days of a recall, with a 99 percent success rate, according to internal emails. And the Food and Drug Administration already has a nationwide program to track medical devices. Nevertheless, Moskowitz spurred the VA to organize a conference on the subject, with extensive input from him and his son, according to notes from weekly 7:30 a.m. planning calls. Planning documents named Moskowitz’s foundation as a “participating partner” and a “private interest.”

Moskowitz even had say over the conference’s budget: In an April 2018 email, the VA official running the effort said, “I owe Dr. Moskowitz a budget — Bruce and I are editing it.” Cashour, the VA spokesman, declined to say how much the program cost.

The Mar-a-Lago Crowd’s interventions sometimes bumped into each other. Once, in May 2017, when Selnick tried to schedule a call about the Apple partnership, Moskowitz replied that the time conflicted with another call he had with the acting head of the VA’s health division.

When Wilkie first met the Mar-a-Lago Crowd, they seemed to get along.

“For the first time in 1½ years we feel everyone is on the same page,” Perlmutter said in an email after the meeting at Mar-a-Lago in April. “Everybody ‘gets it.’”

Wilkie returned the enthusiasm, thanking the men for providing a foundation to build on.

“I was honored to visit with you,” Wilkie, who at the time was the acting secretary, wrote. “No matter how long I am here, there is a template in place based on your efforts to move this institution out of the Industrial Age.”

(That last sentence was redacted when the VA originally disclosed the email to ProPublica under the Freedom of Information Act; the agency cited an exemption for internal deliberations. After ProPublica challenged that redaction, the VA released the full message.)

But since that initial meeting in April, Wilkie’s relationship with the Mar-a-Lago Crowd has frayed. Under pressure from lawmakers after ProPublica’s investigation, Wilkie said in September that his team cut off contact with the trio.

The loss of access has stung Perlmutter, according to a person close to the administration. But Perlmutter remains close to Trump: he spent election night with him and saw him over the Thanksgiving holiday weekend at Mar-a-Lago.

The person, who spoke on the condition of anonymity to describe confidential discussions, said Perlmutter has begun criticizing Wilkie — as he had Wilkie’s predecessor, Shulkin, before the president fired him.

Perlmutter faults Wilkie, the person said, for snubbing Perlmutter’s calls and for sidelining one of his top allies, former acting secretary Peter O’Rourke. Additionally, the person said, Perlmutter is displeased with the agency’s releasing emails about him and with the course of its electronic health records overhaul.

“It’s very clear that Ike is going to war against Wilkie in a similar way to the way he did against Shulkin,” the person familiar with the matter said. “It’s gotten that bad.”

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Why the VA may be getting too much money

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Too Much Money

 

The Trump administration recently announced a plan to cut each cabinet department’s budget by 5 percent as part of an effort to rein in the federal government’s growing budget deficit. However, Secretary of Veterans Affairs Robert Wilkie said that while he is developing proposals to reduce spending within the Department of Veterans Affairs, he still expects Congress to approve another record-breaking VA budget for fiscal 2020.

If that is what ultimately transpires, that would represent a huge missed opportunity to eliminate waste and better allocate resources within the VA. Here’s why:

Since 2001, the VA budget has more than quadrupled from $45 billion to close to $200 billion for the current fiscal year. This massive infusion of funds couldn’t prevent the falsification of thousands of Veterans’ medical records or bribery and fraud among VA officials.

More money hasn’t stopped reports of poor quality medical care for our Veterans and didn’t prevent the deaths of hundreds of Veterans on waiting lists.

Instead, we continue to see examples of waste, fraud and mismanagement at VA.

We read about VA facilities not meeting cleanliness or infection-prevention standards and about 10,000 patients awaiting prosthetics.

We learn that VA continues using an inefficient and outdated IT system, making it particularly susceptible to fraud and abuse.

We find out about the department renting in-home hospital beds for three patients for three years at a cost of $877,000 when the beds could have been purchased for $21,000, or buying a “special needle” for $900 that could have been bought for $250.

And still the critics say, “More money!”

In addition to funding increases, the VA has seen a dramatic increase in personnel beyond the increase in patients. From fiscal 2014 to the end of fiscal 2017, the number of VA patients grew by 3.6 percent while the number of department personnel grew by 12.5 percent. Today, the Department of Defense is the only federal agency with more employees than the VA. These personnel increases have not solved the VA’s core problems.

Instead of alarmist warnings about budget cuts, policymakers should focus on substantive reforms that will improve the VA’s current system while ensuring taxpayer dollars are more wisely spent. While the VA MISSION Act was a good first step down this road, there’s still plenty more to do.

Approximately 80 percent of Veterans have insurance coverage through private providers or federal programs like Medicare. When Veterans elect to receive medical care not related to their service-connected disabilities through the current VA Choice program or the future VA community care program, the VA should serve as their secondary payer (as opposed to the primary payer, which is the first to cover medical expenses). In 2016, the Congressional Budget Office estimated this could save about $200 million over 10 years.

Similarly, according to the 2015 Independent Assessment of the Veterans Health Administration, streamlining the VA’s processes for collecting monies owed by insurance companies and aligning its reimbursement standards with best practices from the private sector could save upwards of $1 billion a year.

Equalizing copayments for non-service connected care within the VA with those paid by military retirees enrolled in TRICARE is another commonsense reform. Some would argue that this would raise the costs of health care for Veterans but why should someone who served two to four years pay less for their health care than someone who served more than 20?

This small adjustment to copays, which would amount to a few dollars a month, would save the VA up to $1 billion a year.

VA should also continue to dispose of some of its 430 vacant properties and 784 underutilized buildings. Additionally, the VA must stay on track to meet deadlines set by the VA MISSION Act to evaluate its current infrastructure and identify adjustments to meet the needs of current and future generations of Veterans. If the VA fails to realign its infrastructure to the future needs of the Veteran population, the cost of maintaining outdated facilities is expected to soar billions of dollars above what has been budgeted for maintenance.

These reforms and others would allow the VA to focus resources on what really matters ― giving Veterans the best care and benefits possible. Instead of fearmongering about a potential budget reduction, we should be more concerned with the VA spending what it already gets in a more efficient and effective manner.

Throwing more money at the VA will not solve all its problems. Instead, Congress and the VA need to be held accountable to implement urgently needed reforms. Simply dumping more resources into the VA without eliminating waste and inefficiency does a disservice not only to our Veterans but to the American taxpayer as well.

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VA secretary praised Confederate president as a "martyr to 'The Lost Cause'" in 1995 speech

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Robert Wilkie 07

 

(CNN)Secretary of Veterans Affairs Robert Wilkie praised Confederate States President Jefferson Davis effusively in a 1995 speech, calling him a "martyr to 'The Lost Cause'" and an "exceptional man in an exceptional age."

Wilkie, who delivered the speech in front of a statue of Davis at the US Capitol during an event sponsored by the United Daughters of Confederacy, also said that while he was "no apologist for the South," viewing Confederate "history and the ferocity of the Confederate soldier solely through the lens of slavery and by the slovenly standards of the present is dishonest and a disservice to our ancestors."

Wilkie's speech, a transcript of which ran in the United Daughters of the Confederacy Magazine, reveals his belief in the "Lost Cause" theory of the Civil War, which portrays the Southern states who seceded as heroic and denies the central role slavery played as a cause for the conflict.

A KFile review also found Wilkie attended a pro-Confederate event as recently as 2009, giving a speech on Robert E. Lee to a Maryland division of the Sons of Confederate Veterans.

CNN's KFile found references to Wilkie while researching the neo-Confederate movement, which seeks to promote a more sympathetic view of the Confederate states during the Civil War, and obtained copies of the speeches from Edward Sebesta, a scholar on the neo-Confederate movement.

Veterans Affairs press secretary Curt Cashour did not address the content of Wilkie's remarks when asked by CNN but said in a statement that the events Wilkie attended "were strictly historical in nature, and as Secretary Wilkie said at his confirmation hearing in June, he stopped participating in them once the issue became divisive."

"Today marks the 187th anniversary of the birth of Jefferson Davis; planter, soldier, statesman, President of the Confederate States of America, martyr to 'The Lost Cause,' and finally the gray-clad phoenix ---- an exceptional man in an exceptional age," Wilkie, who at the time was a staffer for Republican then-Rep. David Funderburk, said in the 1995 speech, according to the transcript.

Wilkie later said, "I must add, as the distinguished scholar and historian James I. Robertson of Virginia Tech did here last year, I am no apologist for the South, and I have never bought into what Penn Warren and his colleagues called the 'moonlight and magnolia school,' where the decorative past replaces the useable past."

"The South has many warts," he continued. "Chattel slavery and its aftermath is a stain on our story as it is a stain on every civilization in history. But slavery was a collective American tragedy. (President Abraham) Lincoln understood that there was enough guilt to be spread from Maine to Key West. To view our history and the ferocity of the Confederate soldier solely through the lens of slavery and by the slovenly standards of the present is dishonest and a disservice to our ancestors. We can't surrender American history to an enforced political orthodoxy dictated to our children by attention-starved politicians, street corner demagogues, and tenured campus radicals."

Professor David Blight, a Civil War historian at Yale, told CNN in an interview that Wilkie's comments were "right from the neo-Confederate playbook."

"That is standard Lost Cause ideology circa 1890 to 1910," he said. "This man, that language right there, is the standard defense of the Lost Cause built over the period of decades as an ideology explaining confederate defeat, but also as a racial ideology."

Wilkie was confirmed by the Senate as the Secretary of Veterans Affairs in July. Prior to his confirmation hearing, the Washington Post reported that Wilkie was a formerly a member of the Sons of Confederate Veterans and attended memorial ceremonies for Confederate Veterans. Wilkie told the Post that in a statement that the events had become "part of the politics that divide us" and that he no longer attended them.

'Their cause was honorable'

In his 1995 speech, Wilkie said Davis' life was the reflection of "a proud people" and that not all of "man's noble experiments succeed."

"In the case of Jefferson Davis, we must tell America the truth about the complicated man who carried with him the dreams of Southern independence," he said. "His life was the reflection of the simplicity and perseverance of a proud people; men and women who endured the horror of defeat and its equally hellish aftermath; men and women who through their Christian prism understood the fall of man and the imperfection of human institutions -- that not all of man's noble experiments succeed."

He also said Davis' "contempt for the radical abolitionists of the Republican Party" was not about slavery, but rather about out of fear "they would violate any law and abridge any freedom to impose their idea of the just society on others." Wilkie said the radical abolitionists in Congress were "as mendacious as the Jacobins of Revolutionary France" and called those who funded the abolitionist John Brown's raid on Harpers Ferry "enemies of liberty."

Wilkie added Davis' "unbroken spirit" after the war served as a reminder to the southern people "that their cause was honorable and that all would be right in the end."

Wilkie concluded his speech by linking Davis' fight to the fights in the Congress at the time, shortly after Republicans won the majority in the House of Representatives in the 1994 midterm elections.

"Once again the halls of Congress reverberate with odes to rugged individualism, state sovereignty, and contempt for the centralized super-state," Wilkie said in closing. "These are bloodless battles Davis could never fight but, they are no less vital for the future of American civilization. As our cities decay and our standards and spiritual traditions deteriorate, America is searching for a better way. Walker Percy urged us to look South to recover community, stability, and sense of place in God's order which we have regrettably lost. That is a tall proposition but it is certainly one Jefferson Davis would understand and certainly one for which he would fight."

More recent pro-Confederate ties

In 2009, Wilkie spoke to a Maryland division of the Sons of Confederate Veterans -- Jefferson Davis Camp 305 -- which meets in the DC-area.

The group's webpage at the time featured a Confederate proclamation from 1862 calling Union occupation of Maryland "oppression" and "tyranny" and "terrible despotism." The head of that camp at the time, according to reports and archived web pages, was Richard T. Hines, a prominent member of the neo-Confederate movement.

Wilkie began his career as an aide to Sen. Jesse Helms, the North Carolina Republican known for criticizing Martin Luther King Jr. and opposing a holiday in his honor. Wilkie later worked for Sen. Trent Lott from Mississippi, who resigned as Republican Leader in 2002 after praising Strom Thurmond's 1948 segregationist presidential campaign. Wilkie later served in the Bush administration, working for Condoleezza Rice at the White House National Security Council and under Donald Rumsfeld at the Pentagon.

Wilkie's past work with Helms and Lott came under scrutiny at his confirmation hearing in June. Democratic Sen. Mazie Hirono asked Wilkie, citing his past bosses and a Washington Post article, whether he would "welcome the scrutiny that you will probably face based on your past positions to make sure that you are treating women and minorities fairly and with respect as the head of the V.A., should you be confirmed?"

Wilkie responded, "Well, Senator, I will say -- and I say it respectfully -- I welcome a scrutiny of my entire record. The Washington Post seemed to stop at my record about 25 years ago. If I had been what the Washington Post implied, I don't believe I would have been able to work for Condoleezza Rice or Bob Gates or Jim Mattis."

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