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Watchdog.org goes inside Veteran Affair’s secret wait list system

By   /   March 17, 2015  /   No Comments

Part 11 of 18 in the series Veterans Affairs

By Tori Richards | Watchdog.org

Photo courtesy of Shea Wilkes

SHEA WILKES: The VA whistleblower on duty in Afghanistan and back home with his young daughter.

Shea Wilkes had a problem. The performance goals he faced as a Veterans Affairs employee in Shreveport, La., required him to meet rising demand for health care with an increasingly outnumbered staff.

“I was legitimately trying to do that, going to the meetings and trying to figure out (how to meet the performance measures) with such a limited staff of doctors,” said Wilkes, a social worker who was formerly assistant to the director of the Mental Health Division at Overton Brooks VA Medical Center.

The emphasis on performance goals was driven by a concern for patient care, but also by a bonus system that rewarded Wilkes’ superiors for the large numbers of patients who saw health-care providers.

Many managers seemed to meet their goals. But Wilkes couldn’t see how that was possible.

And then about 15 months ago, Wilkes says, he understood everything. He says he was making a photocopy near the hospital’s scheduling windows and overheard a conversation between a scheduler and a veteran.

“We don’t have any providers,” Wilkes says the scheduler was telling the vet. “We don’t have ‘em right now. They are coming. We are going to put you on this list.”

Wilkes says he vividly recalls that the scheduler did not enter the veteran’s name into the hospital’s computer system — where it could be tracked by federal officials — but instead used a pencil to write the veteran’s name on a piece of paper. Wilkes leaned in for a closer look.

“There were a lot of names on there, I noticed,” Wilkes said. “I said, ‘What is that?’ They said, ‘Oh, this is the list they have us keeping because we don’t have (enough) providers.’ I started putting two and two together.”

That’s when Wilkes recalled news media reports of an audit at the Atlanta VA Medical Center. Patients there had waited up to a year for appointments. Three who wanted to see psychiatrists committed suicide before they could. Veterans Affairs officials in Atlanta admitted that many of their 4,000 veterans simply “fell through the cracks.”

Wilkes alerted his superiors, telling them he suspected a similar scam was playing out in Overton Brooks. When they failed to act, he filed a complaint with the VA Office of Inspector General. But as Watchdog has reported, Wilkes, the whistleblower, suddenly found himself the target of the Inspector General’s investigation after reporting the whole messy affair to the media: Overton Brooks has an Atlanta-style scandal of its own — a waiting list of 2,700, including 37 veterans who apparently died while awaiting care.

At a press conference weeks later, Overton Brooks Director Toby Mathew had said no such lists existed at his hospital.

Today, Wilkes has help — the U.S. Office of Special Counsel, which reports directly to the president, is investigating his claims about the existence of secret waiting lists, as well as what looks like an effort to silence him.

Beginning of a firestorm

Wilkes isn’t your average VA employee — he has devoted his life to the military and when veterans aren’t treated right, he takes it personally.

He joined the U.S. Army in 1992, the Alabama National Guard in the late 1990s and then the Army Reserves in 2005. Along the way, he obtained bachelor’s and master’s degrees in social work. He went to work Overton Brooks in 2007.

A year later, he deployed to Afghanistan where he served first as first lieutenant. After he got home, Wilkes was promoted to captain.

Photo: U.S. Dept. of Veterans Affairs

A HISTORY OF SCANDAL: Overton Brooks VA Medical Center has had a rocky 2013.

In 2009, he was placed on inactive reserve and returned to Overton Brooks. The married father of three began working at a master’s degree in business administration. He excelled at his job as well, earning stellar performance evaluations and a series of promotions up to his job as senior adviser to the chief of mental health.

His discovery of secret waiting lists at Overton Brooks mirrors the experience of Michael Stewart, a Navy veteran with bipolar disorder. After the scandal broke last July, Stewart recounted for Shreveport’s KTBS-TV his nine-month struggle to get a doctor’s appointment.

“The secretary that I was standing in front of, she said, ‘Well, we need to see if I can schedule you an appointment, and let’s see if you’re on this list.’ She pulls out this list that’s all stapled together. It’s five to seven pages of veterans’ names and Social Security numbers. I mean it was five to seven pages of it, and I was not on that list. So she leans back and talks to her neighbor.

“She asked the other person if I was on her set of lists, and she brought it over, and it was another list…. And of course they found my name on the list, and they said, ‘OK, we’ll put you down for an appointment.’ And they marked my name down. They put a check beside it,” Stewart said.

Viewing the list

Wilkes first reported his findings to interim Chief of Staff Patrick McGauly in May 2013 and then to the VA Inspector General a month after that without much success.

Then a year later, news of something eerily identical surfaced — an employee at the Phoenix VA hospital reported a similar list to the media. Wilkes was emboldened to go to the media himself and he also called Sen. David Vitter, R-La., and told him what was happening.

By then, Shreveport’s list had graduated from a paper version to several electronic versions on a computer server, with one list accessible by password. The data was contained on several Excel spreadsheets with the following tabs containing numbers of veterans waiting up to two years for appointments:

  • Original list:  2707
  • Appointments needed:  620
  • Seen recently but no follow up:  62
  • Followed up by another VA:  32
  • Deceased:  38

Vitter called the Inspector General and demanded an investigation. And the next thing Wilkes knew, investigators were extremely interested in what he had to say. They wanted to investigate — but not who was responsible for creating the list. They wanted to look at how Wilkes came to have it in his possession.

“They said they were coming to get the list,” Wilkes recalled. “They came up and showed me ID, sat in my office and had me sign over my rights. I was talking to them and explained to them how I got the list.”

Wilkes had printed out copies that were locked in his desk and, just in case that disappeared, others were placed above a ceiling tile in his office. A third version was saved on his computer.

The investigators asked for all copies of the list, and Wilkes turned them over, including the one in the ceiling. Then they took the hard drive from his computer and didn’t ask any questions about how or why the list was compiled. They were concerned only that Wilkes might have violated patient privacy. They informed him that he was now the subject of a criminal investigation.

Investigators asked Wilkes to take a polygraph but he refused, angry that he appeared to be under investigation.

Retaliation

Since starting with the VA in 2007, Wilkes has received performance evaluation ratings of “exceptional,” “outstanding” and “fully successful.”

He has implemented many programs to speed up the access and quality of health care for veterans and his work was rewarded with a series of promotions until he became an assistant to both the hospital chief of staff and the director of the Mental Health Division.

“His exceptional assistance in program management and administrative assistance is outstanding,” a supervisor wrote in 2009. “Mr. Wilkes’ win-win attitude and as a team player is exceptionally evident in his clinical services. He has gone above and beyond the call of duty to provide leadership qualities….

“His outreach/community affairs are phenomenal … Due to Mr. Wilkes’ selfless efforts, he was selected for the planning committee for Louisiana Small Business Development Center to help veterans start businesses.”

But once he went public with the media last summer, all of that changed. In his next evaluation, he was rated mostly “unacceptable.”

Supervisor Laura Campbell wrote: “Mr. Wilkes has not maintained courteous and positive relationships with all staff…Mr. Wilkes has not produced significant workload in comparison to other team members…He is not efficient in his use of time and takes extended time frames to complete tasks.”

In response, Wilkes wrote that he often was asked to prepare and research items for the Inspector General and Special Counsel — matters that would take numerous hours. When he explained this to Campbell she said, “I don’t pay you to work for stuff for those organizations.”

Wilkes was demoted from his management position of organizing special projects to a rank-and-file social worker under pressure to answer phones and keep up high numbers of patient visits.

“For a person that has developed organization charts, business plans, brought in world-renowned scholars to speak and have developed innovative ways to recruit physicians (to) the task I have been regulated to perform (is) a major misuse of my skills and abilities,” Wilkes wrote in his evaluation.

“I am mad and frustrated that I have been called a liar in emails, that the hospital refuses to own up to wrongdoing, and that the Office of Inspector General still has me under criminal investigation for trying to doing the right thing,” he added.

Wilkes knew that reporting wrongdoing would be difficult, but he wasn’t prepared for how “frustrating, aggravating, depressing and hurtful” the situation would become.

“You know it is going to be hell after you come forward. But never in your wildest dreams do you expect the magnitude of what you did to result in what happens after. All this said,” he concludes, “I would and will do it again if I have to. It gives you such relief to get it off your chest.”

 

Part of 18 in the series Veterans Affairs

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Tori formerly served as staff reporter for Watchdog.org.