Late summer of 2013 was a rocky stretch for the St. Cloud Veterans Affairs Health Care System. From July 31 to Sept. 7, five of its medical providers — out of a staff of 21 — resigned. That startling number raised serious concerns about the medical center’s management and care, especially after 26 primary care providers had resigned from the center from 2011 to 2013.
While VA officials recently assured U.S. Rep. Tim Walz, D-Minn., that they have sufficient staffing and improved management at the facility, it’s regrettable that a lucky break was required to find out about these staffing issues and then follow up. Even though a regional VA panel had investigated the turnover in 2013 and had substantiated several concerns about the management culture and canceled appointments, the report was not made public until this year, when it was mentioned by a whistle- blower during a U.S. Senate hearing in July. Walz’s office requested a copy; the Star Tribune then obtained it through an open records request.
It is an outrage that it took this report so long to come to light. The VA is entrusted with caring for the nation’s veterans, and the agency’s independent watchdog, the VA Inspector General’s Office, is charged with investigating care and management concerns. Shielding staff and facilities from scrutiny by shelving reports like this undermines these vital missions. It should be the VA Inspector General’s default policy to swiftly make information like this publicly available so that those who run the sprawling, troubled health care system are promptly held accountable when deficiencies occur.
In light of the VA Inspector General’s dubious record on transparency, Congress may need to pass legislation to make that role clear. Earlier this year, USA Today reported that the agency had sat on 140 health care investigations. The VA only released data on those probes after the USA Today report. One of the investigations involved overprescriptions of powerful painkillers at a Tomah, Wis., VA facility.
The investigation of the St. Cloud facility dismissed many concerns about the facility’s management, but the turnover numbers speak for themselves. Even if provider staffing has improved, the facility bears future scrutiny to ensure it is providing quality care. It would be worthwhile for Walz and Republican U.S. Rep. Tom Emmer, whose district includes the St. Cloud VA center, to verify improvements with a visit and meetings with staff. The facility’s management should embrace an opportunity to showcase improvement.
Congress should also give greater scrutiny to the process by which VA care and management concerns are investigated. The Inspector General farmed out the St. Cloud investigation to a regional VA team, a practice that is not unusual. How this agency decides which investigations to do itself and which to delegate back to the VA is unclear. Whether the Inspector General is striking the right balance is another question in need of an answer.