Whistleblowers: Atlanta VA patients experiencing major delays in getting care amid pandemic

ATLANTA — Staffers at the Atlanta Veterans Affairs hospital said thousands of veterans are experiencing major delays in getting the care they need — all during a pandemic.

Some said the delays are actually making things worse.

Channel 2 investigative reporter Mark Winne spoke with four whistleblowers, who asked not to be identified and said their pleas for help are unanswered.

The Atlanta VA Community Care Department handles medical appointments for veterans outside VA hospitals ranging from routine to lifesaving surgeries.

The whistleblowers said veterans are experiencing major delays in getting the care they need.

“It’s thousands of veterans that are affected. Not 10, not 20, not 500. It’s thousands,” one of the whistleblowers said.

The four said they are speaking up about the Atlanta VA Community Care because men and women who receive care from there have already put their lives on the line for the United States.

“I’m going to do everything that I can in my power to make sure that they get the possible and the best care that they deserve,” one of the whistleblowers said.

The whistleblowers told Winne they repeatedly find themselves in horrifying situations because the system is broken and pleas to Atlanta VA management haven’t brought help.

One whistleblower said medical delays brought on by the COVID-19 crisis have made the situation exponentially worse.

“Some providers aren’t scheduling until next year,” one whistleblower said.

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A source identified as an Atlanta VA official said a document shows that as of Sept. 25, out of 28,145 referrals for veterans to get care in the community, 5,458 referrals had been sitting with no action or follow-up for more than 30 days, and 397 referrals had been sitting for more than three months.

The four whistleblowers alleged failed leadership, saying managers overseeing Community Care have come and gone as if through a revolving door and that some have little or no background in community care, leaving them unable to offer workable solutions.

The four suggest many delays result from a change from a system heavily involving a private vendor to a new system where a new private vendor plays a much smaller role — a new system for which they say Community Care workers have received very little training.

The whistleblowers said many medical providers turned down Atlanta VA referrals because they didn’t understand the new system or hadn’t agreed on a contract with the new vendor managing the network of providers and bill payment called Optum.

One whistleblower said a veteran told him recently it took a year or more to get a procedure even after he finally got a meeting at a hospital.

“It still took him eight months,” the whistleblower said.

“In order for it to be fixed, it starts from the top,” another whistleblower said.

An official told Winne that numbers began to get dramatically worse before the new system was implemented.

Optum reported it took over in June and has signed up 23,500 medical providers, including most major Georgia hospital systems.

Winne had sent the Atlanta VA a list of detailed questions about the concerns raised by the four whistleblowers on Tuesday. Late Wednesday evening, the VA responded to Winne with a statement:

"All Atlanta VA Health Care System patients in need of treatment are getting it in the most timely fashion possible – whether at our facility or in the community. No patients are encountering clinically significant delays.

"Every Atlanta VAHCS consult is reviewed by an in-house provider before it is sent to community care to ensure all urgent and time sensitive requests are handled as soon as possible. Both before and throughout the pandemic, all VA health care facilities have been providing same-day services in primary and mental health for Veterans who need them.

"The volume of community care requests is fluctuating because of the pandemic.

"The crux of this matter is that many community providers were not accepting referrals for certain services during COVID-19.

“In instances where community providers are not accepting referrals, VA is offering Veterans any needed services at VA facilities.”

In response to some of the allegations, the VA asked Winne to provide more information, “so we can look into it right away.”

The agency also responded to a number of specific allegations Channel 2 forwarded from Community Care staffers.

In response to allegations that backlogs can run weeks or months longer than they should, the VA responded:

"The pandemic led to a lag in referrals among all health care providers – not just VA – because many community providers were not accepting referrals for certain services during COVID-19.

“Atlanta VA Health Care System’s outstanding community care requests are mostly for preventive care that is appropriately scheduled three to six months – or even longer – in advance.”

When asked about the allegations that there has been a revolving door of managers overseeing Community Care and that some have little or no background in community care, leaving them unable to offer solutions to problems, the VA replied, “That’s not true. The Atlanta VA Health Care System has been working continuously to improve its Community Care department.”

The agency listed improvements, including:

• “We have installed a new community care leadership team in early 2020, including a new Associate Chief of staff for care in the community.”
• “After the Associate Chief of staff for care in the community unexpectedly passed in September, we brought in someone from another VA medical center with extensive knowledge of both community care and group practice management.”
• “We have standardized the community care consult process.”
• “Increased Community Care employees by 20 percent in the past year.”

Concerning a report that some providers are not scheduling until next year, the VA alleged “a fundamental misunderstanding of how the medical appointment scheduling and referral process works. Preventive care is routinely and appropriately scheduled three to six months – or even longer – in advance.”

Winne asked the VA for a response on the allegation that thousands of referrals had been sitting with no action or follow-up for more than 30 days, as well as hundreds more with no action after three months, and the VA replied, “Please provide the referenced document.”

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Cox Media Group