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Advocating for Better Care for Veterans

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There is a need for reformation in veteran healthcare in the United States. There has been horror story after horror story detailing how vets are passing away before they even receive care for their health issues. A report going back to 2014 show that Veterans Health Administration has evident issues with both their policies and procedures that have caused the death of countless veterans. A VA whistleblower report states that there were 238,000 veterans in 2014 that died before they could receive care. The system is beyond broken and not a lot of people are talking about it or trying to change it but there are some people that are trying to change that.

This issue is a sad one. Men and women who have served in the military and risked their lives only to come home to only experience inadequate care.  There are certain people that are trying to fight this and make it better. Karen Chwick, a social worker at a California VA facility, and her attorney, Natalie Khawam are taking a huge step towards shedding more light on this issue. This last April, Chwick and her attorney filed a whistleblower complaint with the Office of Special Counseling. The complaint stems from Chwick being disciplined at her facility for calling out that fact that critical care for vets with cancer was being systemically denied or delayed.

Chwick began to notice that after she started to document these delays and the effect it was having on the health of veterans, she soon faced serious repercussions. She was banned from attending patient meetings and was then ordered to attend a disciplinary hearing. All these repercussions were based on the fact that Chwick was trying to call attention to the fact that people were dying due to this delay of care. The VA facility in Palo Alto did not offer radiation treatment so all veterans were referred to community services but those referrals were either being repeatedly delayed or just outright denied. This left many veterans without care and or currently waiting to receive care.

Chwick’s story is not uncommon. Unfortunately, there are numerous stories that go unnoticed. Some of the more heinous incidents will sometimes make the news but most of the issues are so commonplace now that they barely make the news.  In 2016, Congress tasked a commission to try and figure out how to fix the issues that stem back decades. The fifteen-member Commission on Care was created after there was a huge VA scandal that erupted in 2014. It was proven that there was a pattern of negligence that forced patients to wait upwards of 6 months to get an appointment, The VA’s target goal was supposed to be a 14 day waiting period but instead, it was taking months to get an appointment. Some hospitals were falsifying data to report inaccurate wait times. This scandal showed how bad things had actually gotten for vets.

This commission was made up of healthcare professionals and veterans’ organization leaders. They were tasked with an in-depth review of what went wrong and how could it be fixed. The commission was asked to outline a strategy that would help to right the ship. The issues in the VA stem from flawed governance, inadequate staffing, insufficient facilities, old computer systems, and ineffective use of staff. The commission also found that the VA’s Choice Program was also ineffective. The VA’s Choice Program was set up in 2014 and the commission found that even though this program was supposed to help vets, it was vastly ineffective and only added to the problem.

The VA’s Choice Program (VCP) was designed to help alleviate some issues that had arisen with wait times in 2014. This program allowed vets to make an appointment with a community provider instead of the VA medical facility if they are unable to get an appointment with the VA in a timely fashion. The VA would pay for this appointment but the vets had to get approval before they could make the appointment. The VA would coordinate with the private care providers to help vets get the care that they so desperately needed.

The program, in theory, sounded great. Some of the burden would be taken off of the VA medical facilities and in turn vets would be getting appointments within a few weeks. However, this program only added to the issue. Instead of decreasing the wait times, it only increased them. There was some confusion over eligibility requirements and the VA and the private care providers couldn’t come to a consensus on policies and the necessary coordination between the two entities to ensure that care was received in a timely fashion.

The report is scathing when discussing the findings into the VCP. It stated that “Implementing the Choice Program has posed challenges, including difficulties

Arising from overlapping, but fundamentally different, care-purchasing authorities. Veterans, VHA staff, and community providers have been confused because of conflicting requirements and processes in eligibility rules, referrals and authorizations, provider credentialing and network development, care coordination, and claims management.”

The lines of responsibility between the VA and these private care providers were blurred and it was hard to pinpoint responsibility. The report said, “Adding to the confusion is the fact that VHA, facing a 90-day deadline for implementing the program, outsourced the creation and management of its provider networks to two private contractors, thus blurring lines of responsibility and leaving both patients and providers confused about who exactly holds responsibility for what. In execution, the program has aggravated wait times and frustrated veterans, private-sector health care providers participating in networks, and VHA alike.”

It was this severe dysfunction that led Chwick to file her whistleblower complaint with the Office of Special Counsel. This action, however, led to her employer punishing her for speaking out. Chwick wants the problem to be fixed not only to help her patients but also because she has very close ties to the armed forces. After her son joined the Navy, Chwick wanted to help serve veterans any way she could. She left her job as an advocate for the mentally ill in Miami and moved across the country to California to work as a social worker in Palo Alto to help aid veterans with cancer navigate the VCP. She was happy to be working in a situation that helped vets receive the care that could make the difference between life and death.

She soon discovered that she was working on an insurmountable task. The VA Palo Alto facility didn’t offer radiation treatment so vets with cancer had to seek outside private care. The VCP was supposed to help facilitate getting vets the proper treatment but instead, as Chwick soon found out, the radiation treatment referrals for the cancer patients were being denied or delayed on a consistent basis. Vets were getting frustrated and scared. They were afraid that they would not be able to receive treatment in time.

It was when Chwick was ordered to attend a disciplinary hearing that she decided to hire an attorney. Natalie Khawam and her firm, the Whistleblower Law Firm, filed the complaint and provided emails that that proved Chwick’s attempt to get veterans the referrals they so desperately needed. Khawam is hoping that the complaint will not only help resolve the issue with her client but will help to draw more attention to the healthcare issues that vets face when dealing with the VA.

Khawam said that “We have a duty to protect our Veterans, just like they protected us and our freedom, when they honorably served our country. My client Ms. Chwick, experienced retaliation after speaking out for her Veteran patients. Management’s ongoing reprisal has obstructed her ability and duty to care for and treat her Veteran patients. Whistleblowers who try to protect our Veterans and expose waste, fraud and abuse, should be protected, just like they try to protect and help our Veterans. We care about our Veterans and believe they deserve the best patient care, after all they proudly served our country.”

After Chwick went public with her concerns over delayed care, the VA sent her a memo saying that the disciplinary issues had been resolved and that she could start attending patient meetings again. Even though she is back at work, there has been no change in the delays. She says that she will continue on to try and help vets get the appointments and care that they deserve.

The system is broken and vets are dying simply because the VA can’t figure out how to help in a timely fashion. Congress has plans to reform the VA health care system but it seems to be taking a long time getting to the president’s desk for the final sign off. The Caring for our Veterans Act would create an integrated network that would combine all the existing VA programs into one program. There is hope that this will help the communication and policy issues that cause the excessive delays.

This is still an ongoing issue. Although Congress is working to address the problems, vets are dying. There needs to be a call to action and the only way that can happen is if more people speak out about their experiences with the VA. Hopefully the stories of those impacted will spurn a real change. The men and women that serve in our military deserve far better than what they are receiving now.

Author Bio:

Sarah Jones lives in LA with her corgi. She loves yoga, the beach, and writing about important issues that impact the health and well-being of those around her. You can follow her on Twitter

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