It has been two years since the Department of Veterans Affairs Health Care System in St. Louis has had a permanent director. In that time, at least seven acting directors have filled the top spot on short-term rotations of about 120 days, according to Marcena Gunter, the public affairs manager with the VA in St. Louis.
That, combined with a recent report from the Department’s Inspector General’s Office identifying 45 problems at the facility including, expired medications, unsanitary conditions in patient care areas and improper storage of oxygen tanks and other supplies, has prompted both of Missouri’s U.S. senators to urge VA Secretary Robert McDonald, to move quickly in hiring a new director.
Kevin Arnhold, executive assistant for the VA’s regional office in Kansas City, told St. Louis Public Radio Wednesday, that a candidate has been selected: “The individual that we have for the nominee has gone through a rigorous interviewing process and we feel that this person is a seasoned and experienced health-care administrator that will excel at the St. Louis Health Care System.”
Arnhold said the individual was selected in March and is going through the vetting process at the VA’s Central Office in Washington. No time frame has been given for when the new director will be named publicly. A call to the department’s central office requesting that information was not returned by the time of this publication.
Senators send letter to VA secretary
Republican Roy Blunt and Democrat Claire McCaskill have worked together on two letters this week to the VA, following Monday’s reported deficiencies. The first letter, sent to the current acting director at the St. Louis facility, requests that they be kept informed of her plans to address the problems identified in the most recent Combined Assessment Program Review.
Their second letter, to VA Secretary Robert McDonald, urges him to quickly find a new permanent director for St. Louis. It was issued late Wednesday after both fielded questions from Missouri reporters in separate conference calls asking about the report and the lengthy search for a new director.
“Immediate steps must be taken by the current leadership at the St. Louis VA to implement the [inspector general’s] recommendations,” the two wrote. “However, making permanent improvements will require strong, consistent leadership willing and able to enforce standards and provide staff the guidance they need to properly care for our veterans.”
In his call with reporters, Blunt said this week’s report on deficiencies at the facility “was in response to a letter we sent last May, and discussions that followed on that with the VA about the importance of serving veterans rather than serving the needs of the Veterans Administration,” Blunt added. “I’ve been there multiple times looking at the facility, talking to people, both who are served in the facility and who work in the facility; and I don’t think I’ve been there twice with the same administrator over the last couple of years and that’s a large part of the problem.”
McCaskill agreed. She said that "in trying to reform problem in the military, it’s all about accountability, it’s all about people at the top suffering when there are problems under their care and I think the biggest problem we have in St. Louis is this turnover of acting directors.”
Scrutiny slows search
Part of the delay in finding a replacement for the last permanent director, who left in June 2013, said Arnhold, has been the difficulty in finding “candidates that we felt have been experienced enough for such a large, complex medical center or health-care system.”
Some of the VA’s problems in finding willing and qualified people to apply for this and other vacancies across the VA system may also have come from last year’s intense media and congressional attention following revelations of long wait times and falsified medical records at VA facilities. The scrutiny “made it a little more challenging in finding candidates to enter the SES (Senior Executive Service) career field due to some of the focus on them and some of the changes that are potentially being made,” Arnold said.
The controversy saw the resignation of the then VA Secretary, Gen. Eric Shinseki, and passage of legislation giving the incoming VA secretary expanded authority to quickly demote or fire employees accused of lying or otherwise engaging in mismanagement. Indeed, McCaskill was the sponsor of legislation giving the VA secretary the ability to fire anyone involved in the poor treatment of whistle blowers from within the department.
Competition and surveys
Blunt says the VA is not being run well and he doubts problems in the system can be “satisfactorily fixed until the VA has to compete for the people it serves. He said, "That’s why I think veteran’s choice is an important concept.” He argues that veterans should be able to seek medical care from the “hospital they drive by to get to a VA clinic.”
McCaskill, who has asked for comments from veterans via surveys, told reporters Wednesday that responses to those surveys show veterans “feel better about (John) Cochran since four or five years ago when we began trying to deal directly with them rather than all of the bureaucrats, but that doesn’t mean that we don’t still have some head-banging to do among some bureaucrats.”
McCaskill said, this year’s surveys will be coming out next month.