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==Background==
==Background==


The [[Veterans Health Administration]], a division of the U.S. [[Department of Veterans Affairs]], is responsible for providing health care to U.S. military veterans, and is one of the largest healthcare operations in the United States, with dozens of hospitalas and medical facilities across the nation. It has had a long and troubled history.<ref name="natl_journ_2014_05_20_who_broke_va">[http://www.nationaljournal.com/defense/who-really-broke-veterans-affairs-20140520 Who Really Broke Veterans Affairs?"], National Journal, May 20, 2014 (Fairly objective report blames EVERYone -- both parties, in the White House, the Congress and the VA, going back GENERATIONS, albeit with too obsessive a focus on the Agent Orange debacle. Follow-on report suggests VA fixes.)</ref>

===VA Caseload===
There are fundamental problems at the Veterans Health Administration of staffing being inadequate for aging [[Vietnam veteran]]s and more recent veterans from Iraq and Afghanistan who may have complex health challenges such as [[traumatic brain injury]], multiple limb [[amputation]]s and [[Prosthesis|prosthetics]], [[diabetes]] and [[post-traumatic stress disorder]].<ref name="geiling_2012_11_medical_costs_of_war">http://www.ncbi.nlm.nih.gov/pubmed/23198496 Geiling, J; Rosen, JM; and Edwards, RD., [http://www.ncbi.nlm.nih.gov/pubmed/23198496 "Medical costs of war in 2035: long-term care challenges for veterans of Iraq and Afghanistan."], ''Mil. Med.'' (''Military Medicine'' journal?), 2012 Nov;177(11):1235-44, abstract, as retrieved June 10, 2014.</ref><ref name="gao_2007_03_08_dod_and_va_challenges">Bascetta, Cynthia A., Director, Health Care (for the Gov't Accountability Office - GAO), [http://www.gpo.gov/fdsys/pkg/GAOREPORTS-GAO-07-606T/html/GAOREPORTS-GAO-07-606T.htm "DOD and VA Health Care: Challenges Encountered by Injured Servicemembers during Their Recovery Process,"] Testimony Before the Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, House of Representatives, U.S. Congress, Report# GAO-07-606T, ACC.# A66624, U.S. Government Accountability Office (GAO), March 8, 2007, Washington, D.C. ASCII transcript retrieved June 10, 2014</ref><ref>{{cite web|last=Michael D. Shear and Richard A. Oppel Jr.|title=V.A. Chief Resigns in Face of Furor on Delayed Care|url=http://www.nytimes.com/2014/05/31/us/politics/eric-shinseki-resigns-as-veterans-affairs-head.html?hp|work=The New York Times|accessdate=31 May 2014}}</ref>
There are fundamental problems at the Veterans Health Administration of staffing being inadequate for aging [[Vietnam veteran]]s and more recent veterans from Iraq and Afghanistan who may have complex health challenges such as [[traumatic brain injury]], multiple limb [[amputation]]s and [[Prosthesis|prosthetics]], [[diabetes]] and [[post-traumatic stress disorder]].<ref name="geiling_2012_11_medical_costs_of_war">http://www.ncbi.nlm.nih.gov/pubmed/23198496 Geiling, J; Rosen, JM; and Edwards, RD., [http://www.ncbi.nlm.nih.gov/pubmed/23198496 "Medical costs of war in 2035: long-term care challenges for veterans of Iraq and Afghanistan."], ''Mil. Med.'' (''Military Medicine'' journal?), 2012 Nov;177(11):1235-44, abstract, as retrieved June 10, 2014.</ref><ref name="gao_2007_03_08_dod_and_va_challenges">Bascetta, Cynthia A., Director, Health Care (for the Gov't Accountability Office - GAO), [http://www.gpo.gov/fdsys/pkg/GAOREPORTS-GAO-07-606T/html/GAOREPORTS-GAO-07-606T.htm "DOD and VA Health Care: Challenges Encountered by Injured Servicemembers during Their Recovery Process,"] Testimony Before the Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, House of Representatives, U.S. Congress, Report# GAO-07-606T, ACC.# A66624, U.S. Government Accountability Office (GAO), March 8, 2007, Washington, D.C. ASCII transcript retrieved June 10, 2014</ref><ref>{{cite web|last=Michael D. Shear and Richard A. Oppel Jr.|title=V.A. Chief Resigns in Face of Furor on Delayed Care|url=http://www.nytimes.com/2014/05/31/us/politics/eric-shinseki-resigns-as-veterans-affairs-head.html?hp|work=The New York Times|accessdate=31 May 2014}}</ref>

===VA Funding===
The intense influx of recent war veterans with their high-workload needs created a demand at the VA for additional resources, and funding, to meet the demand. In February, 2014, Congressional Democrats and the Obama Administration proposed a bill to allocate an additional $24 billion in spending for the VA, which was to include funding for "27 new medical facilities" to help meet the demand and relieve the overburdened VA system. However, Republicans in Congress -- citing budget concerns -- blocked their efforts. By adding a "poison pill" amendment (about sanctions on Iran, that Obama had already made clear he would not sign), and filibustering the proceedings, and by a vote on procedural measures (41 of 45 Senate Republicans voting to block), Congressional Republicans managed to kill the bill, and VA funding was held at the existing level.<ref name="reuters_2014_02_27_va_funds_blocked">Reuters News Service, [http://www.reuters.com/article/2014/02/27/us-usa-veterans-congress-idUSBREA1Q26O20140227 U.S. Senate Republicans block veterans' health bill on budget worry"], ''Reuters'' (news reporting service for U.S. and European newspapers), Washington, D.C., Thurs. Feb 27, 2014, retrieved June 8, 2014
</ref><ref name="pensitoreview_2014_05_29_should_senators_resign">[http://www.pensitoreview.com/2014/05/29/should-u-s-senators-who-voted-against-additional-funding-for-va-hospitals-in-february-2014-also-resign/ ESSAY: "Should U.S. Senators Who Voted against Additional Funding for VA Hospitals in February 2014 Also Resign?"]
Jon Ponder in ''PensitoReview.com,'' May 29, 2014 (NOTE: Attached list of senators that voted for the filibuster.)</ref><ref name="politicususa_2014_05_29_demo_blasts_repubs">[http://www.politicususa.com/2014/05/29/loud-critic-va-tables-turned-voting-record-vets-sucks.html "Democrat Turns The Tables and Blasts House Republican for Voting Against VA Funding]: Colorado Demo congressional candidate exploits incumbent Republican's record on VA funding.", May 29, 2014, ''PoliticsUSA.com''</ref>
<blockquote>
('''NOTE:''' In early June, 2014, soon after the scandal erupted, the U.S. Senate -- Republicans and Democrats -- hastily joined to sign a $500 billion aid bill for the VA, voting 93-3 for it.).<ref name="cnn_2014_06_11_senate_approves_va_bill">Barrett, Ted (CNN Senior Congressional Producer), [http://politicalticker.blogs.cnn.com/2014/06/11/senate-approves-va-reform-bill/ "Senate approves VA reform bill,"], CNN, Washington, D.C., June 11, 2014</ref><ref name="foxnews_2014_06_13_sticker_shock">Chakraborty, Barnini, [http://www.foxnews.com/politics/2014/06/13/sticker-shock-house-senate-pass-va-bill-but-could-cost-cripple-economy/ "VA bill shooting through Congress could cost taxpayers billions, fiscal hawks warn,"] June 13, 2014, ''·FoxNews.com''</ref>
</blockquote>

===Merit Pay Bonuses===

A bipartisan string of presidents and Congresses, over multiple decades, developed a systsem of [[pay-for-performance (federal government)| "pay-for-performance" ] or [[merit pay]] bonuses, designed to introduce "market forces" into the public sector, to motivate better worker performance, especially among the federal government's Senior Executive Service (upper-echelon, appointed, career officials).<ref name="wiki_merit_pay">[[Merit Pay| Wikipedia "Merit Pay" article]]</ref>


Veterans Affairs employees received bonuses for meeting goals for timeliness of patient visits.<ref name="Were bonuses tied to VA wait times?">{{cite web|last=Carter|first=Chelsea J.|title=Were bonuses tied to VA wait times? Here's what we know|url=http://www.cnn.com/2014/05/30/us/va-bonuses-qa/index.html|publisher=CNN|accessdate=2014-05-31}}</ref>
Veterans Affairs employees received bonuses for meeting goals for timeliness of patient visits.<ref name="Were bonuses tied to VA wait times?">{{cite web|last=Carter|first=Chelsea J.|title=Were bonuses tied to VA wait times? Here's what we know|url=http://www.cnn.com/2014/05/30/us/va-bonuses-qa/index.html|publisher=CNN|accessdate=2014-05-31}}</ref>



==Phoenix Veterans Health Administration system==
==Phoenix Veterans Health Administration system==

Revision as of 21:03, 13 June 2014

Veterans Health Administration
Seal of the Department of Veterans Affairs
VA Logo
Agency overview
Formed1778[1]
JurisdictionFederal government of the United States
Headquarters810 Vermont Avenue NW., Washington, D.C., United States
Employees279,792 (March 2011) [2]
Annual budget$47 billion USD (2011) [3]
Agency executives
Parent agencyUnited States Department of Veterans Affairs
Websiteva.gov/health
A Veterans Affairs veteran identification card with information redacted

It was reported on April 30, 2014 that at least 40 United States Armed Forces veterans died while waiting for care at the Phoenix, Arizona, Veterans Health Administration facilities. By June 5, 2014, Veterans Affairs internal investigations had identified a total of 35 veterans who had died while waiting for care in the Phoenix VHA system.[6] An investigation of delays in treatment throughout the Veterans Health Administration system is being conducted by the Veterans Affairs Office of the Inspector General,[7][8][9] and the House has passed legislation to fund a $1 million criminal investigation by the Justice Department.[10] On May 16, 2014, the Veterans Health Administration's top health official, Dr. Robert Petzel, retired early at the request of Secretary of Veterans Affairs Eric Shinseki.[5][11] On May 30, 2014, Secretary Shinseki himself resigned from office amid the fallout from the controversy.[4][12] As of early June 2014, several other VA medical centers around the nation have been identified with the same problems as the Phoenix facility, and the investigations by the VA Inspector General, the Congress and others are widening.[7][12][13][14][15][16][17]

An internal VA audit released June 9, 2014 found that more than 120,000 veterans were left waiting or never got care and that pressures were placed on schedulers to use unofficial lists or engage in inappropriate practices to make waiting times appear more favorable.[18]

On June 11, 2014, the Federal Bureau of Investigation opened a criminal investigation of the VA.[19]

Background

The Veterans Health Administration, a division of the U.S. Department of Veterans Affairs, is responsible for providing health care to U.S. military veterans, and is one of the largest healthcare operations in the United States, with dozens of hospitalas and medical facilities across the nation. It has had a long and troubled history.[20]

VA Caseload

There are fundamental problems at the Veterans Health Administration of staffing being inadequate for aging Vietnam veterans and more recent veterans from Iraq and Afghanistan who may have complex health challenges such as traumatic brain injury, multiple limb amputations and prosthetics, diabetes and post-traumatic stress disorder.[21][22][23]

VA Funding

The intense influx of recent war veterans with their high-workload needs created a demand at the VA for additional resources, and funding, to meet the demand. In February, 2014, Congressional Democrats and the Obama Administration proposed a bill to allocate an additional $24 billion in spending for the VA, which was to include funding for "27 new medical facilities" to help meet the demand and relieve the overburdened VA system. However, Republicans in Congress -- citing budget concerns -- blocked their efforts. By adding a "poison pill" amendment (about sanctions on Iran, that Obama had already made clear he would not sign), and filibustering the proceedings, and by a vote on procedural measures (41 of 45 Senate Republicans voting to block), Congressional Republicans managed to kill the bill, and VA funding was held at the existing level.[24][25][26]

(NOTE: In early June, 2014, soon after the scandal erupted, the U.S. Senate -- Republicans and Democrats -- hastily joined to sign a $500 billion aid bill for the VA, voting 93-3 for it.).[27][28]

Merit Pay Bonuses

A bipartisan string of presidents and Congresses, over multiple decades, developed a systsem of [[pay-for-performance (federal government)| "pay-for-performance" ] or merit pay bonuses, designed to introduce "market forces" into the public sector, to motivate better worker performance, especially among the federal government's Senior Executive Service (upper-echelon, appointed, career officials).[29]

Veterans Affairs employees received bonuses for meeting goals for timeliness of patient visits.[30]


Phoenix Veterans Health Administration system

In one example, 71-year-old U.S. Navy veteran Thomas Breen was rushed to the Phoenix VA on September 28, 2013 with "blood in his urine and a history of cancer." His family said that he was sent home with instructions that he was to be seen within "one week" by a primary care doctor or urologist, and a note on his patient chart said the situation was urgent. After being sent home, his family said that they were told that there was a seven month waiting list and that there were other critical patients. Thomas Breen died on November 30, 2013. His death certificate shows that he died from bladder cancer. His family said that the VA called on December 6, 2013 to make an appointment, after Breen had died.[8]

Dr. Sam Foote, who retired after 24 years of service with the Phoenix VA system, went public with allegations against the VHA in comments to CNN in April 2014. He said that there was an "official" list at the Phoenix VA which was sent to Washington officials and showed that appointments were timely, and an unofficial list where veterans may wait for care for more than a year. Foote said that "The scheme was deliberately put in place to avoid the VA's own internal rules". He said that workers at the Phoenix VA were intimidated into complying with the deception. "They have families, they have mortgages and if they speak out or say anything to anybody about it, they will be fired and they know that."[6][8]

Austin Veterans Health Administration system

A scheduler at an Austin, Texas, VHA care clinic said that the practice of "zeroing out" delays in appointments "wasn't a secret at all" at the clinic, and he was instructed by a supervisor in how the process worked. The Austin scheduler said that said "zeroing out" was a practice of falsifying information in the VA’s records system that Washington officials used to monitor patient wait times.[31]

Investigations and findings

An audit from the Secretary of Veterans Affairs said that "some front-line, middle, and senior managers felt compelled to manipulate" records to meet performance goals. The manipulation of records was done with the knowledge of senior managers in the Phoenix VA system and possibly those of other VA facilities. Investigations are ongoing as of May 31, 2014.[30]

An official report from the VA Inspector General "found that about 1,700 veterans in need of care were 'at risk of being lost or forgotten' after being kept off an official waiting list."[32] Schedulers for the Veterans Health Administration were instructed to change the dates for which veterans had requested an appointment in order to hide delays. At the Phoenix VA, "official data showed (veterans) waited an average of 24 days for an appointment. In reality, the average wait was 115 days." Shinseki called the situation "reprehensible". Former VHA doctors were not surprised by the findings.[31]

At least 1700 veterans at the Phoenix VA who wanted an appointment were never placed on an official wait list. The VA's Office of Inspector General called the manipulation of appointments at the Phoenix VA a "systemic" problem and called for a nationwide audit. As of May 30, 2014, 42 VA medical centers were under investigation for their scheduling practices.[33]

The VA OIG reported in May 2014 that 17 veteran deaths had occurred while waiting for VHA treatment in the Phoenix VA system, and on June 5, 2014 the Acting Secretary of Veterans Affairs, Sloan Gibson, reported that the VA had identified 18 additional deaths. The 18 deaths were among the group of 1700 identified as "at risk of being lost or forgotten". Griffin said that autopsy reports would need to be investigated to determine if the deaths were caused by the delays in treatment.[6]

Internal VA Audit

An internal Veterans Affairs audit released June 9, 2014 found that:[34]

  • More than 120,000 veterans were left waiting or never got care
  • Pressures were placed on schedulers to use unofficial lists or engage in inappropriate practices to make waiting times appear more favorable

FBI Investigation

On June 11, 2014, the Federal Bureau of Investigation opened a criminal investigation of the VA.[35]

Responses

Politicians from both Republican and Democratic parties have commented on the scandal. Democratic Representative Steve Israel said that "It's a shame that when Republicans had a chance to help vets get their benefits from the V.A., they blocked a solution", referring to Republican opposition to the 2013 Veterans Backlog Reduction Act. Democrats, led by Senator Patty Murray, have aggressively sought more money for veterans services since the second term of President George W. Bush. Many Republicans have countered that the problems in the VA are ones of management rather than funding and that Obama Administration officials are responsible for not discovering the patient backlog. Republican Representative Jackie Walorski said that the VA had "bureaucracy run amok" and noted a case in Atlanta where "two top officials were able to retire early and three were reprimanded" over three preventable deaths. At the end of May 2014, bipartisan agreement emerged among Democratic Senator Barbara A. Mikulski and Republican Senator Richard C. Shelby on the Senate Appropriations Committee to include funding for civil and criminal investigations into Veterans Affairs in a veterans spending bill.[36][37][38]

Democratic President Barack Obama's chief of staff, Denis McDonough, said on May 18, 2014 that Obama was "madder than hell" about the reports of delays in treatment. McDonough said that "At the same time that we're looking at accountability we want to continue to perform to provide our veterans the services that they have earned."[39]

On May 21, 2014, in a vote of 390-33, the House of Representatives passed the Department of Veterans Affairs Management Accountability Act of 2014 (H.R. 4031; 113th Congress).[40] The bill would give the Secretary of Veterans Affairs the authority to remove or demote any individual from the Senior Executive Service upon determining that such individual's performance warrants removal or demotion.[41] The House members who sponsored the bill argued that, although federal workers can be fired, the process is extremely lengthy, sometimes taking years, and that the officials who are "under scrutiny for neglecting veterans actually received tens of thousands of dollars in bonuses and positive performance reviews."[42] Florida Republican Representative Jeff Miller, who sponsored the bill, said that "this bill would simply give the VA Secretary the authority to fire or demote VA Senior Executive Service employees based on performance, similar to the authority the Secretary of Defense already has to remove military general officers from command or how I am able to fire someone who works for me on my staff."[42]

Eric Shinseki, Secretary of Veterans Affairs, resigned on May 30 as a result of the scandal.

The United States House of Representatives was also scheduled to consider the bill "Demanding Accountability for Veterans Act of 2013", related to the scandal.[43]

On May 30, 2014, Shinseki apologized and accepted responsibility for the scandal.[44] Later that day he formally resigned as Secretary of Veterans Affairs.[44]

On May 30, 2014, The Hill reported that the Senate was expected to consider legislation related to the VA scandal during the week of June 2, 2014.[45] Their legislation was expected to address both the need to improve the healthcare that was being provided to veterans and the poor management of the Department of Veterans Affairs.[45]

Also on May 30, 2014 the House passed by a 321-87 vote the Commerce, Justice, Science, and Related Agencies Appropriations Act, 2015 (H.R. 4660; 113th Congress) which authorized a $1-million appropriation for a criminal investigation by the Justice Department.[10]

On June 5, 2014, Senator Bernie Sanders, independent of Vermont, and Senator John McCain, Republican of Arizona, announced a bill that would allow veterans who wait for health care for more than 30 days or who live more than 40 miles from a VA facility to instead see private doctors who already provide services through other government programs.[6]

On June 10, 2014, the House voted 426-0 to pass the Veteran Access to Care Act of 2014 (H.R. 4810; 113th Congress), a bill that would allow United States veterans to receive their healthcare from non-VA facilities under certain conditions.[46][47] The Congressional Budget Office estimated that the bill would cost about $620 million over the 2014-2016 period.[47] Rep. Jeff Miller, who sponsored the bill, said that the wait times veterans were forced to face was "a national disgrace."[48]

On June 11, 2014, the Senate voted 93-3 to pass the Veterans' Access to Care through Choice, Accountability, and Transparency Act of 2014, the bill written by Senators McCain and Sanders to reform the VA.[49] Chairman of the House Committee on Veterans Affairs Jeff Miller said that "many of the provisions included in today's Senate-passed bill are based on ideas that have already cleared the House, so I'm hopeful both chambers of Congress can soon agree on a final package to send to the president's desk."[50] Miller was referring to the House's Veteran Access to Care Act of 2014 (H.R. 4810; 113th Congress) which contained similar provisions and passed the House on June 10, 2014.[46]

See also

References

  1. ^ "Pittsburgh History, Pennsylvania Department, Carnegie Library of Pittsburgh". Carnegielibrary.org. Retrieved 2014-05-16.
  2. ^ FedScope
  3. ^ VHA Media Management (2014-04-15). "About VHA - Veterans Health Administration". Va.gov. Retrieved 2014-05-16.
  4. ^ a b "Veterans Secretary Eric Shinseki resigns after report". BBC News. Retrieved 31 May 2014.
  5. ^ a b Oppel, Richard A., Jr. "Veterans Secretary Ousts Health Care Official Amid Criticism". The New York Times. Retrieved 6 June 2014.{{cite web}}: CS1 maint: multiple names: authors list (link)
  6. ^ a b c d Associated Press. "VA chief: 18 vets left off waiting list have died". The Washington Post. Retrieved 6 June 2014.
  7. ^ a b Griffin, Richard J., Acting Inspector General, Interim Report: Review of Patient Wait Times, Scheduling Practices, and Alleged Patient Deaths at the Phoenix Health Care System, VA Office of Inspector General, Veterans Health Administration, Dept. of Veterans Affairs, May 28, 2014, 14-02603-178, Washington, D.C., retrieved June 7, 2014
  8. ^ a b c Scott Bronstein and Drew Griffin. "A fatal wait: Veterans languish and die on a VA hospital's secret list". CNN. Retrieved 31 May 2014.
  9. ^ "Obama vows action on any VA 'misconduct'". BBC News. Retrieved 31 May 2014.
  10. ^ a b Marcos, Cristina. "House passes third '15 appropriations bill". The Hill.
  11. ^ Shane, Leo III. "VA's top health official resigns amid scandal over delays in vets' care". Military Times. Gannett. Retrieved 1 June 2014.
  12. ^ a b Obama, Barack, President of the United States,"Statement by the President, May 30, 2014, Office of the Press Secretary, The White House, retrieved June 7, 2014
  13. ^ Giblin, Paul & Rebekah L. Sanders, "VA audit: Staff falsified records to collect bonuses," from The Arizona Republic as published in USA TODAY, May 31, 2014, as retrieved June 7, 2014
  14. ^ Carter, Chelsea J., "Were bonuses tied to VA wait times? Here's what we know," Cable News Network (CNN), May 30, 2014, retrieved June 7, 2014
  15. ^ Andrews, Wyatt, "VA bonuses were incentive to hide wait times, whistleblowers say," CBS News, May 13, 2014, retrieved June 7, 2014
  16. ^ Hennessy-Fiske, Molly & Richard Simon, "Veterans' wait times at El Paso VA are latest to come under scrutiny," Los Angeles Times, June 4, 2014, retrieved June 7, 2014
  17. ^ Associated Press (AP) Indianapolis, IN, "Coats, Donnelly demand answers on VA wait times," WTHR News, June 4, 2014, retrieved June 7, 2014
  18. ^ "Audit: More than 120,000 veterans waiting or never got care". CNN. 10 June 2014. Retrieved 12 June May 2014. {{cite web}}: Check date values in: |accessdate= (help)
  19. ^ "FBI launches criminal probe of VA". CNN. 11 June 2014. Retrieved 12 June May 2014. {{cite web}}: Check date values in: |accessdate= (help)
  20. ^ Who Really Broke Veterans Affairs?", National Journal, May 20, 2014 (Fairly objective report blames EVERYone -- both parties, in the White House, the Congress and the VA, going back GENERATIONS, albeit with too obsessive a focus on the Agent Orange debacle. Follow-on report suggests VA fixes.)
  21. ^ http://www.ncbi.nlm.nih.gov/pubmed/23198496 Geiling, J; Rosen, JM; and Edwards, RD., "Medical costs of war in 2035: long-term care challenges for veterans of Iraq and Afghanistan.", Mil. Med. (Military Medicine journal?), 2012 Nov;177(11):1235-44, abstract, as retrieved June 10, 2014.
  22. ^ Bascetta, Cynthia A., Director, Health Care (for the Gov't Accountability Office - GAO), "DOD and VA Health Care: Challenges Encountered by Injured Servicemembers during Their Recovery Process," Testimony Before the Subcommittee on Oversight and Investigations, Committee on Veterans' Affairs, House of Representatives, U.S. Congress, Report# GAO-07-606T, ACC.# A66624, U.S. Government Accountability Office (GAO), March 8, 2007, Washington, D.C. ASCII transcript retrieved June 10, 2014
  23. ^ Michael D. Shear and Richard A. Oppel Jr. "V.A. Chief Resigns in Face of Furor on Delayed Care". The New York Times. Retrieved 31 May 2014.
  24. ^ Reuters News Service, U.S. Senate Republicans block veterans' health bill on budget worry", Reuters (news reporting service for U.S. and European newspapers), Washington, D.C., Thurs. Feb 27, 2014, retrieved June 8, 2014
  25. ^ ESSAY: "Should U.S. Senators Who Voted against Additional Funding for VA Hospitals in February 2014 Also Resign?" Jon Ponder in PensitoReview.com, May 29, 2014 (NOTE: Attached list of senators that voted for the filibuster.)
  26. ^ "Democrat Turns The Tables and Blasts House Republican for Voting Against VA Funding: Colorado Demo congressional candidate exploits incumbent Republican's record on VA funding.", May 29, 2014, PoliticsUSA.com
  27. ^ Barrett, Ted (CNN Senior Congressional Producer), "Senate approves VA reform bill,", CNN, Washington, D.C., June 11, 2014
  28. ^ Chakraborty, Barnini, "VA bill shooting through Congress could cost taxpayers billions, fiscal hawks warn," June 13, 2014, ·FoxNews.com
  29. ^ Wikipedia "Merit Pay" article
  30. ^ a b Carter, Chelsea J. "Were bonuses tied to VA wait times? Here's what we know". CNN. Retrieved 2014-05-31.
  31. ^ a b Fahrenthold, David A. "How the VA developed its culture of coverups". The Washington Post. Retrieved 31 May 2014.
  32. ^ Associated Press. "VA secretary describes last weeks as challenging, says agency takes caring for vets seriously". Fox News. Retrieved 30 May 2014.
  33. ^ Carter, Chelsea J. "Report: 1,700 vets not on Phoenix VA wait list, at risk of being 'lost or forgotten'". CNN. Retrieved 31 May 2014.
  34. ^ "Audit: More than 120,000 veterans waiting or never got care". CNN. 10 June 2014. Retrieved 12 June May 2014. {{cite web}}: Check date values in: |accessdate= (help)
  35. ^ "FBI launches criminal probe of VA". CNN. 11 June 2014. Retrieved 12 June May 2014. {{cite web}}: Check date values in: |accessdate= (help)
  36. ^ Hulse, Carl. "Politically, V.A. Scandal Cuts Both Ways". The New York Times. Retrieved 31 May 2014.
  37. ^ Becker, Bernie. "GOP slams VA: 'Bureaucracy run amok'". The Hill. Retrieved 31 May 2014.
  38. ^ Cox, Carmen. "GOP Weekly Address: 'Calling on President Obama to Support VA Accountability'". YourFortDodge.com.
  39. ^ Jackson, David. "Aide: Obama 'madder than hell' over VA problems". USA Today. Retrieved 6 June 2014.
  40. ^ "H.R. 4031 - All Actions". United States Congress. Retrieved 16 May 2014.
  41. ^ "H.R. 4031 - Summary". United States Congress. Retrieved 16 May 2014.
  42. ^ a b Ferrechio, Susan (21 May 2014). "Congress mulls making it easier for Barack Obama to fire people". The Washington Examiner. Retrieved 21 May 2014.
  43. ^ Marcos, Cristina (23 May 2014). "Next week: Appropriations, VA reform, intelligence authorization". The Hill. Retrieved 27 May 2014.
  44. ^ a b "US president accepts with 'regret' Veterans Affairs chief's resignation". Chicago Chronicle. Retrieved 31 May 2014.
  45. ^ a b Cox, Ramsey (30 May 2014). "Next week: Nominations, possible VA fix". The Hill. Retrieved 2 June 2014.
  46. ^ a b "H.R. 4810 - Summary". United States Congress. Retrieved 12 June 2014.
  47. ^ a b "CBO - H.R. 4810" (PDF). Congressional Budget Office. Retrieved 12 June 2014.
  48. ^ Marcos, Cristina (10 June 2014). "House passes VA overhaul bill... twice". The Hill. Retrieved 12 June 2014.
  49. ^ Matishak, Martin; Cox, Ramsey (11 June 2014). "Senate passes overhaul of VA in 93-3 vote". The Hill. Retrieved 13 June 2014.
  50. ^ Matishak, Martin; Wong, Kristina (11 June 2014). "Overnight Defense: Senate passes bipartisan VA fix". The Hill. Retrieved 13 June 2014.
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