After Independent Audit Examines Missouri Veterans’ Healthcare, McCaskill Continues Push for Improvement

WASHINGTON – After a Department of Veterans Affairs (VA) Office of Inspector General audit examined veterans’ access to care at Missouri VA facilities or through the Choice program—which is intended to expedite care for veterans or give them healthcare options closer to home than their local VA facility—U.S. Senator Claire McCaskill is asking for additional details on what the VA is doing to improve Missouri veterans’ healthcare experience.

According to the Inspector General audit, Missouri VA facilities incorrectly recorded wait times for some patients, failed to ensure that all veterans requiring a follow-up consult with a specialist were provided with appointments, and TriWest, the contractor that manages the Choice program, did not always fulfill its responsibilities.

“The VA needs to be vigilant to ensure that Missouri veterans are receiving timely care and that the Choice contractor is doing its job,” McCaskill said. “The men and women who served our nation in uniform deserve nothing but the best, and I look forward to hearing from the VA about what it will do to act on the recommendations issued in this audit in order to better serve Missouri veterans.”

The audit looked at facilities in the VA Heartland Network – which is largely made up of Missouri and Kansas VA facilities – and found that facilities recorded incorrect wait time data for 47% of appointments with wait times greater than 30 days. Recording incorrect wait time data can cause delays in patient care and prevent access to the Choice program for veterans who qualify. “However, according to [the Inspector General], the Choice program has its own deficiencies in regard to patient care,” McCaskill wrote. Forty-one percent of veterans in the audit who received care through the Choice program waited longer than 30 days, even though the contract for the Choice program requires patients to be seen within 30 days.

The VA facilities reviewed in the audit inappropriately discontinued or cancelled 27% of specialty care consults for patients included in the audit, which can impact patients’ health because they may not receive the care they need or may experience unnecessary delays in accessing it.  

The Inspector General’s audit also found that throughout the region, TriWest only provided medical documentation within the timeframe outlined in the contract for a little less than half of its patients. One of TriWest’s contractual responsibilities is to ensure that medical documents are sent from non-VA doctors that treat veterans through the Choice program to the VA within 75 calendar days of the initial appointment, and delays in doing so can jeopardize patient health.

The daughter of a World War II veteran, McCaskill has a long history of standing up for veterans. She is seeking answers from the VA after a report finding that thousands of servicemembers with PTSD or other mental health conditions who received “other than honorable” discharges were potentially barred from receiving mental healthcare and other benefits. Following issues with construction at VA facilities in Missouri, McCaskill called for answers on what the agency’s Inspector General is doing to improve oversight over major construction projects. McCaskill recently raised concerns over what the VA is doing to ensure quality care for Missouri veterans using an eye care screening program that is intended to expand eye care for veterans

Aiming to continue improvements to the quality of customer service at statewide VA facilities, McCaskill created a “secret-shopper program,” the Veterans’ Customer Satisfaction Program, which allows veterans to share timely, confidential feedback about their VA health care visits, and helps provide oversight and accountability for VA health care facilities. The program is now active in five regions: St. LouisKansas CityColumbiaPoplar BluffSouthwest Missouri (Fayetteville). In 2016, following advocacy from McCaskill and more than one-thousand rural veterans in Missouri, the Department of Veterans Affairs announced it would expand the hours of operation at the Salem Veterans Clinic to be open Monday through Friday.

Read McCaskill’s letter to the Department of Veterans Affairs HERE.