CAVHCS should take its medicine

Published 11:17 pm Tuesday, December 1, 2015

The multiple failures of the Central Alabama Veterans Health Care System in Montgomery and Tuskegee to provide adequate care for veterans make the point for aggressive reforms to turn it and other troubled VA facilities around.
U.S. Rep Martha Roby’s proposal to allow federal VA officials to take over dysfunctional medical centers around the country with rapid-response teams is the best strategy available.
The Montgomery Republican testified before the House Veterans’ Affairs Subcommittee on Health last week, citing bureaucratic and cultural problems at CAVHCS that have made a quick transformation there difficult, if not impossible.
A vote wasn’t immediately scheduled for the bill, and it was criticized by VA officials on several fronts, including potential unfairness to employees, cost and employee recruitment concerns, and possible duplication of already existing programs.
Those issues should be hashed out, and the legislation tweaked to address them, and Roby has wisely voiced some flexibility on parts of the VA feedback.
But the basic tenets of the bill are needed to restore accountability to the system – and dignity to veterans in its care.
They include creation of an Office of Failing Medical Centers Recovery to temporarily control daily operations at a minimum of two and a maximum of seven centers with the most severe problems, based on criteria such as in-hospital mortality rates, turnover among registered nurses and how long patients wait to get an appointment.
Roby is right that the tough grading method and threat of takeover are necessary to create a sense of urgency in improving patient care and outcomes, as opposed to the lax or incompetent culture too long the status quo.
Lest we forget, the deplorable list of blunders and fraudulent activity at the Alabama sites included attempts to cover up long wait times for patients, X-rays that went unread, and falsified information on medical records.
The former director’s reaction to employee misconduct on his watch was shamefully inadequate.
The Roby proposal would also give national VA officials authority to hire and fire employees, sure to be opposed by civil service advocates worried about job security.
Again, the status quo of sluggish response to inept or criminal conduct cannot be allowed to stand. Veterans’ health and lives are at stake.
We also agree with Roby’s proposal that quality scores giving hospitals ratings of one to five stars be made public every year, a win for transparency that would keep failures in the spotlight until true turnarounds are achieved.
Roby’s package of reforms is ambitious, applying to VA medical centers nationwide.
But such strong medicine appears to be the only way to force needed change in the system.
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