East Hawaii News

Gabbard Calls for Firing of Hawaii VA Health Director

June 13, 2014, 2:12 PM HST
* Updated June 14, 12:20 PM
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***Updated 3:34 p.m.*** US Rep. Tulsi Gabbard today called for the firing of the director of Veterans Affairs health care in Hawaii, saying he was dishonest about the delays veterans face in seeing a physician. Gabbard sent a three-page letter to Sloan Gibson, acting secretary of Veterans Affairs, calling for the termination of Wayne Pfeffer. Gabbard said during a June 5 meeting with her staff, Pfeffer, director of the VA Pacific Islands Health Care System, said that the current wait time for veterans to see a primary care physician for the first time was “around 30 days.” She later found that his comment was inaccurate, and that a VA audit found the average wait in Hawaii was 145 days, the longest in the nation. Gabbard, a military police captain in the National Guard who has twice voluntarily deployed to Iraq, said on June 9 she spoke with Pfeffer who denied discussing wait times with her staff. “This blatant display of dishonesty undermines the nature of public service,” Gabbard’s letter said. “Additionally, it reflects an arrogant disregard for our veterans, and being held accountable to the American people. Pfeffer reportedly has said he will not resign. In a related matter, the Honolulu Star-Advertiser is reporting that Sen. Brian Schatz has asked the VA’s acting inspector general to investigate reports that Hawaii VA staffers were asked to delete information about wait times from their computers. In other VA news, the Senate this week passed a bill which would authorize the expansion of VA facilities in 18 states, including Hawaii, where an outpatient clinic would be established in Ewa on Oahu. And Hawaii Sen. Mazie Hirono has co-sponsored a bill designed to cut red tape for veterans who rely solely on the VA for medical care. The Veterans Emergency Health Safety Net Expansion Act of 2014 would also eliminate the 24-month rule — involving veterans who have not been seen at a VA hospital in two years — that prevents veterans from being reimbursed for out-of-pocket emergency medical expenses. Earlier in the week, the House unanimously passed a bill which would provide private medical care for veterans who live more than 40 miles from a VA clinic or are unable to obtain an appointment inside the VA’s wait-time goal of 14 days. According to a VA website, the agency provides health care to an estimated 127,600 veterans in Hawaii and the Pacific Islands. Its main health-care facility is located at Tripler Army Medical Center on Oahu and it also has outpatient clinics in Hilo and Kailua-Kona and on Maui and Kauai. The full text of Gabbard’s letter follows: June 13, 2014 The Honorable Sloan Gibson Acting Secretary of Veterans Affairs 810 Vermont Avenue, NW Washington, DC 20420  Dear Acting Secretary Gibson, I am writing to express my serious concerns regarding the leadership of the VA Pacific Islands Health Care System (PIHCS), Director Wayne Pfeffer.  I request your serious consideration of the issues I’m raising, and ask that you take immediate action. The VA PIHCS leadership recently provided information to me on new enrollee wait times, and implementation of the Accelerating Access to Care Initiative in the PIHCS.  The information and responses I received from Mr. Pfeffer, a man with 40 years of VA service, were dishonest, lacked transparency, and showed a level of incompetence that should not exist in the VA.  I request your immediate attention and action. On June 5, 2014 members of my staff attended a quarterly update organized by the VA PIHCS. Mr. Pfeffer and senior representatives were present as well as staff from all Hawaii delegation members.  My staff representative specifically asked for the current wait time for a newly registered veteran on the New Enrollee Appointment Request (NEAR) List before receiving an appointment with a Primary Care Physician. Mr. Pfeffer replied explaining the differences between NEAR List and Electronic Wait List (EWL), and then stated the wait time for the NEAR List was “around 30 days.”  He then referred to a staff member from the Enrollments Department also at the briefing, who confirmed that the NEAR list wait time was between 30-50 days. This was an inaccurate statement, based on the overwhelming number of constituent cases processed by my office last year on this issue, as well as in light of information released in the recent Veterans Affairs Access Audit. On June 9, 2014 I spoke to Mr. Pfeffer to question him regarding the inconsistencies in the information he provided my staff in the prior week, and the numbers released in the Access Audit. During our telephone conversation, Mr. Pfeffer denied ever discussing wait times for the NEAR list with congressional staff at the June 5th briefing. This blatant display of dishonesty undermines the nature of public service. Additionally, it reflects an arrogant disregard for our veterans, and being held accountable to the American people. Moreover, during our conversation I asked whether he was implementing the Accelerating Access to Care Initiative, and if so, what was the status in making sure veterans on wait lists were receiving immediate care. Mr. Pfeffer replied that he “assumed” it was being implemented, but could provide no details whatsoever. It appeared he was not even aware of the initiative, or that the authority to implement resides at the facility level. As the director, Mr. Pfeffer should possess a complete understanding of the VA’s strategy to implement this initiative, where that authority is executed, especially considering that Secretary Shinseki directed the initiative last month.  Most importantly, he should have been aggressively taking action with this initiative to ensure long-waiting veterans were getting immediate access to care. At the conclusion of our conversation, I requested additional information that Mr. Pfeffer was unable to provide. (1) I requested the exact number of new enrollees awaiting care at VA PIHCS – Mr. Pfeffer didn’t know the exact number but estimated it to be in the 650 range; (2) the longest waiting time for a new enrollee;  (3) the total number of veterans waiting for care; (4) and the measures taken to expedite the pre-approval process for maximizing non-VA care. To date, I have received no answers to any of these questions. On June 9, 2014 a VA PIHCS representative emailed a response to my staff, stating that the EWL at Honolulu is currently 677 veterans – however, I was not provided with information that I requested concerning the NEAR list, the total number of newly enrolled veterans waiting for care, or the longest waiting time for a new enrollee.   Additionally, VA PIHCS stated that the EWL was reduced from approximately 1,800 in May, to 677 as of June 9, and suggested the EWL is expected to soon reach zero. I have serious doubts about how such a swift reduction in the EWL could have been possible. These responses that my staff and I have received from the office of Director Pfeffer, and Mr. Pfeffer himself are reprehensible. I have zero confidence or trust in Mr. Pfeffer’s ability to oversee the Pacific Island Health Care System, and I do not believe he deserves to be entrusted with the sacred privilege of caring for our veterans and their wellbeing. As a Soldier, a veteran, and a member of Congress entrusted with the responsibility of serving the people of Hawaii and our nation, I demand accountability from those not executing their duties and violating the public trust. Considering my recent encounters with Mr. Pfeffer, I say, without reservation – I have no confidence that he serves the best interest of my fellow veterans, nor do I feel as though he is competent to discharge his duties. The veterans of our state deserve far better, the taxpayers of our nation demand better, and I respectfully urge that you thoroughly review the root causes for the inefficiencies within the Pacific Islands Health Care System starting with its senior management.  Mr. Pfeffer should be fired due to his dishonesty, lack of integrity, incompetence, and his flagrant lack of respect and transparency when dealing with those to whom he is ultimately accountable to – the American people and the veterans who defended freedom even when faced with certain peril. If you require any additional information, I am available to assist you with whatever you need in honoring my requests. Sincerely, Tulsi Gabbard Member of Congress

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