Does Email Exchange Show VA Exec Trying To Control WH Envoy's Access?

Under increasing pressure to address alleged treatment delays and preventable deaths at 26 Veterans Affairs hospitals, President Obama dispatched his deputy chief of staff Rob Nabors to review agency operations nationwide. But an email exchange at a Phoenix VA (shown to International Business Times) seems to imply that Nabors wouldn't get the full picture.

Nabors arrived on Thursday at the Phoenix VA where, according to whistleblowers, as many as 40 veterans died while waiting for treatment, and managers used a "secret list" to hide delays in care.

VA’s acting inspector general (IG) said its Phoenix investigation so far has found no evidence that treatment delays led to fatalities. "It's one thing to be on a waiting list, it's another for that to be the cause of death,” Richard Griffin testified before the Senate on May 15.

According to VA spokesperson Jill Atwood, Nabors was briefed Thursday by Phoenix VA’s interim director, Steve Young, who was brought from the Salt Lake City VA after three of Phoenix VA’s top managers, including Director Sharon Helman, were put on administrative leave while IG and now Nabors investigate the hospital.

Dr. Katherine Mitchell, a physician at Phoenix VA and one of the hospital’s four whistleblowers, hoped that Young could hear from workers who had information about the medical center's actions. But Young made it clear in an email exchange with her on Wednesday, she said, that he wasn’t interested in facilitating those conversations.

“The email string and his [Young’s] response indicates to me that the visit is more of a publicity ploy than a true fact-finding mission,” Mitchell told IBTimes.

The email conversation began with Young telling Phoenix VA staff that Nabors would be visiting the medical center on Wednesday.

“The purpose of his assignment, and the purpose of his visit to Phoenix, is to gain a clearer understanding of the challenges we in the Phoenix VA Health Care System, and we in VA across the nation, face and what we are doing to address those challenges,” Young wrote.

Young also wrote that Nabors’ visit was a “tremendous opportunity for us to showcase our commitment to Veterans and our commitment to moving the Phoenix VA Health Care System forward.”

Mitchell replied, telling Young that the people who could really help Nabors understand these problems included the patient advocates, union administration, current and former Suicide Prevention Team members, Information Safety Officer (ISO) staff, seasoned non-administrative police officers, and current and former nursing supervisors.

Mitchell also told Young in the email that many Phoenix VA staffers were reluctant to speak with either the IG or an envoy from the White House because they fear retaliation by local management.

“Unfortunately, the Phoenix VA has a long history of retaliation against employees who identify patient care concerns, unsafe working conditions, mismanagement of funds, and prohibited personnel practices,” Mitchell wrote to Young. “To date, there has been no indication that the culture of retaliation in this facility has changed.”

In his email response, Young said Nabors’ agenda was focused mostly on speaking to veterans. “So we don’t have much latitude in deviating from the itinerary,” Young wrote.

Young has vowed to listen to the concerns of Phoenix staff members. He told the Arizona Republic this week he’s "learning what the issues are from our employees' perspective. Part of what I have to do is, I have to understand the culture of the organization, the culture of the community, so that we can best figure out how we move forward."

VA spokesperson Atwood told IBTimes that the focus of Nabors’ one-day Phoenix trip and briefing with Young was on quality health care, patient‎ safety, timely access to care, and accountability. She said Nabors met and spoke with "many different staff members and veterans."

“Nabors’ trip and meetings are separate and distinct from the IG’s [Inspector General] ongoing investigation,” Atwood said. “The IG has approved Mr. Nabors’ trip and meetings as independent of the ongoing IG process.”

At a briefing on Tuesday, White House press secretary Jay Carney told reporters, "The president sent Rob Nabors over there [Phoenix] because Rob Nabors is a professional and is one of his most trusted advisers. And he expects Rob to work with the secretary and others at the VA on this review so that we can get to the bottom of these issues, find out what happened, take remedial action where necessary and hold people accountable where necessary."

But Rep. Jeff Miller (R-Fla.), who chairs of the House Veterans Affairs Committee and has been conducting his own investigation, wondered what the point of Nabors’ visit to Phoenix actually was.

"If the White House truly wants to get to the bottom of this, it will make time to meet with the right people,” Miller said. “If not, this is all for show.”

Here is the email chain supplied to the International Business Times:

From: Young, Steven W. (SES)

Sent: Wednesday, May 21, 2014 5:07 PM

To: Mitchell, Katherine L.

Cc: Burke, Christopher T.

Subject: RE: Message from the Acting Director

Thanks for the information. The itinerary for Mr. Nabor’s visit was developed based largely on his requests of what he wanted to do and the people he wanted to meet, with a heavy focus on Veterans and their representatives. So we don’t have much latitude in deviating from the itinerary. I wish I could be more accommodating to your suggestions. I will share it with his staff though and leave it to them if they want to do something beyond what is currently planned.

Thanks.

Steve

***

From: Mitchell, Katherine L.

Sent: Wednesday, May 21, 2014 12:15 PM

To: Young, Steven W. (SES)

Cc: Burke, Christopher T.

Subject: FW: Message from the Acting Director

For your consideration.

From: Mitchell, Katherine L.

Sent: Wednesday, May 21, 2014 12:12 PM

To: Craig, Karen M.; VHAPHOExchangeUsers

Subject: RE: Message from the Acting Director

Over the years, countless Veterans at this facility have been helped because of the existing strong network of truly dedicated front-line VA employees who uphold the standards of integrity, compassion, and commitment for excellent patient care. These employees work in all areas of the hospital/clinic and are easily found in every service line. Mr. Nabors will likely meet a multitude of such individuals during his tour.

Unfortunately, the Phoenix VA has a long history of retaliation against employees who identify patient care concerns, unsafe working conditions, mismanagement of funds, and prohibited personnel practices.

To date, there has been no indication that the culture of retaliation in this facility has changed.

There are many employees who would welcome the opportunity to discuss their concerns privately with the White House Deputy Chief of Staff. Many have been struggling ethically with the conditions in this VAMC for years. However, most staff likely will refuse to speak openly in front of other administrators because of palpable fear of retaliation that echos in our hallways. Such retaliation usually occurs after the investigating officials have left.

Although his itinerary hasn’t yet been finalized, will Mr. Nabors be setting up times so that individual employees can speak with him confidentially/without the presence of management?

Even if he can’t accommodate the entire VA workforce, Mr. Nabors will not gain a clearer understanding of the challenges facing the Phoenix VAMC unless, at a minimum, he speaks privately with the patient advocates, the union administration, the OEF/OIF/OIF transition service case managers, CSTAT physicians, current & former Suicide Prevention Team members, ISO staff, seasoned non-administrative police officers, long-standing ED physicians, and current/former nursing supervisors.

Respectfully yours,

Dr. Katherine Mitchell

****

From: Craig, Karen M. On Behalf Of PHXVAHCS/DIR

Sent: Wednesday, May 21, 2014 11:07 AM

To: VHAPHOExchangeUsers

Subject: Message from the Acting Director

MESSAGE FROM THE ACTING DIRECTOR

As you have probably heard, the President assigned a White House Deputy Chief of Staff to VA to gain a better understanding of what may be happening with Veteran access across the nation. His name is Rob Nabors and he will be visiting our medical center tomorrow, May 22nd. The purpose of his assignment, and the purpose of his visit to Phoenix, is to gain a clearer understanding of the challenges we in the Phoenix VA Health Care System, and we in VA across the nation, face and what we are doing to address those challenges.

Mr. Nabors will be here most of the day tomorrow. As I write this, his itinerary hasn’t been finalized. We anticipate that he will spend a lot of time walking around and talking with Veterans and staff. He will also have a meeting with local Congressional staff members and Veteran Service Organization representatives. We will do our best to minimize disruption, but nonetheless, you may see clusters of people walking around. If you should have the opportunity to talk with Mr. Nabors, I encourage you to be open and honest. That’s why he is here.

I know these are trying times for all of us. It is also a tremendous opportunity for us to showcase our commitment to Veterans and our commitment to moving the Phoenix VA Health Care System forward. President Obama held a press conference today and I want to share one statement that he made because I think it is so reflective of Phoenix VA Health Care System employees. The President said, “I don’t want us to lose sight of the fact that there are a lot of folks in the VA who are doing a really good job and working really hard at it.”