VA boss’s N.H. trip comes at the end of a yearlong road

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    Secretary of Veteran Affairs David Shulkin speaks Friday, June 23, 2017, during "Stand-To," a summit held by the George W. Bush Institute focused on veteran transition, in Washington. (AP Photo/Jacquelyn Martin) Jacquelyn Martin

  • President Donald Trump, accompanied by Veterans Affairs Secretary David Shulkin talks with a patient during a Veterans Affairs Department “telehealth” event, Thursday, Aug. 3, 2017, in the Roosevelt Room of the White House in Washington. (AP Photo/Evan Vucci) AP

Monitor staff
Published: 8/4/2017 12:13:06 AM

A meeting Friday at the state’s veterans hospital will bring together its whistleblowers with some of the people best positioned to make systemic changes, including the congressional delegation and national secretary of veterans affairs.

It won’t be the first time that the doctors and medical staff behind a revolt at the Manchester VA Medical Center bring their concerns to a U.S. senator or representative – that was more than a year ago.

But as VA Secretary David Shulkin makes a trip to New Hampshire, it represents a significant step in the grassroots effort to bring change to the veterans hospital, especially considering that the clinicians feel unheard by their own in-house administrators.

“The head of the entire VA, I don’t think, has ever talked to a whistleblower before,” said Dr. Ed Kois, who is one of the loudest voices calling for reform at the hospital.

The whistleblowers’ early meetings with members of New Hampshire’s congressional delegation set in motion two federal-level investigations, but they petered out before a Boston Globe report last month spurred new action.

Andrea Amodeo-Vickery, the whistleblowers’ attorney, said she and a handful of doctors met with Sen. Jeanne Shaheen as early as May 2016 and Rep. Annie Kuster a month later. Amodeo-Vickery was naively optimistic at the time about the effect those meetings could have, she said.

“At first, I said, ‘This’ll be easy. We’ll meet with the senator and – miracle – she’ll be able to change it,’ ” she said. “As much as she was shocked and appalled by everything, there was not a lot she could do at that time, especially because the doctors were not wanting to go public.”

The attorney said she put down in writing by September a detailed log of the whistleblowers’ then-anonymous complaints, including revelations about flies in an operating room and veterans needlessly suffering with treatable spine conditions, which would eventually become the highlights of the Globe article.

That was about the time that three concurrent investigations began: one by the Office of Special Counsel, which is an independent federal investigator, separate from the VA; one by the VA’s inspector general; and a third by the Globe.

Amodeo-Vickery said Shaheen and Kuster helped her to get the whistleblowers’ concerns before the Office of Special Counsel and the VA’s Office of the Inspector General. “There wasn’t any more they could have done. That’s what I learned. I was very happy when it was sent to the right agency,” she said.

Kois credited Shaheen’s “strong letter” as helpful in validating their claims to the Office of Special Counsel. That agency found a “substantial likelihood” of legal violations, mismanagement, abuse of authority, and a danger to public health, he said, adding that it only reaches a positive finding in about 10 percent of cases.

“I didn’t expect (the congressional delegation) to run up there and beat up the bad guys and bring us their scalps,” Kois said. “What I was hoping for them to do was open doors. That they did.”

But those official channels would run dry. Amodeo-Vickery said a representative of the VA’s inspector general asked the doctors for personal information about their patients that they couldn’t divulge, resulting in a stalemate that killed the investigation.

“He wanted doctors to reveal patient names and Social Security numbers. They were not going to do that to some aide at the OIG,” she said.

That was about the same time that the Office of Special Counsel said it would investigate the case, she said, and the doctors put their faith in that neutral agency over the VA’s inspector general.

But in January, when the Office of Special Counsel concluded that there was a “substantial likelihood” the whistleblowers’ claims were true, the investigation was handed off to the Office of the Medical Inspector – whose investigators work for the VA, Amodeo-Vickery said.

“That’s how the protocol works, because the Office of Special Counsel, they don’t have the jurisdiction to actually do the investigation,” she said. “It’s crazy it has to go to the Office of the Medical Inspector, which is supposed to do a thorough investigation, but they didn’t.”

In June, the Office of the Medical Inspector replied to the Office of Special Counsel to say it had found “no substantial or specific danger to public health” at the hospital, the Globe reported, prompting a new wave of skepticism among the doctors toward VA-led investigations.

Kois characterized the medical inspector’s investigation as “worthless, but the (Office of Special Counsel), I think, really had our backs.”

Amodeo-Vickery said she exercised her right to ask a slew of follow-up questions to the Office of the Medical Inspector, responses for which are due back to her Aug. 20.

Except for those two findings by the Office of Special Counsel and Office of the Medical Inspector, the case was mostly quiet between September and July – until on July 16 the Globe shook things up with its Spotlight Team report, which publicly recounted many of the complaints Amodeo-Vickery wrote in her original letter.

“We all agree, if it wasn’t for press coverage nothing would be done,” said Dr. Stewart Levenson, the recently retired Manchester VA chief of medicine.

That same day, Shulkin removed the top two officials at the hospital – Director Danielle Ocker and Chief of Staff James Schlosser. He also ordered the Office of Medical Inspector and the VA Office of Accountability and Whistleblower Protection to Manchester for a “top-to-bottom review.”

The congressional delegation also responded with a joint letter at the end of that week urging that Shulkin himself come to Manchester for a site visit. He’ll do so today.

Kois said much of Shulkin’s tour of the hospital seems to be mostly a “PR move,” but that’s forgiven so long as the whistleblowers get a chance to meet face-to-face with the VA boss.

“If this guy is just another politician who doesn’t really ask questions and doesn’t really seem engaged, we’ll know about that really quickly,” Kois said. “We’re all old dogs here. We’re going to know if he’s blowing smoke up our asses.”

He added: “And, you know, we’re not going to shut up about it.”

(Nick Reid can be reached at 369-3325, or on Twitter at @NickBReid.)

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