VCS in the News: Long VA Delays Signal VA Needs More Funding, Staff
October 2, 2011 (St. Petersburg Times) – The James A. Haley VA Medical Center closed out its tumultuous fiscal year Friday with a balanced budget after getting a $28.7 million cash infusion from a Department of Veterans Affairs reserve fund.
Haley’s projected deficit was as high at $47.5 million in March, and the hospital’s budget records as late as July outlined “emergency measures” to reduce costs and avert a year-end shortfall.
VA spokeswoman Mary Kay Hollingsworth has steadfastly maintained that patient care was never curtailed at Haley as the facility, one of the nation’s largest veterans hospitals, reduced costs during 2011.
“As stewards of resources, we will continue to improve efficiencies and reduce costs — especially in areas of acquisitions, fee care, indirect and administrative services while improving the delivery of high quality and timely health care . . . to the Veterans we serve,” Hollingsworth said in a statement on Friday.
Haley officials have refused requests by the St. Petersburg Times to interview budget officials, hospital leadership or even public affairs staffers for this and other budget stories.
Reports about Haley’s budget difficulties have caught the attention of Congress. Last month, the chairman and ranking member of the Senate Veterans Affairs Committee sent a letter to VA Secretary Eric Shinseki referring to Haley’s budget woes.
Referring to 111 unfilled positions and cuts to a number of Haley departments, the Sept. 15 letter by chairman Patty Murray, D-Wash., and ranking member Richard Burr, R-N.C., said, “Each of these actions, while fiscally sound, could have an adverse impact on patient care quality.”
The senators asked the VA if it could ensure meeting budget needs at facilities nationally without drawing upon reserve funds, noting 2011 billing collections by the agency had been far below projections.
Shinseki’s office has not yet responded to the letter.
Paul Sullivan, executive director of Veterans for Common Sense, said “unconscionable delays” nationally in veterans obtaining VA health care and benefits points to an overall need for more money.
“The long delays veterans suffer before they can see a doctor or receive disability payments, combined with the tragic suicide crisis, are strong evidence VA needs more funding from Congress plus greater support from the American public,” Sullivan said.
Hollingsworth said Haley funding will increase 6 percent in fiscal 2012 to $552 million and Haley officials do not expect any operating deficit in 2012 after three years of deficits necessitating a year-end bailout.
One previous challenge for Haley, officials have said, is that Haley treated many Orlando-area veterans. But now the VA will open an Orlando hospital in 2012, which will decrease budget stress on Haley, they say.
In fiscal 2011, Haley officials worked frantically to reduce costs after regional VA officials initially told them their year-end bailout would be capped at $14.8 million. The VA later discarded the cap.
A July budget memo, obtained by the Times, showed that budget cuts included $1.5 million from lab services, $130,000 from mental health programs and $92,000 in education funds. Overtime and travel were reduced and maintenance deferred, documents show.
Cuts included a suspension of patient referrals to outside medical providers except in emergencies. Such “fee basis” referrals are done when Haley is too busy or if it does not offer a particular service.
More than 12,800 veterans were authorized to receive fee basis care outside Haley in 2011, the VA says.
A July 20 memo to Haley’s new director, Kathleen Fogarty, from Haley’s fiscal services office said “fee basis expenditures will be limited to those only authorized as emergency.” Asked how many patients have been rejected in a bid to get fee basis care, Haley officials responded in an e-mail, “zero patients.”
Hollingsworth called documents obtained by the Times “unofficial information” and took issue with the word “cuts” in describing reduced spending, noting money is constantly shifted as workload and costs go up and down.
“These are not cuts to services but redistribution of funding,” she said in an e-mail.