WASHINGTON — Grilled by lawmakers, the Department of Veterans Affairs insisted Tuesday it was well on its way to fixing problems with its suicide hotline and largely brushed aside the worst criticisms in an internal watchdog report released two weeks ago.
A March 20 audit by the VA inspector general had found that nearly a third of calls to the Veterans Crisis Line as recently as November were bounced to backup centres run by an outside contractor, as well as other problems including weak leadership and inadequate data to measure the quality of calls. The rollover calls happen when phone lines are busy, leading to possible waits of 30 minutes or more.
It was an early test for new VA Secretary David Shulkin, who has made suicide prevention a signature issue at the troubled agency, riven with scandal in recent years since reports of delays in treatment at veterans' hospitals.
Approximately 20 veterans take their lives each day. Testifying before a House panel, Steve Young, VA's deputy undersecretary for health for operations and management, pointed to a dramatic turnaround in calls answered by the hotline since November. He said it was now a "rare instance" that calls are bumped to a backup centre and that calls are answered by live counsellors within 8 seconds, on average.
The crisis hotline "is the strongest it has been since its inception in 2007," Young told the House Veterans Affairs Committee.
But pressed by lawmakers, the VA acknowledged it was still working to make other improvements it had promised to do by last September. It pledged to beef up quality control and hire a new permanent director as soon as possible.
"Fulfilling the IG's recommendations is a key step in raising the bar," Young said.
Shulkin, who previously served as VA's top health official, has previously described the issue as resolved. "Fixing the Veterans Crisis Line was a critical step in keeping our commitment to veterans," he said in a March 21 statement.
Lawmakers were unconvinced.
Minnesota Rep. Tim Walz, the top Democrat on the House panel, pointed to "re-occuring issues we see time and time again at VA." For more than a year, the crisis hotline has operated without a permanent director and has yet to issue a policy handbook.
"I would be very careful in saying you fixed the problems," Walz warned.
Rep. Phil Roe, R-Tenn., a physician who chairs the House committee, questioned whether the VA intended to fully implement reforms after repeated promises. "There is very clearly a need for more to be done — and soon — so that we can be assured that every veteran or family member who contacts the VCL gets the urgent help he or she needs every single time."
According to internal VA data, calls to the Veterans Crisis Line that rolled over to backup centres steadily declined from 31 per cent in early November, to just 0.1 per cent as of March 25. That came despite growing workloads in which weekly calls to the hotline jumped from 10,558 in November to 13,966 last month, the VA said.
As recently as mid-December, when the IG was finalizing its audit, the share of rollover calls had declined close to the VA's goal of 10 per cent . That figure dropped to less than 1 per cent by early January, according to the VA.
VA inspector general Michael Missal said he cannot confirm the most recent VA data, and stressed that it was vital that the Veterans Health Administration follow through on proposed reforms dating back to February 2016. "Until VHA implements fully these recommendations, they will continue to have challenges," Missal said.
Launched in 2007, the crisis hotline has answered nearly 2.8 million calls and dispatched emergency services more than 74,000 times. Featured in a documentary that won an Oscar in 2015, it later received negative attention after its former director reported frequent rollovers due to poor work habits. Last year, Congress passed a law requiring that all calls and messages to the hotline be answered in a timely manner.
The most recent problems appear to stem from the VA's opening of a second call centre last October.
Spurred by veterans' complaints, the IG said the department launched a follow-up review to its February 2016 audit. Instead, it found many rollover calls, due in part to the VA's decision to divert some staff from its upstate New York call centre to help train new workers in Atlanta.
The IG suggested the Atlanta centre was slow in becoming operational, but the VA says that rollover calls in fact began to fall significantly as workers became trained.
The Veterans of Foreign Wars organization said it worried the VA sometimes focuses too much on metrics — the number of calls received and handled.
"The VFW believes that while the number of calls going to backup centres decreasing at such a rapid rate is a positive, it is not a sign of the quality of work being provided," said Kayda Keleher, VFW's legislative associate.
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Hope Yen, The Associated Press