VA whistleblowers say they've been punished

Two whistleblowers say that not only are they under attack for alerting the public about long wait times being covered up at the central Alabama VA, but that those wait times are getting longer.

Hundreds of leaked documents sent to the Advertiser during a seven-month period revealed patient abuse, inadequate care and unethical practices by the director and other staff at the Montgomery and Tuskegee hospitals.

Records included:

•VA police reports of patient abuse by staff who went unpunished

•Internal reports showing there wasn't enough staff to adequately care for the number of veterans the facility was supposed to be serving

•Internal briefing documents showing that when management discovered thousands of X-rays were disappearing before doctors reviewed them, the problem was ignored for years

•Evidence that former CAVHCS director James Talton knew that records of patient wait times were being manipulated to indicate shorter delays, but took no action for more than a year.

Little has changed

But more than six months after Talton was put on administrative leave and then fired for neglect of duty, very little has changed, according to internal CAVHCS reports obtained by the Advertiser.

As of March 2, there were nearly 4,000 CAVHCS patients who have been waiting more than 90 days for non-VA care, a figure that has more than tripled since July 2014, according to an internal CAVHCS report.

Not only are veterans in central Alabama still waiting long periods for appointments, the facilities aren't sufficiently staffed and a recent VA quality analysis downgraded the system, putting it into a category with the lowest performing facilities in the country.

VA police reports from the past several months also show staff are still abusing and taking advantage of patients, especially those in the drug treatment program and nursing home facility in Tuskegee.

Whistleblowers went public

Richard Tremaine, associate director of CAVHCS, and assistant director Sheila Meuse, who have stayed anonymous until now, chose to go public nearly 10 months after they first expressed concerns about unethical practices and major inefficiencies in several departments. They initially notified VA Regional Director Charles Sepich of their concerns, and later, the U.S. Office of Special Counsel, a federal agency that investigates whistleblower retaliation.

The two whistleblowers were responsible for disclosing information that lead to Talton's firing and alerted the public to the failures at CAVHCS.

Since then, the two employees, who have worked a combined 52 years with the VA, say they have endured 10 months of retaliation from regional and local VA leaders, including the removal of duties, exclusion from important decisions by interim CAVHCS director Robin Jackson and investigations into their conduct that have been ongoing for nearly nine months.

Meuse and Tremaine had both been at CAVHCS less than four months when the hospital was investigated for having some of the worst wait times in the country, which revealed that staff members were keeping a second paper waiting list for veterans — separate from the ones they used for their reports, so they could manipulate wait times. That investigation started a few months before the pair expressed concerns to VA officials in June 2014.

"We felt we weren't being heard within the organization," Meuse said. "And we're still not being heard. You have to reach out until someone hears you ... you can't go home and forget about it. We're talking about veteran's lives."

Tremaine, a four-year Air Force veteran, started working for VA in Denver about 25 years ago, after a procedure at the hospital went wrong and forced the amputation of his leg from the thigh down. He took the position in Montgomery after serving as an associate director in Springfield, Massachusetts.

Meuse, who raised her family in Alabama but worked at VAs all over the country, jumped at the opportunity to take a position at CAVHCS — near her home in Elmore County.

The two new employees started noticing the major problems at about the same time.

CAVHCS' public unraveling started last spring after the investigation became public knowledge, U.S. Rep. Martha Roby, R-Ala., who represents Montgomery, talked with Talton about the scheduling problems.

Talton told Roby that the staff responsible for the waiting lists had been fired, and a story was published about it in the Advertiser June 8. But a few days later, Roby said her office started getting anonymous messages and calls saying no one had actually been fired. It wasn't until after that conversation that Tremaine and Meuse decided to discuss problems with Roby when she reached out to them seeking more information.

Frustrated that she couldn't get in touch with Talton again, Roby called the CAVHCS switchboard looking for answers. Meuse, who was responsible for the public information department before the responsibility was taken away from her, called her back and told the truth: no one had been fired.

'Told ... truth, when no one else would'

"These whistleblowers told me the truth when no one else would," Roby said. "They were honest about the true extent of the problems and the failures of accountability that had created this culture at CAVHCS."

Roby has since been working with the Office of Special Counsel, the U.S. House Committee on Veteran's Affairs and the VA secretary's office to implement change at CAVHCS and make sure that Tremaine and Meuse were protected.

Roby said for those who have told the truth "to face intimidation or retaliation (is) wrong and quite frankly, it's insulting."

The concerns the two whistleblowers expressed in confidence to the regional network a day after the call with Roby were communicated to Talton that same day, according to a Sept. 15 transcript of testimony from Jackson, who at the time was deputy regional director, and a Sept. 23 transcript of testimony from Sepich.

Within a week, Sepich initiated a fact-finding investigation on Meuse and Tremaine, mostly centered on the communication with Roby and whether the two accused Talton of lying, according to a June 20 memo from Sepich.

Results showed there was no evidence that either of the whistleblowers had accused Talton of lying or that they had communicated such to other VA employees, according to a July 30 memo from the fact-finding board.

"We were honest and followed protocol, and told them we were contacted by the congresswoman," Meuse said. "We did our best to best represent the organization accurately and in a positive light without being deceptive. And we were investigated because of that."

Meuse was then sent on a three-month detail to a facility in Charleston, South Carolina where she was cut off from most communication with other CAVHCS leaders. She returned in October to give her testimony for an administrative investigative panel that had been assembled to investigate her and Tremaine.

A human resources consultant in Meuse's Oct. 28 testimony stated that the purpose of the investigation was to investigate "various allegations" involving CAVHCS' leaders.

But after the investigation was extended in January, Meuse found out in an email from a human resources consultant with Veterans Health Administration Labor Relations that the original scope was to look at whether the two whistleblowers conducted themselves in a way that was consistent with the VA's core values. The email said the scope included whether Meuse and Tremaine impeded organizational health, employee satisfaction and patient care.

The results are still not available, Meuse said.

"I think that the (investigation) was a sham," Tremaine said. "It's hard to violate any values when you're standing up and getting attacked for trying to uphold those values. And that's what we did."

CAVHCS officials, who were called for comment Tuesday and Wednesday, said they did not have ample time to respond because they needed to coordinate their statement with regional and VA Central Office officials.

Excluded from decisions

Meuse said there hasn't been any direct personnel action taken against them — they haven't been demoted, suspended or fired. But according to the Office of Special Counsel, retaliation can include any adverse action against an employee.

The two whistleblowers are regularly excluded from meetings and from access to information, they said.

When Jackson is off-site, Tremaine and Meuse should be next in line to be acting director for that period of time. But they're bypassed and acting Chief of Staff Srinivas Ginjupalli acts as director.

"We're supposed to be involved in everything. If you're part of the management team, you're responsible. You're supposed to be part of the advisory group," Meuse said. "And you can't advise when the director sits behind closed doors all day."

Documents show that a recently proposed reorganization of CAVHCS by Jackson and Sepich would have eliminated the assistant director position and significantly weakened the associate director position. Meuse said as the No. 2 and No. 3 leaders at CAVHCS, they should have been part of the discussions, but weren't.

"It might sound paranoid, but when you don't have access to the information you need to do your job, eventually you're going to fail," Meuse said. "They've cut us out of our responsibilities. They've watered down our positions."

Tremaine, who is directly in charge of six departments, said Jackson gives assignments to the chiefs of his departments and asks for information, reports and updates without involving him. A seventh department, human resources, was taken away from Tremaine when Jackson became director.

"It's like I'm not even here, honestly," Tremaine said. "I should be involved in everything going on here. It should come across my desk as the second in command at this hospital."

Tremaine said the chief of one his departments reported that staff members were selling small bottles of alcohol to patients. Instead of Tremaine handling it, Jackson asked another department to investigate.

Tremaine said he hasn't been included in any communication about the investigation since then.

"It's designed to minimize and humiliate me," Tremaine said. "It gives everyone in the organization reason to say, 'hey, don't trust (me).'"

The public affairs department were taken away from Meuse's services, she said. Chiefs who are supposed to report to her, report to Jackson directly, circumventing her completely.

"I know enough of the bad stuff going on, and I don't have any trust in the leadership to be forthcoming," Meuse said. "I feel responsible for things I have no control over."

More recently, Meuse said there have been significant delays in care at the Dothan and Columbus, Georgia facilities, but the two administrators don't have access to the information and are left out of meetings.

"I believe it is deliberate to enable cover-ups," Meuse said. "We have responsibility but not authority or respect."

Waiting-list woes

There are still a significant amount of patients at the VA Columbus Clinic who are supposed to be seen by the Roman Medical Group, a company that's being contracted to provide care to VA outpatients. Meuse said those patients initially weren't put on a waiting list, but since she no longer is being given access to that information, she has no way to know whether they've since been put on a list.

An internal CAVHCS clinical performance report shows that systemwide, there are currently more than 1,300 open consults that are more than 90 days old. In January 2014, the figure was about 1,072 and dropped dramatically to 337 by May.

But it's been growing since November 2014, when it was at about 959.

As of March 2, nearly 4,000 CAVHCS patients had been waiting more than 90 days for non-VA care, according to an internal CAVHCS report.

A July 7, 2014 report showed that there were more than 1,200 pending requests for care that were more than 90 days old.

"I continue to request information from (CAVHCS) about what they're doing to improve access to care for our veterans, and it's not looking as up as we want it to look," Roby said. "I'm still distrustful of some of the information they're giving us."

Todd Stacy, a spokesman for Roby's office who takes calls and tips from veterans, family members of veterans and VA whistleblowers, said they were focused on making sure veterans got care. But last year, as the office started getting information from Meuse, Tremaine and countless other whistleblowers, the seriousness of problems at CAVHCS became apparent.

"It went really deep — deeper than anyone could have imagined," Stacy said. "As the first bit of information started being exposed, more and more sources began coming forward, which led to major exposures."

One of those exposures was a situation where a veteran in the Tuskegee drug rehab program was taken by a VA employee to a crack house and left there for three days — but not before the employee "borrowed" money from the veteran and took him along to run personal errands in a government vehicle while on the clock.

Although Talton knew about the situation, the employee went unpunished for more than a year until the Advertiser wrote a story about the situation.

Meuse, who is retiring at the end of the month, said trying to do the right thing has taken a lot out of her in the past year.

"No one could have fixed this in six months or a year or even three years, but we could have addressed the transparency and started to improve care for veterans," Meuse said. "My loyalty to central Alabama is loyalty to our veterans and the public — but it's not to preserving a bureaucracy that has not demonstrated its trustworthiness."

Tremaine, who has been offered a "detail" in Birmingham, said he doesn't know what will happen to his job or his career. But he said the most important thing — the reason he is risking his career — is making sure veterans get the care they deserve.

— Kachmar is a former Advertiser reporter who now works for the Asbury Park Press in New Jersey.