Veterans Affairs Secretary Eric K. Shinseki called in leaders of key veterans groups Thursday and pledged to keep VA hospitals open nights and weekends if necessary to set up speedy appointments for veterans whose long waits for medical care have triggered a growing crisis at the massive agency.
As bipartisan pressure mounted in Congress for his resignation, Shinseki said he would announce as early as Friday new steps to hold VA employees accountable, including personnel changes and the option for veterans to seek private-sector care, according to participants at the hourlong meeting.
"I got the idea that there might be some heads that will roll," said Garry Augustine, executive director of the Disabled American Veterans' Washington office. "I think they realize the urgency."
Shinseki's fate could be determined by the preliminary findings of an audit he ordered of the VA healthcare system, which he is expected to deliver to the White House as early as Friday.
A report from the VA's Office of Inspector General on Wednesday found systemic problems throughout the hospital network in scheduling veterans for medical care, including manipulating records to hide long waits for appointments.
Veterans at the Phoenix VA Health Care System, which the report focused on, waited an average of 115 days for appointments.
The report also disclosed that the investigation had expanded to 42 sites, up from the 26 previously stated.
In Texas, meanwhile, Republican Sen. John Cornyn said he sent a letter to President Obama calling for the FBI to lead the investigation into allegations that VA employees falsified records to cover up long waits.
At the White House, spokesman Jay Carney stopped short of declaring Obama's full confidence in Shinseki, a retired four-star Army general, saying that the president has "made clear that he believes there ought to be accountability once we establish all the facts."
The firestorm surrounding Shinseki grew hotter amid calls for his resignation from members of both parties, including at least 11 Democratic senators, a number of whom face tough reelection campaigns.
Derek Bennett, chief of staff of the Iraq and Afghanistan Veterans of America, one of the veterans groups that met with the VA chief Thursday, said Shinseki "did not seem to me to be shaken by the recent drumbeat from both sides of the aisle for his resignation."
But Bennett said the meeting "did nothing to restore confidence" in the secretary to fix the problems.
"We do not doubt the secretary's sincerity in wanting to fix the problem, but we still have serious questions about whether the secretary has the tools, resources and the confidence of VA staff and veterans to create real reform," he said.
Augustine said Shinseki was upfront. "He started out the meeting by saying, 'Look, I'm a general. I had to look at crises all the time, and maybe I'm not as dramatic as some would like, but that's just who I am. But I can assure you that this is very upsetting, and I'm going to get to the bottom of it.'"
Cornyn, who met in Houston with about a dozen local veterans and leaders of veteran groups Thursday, said he wanted the FBI to investigate allegations by Texas VA employees that managers received bonuses after concealing wait times for appointments.
"When you hear the leadership at the VA are receiving bonuses only for cooking the books, to me that speaks of corruption," Cornyn said.
Rep. Jeff Miller (R-Fla.), chairman of the House Veterans Affairs Committee, said in a letter to Atty. Gen. Eric H. Holder Jr., "I believe it is now time for the Department of Justice to assess the criminality of these facts to ensure this blatant manipulation of patient wait times … does not go unpunished."
Although the VA inspector general has said his office is working with the Justice Department, Cornyn said that "the breadth and complexity of these problems very likely exceeds the capabilities of any IG office."
Reginald White, a retired longtime Houston VA cardiology supervisor, told the gathering how high-level VA managers had profited by artificially reducing wait times to improve their annual evaluations and receive bonuses, even as veterans suffered without care.
"A lot of individuals will do what they have to do to inflate that and make it look good to get that bonus," White said.
Dr. Joseph Spann, who recently retired from the VA in Austin, Texas, after 17 years, this week discussed his recent letter to VA investigators accusing a doctor manager at a facility in nearby Temple, Texas, of directing doctors to manipulate patient appointments to hide treatment delays.
"I saw patients waiting for cancer evaluations, for staging for [CT scans] or MRIs, even ultrasounds. They would have to wait for several weeks, more weeks than I felt comfortable with," Spann said. "If someone told you that you had cancer, would you want to wait several weeks for treatment?"
Spann said VA officials cleared the doctor involved and dismissed the problem as a training issue.
He disagreed, insisting that, as a Texas VA clerk has claimed, supervisors routinely broke the rules and instructed staff to adjust patient appointment dates.
Spann is now assisting IG investigators.
In Washington, Carney was peppered with questions at Thursday's briefing about the VA scandal and said the president expected to see "action taken immediately."
"The president's focused first and foremost on the need to address the problems that have impeded the quality and speed of care and benefits that our veterans have been receiving," he said. "He is also committed to making sure that people are held accountable if it is established that there was misconduct or mismanagement. But we can take action on the former while we await assessments on the latter."
Also Thursday, Sen. Mark R. Warner (D-Va.) said, "The controversy over Gen. Shinseki's leadership has taken attention away from the real issue: the need for swift, decisive action to reform the VA, change its culture and ensure that we provide quality, timely services for our veterans."
Sen. Mark Begich (D-Alaska) called the revelations about VA wrongdoing in Phoenix "appalling" and "unacceptable" during a news conference in Anchorage, but when pressed about whether Shinseki should be ousted, he said the country needed to wait for the results of a report on the scandal before anyone loses a job.
"We need to hold people accountable," Begich told reporters. "If this is more widespread, I believe everyone from the top down should be accountable.... But just getting rid of people won't fix the problem."
In Alaska, home to what Begich described as more veterans per capita than any other state, a novel pairing of the VA with a network of local and tribal healthcare providers over the last four years has dramatically improved access to healthcare for former members of the military.
In 2010, "waiting lists were as high as 1,000 people and it took 90 to 120 days to get in for primary care service" through the VA, Begich said. Today, "Alaska is doing it right. We still have some struggles. But when you go from 1,000 to 10 [on the waiting list], 120 days to seven, it's an incredible improvement."
Although numerous Republicans have called for Shinseki to step down, House Speaker John A. Boehner (R-Ohio) said Thursday: "The question I ask myself is, is him resigning going to get us to the bottom of the problem? Is it going to help us find out what's really going on? And the answer I keep getting is no."
Simon reported from Washington and Hennessy-Fiske from Houston. Times staff writer Maria L. La Ganga contributed to this report.Copyright © 2014, Los Angeles Times