Between his vows to replace ObamaCare, build a border wall and renegotiate trade pacts, President Trump’s inbox is mighty full his first week in office.
But one of the biggest challenges will be the Department of Veterans Affairs, where massive problems persist – many in the same hospital that was the epicenter of the waiting-list scandal that rocked the agency, and shocked the public, in 2014.
“Until Congress passes strong accountability measures, VA employees from top to bottom will have little incentive to change this toxic culture,” said Mark Lucas, executive director of Concerned Veterans for America, a veterans’ advocacy group.
A recent survey of employees at the Phoenix facility reported employees have little confidence in the integrity of their supervisors -- findings Lucas called “unsurprising.” Two government audits also found little improvement and costly inefficiencies in the agency as a whole. 
Trump, who vowed during the campaign to overhaul the scandal-scarred department, has nominated Dr. David Shulkin, a VA undersecretary in the Obama administration, to take over.
If confirmed, Shulkin and Trump together will confront problems that extend well beyond morale issues. 
The Government Accountability Office for the third year reportedly will place the VA health system on its “high risk” list when it’s released in February, because of continued problems of waste, fraud or mismanagement. The forthcoming report will say the VA has showed “only limited progress” since the scandal erupted.
The VA Office of Inspector General also reported earlier this month that in 2015, the VA awarded more than $177 million in improper relocation or retention bonuses based on inaccurate information to 238 different employees, many of them executives. The report blamed the VA for “ineffective oversight processes to ensure compliance,” and “ineffective procedures to recoup funds from individuals with outstanding recruitment and relocation incentive service obligations.” 
And the January survey of employees at the Carl T. Hayden VA Medical Center in Phoenix – which has had seven directors since 2014 revelations about VA officials falsifying patient wait times as some died waiting for care – found fewer than one-third of employees feel their supervisors have integrity or that whistleblowers would be protected. 
Trump’s 10-point plan to reform the VA included firing bad employees; creating a special commission to investigate cover-ups; and ensuring veterans have the option of VA vouchers for private health care.
The department clearly is still high risk. Yet some of Trump’s goals already are in the process of being realized, said Joe Chenille, executive director for the veterans advocacy group AmVets.
“We have gone from 19 percent getting care from outside sources, paid for by the VA, to 31 percent,” Chenelly told Fox News. “My prediction is a surge of people will want care outside the system.”
Shulkin, who has experience as a hospital CEO, came to the agency with now-former VA Secretary Bob McDonald to make reforms after the scandal, and has the confidence right now of the Trump administration.
“Dr. Shulkin is a nationally-recognized turnaround artist, health care leader, and passionate veterans advocate who is eager to transform the VA and will be able to do so in the Trump administration,” Trump spokesman David White said. “If confirmed, Dr. Shulkin will be ready on day one to enact President Trump’s 10-point plan to end mismanagement and incompetence at the VA, and ensure our veterans get the timely, quality care and support they deserve.”
A VA spokeswoman declined to comment and deferred to the Trump team.
A new VA secretary isn’t enough, though, said Lucas of the CVA.
“These are problems that arose as a result of a system that is set up to fail, a system no one leader can change without meaningful reforms from Congress,” Lucas said. “The VA needs to be transparent with veterans and taxpayers about its performance and how money is being spent. But most importantly, veterans deserve to be empowered with choice over where and when to see a doctor.”
In September, RimaAnn Nelson, became the seventh director of the Phoenix veterans health system since the 2014 scandal. Nelson is no stranger to other VA controversies. She previously was director of the St. Louis system, where an inspector general report determined 1,812 patients were potentially exposed to hepatitis and HIV infections because of breaches in cleaning and sterilization of medical equipment.

Phoenix VA Hires Fed After She Was Fired By Chicago VA For Lies, Abuse


BY Luke Rosiak

Investigative Reporter

Phoenix Department of Veterans Affairs (VA) officials hired a woman this year who was recently fired from another VA facility for abusing patients and lying, giving her preference over veterans and other applicants who applied for the job, The Daily Caller News Foundation has learned.
Deloris Judd was fired from the North Chicago VA for numerous incidents of patient abuse. Her union tried to block the firing, but arbitrators found that she also lied during her appeal, and seconded the dismissal in March 2016.
Three months later, she was hired by the Phoenix VA, which claims that, since a major 2014 scandal involving employees lying about patient wait-times, it has turned things around and has no tolerance for such behavior.
The Arizona VA facility hired Judd even though the state of Illinois put a lien on her for unpaid taxes in 2015. And thanks to a union contract and federal hiring policy that favors former federal employees over the public when hiring, the fired ex-fed appears to have been vaulted to the front of the line in front of veterans who wanted the job.

Phoenix put Judd to work on the Choice Card program, TheDCNF learned, an initiative intended by Congress to let VA patients escape long wait-times by going to private doctors. Judd had no experience in the area, and her department is now the worst-performing at Phoenix, trapping patients for months and improperly managing waiting lists.
In Chicago, Judd was repeatedly cited by VA police for her inappropriate behavior. In another case, when her boss asked her to do some work, Judd indignantly called the police on her boss, calling it harassment. In another case, she was suspended for inappropriate behavior with a patient.
That was all before the final incident, in which an elderly woman asked for a printout of her appointments and Judd refused, saying it was not her job. The woman crumpled up the one piece of paper that Judd did give her and laid it on the counter. In response, Judd called the police on the old lady and accused her of threatening her.
The elderly woman burst into tears at the hostility, and Judd did nothing to console her, such as asking a patient advocate or nurse to comfort her, the VA determined.
Judd paced back and forth and tried to intercept the police to give them her version. She was fired after an administrative investigation, and the incident was re-litigated when Judd refused to accept the firing and appealed it in a union hearing. Testimony in all those, including from a nurse and a naval officer, found that Judd lied about being threatened and showed no empathy for the people she was supposed to be caring for.
Asked by TheDCNF why the hiring manager at Phoenix didn’t call a VA colleague in Chicago for a recommendation, consult a central VA human resources file or examine federal employee exit paperwork — or if it did, but hired her anyway — the department issued a rare mea culpa.
“We are changing our culture, which includes acknowledging when we have not lived up to these values in some cases. The hiring process regarding Deloris Judd that took place this summer is regrettable and not as thorough as it should have been,” Phoenix spokeswoman Jessica Jacobsen said.
The just-fired-for-misconduct Judd likely got the job without having to compete against anyone else, potentially cutting in front of veterans who wanted the job. (RELATED: Only VA Job Reserved Specifically For Vets: Janitor), the official civil service employment web site overseen by the U.S. Office of Personnel Management (OPM), says “individuals who previously held a career or career-conditional appointment with the federal government may be eligible for reinstatement, which allows reentry to the Federal competitive service workforce without competing with the public.”
According to OPM, “If you were removed for cause from your previous federal employment, it will not necessarily bar you from further federal service. The facts in each case as developed by inquiry or investigation will determine the person’s fitness for re-entry into the competitive service.”
Judd had worked at the North Chicago hospital since April 2007, mostly as a clerk. But Phoenix put her to work in an area in which she had no experience as a voucher examiner for non-VA care — in other words, in charge of the Choice Card.
Congress established the Choice program to let veterans seek services from private doctors when VA could not do so sufficiently quickly. The Choice program was approved over intense opposition by a federal employee union that argued it jeopardized government jobs. But VA managers have also opposed the program, failing to pay private doctors until they refused to see any more veterans.