1. THE ORANGE COUNTY REGISTER LONG BEACH – Sarah La Brada was terrified and confused after she was diagnosed
with multiple sclerosis four years ago. She decided to leave her position as an Army
specialist and move with her husband to live with family in Long Beach. She was seven
months pregnant. She was out of a job.
La Brada, 31, turned to the Veterans Administration Long Beach Healthcare System.
But La Brada learned that the hospital only has one neurologist on staff equipped to
help her fight an illness in which even small symptoms, such as headache or flu, must
be attended to. Wait times to see the doctor at the Long Beach VA hospital took up to
a month.
She exited the VA system, where care was free, and signed up for private health
insurance.
“I have a 2 1/2-year-old and I want to see my little boy grow up – I want to be able to
play with him,” said La Brada.
Veterans who use the Los Angeles and Long Beach VA hospitals say the wait to see
their primary care physician can be as long as 90 days, forcing some of them to line up
their own health care outside of the federal system. Appointments with specialists can
take as long as eight months, vets say.
While many veterans report receiving good care, others say major problems went
undiagnosed until they were hospitalized by acute illness.
The problems at the Los Angeles and Long Beach hospitals, which served nearly
140,000 veterans in 2013, appear to mirror those at VA hospitals across the country.
Southern California has one of the largest concentrations of any region in the U.S. The
Greater Los Angeles VA system alone handled more than 1.2 million outpatient visits
and treated 90,000 new patients in 2013, according to the hospital’s annual report.
It’s not clear where the problems in Los Angeles, Long Beach and Loma Linda rank
among more than 1,500 VA medical centers and clinics in the U.S. At the VA medical
center in Phoenix, at least 23 veterans have died waiting to receive an appointment to
see a doctor, the VA has admitted.
The Register filed Freedom of Information Act requests on May 15 for wait-time
statistics at all U.S. VA hospitals but the VA has so far only acknowledged the request.
And it’s likely numbers recorded before 2012 aren’t accurate anyway, according to the
U.S. Government Accountability Office.
A 2012 GAO study that examined VA hospital scheduling and wait times at four
Page 1 of 6
Doctor delays send California vets
outside VA system
Published May 24, 2014
BYLINE: David Hood and
Brittany Hanson
SECTION: A PAGE 1
LENGTH: 2187 words

2. THE ORANGE COUNTY REGISTER
Page 2 of 6
Doctor delays send California vets
outside VA system
Published May 24, 2014
BYLINE: David Hood and
Brittany Hanson
SECTION: A PAGE 1
LENGTH: 2187 words
major VA medical centers, including Los Angeles, and 23 smaller clinics found that
schedulers changed records so that appointments would appear to meet performance
measures, essentially papering over the problem.
Debra Draper, director of health care for the GAO, said investigators found a variety of
scheduling flaws – including workers who admitted to falsifying records to make their
center look better – in all four VA medical centers studied. Draper said that the deaths
in Phoenix are a direct result of problems identified in that 2012 report.
In one example, Draper’s team found some clinics were reporting that 94 percent of
existing patients saw their doctors with primary care appointments within 14 days, one
of the desired performance goals. A year later, after an automated system was in place
and schedulers could not change dates, the identical metric yielded just 40 percent.
“It’s disturbing in the sense that we can’t tell whether veterans actually got the care
that was needed and how extensive their delays might have been in receiving care,”
Draper said. “But any time you have a delay in care, it’s a potential harm to veterans –
like, worsening conditions and in the worst case, death.”
Embattled VA Secretary Eric Shinseki last week ordered a massive, systemwide
audit of wait times and other deficiencies in the system by the Office of the Inspector
General; Congress ordered the inspector general to look for criminal activity in
falsifying records.
“The scheduling issue is complicated,” said a spokesman for the Long Beach VA.
He said scheduling appointments within a 14-day window can be difficult when the
hospital does not have enough doctors. He defended longer wait times as part of
the solution: “We use the wait list to see where we have gaps where we might have
problems – where we need additional resources,” the spokesman said.
The Los Angeles VA responded in a statement: “As part of the review during the next
few weeks, a national audit will be conducted at all clinics for every VA Medical Center.
The VA Greater Los Angeles Healthcare System will be part of the national audit and
welcomes the opportunity for an external set of eyes to take a look at our scheduling
operations.”
GROWING PATIENT LOAD
La Brada’s story gets to the heart of VA scheduling woes: not enough doctors to serve
a patient load growing as aging Vietnam veterans require more medical attention and
more troops return from Afghanistan.
Many veterans tell a similar story.

3. THE ORANGE COUNTY REGISTER
Page 3 of 6
Doctor delays send California vets
outside VA system
Published May 24, 2014
BYLINE: David Hood and
Brittany Hanson
SECTION: A PAGE 1
LENGTH: 2187 words
“There have been a few problems over the years – mainly a growth problem,” said
Jeff Wood, 65, of Los Angeles, a Vietnam-era Army veteran who is being treated for
prostate cancer at the Los Angeles VA.
“You’ve got the guys coming back from Iraq and Afghanistan, and the patient load
increased dramatically. (And) with some of us old guys, they had to learn how to take
on senior citizens. … It’s created a huge pool of patients. … It’s a tough situation
they’re in here.”
Wood describes his care as “very good” and says he has stuck with the VA system.
But other vets tell harrowing tales of chronic illness that went undiagnosed until they
collapsed and were hospitalized.
Alan Hoffman, 74, of Woodland Hills, a Navy veteran, says months of delays at the Los
Angeles VA nearly cost him his life. In January 2013 a doctor noticed that his prostate-
specific antigen – a marker for cancer – was elevated, at 45.
“They ignored it,” Hoffman said, and pushed around follow-up appointments.
In November his kidneys failed and Hoffman was rushed to the VA Emergency Room.
At that point his PSA score had skyrocketed to 700. Doctors diagnosed prostate
cancer but said it had been caught too late – he wasn’t expected to live past June. His
wife began looking at burial options.
In the last two months, his care and his condition has improved. He was given a new
primary care doctor and a cancer specialist. His appointments are regular.
Hoffman credits the recent scrutiny for the positive change.
“I should be dead already,” Hoffman said. “It just so happens I have a strong
disposition.”
Darin Selnick, a retired Air Force captain who is now a consultant for the Concerned
Veterans of America said he has received many reports of problems at the Los
Angeles VA.
“On the claims side, the L.A. office has one of the worst backlogs,” he said.
Selnick said he has arranged for his own health care outside of the VA system.
Don Rico of Huntington Beach served in the Navy from 1957 to 1960 and volunteers

4. THE ORANGE COUNTY REGISTER
Page 4 of 6
Doctor delays send California vets
outside VA system
Published May 24, 2014
BYLINE: David Hood and
Brittany Hanson
SECTION: A PAGE 1
LENGTH: 2187 words
at the Long Beach VA, directing patients around the sprawling hospital complex.
But he also goes outside the VA for his own health care.
“The wait to see your primary care doctor – the standard is 90 days,” said Rico.
“That’s the general – I don’t know what it would be if I had a specialty situation. … I’m
covered off-site; I see my own doctor.”
Mike Escarcido, 65, a Vietnam-era Marine from Huntington Beach, is being treated for
glaucoma, diabetes and post-traumatic stress disorder at the Long Beach VA. He said
getting an appointment at a specialty clinic can take up to eight months.
“It takes so long to be seen – seven to eight months down the line,” Escarcido said.
“You need to be seen with more frequency than every six months.”
CONGRESS DEMANDS ANSWERS
Shinseki of Veterans Affairs was called before the Senate Veterans Affairs Committee
last week to answer questions about his department’s oversight of the Phoenix VA.
Republican Sen. Richard Burr of North Carolina blasted Shinseki, saying that his office
should have been aware of the national scheduling crisis.
“VA’s leadership has either failed to connect the dots or failed to address this ongoing
crisis, which has resulted in patient harm and even death,” Burr said.
Shinseki said the department has been “working very hard” to implement critical
changes and renew stricter policies.
Sen. Bernie Sanders, a Vermont independent and chairman of the Senate VA
Committee, pointed out during the hearing that VA health care is comparable or better
than health services provided in the private sector, despite the scheduling issues that
have surfaced. He suggested that the actual care provided by VA hospitals serves
veterans well.
The Los Angeles VA system has one medical center, two ambulatory care centers and
eight community clinics for an area that spans a coverage area from East Los Angeles
to San Luis Obispo. While there are many reports of lengthy waits to see a doctor,
there are also reports of good care.
Performance data collected by the U.S. Centers for Medicaid and Medicare showed

5. THE ORANGE COUNTY REGISTER
Page 5 of 6
Doctor delays send California vets
outside VA system
Published May 24, 2014
BYLINE: David Hood and
Brittany Hanson
SECTION: A PAGE 1
LENGTH: 2187 words
the Los Angeles VA hospital performed similar to the national average on death rates
for heart attack patients and on other key measures. The national average is 11.7
percent deaths for heart failure patients and at the Los Angeles VA the rate was lower,
8.7 percent.
The VA Long Beach Healthcare System and Loma Linda VA Medical Center
performed around the national averages as well, scoring a 10.2 percent and 12.3
percent death rate for heart failure patients, respectively.
ANGER OVER PROBLEMS
Navy veteran Tony Zapata, 69, of Los Angeles has been treated for cataracts and has
had gallbladder surgery at the West Los Angeles VA hospital.
“I’ve got no complaints about the VA in L.A. – the only thing is what happened in
Phoenix,” Zapata said. “We need a VA director that stays on top of things. This never
should have happened. The people should have never have died. What happened in
Phoenix – nobody was keeping an eye on things,” he said.
Petty Officer 2nd Class David Lehtnen, 29, of Trabuco Canyon says he can’t complain
about the kind of care he has received either, but noted that he hasn’t had to come to
the VA for anything more than basic medical care.
“If the VA has had these issues going on and they’re not taking care of it – something
needs to be done,” Lehtnen said. “I feel the VA is trying to do the best for us, but they
may make mistakes.”
California Republican and House Majority Whip Kevin McCarthy, R-Bakersfield, on
Thursday called for Shinseki’s resignation, the first Republican leader in the House to
go that far.
“General Shinseki, Secretary of the Department of Veterans Affairs, has served his
country with honor and integrity,” said McCarthy in a statement. “However, the current
state of the VA is wholly unacceptable and has become a national embarrassment – it
requires immediate action. I believe new leadership at the Department of Veterans
Affairs is imperative to fixing the wrong that this massive bureaucracy has done to the
men and women we owe so much to.”
President Barack Obama met with Shinseki in the Oval Office this week and said he will
further review the situation before deciding whether the secretary will remain in his post.

6. THE ORANGE COUNTY REGISTER
Page 6 of 6
Doctor delays send California vets
outside VA system
Published May 24, 2014
BYLINE: David Hood and
Brittany Hanson
SECTION: A PAGE 1
LENGTH: 2187 words
CONGRESSIONAL ACTION
Congress is considering at least 10 bills that would change VA patient scheduling and
other practices.
Two are from McCarthy, who had requested the GAO study three years ago after
hearing about prolonged wait times, unanswered claims and poor support from his
Kern County constituents. Kern County veterans often have to travel 100 miles to Los
Angeles to receive medical attention at the VA hospitals.
“(The GAO report came out and) lo and behold, it’s everything the veterans were
saying and it’s everything we were fearful of,” McCarthy said in an interview.
McCarthy introduced two bills in 2013 that would allow only fully trained schedulers to
make appointments and force hospitals to provide accurate data on how long patients
wait for appointments.
On May 21, the House passed a bill that would give the VA secretary the freedom and
power to fire anyone in the system, a warning to administrators in the system that their
tenure is unprotected if anything is amiss.
In the Senate, Sanders introduced a bill in February that would have allowed the VA to
open 27 clinics and medical facilities. Most Republicans disliked Sanders’ bill because
it diverted money allocated for Afghanistan operations; it failed to receive the 60 votes
necessary to advance.
“I had hoped that at least on this issue – the need to protect and defend our veterans
and their families – we could rise above the day-to-day rancor and party politics that
we see here in Congress,” Sanders said in a statement.
Draper, the GAO investigator, is encouraged that the problems are finally getting
attention on Capitol Hill.
“The most troublesome thing for me is that we’ve been reporting on this since 2000.
So here we are, 12-14 years later and we still have the same issues,” Draper said.