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Civilian Exposure - Camp Lejeune Contamination - VA Mismanagement Editorial

VA Doesn’t Have A Money Problem, It Has A Management Problem

by Gavin P. Smith


For the past several months, the Veteran’s Administration (VA) has come under fire for its lack of care, delays and other problems across the country.  In late July, public scrutiny and controversies led to the eventual selection of Robert McDonald as the new head of the VA.  Unanimously confirmed by the Senate on July 29th, Robert McDonald took the helm of an agency steeped with issues surrounding inadequate facilities, poor veterans care and operational mismanagement.

McDonald replaced former VA chief Eric Shinseki.  McDonald is no stranger to the military.  A former West Point graduate, he also served as a Captain in the 82nd Airborne.  In business,  McDonald rose to leadership of Proctor & Gamble, starting as a brand manager and eventually becoming Chairman of the Board in 2010.  His career at P&G spanned from 1980 to 2013.

“This is an opportunity for me to make a difference in the lives of veterans I care so much about,” McDonald told Politico.

Here’s McDonald addressing potential restructuring efforts on CNN in November.

Vowing to reform the VA, McDonald has a full plate of issues to address.

“This is going to be the largest reorganization of the Department of Veterans Affairs since its establishment,” McDonald told CNN.

McDonald plans to hire about 28,000 medical professionals to join the agency’s hospitals and clinics around the country, including about 2,500 mental health professionals.

“It’s obviously in my best interest to move as quickly and as aggressively as possible,” McDonald added.

The real question, however, is can he?  Wait times, veterans claims, and now spending/budgeting controversies abound.  Just out today, a new report shows massive waste and mismanagement on various construction projects across the country into the billions of dollars.

Civilian Exposure - GAO OfficeA 2013 report by the Government Accountability Office found that delays and mismanagement contributed to a total cost increase of $1.5 billion at VA construction projects in Denver, Las Vegas, New Orleans and Orlando.

Some of my notable faves in the list include:

  • $489 million spent on “office makeovers” in less than five years
  • $5 million spent on unused computer software between 2006 and 2011
  • $50,000 spent on the production of a parody of the movie “Patton”
  • lavish employee trips and conferences
  • Renovating unused buildings, including an historic monkey house

As a standalone story of waste, fraud and abuse, this report on the VA would, in itself, be shameful. Yet, let’s drill down to see how this abuse permeates throughout the VA and has a detrimental impact on a certain military community.

With all due respect to the monkeys, those millions or billions wasted could have certainly been spent on much better and more fruitful projects that cater to the very spirit of why the VA was created.  For example, that money would certainly go along way to expediting care for victims of contamination aboard U.S. military installations across our country.  Over 150 federal sites are listed on the EPA Superfund Site list today.  Large pockets of veterans, military personnel, spouses, children and civilian DOD workers exposed to contaminants at various bases are sprouting up with a litany of health concerns and casualties.

Civilian Exposure - Camp Lejeune ContaminationThe flagship of these health catastrophes is Camp Lejeune, NC.

Between Aug. 1, 1953, and Dec. 31, 1987, potentially 1 million+ military personnel, spouses, children and civilian DOD workers were exposed to unusually high levels of known carcinogens in base drinking water.  Over 30 wells were contaminated across the base leading to elevated risks for a variety of blood cancers, rare cases of male breast cancer and more.  Four studies released by the CDC Agency for Toxic Substances and Disease Registry (ATSDR) this year alone paint a vivid picture of the extensive health impact and damage done.

What’s worse?  Base officials knew about the contamination as early as 1980/1981 but ignored studies and delayed any corrective activity until forced to address the issue by the EPA.  Even so, evidence shows that soil vapor contamination plagued the base well beyond 1989.  Evidence also suggests that a plume of toxins continues to exist to this day beneath the base just waiting to surface.

Civilian Exposure - VAAs of this posting, claims continue to be tied up by VA bureaucracy.  To make matters worse, some high-ranking officials address the issue with a distinctive and sometimes appalling level of ineptitude, disrespect and dismissive tone that leads many to believe that the VA is utterly tone deaf on Camp Lejeune contamination and its very real health impacts.  Further,  one can easily infer from their activity, or rather inactivity (as many cases remain in limbo to this day), that their primary concern is solely based on mitigating the financial risk burden for their agency.

Point 1: Two Years to Implement 2012 Caring for Camp Lejeune Families Act

In a recent article, it was reported that:

The VA needed two years to start family-member coverage because the agency effectively had to create a supplemental health insurance plan by writing rules, hiring clinical care reviewers, creating computer systems and billing mechanisms, and developing a method to transmit medical records from civilian doctor offices to the VA’s financial service center for review.

Two years to implement? Perhaps they were too busy with other things, such as all of the wasteful spending mentioned in the CNN report. Regardless, the Honoring America’s Veterans and Caring for Camp Lejeune Families Act was signed into law in 2012.  According to Title 1 of the Act:

“Marines and their families stationed at Camp Lejeune in North Carolina were exposed to contaminated well water. Veterans and their families who fall ill (or are ill) due to this contamination will be eligible to receive healthcare through VA, for certain medical conditions. For family members, VA will be considered as the “payer of last resort.” (Section 102, S. 277, Sen. Richard Burr)

The mere fact that the VA, knowing that people are dying daily from their exposure, takes two years to implement a law says it all.  It shows the complete lack of urgency and compassion to help veterans in need.

Point 2: Dr. Terry Walters’ Training PowerPoint Slides, CAP Meeting Attendance Issues and Public Remarks

Dr. Terry Walters, Deputy Chief Consultant of the Department of Veterans Affairs, Public Health, Post-Deployment Health group, is the current high-ranking point person involved for the VA concerning Camp Lejeune contamination.  Dr. Walters has missed four consecutive Camp Lejeune Community Assistance Panel meetings over the past year.  In two of those, she only partially participated by phone.  In the most recent CAP meeting at the CDC in Atlanta, she participated briefly by phone only to flatly refuse to answer any of CAP questions concerning the outrageously disrespectful, unprofessional and inaccurate training power point that she recently disseminated to workers at the VA.

In the PowerPoint, her description of a hypothetical Camp Lejeune veterans’ spouse on pages 10-12 has been called into question.  For those veterans and civilians exposed, take a good and careful look at the following screenshots of those pages.  This is how the entire VA views both you and your health issues:

Civilian Exposure - VA Environmental Health Champion Training - Page 10
Civilian Exposure - VA Environmental Health Champion Training - Page 11
Civilian Exposure - VA Environmental Health Champion Training - Page 12

“She took the worst attributes of three actual cases and created the one example she used to train clinicians with,” said Jerry Ensminger, CAP member and long-time advocate of the exposed. “This is documented proof that she holds disdain for our issue and that the health of our community is the least of her concerns.”


Unfortunately, Dr. Walters did not stop there.  In the past month, at around the same time that the 4th ATSDR’s health study was released (this time showing extensive in-utero birth exposures for pregnant mothers during contamination at Camp Lejeune), Dr. Walters used an interview with a syndicated reporter (Tom Philpott) to downplay the issue and undercut the validity of the science involved.  That story has since found its way into dozens of news outlets, websites and was even distributed word-for-word without rebuttal through an email blast to the entire MILRETVET-INFO email channel.

In it, she states:

“Statistically speaking, there has been nothing really solid” to show the toxins caused diseases among Lejeune’s population of that era, said Walters. “There has been hints,” she added.

Later, Walters continues:

“The science to show whether drinking the contaminated water results in cancers or adverse health effects is just not mature enough.”

Hints? Here’s a hint, Dr. Walters.  Perhaps you should actually show up to a CDC/ATSDR CAP meeting.  If so, you would have heard of those four new studies in detail. You might have also heard from those who are dying, right now, on your watch.  Who knows.  Maybe you just might learn something.

There is, in fact, documented proof of high levels of internationally classified known carcinogens present in the base water supply.  There are years of CDC/ATSDR studies showing the contamination. There are extensive water modeling reports that provide such data.  There is also the fact that the issue was so bad that it became the biggest installation to be listed on the EPA Superfund Site list. Last I checked, Dr. Walters, the EPA does not add sites to that list based on mere hints of contamination.

Studies not mature enough?  There are four brand new studies released just this year proving elevated risks of serious cancers and other ailments for marines, civilian DOD workers, pregnant mothers, children and just about every other living thing that spent time aboard that base between 1953-1987 all provide “really solid” evidence.

Civilian Exposure - VA Claims DeniedThanks to purposeful misinformation media campaigns and the dissemination of the aforementioned training slides throughout the entire VA system, a bias has been inherently created to the detriment of exposure victims seeking help.  As a result, the CAP has formally requested that Dr. Walters’ be replaced by a new point person to handle Camp Lejeune needs.

Point 3: Lengthy Claim Processing Delays and High Claim Denial Rates

Claims for Camp Lejeune water contamination are processed by the VA in their Louisville, KY, office.  If one digs deeper into the numbers, it becomes all too apparent why many veterans or civilians have not even tried to file claims.  It’s also easy to see why very few applicants maintain any faith at all in seeing results from their claims they have submitted.  In the same aforementioned article regarding Dr. Walters, the writer does share this fact:

“Through Sept. 30 this year, 16,320 Lejeune vets had applied for VA health care citing the law; only 1,231 were receiving care for one of the toxin-related conditions.”

If you do simple math, that means that roughly 7.5% of claimants actually were approved to receive care.  That also means that 92.5% either have yet to hear back, or have been outright denied either for their claim or for care.

Don’t take our word for it.  In a Veterans Today report from July, the author shares some very interesting statistics:

“The VA’s statistics as of January 31, 2014, showed that the VA’s Louisville office had processed 9,703 medical claims, approved 349 (3.6%), and denied 9,354 (96.4%)”


“Statistically speaking”, as Dr. Walters put it earlier, that’s completely unacceptable.

There are so many angles to this mess.  Obviously, there is much more to this story than just the three points above.  Regardless, one only has to sum up the following:

  1. The recent VA waiting times scandal
  2. Massive monetary mismanagement and waste
  3. A history of bureaucratic red-tape slowing policy execution
  4. Improper training materials creating bias given to VA workers
  5. Ongoing resistance to scientific evidence in favor of pursuing protective risk mitigation policies
  6. Creation of inappropriate interpretation authority and convoluted claims policies by high-level officials to slow or impede claims
  7. An overall dismissive response to all parties affected in the Camp Lejeune case

Add up all of the above and one can only conclude that the VA certainly does not have a money problem (by the way, their annual budget is now a whopping $154 billion per year).  The VA has a management problem.  To a large extent, due to the management problem, it also has a culture problem.  In slang and in short, it’s “CYA” at the VA.

There’s an old saying about leadership and culture – “A fish rots from the head first.”

There are decades of rot within the VA.  Mr. McDonald should start at the top quickly, change the “CYA” culture, and work his way down to completely root it out.  That’s the only way both McDonald and the VA can truly achieve meaningful reform.

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