Atlanta VA exec scored bonuses while audits found lapses

The former top administrator at the Atlanta VA Medical Center received $65,000 in performance bonuses over a four-year span as internal audits revealed lengthy wait times for mental health care and mismanagement that led to three deaths.

James A. Clark, the former director of the Atlanta VA, received a $13,822 bonus in 2011, on top of his $176,327 base salary, according to records obtained by the Atlanta Journal-Constitution and Channel 2 Action News.

That year a patient with the Health Care for Homeless Veterans program told staff he was suicidal, but because a psychiatrist was unavailable to see him, staff told the patient to take public transportation to the emergency department. The patient did not do so and killed himself the next day, according to an audit by the Department of Veterans Affairs Inspector General released last week. The audit described two more deaths in 2012 that it linked to mismanagement at the Atlanta VA.

Another IG audit released in 2011 – when Clark served as both director of the Atlanta VA and acting director for the VA’s Southeast Network – found lengthy waiting lists for mental health treatment and staff not acting quickly enough to address the problem.

Clark retired in December. The hospital’s interim director is Sandy Leake, who had been the assistant director for nursing and patient services and was not on the list of top executives and their bonuses obtained by the AJC.

An Atlanta VA spokesman referred all questions to the department’s Washington office. VA spokeswoman Jan Northstar said “In most cases, VA is not able to comment on the performance ratings of our employees.” But Northstar pointed out that Clark had taken on additional responsibility as acting director of the Southeast Network, responsible for eight VA Medical Centers and 42 outpatient clinics.

Attempts to reach Clark through the VA were unsuccessful.

The VA gave out about $2.8 million in executive bonuses in 2011, according to the data reviewed by the AJC. Executive bonuses were a tiny fraction of the overall VA bonus pool, which was $194 million, according to information disclosed in a Senate hearing last year.

Clark received a $14,587 bonus in 2008; $20,000 in 2009, $17,469 in 2010 and $13,822 in 2011, the most recent year available. Lawrence Biro got bonuses of $29,000, $30,000, $21,000 and $18,000 from 2007 to 2010, when he was the Southeast Network Director overseeing the Atlanta VA. The current Southeast Network Director, Charles Sepich, received performance bonuses of $14,000, $15,172 and $12,924 from 2009 to 2011, when he was the head of the Richmond, Va., VA Medical Center.

“Unfortunately, this looks like more proof of VA’s well-documented reluctance to hold employees and managers accountable,” said U.S. Rep. Jeff Miller, R-Fla., the chairman of the House Committee on Veterans’ Affairs, in a statement. “VA owes us all – especially the families of those who died – an explanation as to why the department awarded these bonuses.”

Miller said this week that he would likely tour the Atlanta VA soon and raised the possibility of a field hearing in Georgia to examine failings in the VA’s treatment of mental health patients.

The audits paint a grim picture of mental health services at the 405-bed hospital in Decatur which, in conjunction with eight outpatient centers in the Atlanta region, serves 86,000 patients.

Many of the thousands of mental health patients the Atlanta VA referred to the DeKalb County Community Service Board “fell through the cracks,” including the man who committed suicide in 2011. On the hospital’s fourth floor mental health ward, patients who were supposed to be under constant supervision at times roamed free, the audit states. One veteran died after overdosing on drugs he obtained while unsupervised.

The inspector general audits also identified waiting lists for treatment as a fluctuating problem, but a separate report cast doubt on the entire waiting list record-keeping system. An employee at the Manchester, N.H., VA Medical Center told the Senate Veterans’ Affairs Committee last year that staff routinely “gamed” the system to meet performance standards — and earn bonuses.

Then-U.S. Sen. Scott Brown, R-Mass., asked William Schoenhard, the VA’s Deputy Undersecretary for Health for Operations and Management, whether he thought $194 million in bonuses was appropriate under the circumstances.

“We … have done an extensive review of performance bonuses and have reduced those in both the number of ‘outstanding’ ratings and the dollar amount,” Schoenhard replied.

“So the number was actually higher at one point than $200 million?” Brown asked.

“It was, yeah,” Schoenhard said.