The VA’s
federal watchdog has uncovered filthy conditions at facilities across the
country. Yet some 40 percent of all VA hospitals recently suffered from severe
shortages of housekeeping staff.
JASPER CRAVEN JULY
4, 2020
On a warm november day in
2017, Representative Mark Takano, a California Democrat, met with a
whistleblower who had serious concerns about the 270-bed Veterans Affairs
facility in Loma Linda. Later that day, Takano took a tour of the hospital, and
was shocked by what he saw. Grime encrusted the water fountains; the floors of
the operating room were noticeably dirty. Takano called for the VA’s inspector
general to launch an investigation, which found “inconsistent levels of cleanliness” in the
main hospital building, and unwashed floors, dusty cabinets, and a sterile
instrument resting on a dirty rack in the inpatient dental unit. The rate of
infection among Loma Linda’s patients was higher than the agency average, and
the housekeeping department was largely incapacitated by high turnover, poor
pay, and shaky management. A separate investigation found the bacteria Legionella
pneumophila, which causes Legionnaires’ disease, in the water supply—a
discovery that the facility had failed to communicate to clinicians.
Today, in
the midst of a pandemic that threatens everyone, but especially people with
preexisting conditions, including the many veterans who suffer respiratory
illnesses likely brought on by exposure to Agent Orange and burn pits, problems with cleanliness at VA
facilities endure. For nearly two decades, the agency’s federal watchdog has
uncovered filthy conditions at facilities across the country. The problem is due, at least in part,
to the fact that 40 percent of all VA hospitals suffered from severe shortages of housekeeping staff in
fiscal year 2019—the most recent data available. More than 2,000 cleaning
positions are vacant across the VA’s national network, according to granular
workforce data released by the agency in late May. And despite Takano’s
spotlighting of issues in Loma Linda, the facility still has 21 unfilled
housekeeper positions.
“The way
many think of custodial staff does not reflect the value that they provide to
hospitals,” Takano told me recently. “They are critical to infection control;
we need to see these employees as skilled workers.”
In the
VA, housekeeping positions are generally reserved for those who served. Retired
service members struggling with mental illness or physical impairments fill
many of those slots. As of 2015, roughly 65 percent of VA housekeepers were
people of color; currently 85 percent are veterans. Unlike clinical hospital
staff, who are less likely to be veterans or minorities, housekeepers aren’t
required to have advanced degrees, and they rarely win public accolades. But
the VA’s 257-page COVID-19 battle plan relies heavily on housekeepers,
and requires sanitizing everything from hospital chapels to body bags holding
the remains of those who succumbed to the coronavirus. The VA, however, lacked
enough cleaning staff to fully execute that plan. Ten days after its release,
agency officials announced they needed to quickly hire housekeepers.
In an
impressive feat, the department hired 1,126 cleaning staff over the next month.
But it’s unclear how quickly these employees were onboarded and whether this
boost meaningfully shrunk the vacancy number or simply replaced some of the
staff lost to attrition each quarter. The VA did not respond to a request for
comment for this story.
President
Donald Trump earned historic support from veterans in 2016, in
part by promising to fix the VA. Yet one of his signature legislative
achievements, the Department of Veterans Affairs Accountability and
Whistleblower Protection Act of 2017, has disproportionately
targeted lower-level employees, who are typically veterans. Many of them are
housekeepers.
From 2017
to 2018, nearly 900 cleaning workers were suspended or fired as a result of the
bill, many of them for specious reasons or minor mistakes. The president,
however, boasted of the office’s firing spree just a few weeks ago, in Memorial Day comments dedicated to
America’s fallen. “They don’t take care of our vets, we fire them,” Trump said.
He enthusiastically estimated 8,000 employee terminations—many of them
veterans—calling the fired staffers “sadists” and “thieves.”
“They
didn’t take care of our vets,” Trump said. “Now they’re gone. We got ’em out.”
Those no longer in the agency include housekeepers, yes, but also clinical
staff crucial to COVID-19 care. Although an analysis by the American Federation
of Government Employees showed housekeeping as the top position targeted by the
Office of Accountability and Whistleblower Protection, nursing came second.
The necessity of va
housekeepers—and the story of their mistreatment—is vividly illustrated
on the grounds of the Pittsburgh VA’s University Drive campus, a sprawling,
14-acre system built on top of an abandoned mine shaft. When the virus reached
the Steel City in March, it circulated on the third floor of the Pittsburgh
VA’s mental-health ward. Four housekeepers manned the floor in good times, but
staff fluctuations in recent years had brought that number to as low as two.
Just before the pandemic, the Pittsburgh VA acknowledged 36 custodial
vacancies, and had three housekeepers on the third floor, all of whom were
veterans. The oldest was in his 70s. The virus moved throughout the floor
quickly. Soon most of its patients were sick.
None of
the rooms in the mental ward were negatively pressurized, which heightened the
chances of virus transmission. Staff witnessed dust spilling out of the
building’s air ducts, and housekeepers spent precious time running water
faucets—supposedly to prevent the spread of contaminants. Another puzzling
policy that raised eyebrows on the third floor: COVID-19-positive patients were
allowed to freely walk about, in and out of their rooms. This added stress to
already-demanding eight-hour cleaning shifts. A VA Pittsburgh spokesperson did
not respond to a detailed list of questions concerning conditions and policies
on the floor.
“In that
situation, you’re constantly having to disinfect,” one housekeeper, who
requested anonymity because of a fear of retaliation from management, told me.
“Even if [patients] were wearing a mask, anything they touched you had to
bleach clean. But not knowing exactly what they touched or didn’t touch, we
were constantly wiping. That’s your whole day. And after a while, that bleach
gets to your head.”
In the
early days of the pandemic, housekeeping staff lacked access to preferred
cleaning supplies and nurses had to reuse protective gowns. N95 masks were also
in short supply and seemed to come last for cleaners. “If they did have them,
we weren’t the priority,” the housekeeper said. “We are the ugly stepchild.” As
housekeepers shoulder additional risks related to COVID-19, only a few are
receiving additional pay.
As of
April, at least half a dozen Pittsburgh VA employees had caught the virus,
including the oldest housekeeper, who fought in Vietnam. Reached by phone, he
confirmed that he had been diagnosed with COVID-19, but declined to speak on
the record. More than 24,000 VA patients and employees have been diagnosed,
and nearly 1,700 have died, including at least 40 VA employees.
As the pittsburgh va’s
housekeeping staff contended with COVID-19, they surely could have
used the hands of Kevin Patterson, a feisty Marine veteran who, for 16 years,
cleaned many of the hospital’s nooks and crannies. I first met Patterson more
than two years ago when on a reporting trip to assess the immediate impacts of the VA’s
Office of Accountability and Whistleblower Protection. The office was created
under Trump’s 2017 law and was responsible for the VA purge. At the time,
Patterson was busy fighting an overwhelming number of proposed terminations as
part of his work as the local vice president of the Pittsburgh chapter of the
American Federation for Government Employees. Speaking in his cramped union
office in 2018, Patterson warned that the purge was “getting the guppies
instead of the trout.”
The VA’s
leadership has long undervalued housekeepers, and the federal Office of
Personnel Management hasn’t updated the job description for VA housekeepers
since the Vietnam War. As a result, many earn a lower hourly wage than their private-sector
colleagues, which puts them on the edge of poverty. Their firing can
be catastrophic to their personal finances.
The AFGE
warned that the 2017 law’s provisions could be exploited to fire employees
without cause and crack down on union activity, but few lawmakers took their
warnings seriously. Although the OAWP no longer releases adverse action reports
to the public, data from 2017 to 2018 show thousands of frontline employees
were demoted, suspended, or fired, including the housekeepers.
Although
some OAWP terminations were surely justified, many others relied on issues as
minor as narrowly missing performance metrics or arriving late to work. Last October, the VA’s
inspector general found that the OAWP “did not consistently
conduct procedurally sound, accurate, thorough, and unbiased investigations.”
In March, the Project on Government Oversight came to
a similar conclusion, and found repeated instances of retaliation against
employees who raised concerns about office dysfunction. (As of late last year,
the OAWP’s current director had targeted just one department leader for punishment.)
In our
2018 interview, Patterson bluntly warned that the widespread termination of
employees would cripple hospital services and hit veteran households hardest.
He and other sources also pointed me to a Pittsburgh VA administrator untouched by
the accountability office despite his work to cover up the 2011–2012 Legionnaires’ outbreak and other
accusations of misconduct. (He has denied any wrongdoing.)
Shortly
after my story was published, Patterson was fired under Trump’s accountability
statutes. The official justification for his departure cited a shouting match
between him and a colleague, though multiple VA employees described the
incident as a minor dispute.
During
arbitration, Patterson argued that he was slapped with the charge as
retaliation for his union activity, including his cooperation with my story.
(In the course of his case, then-AFGE local president Colleen Evans, who also
spoke with me on record, testified that after my piece went live, she was
“approached by somebody from public affairs, who basically told me to watch my
back.”) In May, a federal arbitrator overturned Patterson’s firing and ordered
the department to reinstate him with back pay. (The arbitrator found no
evidence that the firing was retaliatory.)
Patterson
is eager to return to work, both to help out his fellow union members and to
come back from the brink of his financial collapse. After being fired from the
VA, he found a job at an Amazon warehouse. Within a few weeks, a colleague
injured Patterson with a pallet jack.
As he
healed and sought employment elsewhere, Patterson said his job history made it
virtually impossible to secure a steady position. “My wife told me to stop
saying I had been fired, but that was the truth; I couldn’t lie about it,” he
told me. “Plus, some employers just don’t like to hear that word, union.”
Despite a couple years off
the job, Patterson can still quickly run through a housekeepers’ best-practices
list and can tick off specific uses for the cleaning chemicals tucked away in
broom closets throughout the Pittsburgh VA. “You have to pay attention to
detail,” he told me, “because cleanliness in a hospital is not just wanted—it’s
necessary and needed.”
Many
veterans face an untenable economic future. The veteran unemployment rate has
nearly tripled since January, to
8.6 percent, only slightly lower than it was in the aftermath of the
2008 financial crisis. At the same time, the VA is grappling with roughly
50,000 vacancies across a host of departments. Hiring qualified veterans into
these positions would not only improve agency functionality but also provide
security for struggling veteran families. Patterson and his wife, Crystal, face
foreclosure on their home and pressure to pay their daughter’s college bills.
Even though he won his arbitration case, he noted the VA could still appeal the
decision, preventing his return to work for months.
Takano
told me he had reservations about the VA bill that led to so many terminations,
but he voted for it, citing its statutes as strengthening
whistleblower protections. He told me he now sees the OAWP’s work as “classist”
and “galling.”
“They
fired a lot of cleaning staff to prove accountability came to the VA,” he said,
“only to create a situation where cleanliness during a pandemic is difficult.”
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JASPER CRAVEN is a
freelance reporter covering the military and veterans’ issues.
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