The Problems with the Tomah VAMC 100-Day Plan

Rory E. Riley Our Veterans, Tomah, VA 2 Comments


By Rory E. Riley

The recent problems at the Tomah VA medical center have been well-documented, from the over-prescription of opiates to its patients, the struggle in how Senator Tammy Baldwin’s office handled information, to a human game of “hungry hungry hippos” instead of caring for veterans on Halloween.   So, the VA’s release of the “Tomah VAMC 100-Day Plan” seems like it would be a step in the right direction in addressing these serious problems, right?

However, because as the Arizona Republic recently noted, “VA is a two-letter synonym for insanity,” this plan will not solve the issues at the troubled medical center.  Here is why:

First, the plan consists of only four pages of four highlighted titles and several bullet points as a description of implementation for each one (Open Access to care, Improve Employee Engagement, Restoring Trust, and High Performing Network & Best Practices).  Although VA has used all the right buzzwords in issuing this document, the lack of substance is troubling to the say the least.  It would seem that problems of this magnitude — which resulted in the death of veterans in the care of that facility — would warrant much more detail and attention than merely four pages that lack complete sentences.  By contrast, the VA OIG report that confirmed the unexpected death of a veteran during the course of mental health treatment at the facility warranted a full 28 pages of single-spaced information, including a summary of the issue, scope and methodology used in the investigation, results, and recommendations for improvement.  Even VA’s official response to the OIG report’s recommendations are more in-depth than the information contained in the 100-Day Plan.

The Tomah VA Medical Center

Second, passing off power point presentations as a “plan” is not a new tactic from the VA.  Despite the recent rhetoric given to accountability and restoring the public trust, VA does not seem to have progressed much from three years ago when, in a heated exchange with then-Ranking Member Bob Filner of the House Veterans’ Affairs Committee, the Veterans Benefits Administration purported to have a “Transformation Plan,” which, in reality was just an 11-page power point presentation.  Despite promising to produce the plan at the June 19, 2012, hearing, VA failed to produce a substantive document until seven months later, in January 25, 2013.  Further, even when the VBA’s strategic plan was produced in January 2013, many questions still lingered as to the viability of its implementation – suspicions that ultimately proved correct when VA failed to meet its 2015 deadline for eliminating the claims backlog.

Finally, prior to the issuance of the 100-Day Plan, the Tomah VA issued a “30-Day Plan,” which was largely unsuccessful.  The 100-Day Plan is not all that different from the 30-Day Plan and, as noted by Benjamin Krause of, “the press corps largely gobbled it [the 100-Day Plan] up without discussing the contents of the plan or why the previous plan was insufficient to improve.”   This is the essential issue with VA accountability, not just at Tomah, but nationwide.  While there have been many calls for “accountability,” there have been far fewer substantive proposals and suggestions as to how such accountability can be achieved within such a burgeoning bureaucracy that has gotten away with ignoring its critics for decades.  Of course, the fact that the public and the media are paying more attention and are rightfully outraged at VA’s organizational behavior is, like the 100-Day Plan, a step in the right direction.  But, more needs to be done.

In essence, the Tomah VAMC 100-Day Plan is like a microcosm for the VA’s issues at-large – a problem is identified, the public is outraged, and VA pays lip-service to the problem by issuing a document with a few key buzzwords as they wait for the public to turn its attention elsewhere.  Let’s be sure to keep the pressure on not just the staff of the Tomah VAMC, but the VA in general in pushing for true improvements in veterans care (for example, by working collaboratively with those both inside and outside the Department), and restoring the public’s trust by demonstrating actions with integrity, not just listing them on a powerpoint.

Rory E. Riley is the is the principle of Riley-Topping consulting, a consultancy that specializes in issues pertaining to veterans law and policy.  She can be reached on Twitter @RileyTopping or via email at

Comments 2

  1. A New Office should be created, since the VA does not think it has to report to Congress properly, or the American people! This new office should be positioned directly above the Leaders at the VA, since they do not think they have to be accountable to anyone. Thus, I am saying give them a REAL SET OF NEW BOSSES, and keep that office unconnected from the Political food chain at the VA. Something must be done to rattle their cages! The TRUST IS BROKEN!

    Albert Einstein is widely credited with saying “The definition of insanity is doing the same thing over and over again, but expecting different results.”

    So, the answer remains fix it, because it is broken!

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