Dandira (2012), in an epic discussion on the origins of organizational cancer, discussed how communication, among other things, breeds organizational cancer. The author stated what should be obvious, but the government remains oblivious to government agencies and the body’s organizational cancer. “Responsibility and authority: (the CEO/Executive Chief) he should have the power to hire and fire, especially those who continue to follow the old system of playing political games at the expense of the organization” (Dandira, 2012, p. 191). Again, while the following is using the Department of Veterans Affairs (VA), the examples spread like thick peanut butter, or bathtub scum, across all government agencies and NGOs.
From the Department of Veterans Affairs – Office of Inspector of General (VA-OIG) reports, we find:
“Michael Wibracht of San Antonio, Texas, the former owner of several construction companies, defrauded the United States by obtaining government contracts under programs administered by the Small Business Administration for which neither his nor his co-conspirators’ companies were eligible. One co-conspirator, Ruben Villarreal, also of San Antonio, pleaded guilty on Nov. 20, 2020, to participating in the same conspiracy. “The defendants conspired to fraudulently obtain multi-million dollar government contracts under a program designed to benefit service-disabled veterans,” said VA Inspector General Michael J. Missal. “These guilty pleas send a clear message that individuals and companies who defraud the government contracting process for service-disabled veterans will be held accountable.”
VA Inspector General Michael J. Missal, you are 100% incorrect! Holding third-party contractors responsible for defrauding the VA does not “send a clear message,” nor will any of the actual problems be addressed; hence the fraud will continue, and the taxpayer and veterans will continue to suffer. A little research into this story reflects that no VA Employees, who had to have been aware of the schemes and aided and abetted the schemes, have been held accountable for dereliction of duty. Thus, the fraud will continue, and frankly, I wish you would learn this particular lesson!
Dandira’s (2012) point is the hinge upon which fraud will or will not continue, does the executive heads at the hospital, VISN, and D.C. levels have the power and authority to act? No; they do not, because Congress refuses to grant this power, while also refusing to scrutinize the government properly! A convoluted mess that should have already been resolved, but the bureaucrats prefer designed incompetence and inertia to perform any work to improve the culture and accountability to the American Citizen and veterans.
Speaking of a culture needing work, the VA-OIG reports:
“Matthew Pizarro, 32, of Stoughton, Massachusetts, was sentenced to 10 years in prison and eight years of supervised release for distribution of fentanyl, one count of distribution of 40 grams or more of fentanyl, and one count of possession with intent to distribute 28 grams or more of crack cocaine. Pizarro was indicted in October 2018 and has been in custody since his arrest in August 2018.”
Speaking to the cultural problems allowing for criminal behavior to be accepted as part of the VA’s normal daily operations, consider visiting the following link. That link will take you to incidents of failure to correct the criminal and toxic culture at the VA starting from 2013. Not that the culture began in 2013, but that is as far back as the VA is willing to admit the culture extends from. For example:
“Lisa M. Hoffman, 48, a former pharmacy technician at East Orange VA Medical Center in New Jersey, was charged with stealing more than $8.2 million worth of HIV medication. Hoffman used her position to order, then steal, large amounts of HIV medication, which she later sold to an associate for cash.”
While the last two examples of toxic culture include individuals, I am always impressed with the lack of integrity and the language games to spin a VA-OIG investigation report to more favorably report a Charlie-Foxtrot! The VA-OIG investigated the use of virtual appointments for primary care during the COVID Pandemic. Here’s the issue, before the pandemic, the only people regularly using virtual appointments were the psychologists treating individual patients who had the technology. My Primary Care Provider (PCP) refused to use virtual appointments until last March. Even then, my current PCP refuses to diagnose, treat, or even answer general health questions using virtual appointments. The last three appointments using virtual technology have been technological disasters where the sound cut off and on, the picture cut off and on, random noise was broadcast, and nobody can explain how secure the technology is and how it meets HIPAA requirements. The VA-OIG is crowing and magnanimous about the growth of virtual care appointments using VA Video Connect (VVC) in the VA.
Worse, the virtual appointments using the VVC technology do not come with technical support, so the veteran is left trying to fix connection issues without guidance and assistance. Training for the VVC technology is either missing or obsolete, and frustration is the only regular VVC technology product. Go ahead and crow VA-OIG; the veterans stuck using this garbage should have been part of your survey, and the fact that you refused to obtain the veterans’ input tells much about how respectful the VA is about their patients!
Here is a real-life example of a toxic culture with inert actors in action. It is reminding me of those “Priceless” MasterCard commercials from a few years back!
“This management advisory memo identifies potential risks associated with the Veterans Health Administration’s (VHA) efforts to expedite adding new staff to meet increased demand caused by the COVID-19 pandemic. The VA Office of Inspector General (OIG) recognizes the tremendous pressure to hire staff to meet unprecedented needs quickly. To achieve VHA’s goal of bringing all new employees on duty within three days of making a tentative offer, VHA has modified or deferred tasks such as fingerprinting, background investigations, drug testing, credentialing, and preplacement physicals. The potential risks identified by the OIG may threaten VHA’s ability to safeguard veterans’ sensitive information and ensure its workforce is suitable for serving patients at VA medical facilities. The OIG organized these potential risks into three categories: (1) employees who do not have a completed fingerprint-based criminal history check may gain access to sensitive information and controlled substances; (2) delays in processing fingerprints add to a backlog of investigations; (3) onboarding tasks are deferred—such as drug testing and credentialing—that is not being centrally monitored to ensure completion. If realized, these risks could damage the trust veterans have in VA, keeping their information secure and meeting employee suitability standards; this memorandum raises issues for VHA to consider in determining whether vulnerabilities and related processes warrant further review. These include possible changes to centralize governance of deferred actions to improve oversight.”
Who says the veterans trust the VA to keep their data secure? I am amongst thousands of veterans who annually have to track our identity because the VA continues to lose data through the most elementary methods. Worse, the government is a sieve of escaping personal data from the VA to the OPM; the government keeps losing data. These VA articles keep mentioning designed incompetence, want to see designed incompetence in action, “VHA has modified or deferred tasks such as fingerprinting, background investigations, drug testing, credentialing, and preplacement physicals… which is not being centrally monitored to ensure completion.” Change processes, probably never even wrote down the procedures, and then refuse to monitor for completion. Whiskey-Tango-Foxtrot on that Charlie Foxtrot, over! Please excuse the military axiom; I am mentally blown away that this was approved, put into operation, and then left alone to fester! When it is discovered that more criminals and nefarious people were hired, who gets the blame; nobody! It will be COVID-19’s fault, not a mindless and spineless drone!
I am personally aware and have reported both on this blog and to the proper authorities (not that they ever cared or did anything), the HIPAA, EMTALA, and other legal abuses of veterans in several VA Hospitals. Without improvements in operations and providing authority to clean house for those in leadership positions, the VA’s problems will only worsen. Please be aware; it is not for the lack of money or technology to pinpoint abuses and problems with employees; it is all the inertia of the leadership towards action and the toxic culture which allows and encourages pushing the boundaries that are killing the VA. The VA requires a cancer operation, where the potential killing growths are removed and the body allowed to heal—healing through better leaders, better-written procedures and policies, and improved communication chains that promote catching the problems before the VA-OIG!
Dandira, M. (2012). Dysfunctional leadership: Organizational cancer. Business Strategy Series, 13(4), 187-192. doi: http://dx.doi.org/10.1108/17515631211246267
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