LIC and The Department of Veterans Affairs

What is LIC?

Low-Intensity Conflict (LIC) is the official name for when individuals or governments hire intermediaries to conduct violent operations from a secure position.  LIC is a misnomer; those who have become victims of the barbaric cruelty of those practicing LIC find nothing “Low” about the experience.  The conflict is intense, the actions brutal, and the practitioners remain cunning adversaries using and employing willing dupes to hide the true depths of moral decay inherent in the societal destructions and depravations the practitioners are enacting.  Many confuse LIC in describing the actions of unbridled violence committed by ideologues under the banner of terrorism.  The US Military Joint Chiefs of Staff define LIC as:

A limited political-military struggle to achieve political, social, economic, or psychological objectives.  It is often protracted and ranges from diplomatic, economic, and psychological pressures through terrorism and insurgency.  Low-intensity conflict is generally confined to a geographic area and is often characterized by constraints on the weaponry, tactics, and levels of violence (Tinder 1990) [emphasis mine].”

Green (1997) adds a key ingredient to the description of LIC from Tinder (1990).

… Non-international conflict is a refined term for what [was] formerly known as revolutions or civil wars, particularly when these have developed into major operations with the likelihood or reality of atrocities being committed against non-combatants.  Whether civilians or those [rendered] hors de combat, a fact that is often more common in non-international … conflicts, especially when ideological, ethnic, or religious differences are in issue.  It is for this reason that it must be borne in mind that the term low-intensity [conflict] has no relation to the severity or violence of the conflict” [emphasis mine].

Lt. Colonel Alan J. Tinder wrote a paper for the Air War College in 1990 titled: “Low-Intensity Conflict.”  I have learned much from the Colonel and benchmarked this principle to more thoroughly understand LIC, recognize LIC, and detail LIC for others.  The other compelling source is L. C. Green’s paper on “Low-Intensity Conflict and the Law.”  I aim to synthesize this information into a manageable topic and aid understanding.  Let me state emphatically that the Department of Veterans Affairs (VA) leadership’s actions are nothing short of LIC where employees and veterans/customers are concerned.

Regularly, the Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports on a comprehensive healthcare inspection of a VHA facility, reports on employee morale in the VBA, or sum analysis of an employee or customer surveys, and include in the report a fairly descriptive, yet starkly utilitarian phrase, “reduce staff feelings of moral distress at work.”  Generally, the efforts to reduce “moral distress” is left to an underling, an assistant, or a person for whom this is a secondary or collateral duty and is not considered important or relevant.

Do the actions of a leader represent complicity in creating moral distress fit the general definition of LIC?  Absolutely.  Consider that the leader sets the culture through actions, words, and behaviors, which originate in the thoughts and feelings of the leader.  Correcting moral distress is pawned off on a junior staff member as a collateral duty, another method for displaying disrespect and communicating principles of abuse to employees.  But there is no physical violence; how does this apply to LIC?  Aren’t dead veterans’ examples enough of violent tendencies to justify the definition of LIC?  The VA leader operates from a place of security, exemplifies the culture they deem acceptable, and then works through minions to achieve a “to achieve the political, social, economic, or psychological objective.”

Never forget these two critical points in the description of LIC:

Often protracted and ranges from diplomatic, economic, and psychological pressures.”

LIC has no relation to the severity or violence of the conflict.”

At the VA, the leadership calls their example politics; keeping your position or advancing is economical, and the psychological pressure to conform is palpable.  All fundamental keys to conducting LIC against veterans, taxpayers, dependents, and non-conforming employees.  Multiple times Congress has held hearings and listened to how the VA Leadership exacted revenge and retaliation upon those who reported problems to the VA-OIG, their elected congressional leaders, and other investigative parties.  Feel free to peruse some of these hearings; you will hear victims relating physical, economic, and mental abuse, and the VA leadership never takes action.  Elected officials never scrutinize and hold accountable those executing LIC, and the victims are victimized a second time.

Want another indicator that LIC is being practiced, the VA-OIG, after learning there are problems with moral distress at work, makes the following to slide the issues under the proverbial rub:

“The OIG’s review of the medical center … did not identify any substantial organizational risk factors.”

Signifying that even though the VA-OIG found moral distress is affecting and influencing employee behavior, the VA considers employee moral distress not an “organizational risk factor.”  What does an employee who feels morally distressed do in performing their duties?  Delay patients’ appointments, make mistakes on medication shipped, slow walk any responsibility to make things more complicated and take longer than they should.  Does any of these actions sound familiar; they should, for this is the standard operating procedure for VA employees.

As reported previously, while I worked at the VA, I had intimate observations of what morally distressed employees do.  When I wrote to the VA-OIG, I was informed that since I had my employment terminated, I could not be a whistleblower and get my job back.  Plus, what I reported could not be actioned because it did not apply.  How’s that for protecting the guilty?  The VA Leadership is writing procedures and policies to target anyone and everyone who would report problems and seek help.  An employee physically assaulted me; the camera mysteriously broke when I reported it, so no evidence was available.  Who was at fault?  Me; the assistant director promoted the attacker, and I got ostracized.  The attacking employee took moral distress to new heights after this incident, and anyone who reported their behavior felt the wrath of the attacker and the VA leadership at the Albuquerque VAMC.

What is horrendous, this is not an isolated incident.  What happened to me frequently repeats daily across every VA office.  LIC is the overarching term, LIC is the behaviors named, and LIC is what the taxpayers are forced to pay for, all at the expense of veterans, dependents, and employees who see, know, and can do nothing.  Repetitions of moral distress in employees, reported by the VA-OIG, are more than 20 just in 2022.  The problem is cultural, and the elected officials desperately need to begin doing their second job, scrutinizing the executive branch and holding people accountable, including canceling the retirement packages of those practicing LIC.

Before someone tries to make this a Republican vs. Democrat issue, it is NOT political.  LIC is never political, just as LIC is never religious, never racist, not sexist, or any other distinction.  These distinctions are excuses, and the reasons do not justify the means for being violent.  The leadership at the VA, and many other government agencies, have found that abusing the taxpayer pays well, provides protection, and allows them to exercise dominion to their heart’s content, all with the power of government to justify their deeds.

Do you realize that the VA-OIG has a metric for measuring moral distress, and the only time the VA-OIG reports moral distress among employees is when the results are higher than national averages?  How scary is that to ponder?  The problem is so prevalent that it only warrants reporting when it exceeds the norm.  Thus, moral distress is declared less frequently when the average worsens.  Official protection for LIC is provided by LIC, increasing, and the taxpayer is footing the bill.

I have read reports where the moral distress has worsened from year to year.  The same leaders exacerbating the problem of employee moral distress are promoted and moved instead of reprimanded, punished, or fired.  One of the VA-OIG reports is particularly heinous in hiding moral distress in employees.

Selected employee survey responses demonstrated satisfaction with leadership and maintenance of an environment where staff felt respected and discrimination was not tolerated.  Patient experience survey data implied general satisfaction with the outpatient care provided; however, leaders had opportunities to improve inpatient care satisfaction [emphasis mine].”

Mark Twain is oft quoted as stating, “There are lies, damn lies, and statistics.”  How much more valid are these words when results are “selected,” “cherry-picked,” or allowed to “imply generalities?”  Those who engage in LIC are criminals, they are comparable to terrorists, and they have infiltrated the bureaucratic halls of government.  Employing government power, they form unholy unions with social media outlets and media companies to further silence and abuse, all while increasing protection.

Where does it end?  How do we put paid to the tyranny?

It ends when ordinary people decide they have had enough.  Ending the LIC-powered tyranny requires nothing more than elected officials scrutinizing the government and doing the jobs they swore to commit.  No violence, problematic or arduous tasks, merely following established law and doing the jobs we elected them to accomplish.  LIC is always destroyed when the citizens being oppressed stand up for their rights and demand the bullies, tyrants, and fiends cease and desist!

Thomas Paine, writing in “Common Sense,” discussed simplicity, stating:

“I draw my idea of the form of government from a principle in nature, which no art can overturn, viz. that the more simple anything is, the less liable it is to be disordered; and the easier repaired when disordered.”

The American government was established on simplicity, and the US Constitution is a simple document.  Using Thomas Paine’s pattern, the disorder in the government is simple to correct; all we need are people insisting that the infection is terminated.  Using the systems established in the US Constitution, the US government can be brought to heel, the rot removed, and justice can be delivered to those tyrants employing LIC for personal gain and political profit.  LIC is happening in every government agency, and it is time for change to begin.  Where are the politicians willing to do the job we elected them to perform?

Mark Twain provides the final word, “The government of my country snubs honest simplicity but fondles artistic villainy, and I think I might have developed into a very capable pickpocket if I had remained in the public service a year or two.”  From artistic villainy to LIC is not an arduous shift, merely the extension of abuse of power to a larger audience.  Learn, choose, and then make your voice known through elections and peaceful assembly for redress per the US Constitution and Bill of Rights.

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

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Scrutinize the Executive Branch – The Charge for the Legislative Branch: Part 1

In what has become typical and usual, the following stories arrive:

From 2019 to 2021, Ira Westbrook of Bozeman, Montana, served as the fiduciary of an elderly relative who had suffered a stroke and became disabled.  A multi-agency investigation found that, during these 16 months, Westbrook stole more than $57,000 in Social Security and VA benefits and used the stolen funds to purchase personal items, including a Jeep Wrangler, a travel trailer, and other day-to-day expenses.”

From 2016 until 2018, Sloane Signal-Debose of Slidell, Louisiana, served as the fiduciary of a veteran who needed assistance managing his finances.  During that time, she took more than $100,000 from the veteran’s accounts, used it as the down payment on a home in her name, and used additional funds from the veteran to pay contractors working on the home.  Signal-Debose then submitted false records to VA to hide her misuse of the veteran’s funds.  The former fiduciary pleaded guilty to misappropriating funds and faces up to five years in federal prison.  The VA OIG conducted this investigation.

In 2013, Brandi Goldman of Jonesboro, Arkansas, was married to a US Army reservist who suffered a severe traumatic brain injury in a service-connected accident.  As a result of this injury, her husband had many serious physical challenges, and Goldman was appointed as his guardian and fiduciary.  Between April 2015 and November 2017, Goldman received more than $258,600 in VA disability payments and $36,000 in Social Security payments.  During that timeframe, she withdrew close to $200,000 in cash and accrued about $900 in ATM and overdraft fees.  Goldman admitted to spending much cash to fund her methamphetamine habit, spending $150 on methamphetamine two to three times per week.  She also admitted that five other people moved into the residence with her and her husband, none of whom paid rent or contributed to expenses, some of whom she regularly gave cash to.  She also admitted to paying $68,000 in cash for another home, furnishings for the home, multiple vehicles, and a motor home.  Goldman was sentenced to 20 months in prison, three years of supervised release, and $143,000 in restitution after previously pleading guilty to misappropriation by a fiduciary.  The VA OIG and Social Security Administration OIG conducted the investigation.”

Why are these stories of particular interest to the supreme legislative body in the United States of America?  The executive branch has refused to police its branch of government, and crimes like this have become all too familiar.  You, the Congressional bodies of these the United States, are duty-bound and sworn to perform two jobs, scrutinize the executive branch (harshly when necessary), and write laws.  You have recently failed too often in monitoring the executive branch, and this story perfectly represents what happens when the executive branch is not examined minutely!  Tell the US Public who put you in elected office, how these crimes continue and what programs and processes they MUST change to prevent them in the future.

By pleading for the legislative branch to scrutinize and audit the executive branch minutely, I am in no way condoning or diminishing the personal accountability of those who committed crimes.  These three examples are from the October and November press releases of 2022.  The widespread ability to commit fraud is a symptom of a more significant problem at the VA.  Their leaders have consistently been able to boondoggle, evade, and profit from abusing veterans through designed incompetence, criminal neglect, and obtuse actions.  When will Congressional leaders take action to clean up the Federal Government in general and the VA specifically?

The US House of Representatives holds the purse strings for the executive branch; use this leverage to claw back your powers and authority to balance the Federal Government and demand accountability from those empowered to lead their designated branches of the executive branch of government.  Let’s talk about patterns; in less than 45 days, three cases of fiduciary fraud were closed, and the speed of closing these cases has escalated throughout 2022.  The American people will see more, not less, of these fraudsters being underreported by the US Media before the year ends.

Shifting slightly, let’s talk about government employees and the need for more scrutiny of the executive branch.

Bruce Minor, of Philadelphia, Pennsylvania, was sentenced to two years in prison, three years of supervised release, and ordered to pay $462,256 in restitution for his scheme to embezzle money from the Philadelphia VA Medical Center.  Between December 2015 and September 2019, Minor, a former travel clerk, created fraudulent travel reimbursement claims in the names of at least three other VA medical center employees.  He then diverted the funds into bank accounts he controlled.  The VA OIG investigated this case.”

Kyhati Undavia, of Houston, Texas, was sentenced to 27 months in federal prison after previously pleading guilty to conspiracy to commit healthcare fraud.  From December 2012 to December 2018, Undavia hired employees to market Memorial Pharmacy, which she controlled and operated, to physicians as a place to submit compounded drug prescriptions.  Instead of providing prescriptions directly to the patients who could select a pharmacy of their choice, physicians sent the prescriptions directly to Memorial Pharmacy.  Then, Undavia paid the physicians illegal kickbacks for the prescriptions.  Beneficiaries often received medicated creams that they did not need or want.  Undavia received approximately $22 million from TRICARE, Department of Labor Office of Workers’ Compensation Programs, and CHAMPVA for the prescriptions.”

These stories also fall into the same timeframe mentioned above.  But, they are not the only stories from 2022 where VA employees conducted long-term fraud for personal profit.  Here’s the rub: hundreds of additional employees knew of these schemes, were probably running their schemes, and haven’t been caught, and nothing is being done by VA leadership to cease the fraud and abuse of veterans by VA employees.  There is a culture of corruption at the VA, long hidden by scheming and abusive leaders and condoned by previous Congresses, that must be stopped!  What will you, the congressional leaders of the United States, do to halt this insanity, demand personal accountability, and clean house of the designed incompetence that allows these criminal activities to flourish?  The American People are waiting!

The following site holds press releases for the VA specifically, but investigations often cross into Social Security, the Department of Defense, state investigatory bodies, the FBI, and more.  Suppose nothing else is learned from only perusing this site, that more scrutiny needs to be done to every single department of the executive branch.  In that case, we, the American People, might count ourselves lucky.  However, this is not the case.  The rot from poor leadership, criminal mismanagement, and supreme dereliction of duty is etched deeply into the workings of the executive branch operations, and more needs additional discussion.

03 November 2022, the VA-OIG released a report titled, “VHA Progressed in the Follow-Up of Canceled Appointments during the Pandemic but Could Use Additional Oversight Metrics.”  The report only covers the time from 2020 to the present, and regular readers know that the VA has been failing on every measurable metric for over a decade.  To couch in politically correct non-threatening jargon, how designed incompetence continues to hamper and hinder is not surprising.  That the current Congress has bought the excuses hook, line, and sinker, from the inept VA leadership, was not surprising either.  This article is about the future, and the next Congress MUST take immediate and direct action to root cause and improve VA performance!

31 October 2022, the VA-OIG released the following: “Review of VA’s Staffing and Vacancy Reporting under the MISSION Act of 2018.”  This is a report about how the VA continues failing to report improvements in hiring practices to the legislative branch.  The report details VA leadership’s continued failures through designed incompetence.  Tell me, if you were in charge of a report for your business that is essential to receiving funding, would you keep your job if, from 2018 to the present, you still cannot report what is happening and why and be held personally accountable for a report to a legislative body?  Don’t take my word for it; read the report, and be careful of the temperature of your blood boiling!

Unfortunately, this behavior is the normal operating procedure for the VA.  The same can be easily and quickly witnessed in every other Federal Department of the US Government under the executive branch.  As the legislative branch, you are duty-bound to investigate and demand compliance in a timely manner.  Where have you been; more importantly, will you allow these problems to continue or kill them?

Do you doubt designed incompetence is a standard operating procedure?  Let’s discuss another part of the MISSION Act of 2018 that the VA-OIG recently reported on, “Additional Actions Needed to Fully Implement and Assess Impact of the Patient Referral Coordination Initiative,” dated 27 October 2022.  The Referral Coordination Initiative (RCI) is a program to improve timely access to care using community providers.  RCI sounds good in theory, but as usual, in the practical application, the program is full of self-serving charlatans, unsupervised or poorly supervised people, weak policies and procedures, and zero accountability!  Plus, when the veteran runs into problems with local providers, reporting these problems is so time-consuming as to be ineffectual at best!

A personal example that was reported to the VA when it happened, and nothing was done but to issue the provider a check.  Dr. Herekar, Neurologist, clinic: Advanced Neurology Epilepsy & Sleep Center, El Paso, Texas.  A VA Primary Care Provider wrote to my employer on VA Letterhead with a wet signature, declaring my inability to wear a mask.  Dr. Herekar’s office was presented with this letter and hassled me before both appointments for not wearing a mask, becoming hostile, argumentative, and a nuisance over the mask issue, even after I complied with putting on a face shield.  23 September 2021, over Facebook messenger, I was informed that I would be invited to find a different provider due to my refusal to wear a mask.  Imagine that; Facebook Messenger became the medium of choice for ending a patient’s relationship with a medical provider.  What did the VA tell me to do; file endless paperwork with TRICARE and then disregard the problem’s urgency.  Worse, the medical care for the neurological issues decreased, and I have had to wait, sit, and hope for future consideration and possible treatment.  Does this sound like an aberration; it is, unfortunately not!

The VA Leadership realized if community care succeeds, they lose power to control the destiny of veterans.  Thus, they implemented the MISSION Act of 2018 with such feet dragging, designing incompetence into every facet of the program, to promote more complaints to Congress, and hopefully to squash the MISSION Act of 2018 and end community care.  07 November 2022, while waiting to speak to representatives of Community Care Services at the VA Out Patient Clinic in EL Paso, the veteran being served ahead of me was told, “The provider does not fax documents, so you will need to go to the provider, and then walk the paperwork back to us.”

The normalcy of reporting providers not submitting paperwork was beyond the pale.  Not having secure document transfer processes between the VA and local providers is technically abysmal and unacceptable.  Are we in the 1990s, where the cream of technology is sending and receiving a fax?  The designed incompetence includes Luddite-like technical disciplines, and the VA_OIG and the Congress should be furious; I know I am!

Before the MISSION Act of 2018, I was making 5 and 6 trips to local providers to retrieve hard copies of medical records, going to the VA Records office, submitting the documents, and then following up 7-14 days later to find out I had to repeat this process as my VA Providers still had not received the records of my interactions with community providers.  Interestingly, in 2020 I discovered the treatment records still had not been submitted from community providers into my VA eHealth Record, from treatment received from 2012-2016.  Is the pattern of designed incompetence clearer?  Is the VA Leadeship’s intransigence more apparent?  How about the fraud, waste, and abuse of VA resources?

You, the congressional leaders, must take immediate action, not wait, not hold hearings, concrete action to demand compliance from the executive branch leaders to the congressional leaders who are held accountable to the citizens.  America is a representative republic, and it is time the bureaucrats learned the citizens are awake and interested.  You, the congressional leaders, are the people’s tool for correcting government abuses; you have two years to show you are dedicated to that principle, or you will be replaced!

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

“That’s Crazy!!!” – More Chronicles from the VA (Ch 9)

I-CareThe Department of Veterans Affairs – Veterans Benefits Administration (VBA) regularly crows about reducing the backlog, improving the veteran experience, and making changes to deliver on the promise.  Every so often, another article is spread, mainly by the VA Public Relations department (PR), about how they meet the legislated obligations.  Then, unsurprisingly the truth is revealed, the curtain thrown back, and the lie exposed.  The Department of Veterans Affairs – Office of Inspector General (VA-OIG) is helping pull the curtain back, and the truth should infuriate every American.  In an investigative report dated 22 June 2022 and linked, we find the following:

“… The VBA disregarded privacy procedures so it could use a workload tracking system more quickly without receiving the appropriate security authorization.  The Mission Accountability Support Tracker (MAST) helps quantify the work VBA’s support services staff perform in response to employee requests for facility, equipment, and vehicle management; reasonable accommodation; and identification card issuance and renewal.  Because staff use personally identifiable information (PII) in their work, the information could be compromised in an unauthorized, unsecured application.  The VA-OIG found that VBA and the Office of Information and Technology (OIT) did not correctly follow privacy and security procedures.  VBA’s privacy threshold analysis was inaccurate, and OIT did not conduct a privacy impact assessment.  OIT’s misclassification of MAST as an asset resulted in insufficient security controls.  Further, VBA lacked the authority to operate MAST before using it in regional offices.”

Lacking authority equates to a leadership failure to follow their standard operating procedures (SOP).  PII being inappropriately released, nothing new at the VBA, or the VHA for that matter.  Losing veterans’ identities and taking advantage of systems for personal gain, regardless of the cost, is nothing new or surprising.  This should be where the VA organizational leadership should be focused; yet, what are they doing?  Where is Congressional oversight and scrutiny?VA 3

FY 2017, the VBA leaders devised a scheme to have third-party vendors conduct compensation and pension exams to deliver on the promise to clear the backlog on veterans’ claims.  Since FY 2017, the VBA has paid over $6.5 Billion on this scheme, and the VA-OIG found in a report dated 08 June 2022, “Some of the exams produced by vendors have not met contractual accuracy requirements.  As a result, claims processors may have used inaccurate or insufficient medical evidence to decide veterans’ claims.”  Is anyone surprised this is the result?  The compensation and pension exam is the key to accuracy in claim completion; yet, inaccurate claims are still being adjudicated wrongly, which is significantly damaging veterans and their families!

From the report, we find the following:

VBA’s governance of and accountability for the exam program needs to improve.  The identified deficiencies appear to have persisted, at least partly because of limitations with VBA’s management and oversight of the program at the time of the review.”VA 3

The VBA’s leaders designed this scheme, shackled the program with ineptitude, and hindered the improvement of the program.  Designed incompetence cannot get any better than this, and the leadership must be held accountable!  Fraud, waste, and abuse remain pillars in Federal Government governance, so why are these leaders not being held liable?

Michael Bowman, Director of IT and Security Audits, in recent Congressional Testimony, made the following claim:

Secure IT systems and networks are essential to VA’s fundamental mission of providing eligible veterans and their families with benefits and services.  VA’s information security program and its practices must protect the confidentiality, integrity, and access to VA systems and data.”

The audacity of this director to claim “confidentiality, integrity, and access” as being secure would be laughable if it weren’t so inept!  How would a non-VA Employee know the IT system is fraught with problems?  VA-OIG report regarding FISMA compliance, Dallas, Texas.  The Federal Information Security Modernization Act of 2014 (FISMA).  FISMA is a United States federal law that defines a comprehensive framework to protect government information, operations, and assets against natural and manmade threats.  FISMA OIG inspections are focused on four security control areas that apply to local facilities.  They have been selected based on their level of risk: configuration management controls, contingency planning controls, security management controls, and access controls.VA 3

What did the VA-OIG find?  “Without effective configuration management, users do not have adequate assurance that the system and network will perform as intended and to the extent needed to support the CMOP’s missions.  The access control deficiencies create risks of unauthorized access to critical network resources, inability to respond effectively to incidents, loss of personally identifiable information, or loss of life.”  All political speak for inept leaders and deplorable leadership actions.  IT/IS systems continue to fail, and the director claims the system has integrity; despicable and detestable!

Worse, the same FISMA inspection occurred at the same outpatient pharmacy mail facility in Tuscon, Arizona.  The same problems were found, in the same systems, manned by the same inept people and led by the same poor leadership.  Integrity, only if the word means sharing ineptitude between different facilities.  Access to systems and data protection, can anyone honestly trust that the IT system at the VBA or VHA is providing the fundamental tools to meet the mission?VA 3

On the topic of IT system integrity, can anyone forget the continuing problems in delivering a functional electronic health record system to the VHA?  How many billions of dollars must be wasted before Congress stops paying for this albatross?  The VA-OIG has substantiated that “… many quality, patient safety, and organizational performance metrics were unavailable, including metrics needed for hospital accreditation.  Additionally, the VA-OIG found that access metrics were largely unavailable.  The VA-OIG remains concerned that deficits in new EHR metrics may negatively affect organizational performance, quality and patient safety, and access to care.”  How’s that integrity doing?  Is it trustworthy?

05 May 2022, failures were discovered in a joint DoD and VHA review of the new electronic health record system.  The new EHR has no plan to create interoperability, yet interoperability was the main selling point for spending billions of dollars on a new EHR.  Would you believe the VA-OIG recommends the DoD and VHA review federal laws and direct the offices overseeing the EHR program to begin complying?  Would Congress please ask, why haven’t the program managers for the HER already been complying with Federal Law?  How about demanding action to recompense the taxpayers who have been defrauded?VA 3

In April 2022, VA-OIG Michael J. Missal addressed Congress in a statement entitled, “At What Cost? – Ensuring Quality Representation in the Veteran Benefit Claims Process.”  The VA-OIG’s mission is “preventing and addressing fraud and other crimes, waste, and abuse in VA programs and operations.”  General Missal then discussed the integrity of VA processes to “help ensure that veterans receive the benefits, health care, and services they have earned through their service to our country.”  Would Congress please ask how the VA-OIG is fulfilling its mission to prevent fraud, waste, and abuse?

The VA-OIG operates a hotline that receives approximately 30,000 complaints annually from veterans, family members, VA employees, and the public.”  If the 30,000 complaints are presumed to be stable, across just the years I have documented the VA’s abuses, then the VA-OIG has received upwards of 360,000 complaints over the last 12 years.  Would Congress please ask about the success in promoting change, reducing fraud, waste, and abuse, and curbing the veterans being actively harmed by the VA, the VHA, and VBA?VA 3

Congress receives these VA-OIG reports first; what is Congress doing to scrutinize the executive branch?  Where is the progress?  The VA-OIG reports annually to Congress, but improvement never occurs.  Permanent change never occurs.  The same people are making the same excuses, using the same flowery language, and nothing ever happens to improve things.  Worse, the same people maintain the same jobs, who pays, the veterans and their families, and the American taxpayer through the nose as the VA loses more and more money!

I do not know about any Congressional elected leader, but I am through buying the Kool-Aid the VA-OIG is selling:

The VA-OIG’s work is focused on protecting VA programs and operations from waste, fraud, and abuse as well as improving their efficiency and effectiveness.”

On a single topic that the VA-OIG has reported on multiple times and remains critically important to all veterans and their families, it is reporting needs for improvement in VHA and VBA suicide prevention.  From the report, we find the following:

“… Suicide prevention coordinators at VA medical facilities are required to reach out to veterans referred from the Veterans Crisis Line.  Coordinators provide access to assessment, intervention, and effective care; encourage veterans to seek care, benefits, or services with the VA system or in the community; and follow up to connect veterans with appropriate care and services after the call.”

The findings from the VA-OIG report are almost criminal in the negligence of leadership to perform the jobs they hold:

The VA-OIG found that coordinators mistakenly closed some veteran referrals because coordinators lacked the proper training, guidance, and oversight necessary to maximize chances of reaching at-risk veterans referred by the crisis line.  VHA lacked comprehensive performance metrics to assess coordinators’ management of crisis line referrals, and coordinators lacked clear guidance on managing crisis line referrals.  Until VHA provides appropriate training, issues adequate guidance, and improves performance metrics, coordinators could miss opportunities to reach and assist at-risk veterans.”VA 3

Why did the media bury this report?  Suicide prevention continues to be a significant military and veteran issue, but this program’s designed incompetence should be a major story on all media networks.  More, this VA-OIG report should be a talking point for every congressional representative seeking re-election.  Why is this not the case?  Integrity requires honesty, honesty and integrity requires action.  When will Congress take action?

How many dead veterans will it take before Congress takes action?  31 May 2022 VA-OIG report:

The VA Office of Inspector General (OIG) conducted an inspection to review the care of an unresponsive patient by Emergency Department staff and the subsequent response of leaders at the Malcom Randall VA Medical Center (facility) after the patient’s death at the University of Florida Health Shands Hospital (Shands).  The OIG determined that facility Emergency Department nurses failed to provide emergency care to an unresponsive patient who arrived by ambulance.  Despite emergency medical services (EMS) personnel having relayed, while en route to the facility, the criticality of the patient’s condition and the limited patient identifying information available, Emergency Department nurses and an Administrative Officer of the Day wasted critical time concentrating efforts on whether the patient was a veteran (which the patient was, but not so identified by the nurses) versus patient care.  As a result, EMS personnel reloaded the patient into the ambulance for transport to Shands.”VA 3

The staff failed to follow EMTALA, and a veteran died due to the inaction and inappropriate focus of the medical providers.  This is not the first or second breach of EMTALA, the federal law requiring any patient presenting at an emergency department receiving federal funds to be treated; yet, what will it take to get Congress off their thumbs?

12 May 2022, deficiencies in care led to a patient dying at the Charlie Norwood VAMC, Augusta, Georgia.  The VA-OIG substantiated that:

medical-surgical unit nursing leaders did not have adequate quality controls or training to ensure the provision of safe and effective alcohol withdrawal nursing care.”  “Primary care staff failed to provide sufficient care coordination and treatment.  A provider failed to address the patient’s abnormal chest images and poor nutrition and failed to communicate test results to the patient as required.  A primary care nurse failed to respond to the patient’s secure message request for assistance two days before surgery.

Additionally, a barium swallow test was not scheduled.  The surgical team completed a preoperative assessment but failed to detect the patient’s overall poor health.  During the patient’s hospital stay after surgery, medical-surgical nurses did not consistently assess alcohol withdrawal symptoms or administer medications as required.”VA 3

My wife is fond of saying, these oversights and failures occur in non-Government hospitals, and this incident should not be considered indicative of the whole system lacking similarly.  Yet, civilian hospitals have lawyers by the dozen looking for a reason to sue providers for malpractice, and the government hospitals protect against accountability and responsibility.  Worse, you will never know the problems unless you track these incidents.

Do you know why I keep declaring there is a problem with designed incompetence; several veterans suffered T-12 burst fractures and multiple rib fractures, all because of poor documentation and even worse communication.  This is a life-changing injury, and the VA-OIG found the VA providers to have culpability but no responsibility due to a lack of documentation.  Delays in provider documenting in the electronic health record the provider’s notes delayed care for another veteran who also suffered life-changing spinal injuries after receiving non-care at a VA facility.  The VA-OIG cannot conclusively document the tie between poor care being received and the injuries sustained by the veteran, all because of delays in the provider documenting treatment.VA 3

Tell me, does anything discussed above reflect the words of Inspector General Michael J. Missal, who claimed the following in Congressional Testimony:

VHA continues to face enormous challenges in providing high-quality care to the millions of veterans it serves.  Despite these challenges, the VA-OIG has witnessed countless examples of veterans receiving the care they need and deserve—delivered by a committed, compassionate, and highly skilled workforce [emphasis mine].”VA 3

Does a provider killing a veteran reflect a committed, compassionate, or highly skilled workforce?  How many veterans must be permanently injured by the VHA providers to reflect a committed, compassionate, and highly skilled workforce?  How often will the electronic health record fail before highly skilled workers are displayed?

Plato 2Unfortunately, the VA-OIG reports discussed are not even the tip of the iceberg of what is happening.  My apologies, dear readers; I have been remiss in my reporting duties.  Why have I been remiss, because my health went sideways since April when I had a medical procedure completed that was advised but not appropriate.  The VHA and VBA are sick organizations and desperately need scrutiny and standards, new leadership, and written organizational policies.  Help me force these nefarious characters into the sunshine for a good dose of sunshine disinfectant, and let’s change the world for the better.

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

The Coffin Where Comedy Goes to Die – More VA Chronicles

I-CareConsider something with me: if you need to proactively reach out to a customer using a phone, would you call that customer’s or his spouse’s phone?  Customer service is all about the customer experience; in an effort to provide customer support, do you call a customer’s or their spouse’s phone?  The answer is obvious, yet the EL Paso VA Outpatient Clinic did the exact opposite of common sense, even though the customer had, within two previous hours, called the EL Paso VA OPC using his phone number on record.

Earlier in the week, a face-to-face patient appointment had to be changed to a VA Video Connect (VVC) appointment, and the provider never showed up.  Later blaming the patient for not showing up to their appointment, even though the patient was online 15 minutes early to the VVC and every 30-minutes logged back into the VVC as the provider never showed.  They are eventually blaming the patient for failing to communicate with the clinic.  Facts essential to know, at 0200 of the morning of the appointment which the provider’s nurse had responded to.  At 0900, the call center changed the in-person appointment to a VVC after contacting the provider for permission to change the appointment to VVC.VA 3

Irony remains critical to comedic gold; the irony of the Department of Veterans Affairs (VA) is the issues discussed above are how veterans are abused daily, and the bureaucrats running the VA do not realize how ironic the designed incompetence has become.  Unfortunately, irony died, and comedy is being sealed into its coffin at the VA.  Veterans are being abused to death, and I can no longer laugh at this ineptitude!

Atlanta VA, as reported by Military.com, 73-year-old Vietnam veteran Phillip Webb is filmed receiving hits and kicks from a VA Employee.  The VA Employee, Lawrence Gaillard Jr., a patient advocate at the VA outpatient clinic in downtown Atlanta, was arrested and charged on April 28 for allegedly assaulting and suspended without pay.  There is nothing to laugh at with this event.  While this event remains under criminal investigation, the abuse at the VA towards veterans from the bureaucrats has not scratched the surface!  Where are the Congressional leaders in demanding change at the VA?VA 3

The Department of Veterans Affairs – Office of Inspector General (VA-OIG) has spent another month reporting on investigations of more malfeasance, misfeasance, and designed incompetence masquerading as bureaucratic inertia.  If your job included the safe handling and storing of medicines, would you be motivated to properly refrigerate the medication, especially if it meant keeping your job?  In January 2019, the VA reported a loss of over $1 million due to improperly stored medication, e.g., refrigerated.  In 2019, the VA was told to improve their safe handling and storing of medicines to prevent additional losses.  2021 more than $1.5 million was lost for the same reason, improperly refrigerated medication.  2022 the VA-OIG has concluded that the VA has done nothing to improve the medication losses.

If we use the annual loss, rounding down to $1 Million, and then presume this has been going on since 2000, we have the potential for a loss of around $20 million.  The Federal Government is always going on about Fraud, Waste, and Abuse, curbing these losses and reporting them.  Will some congressional elected leader please tell me why Congress refuses to act to stop fraud, waste, and abuse?  The full report is nothing but fraud, waste, and abuse, and while the VA-OIG suggests the VA has taken “some steps” to improve the potential of losses, more needs to be done; yet, where is Congress?  Where is the VA Leadership in fixing the problem?

Regarding medication, let’s talk about how prescriptions continue to be delayed and shipped in wrong doses forcing the patient to cut and presume how much meets their needs and prescription level.  Let’s discuss how the providers continue to play games with medications, especially the pain management medications, using the erroneous excuse, “Fighting the opioid crisis.”  I know the political talking points; what I do not know is how these blatant excuses continue to possess traction.VA 3

The Albuquerque VAMC is back in the news due to the continued failure of leadership; why you ask is the Albuquerque VAMC in the VA-OIG reports, they are failing to help in the opioid crisis by delaying the delivery of medication.  From the report, we find the following:

The OIG substantiated that pharmacists declined early refills of buprenorphine despite prescribing providers’ documented clinical rationales, which increased patients’ risk for adverse clinical outcomes associated with interruption of buprenorphine treatment.  The OIG substantiated that justification for declining early refills was incorrectly based on a facility policy that was not applicable to the use of buprenorphine for the treatment of opioid use disorder [emphasis mine].”

Did you get the why?  Leadership at the VAMC is beyond subpar, has been failing the veterans of Albuquerque, and is protected by the ridiculously inept leaders at VISN 22, as documented multiple times over the last five years.  Yet, still, nothing is done to remove the leaders, stop the abuse, and fix the problems; thus, I ask again, why?  Where are the elected leaders in scrutinizing the executive branch?  Even the VA-OIG has reported, “actions taken by leaders did not fully address the reported concerns.”  If this is not a perfect definition of designing incompetence, I’ll eat my hat!VA 3

The VA-OIG’s recommendations reflect the inadequacy of the VA-OIG to demand change and then enforce corrective action effectively.  More designed incompetence and the crosshairs are clearly on the executive and legislative branches to act.  This means that you, the voter, have the power to demand change!

Dare you think the Albuquerque VAMC is the only VA having problems?  The VA-OIG reports the VAMC in Hampton, Virginia is also back in the news.  Consider the patient and the family in the following, “… multiple providers’ failure[d] to communicate, act on, and document abnormal test results from July 2019 until April 2021, when the patient was diagnosed with metastatic prostate cancer.”  More failure of VA leaders to act, and “… facility leaders did not initiate peer reviews within three days, and facility staff did not submit patient safety reports as required.”  Where is the outrage that another veteran is needlessly suffering, the family is needlessly struggling, and the VA Leaders keep their jobs?VA 3

We began this chronicle with a Vietnam Veteran being beaten and kicked by a VA employee who was employed to defend patients, where leaders did not act upon the incident for two months, leading to questions and concerns about the potential cover-up, hushing of witnesses, or manipulation of evidence to hide, what for all intents and purposes appears to be, employee criminal activity.  While the attacker retains their constitutional right to innocence until proven guilty, significant questions need immediate redress, and the VAMC leadership needs to answer these questions.

Continuing on the failure of leadership, the Tuscaloosa VAMC in Alabama shows more leadership failure to address patients’ safety and security in long-term care.  The VA-OIG identified that the administration could not fill critical staff positions, possibly due to the toxic nature of the leadership.  One of the more critical failures of leadership deals with the elopement of patients from the care facility, and the leaders appear to remain inadequate to improve the facility and patient safety.  Why are these leaders still in positions of power in this facility?VA 3

As an organizational psychologist, the continued failure of leadership represents a real and present danger.  The VA-OIG appears to be aiding and abetting the absence of leadership at the VA.  If you think I am exaggerating, consider the continued failure to comply with the payment integrity information act (PIIA).  The VA was failing to comply before PIIA, and the following from the VA-OIG report is telling:

In FY 2021, VA reported improper and unknown payment estimates totaling $5.12 billion for seven programs and activities.  Of that amount, about $1.97 billion (around 39 percent) represented a monetary loss.  The remaining approximately $3.14 billion (about 61 percent) was considered either a nonmonetary loss or unknown payment that cannot be recovered.  Though VA had an overall decrease in total improper payments and unknown payments, the overall monetary loss more than doubled from $892 million in FY 2020 to $1.97 billion [emphasis mine].”

PIIA was legislated and put into effect in March 2020, FY 2021 is the first year, and the investigative reports represent the VA’s inaugural failure to comply.  All facts are desperately pertinent in this report and necessary to understand just how ridiculously inept the VA leadership continues to act.  10% of $5.12 Billion is $512 Million; the VA leadership from the VA-OIG is “encouraged” to become compliant and lose less than $512 Million in FY 2022.  Tell me how “encouraging” your leadership will be losing that much money?

From the VA-OIG Report,  “VA satisfied nine of the 10 requirements; however, it is not considered to be compliant because it failed to report an improper and unknown payment rate of less than 10 percent.”  PIIA was legislated to reduce improper payments to less than 10%; tell me, if you improperly paid someone $512 Million, would you keep your job?  Never forget, every Federal Government facility must have posted a poster discussing how to Report Fraud, Waste, and Abuse; what do you call losing $512 Million?  Would someone please explain why losing less than $512 Million is an improvement?  How is losing less than 10% acceptable and not Fraud, Waste, and Abuse or credible accounting?VA 3

Finally, we conclude with additional reports of criminal enterprises by VA employees, as if anyone is surprised:

  • Bethann Kierczak of Southgate, Michigan, a registered nurse at the John D. Dingell VA Medical Center in Detroit, pleaded guilty to charges related to COVID-19 vaccination record cards fraud. According to court records, Kierczak admitted to stealing or embezzling authentic COVID-19 vaccination record cards from the VA hospital—along with vaccine lot numbers necessary to make the cards appear legitimate—and then reselling those cards and information to individuals within the metro Detroit community.  Kierczak began the scheme as early as May 2021 and continued through September 2021, selling the cards for $150 to $200 each.  The VA OIG investigated this case with the VA Police and the Medicare Fraud Strike Force, a partnership among the Criminal Division, US Attorney’s Offices, and the US Health and Human Services OIG.”
  • Melissa Flores was sentenced to two years in prison and $110,000 in restitution for her role in a scheme to defraud VA. Flores and a codefendant allegedly created aliases and obtained or created fraudulent documents to make it appear they were the heirs of various individuals who had died.  Between 2013 and 2019, the two codefendants defrauded VA out of more than $430,000 and the Michigan Department of Treasury out of more than $40,000 in unclaimed property.  Flores pleaded guilty to two counts of false pretenses last May and one count of forgery.”
  • Bruce Minor of Philadelphia, Pennsylvania, pleaded guilty in connection with his scheme to embezzle money from his former employer, the Philadelphia VA Medical Center. In April 2022, Minor was charged with theft of government funds stemming from his theft of more than $487,000 in VA travel reimbursement funds, which he helped administer as part of his official duties as a travel clerk.  To perpetuate the theft, Minor created fraudulent travel reimbursement claims in the names of at least three other VA employees and then diverted the fraudulently obtained funds into bank accounts he controlled.  According to court documents, in an email to medical center management, Minor admitted to stealing approximately $13,000 in travel funds.  However, a subsequent investigation showed that he stole upwards of $487,000 between December 2015 and September 2019.  The VA OIG conducted this investigation.”

PatriotismWhat connects all three of these criminals; the failures of VA leadership to scrutinize their employees.  Does this remind you of additional leaders, maybe those in Congress who continue to refuse to scrutinize the executive branch?  The US Constitution established three co-equal branches, the judicial protects the Constitution, the Executive operates the government, and the Legislative has two jobs write laws for the executive branch to operate and scrutinize the executive branch as it operates.  Each branch answers to the other, and all branches must operate inside the US Constitution.  America needs the legislative branch to begin doing its job, and we, the voters, are the only way to begin demanding the change we need!?u=https1.bp.blogspot.com-aqaqk18MHoEWRHHsCi_TyIAAAAAAAAAXc7hY4JQuyylIQHYudoR8sbezGZntic4SSwCLcBs640Betrayal2BSayings2Band2BQuotes2Bwww.mostphrases.blogspot.be.jpg&f=1&nofb=1

If comedy is dead, and it is, the VA is the coffin where comedy went to die.  Let’s stop laughing and start acting!  Join me?

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

“That’s Crazy!!!” – More Chronicles from the VA Chapter 7

Oh, how I wish and long for, and am working for, the day when the VA is cleaned up, cleaned out, and corrected completely!  The Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) has been busy reporting more on the failures of the VA to act.  Yet, where is Congressional action in scrutinizing the executive branch’s actions?  Honest question, repeated only for emphasis; we elected you to do two jobs, write fair and equal legislation for all citizens, and scrutinize the executive branch; when are you going to do your jobs?

Let’s begin with some softball issues repeated from previous VA-OIG comprehensive healthcare inspections (CHIPs), specifically how employees report feeling morally distressed while working at the VA.  Moral distress is a leadership failure and is widespread enough to reflect the problem is not limited to a single VAMC/VAHCS.  From Virginia to California, Maine to Florida, and Montana to Arizona, too many VA facilities are poorly led, poorly administered, and poorly executed.  The VA is actively abusing the veterans for political gain; some have asked why I consider the VA is actively abusing veterans; let me see if additional disclosure can explain the problem.

VHA Directive 1004.08.  VHA defines an institutional disclosure as “a formal process by which VA medical facility leader(s), together with clinicians and others as appropriate, inform the patient or personal representative that an adverse event has occurred during the patient’s care that resulted in, or is reasonably expected to result in, death or serious injury, and provide specific information about the patient’s rights and recourse.”

The above quote is from the regulations governing VA care.  The VA-OIG quotes this directive, which has been published and is openly available, yet repeatedly the VA-OIG finds directors.  Hospital administrators who are informed and able to repeat this directive.  Who repeatedly refuse to follow this directive or train their staff to follow this directive.  When sentinel events occur (death, permanent injury, non-permanent injury, disability, etc.), the families report having no idea what to do because the disclosures were never provided to the veteran or designated caregiver.  Is this not abuse of the patient?  Is this abuse not driven by ideologues who gain from the harm they cause others?  Should this abuse not be scrutinized until it is eliminated?  Please feel free to read some of these comprehensive healthcare inspection reports from the VA-OIG, see the resulting injuries and problems caused by the failures of government medical providers, and then tell me whether these atrocious actions need more or less scrutiny and qualify for the title abuse.

North Carolinian veterans, VISN 6 is all yours, and would you be shocked to learn that even with newer leadership, moral distress remains a persistent problem in the VA employees throughout VISN 6, which just happens to include Durham, Asheville, Fayetteville, Hampton, Richmond, Salem, and Salisbury North Carolina?  Probably this is not unfamiliar as the patient experience survey scores remain persistently below VA averages, reflecting that new leadership is akin to putting lipstick on a pig.  Interestingly, medical staff credentialing remains a significant concern in North Carolina.

Western New York veterans, especially those receiving patient services in the Buffalo VAHCS, do you agree with the VA-OIG report?  The Buffalo VAHCS includes Buffalo, Batavia, Jamestown, Dunkirk, Niagra Falls, Lockport, West Seneca, and Olean, and the comprehensive report is mystifying to me.  For example, the VA-OIG reports that “Patients generally appeared satisfied with their care.”   At the same time, “Employee survey data revealed opportunities for leaders to improve workplace satisfaction and reduce feelings of moral distress.”  This is a combination not generally found in these CHIP inspection reports.  Something is definitely off, and I would love to know what, especially since the leadership needs significant improvement in identifying and reporting sentinel events.  Do you agree with the VA-OIG findings?  Please let me know your firsthand experiences, for the double-talk in this CHIP report is above what I usually observe.

With almost identical findings and recommendations in the Syracuse NY VAMC’s comprehensive healthcare inspection, covering communities of Syracuse, Auburn, Freeville, Potsdam, Rome, Binghampton, Watertown, and Oswego, NY., I am concerned that the veterans in New York are in as bad or worse shape than Phoenix’s veteran community.  Hence, I have to ask the VA-OIG, has something changed in your measurement and analysis tools to report such disparate findings as “Employee survey data revealed opportunities for leaders to improve servant leadership and decrease employees’ feelings of moral distress.  Patients generally appeared satisfied with the care provided?”  The double-talk level is higher in these CHIPs from NY, which is rarely observed outside of Phoenix and VISN 22.  Two final thoughts on the CHIPs, staff training, continues to be a high-risk finding, and this continues to be a leadership failure for every VAMC/VAHCS/VISN in the VA; why has progress not occurred?  Training is a system, and leadership and organizational risk, system redesign, and improvement is a quality, safety, and value problem of the highest importance; why is action never taken by leadership or the congressional representatives who are expected to scrutinize the executive branch?

28 March 2022, the VA-OIG released their long-awaited annual “Comprehensive Healthcare Inspection Summary Report: Evaluation of Medical Staff Privileging in Veterans Health Administration Facilities, Fiscal Year 2020.”  I have been interested to see what, if anything, the VA had accomplished in improving their medical staff privileging.  If I were a congressional representative, knowing that medical staff continues to harm and kill veterans, I would have been anxiously awaiting to see if the repeated hits from past years had finally been rectified.  Unfortunately, the VA continues to live down to expectations (digging the hole ever deeper), suffers from failed leadership, and the veterans continue to die or suffer abuse.

What did the VA-OIG discover?  Understand, “The OIG conducted detailed inspections at 36 VHA medical facilities to ensure leaders implemented medical staff privileging processes in compliance with requirements.  The OIG subsequently issued six recommendations for improvement to the Under Secretary for Health, in conjunction with Veterans Integrated Service Network directors and facility senior leaders.  The intent is for VHA leaders to use these recommendations to help guide improvements in operations and clinical care at the facility level.  The recommendations address findings that may eventually interfere with the delivery of quality health care.”  The OIG identified deficiencies with focused and ongoing professional practice evaluation, provider exit review, and state licensing board reporting processes.  Specifically:

    • use of minimum criteria for selected specialty licensed independent practitioners’ focused professional practice evaluations
    • inclusion of service-specific criteria in ongoing professional practice evaluations
    • completion of ongoing professional practice evaluations by other providers with similar training and privileges
    • recommendation by executive committees to continue licensed independent practitioners’ privileges based on professional practice evaluation results
    • completion of provider exit review forms within seven business days of licensed independent practitioners’ departure from a medical facility
    • the signing of exit review forms by service chiefs, chiefs of staff, and medical facility directors if licensed healthcare professionals failed to meet generally accepted standards of care
    • initiation of state licensing board reporting within seven business days of supervisors’ signatures on exit review forms to indicate licensed healthcare professionals failed to meet generally accepted standards of care.

The OIG found ongoing issues from the fiscal year 2019 CHIP summary report that warranted repeat recommendations for improvement.  The OIG issued three repeat recommendations related to the following:

    • inclusion of minimum specialty criteria for focused professional practice
      evaluations
    • inclusion of service-specific criteria in ongoing professional practice evaluations
    • recommendation by executive committees of the medical staff in continuing licensed independent practitioners’ privileges based on professional practice evaluation results.

Boiling the findings of the VA-OIG down, essentially, the administrators and leadership are not weeding out poor and horrible practitioners, reporting these underperforming practitioners, and not acting in the best interests of the veterans seeking care at VAMCs and VAHCSs across the country.  I repeat, only for emphasis: Is this not abuse of the patient?  Is this abuse not driven by ideologues who gain from the harm they cause others?  Should this abuse not be scrutinized until it is eliminated?  Please feel free to read some of these comprehensive healthcare inspection reports from the VA-OIG, see the resulting injuries and problems caused by the failures of government medical providers, and then tell me whether these atrocious actions need more or less scrutiny and qualify for the title abuse.  The link to the full report is available; please feel free to make your conclusions and post your thoughts in the comments section.

On a final note for today, consider with me the problems of the Atlanta VAHCS with pallets of unopened mail containing patient health information, community care provider claims needing payment, and a plethora of other unopened mail.  Understand that when community care providers cannot obtain compensation from the VA, they go to the veterans, who then send in correspondence, which is unopened, thus causing more problems, concerns, and issues for an already abused veteran community!  Want your head to explode?  Look at the pictures the VA-OIG helpfully sent along with this VA-OIG report, and ask yourself if any other business or organization could get away with this type of abuse of the customer.

What did the VA-OIG find?  Well, prepare for your head to explode, again:

    • VA Leadership should have established a formal agreement explicitly detailing each office’s responsibilities.
    • VA HCS leaders did not include responsible managers in decision-making discussions and lacked a clear understanding of the volume of mail processing work they were accepting.
    • Atlanta VA HCS did not ensure mailroom staff was adequately prepared or trained to handle or sort the influx of mail. POM (Payment Operations Management) officials were later reluctant to help, citing the verbal agreement.

Buried in the report is this tidbit, “POM is implementing similar transitions at sites across the country; POM and medical facilities need to ensure adequate staff with sufficient training to handle the mail processing workload.  VA concurred with the OIG’s five recommendations.”  Meaning that in a VAMC/VAHCS near you, unopened mail due to verbal agreements will soon add more distress and disgust to the veteran experience.

I have documented in these articles how verbal agreements, verbal standards of work performance, and verbal processes and procedures are the problem and way of life in too many CHIPs and observed practices at the VA.  Yet, these verbal shenanigans are more apparent than in the dilemma Atlanta faces due to unopened mail.  Payment operations to community care providers are on a controlled and fixed timeline.  Failure to process these payments according to the required timeline leaves providers unpaid, which diminishes the community care provider pool of providers.  Talk to a community care provider, and they will discuss the risks of doing business with the VA and the real possibility of not being paid timely enough or being caught in sufficient red tape never to receive payment.

I know of a provider who called me three years after receiving care and was still trying to appeal and correct the paperwork to receive payment.  A provider recently contacted me who wanted to ruin my credit for failing to pay the balance due from care received, and they are charging interest.  Correcting this problem cost me 48 business hours, 20 calls, and frustrations galore.  By the way, the problem still has not been rectified, an appeal is in process, and we have to wait for the VA to make a decision; this incident was caused by the VA changing the process and the paperwork.  The provider told me they are not accepting any more veterans seeking care, the risk is too significant, the timeline to receive payment is too long, and the VA never pays what is charged.  For example, I recently received a declaration declaring payment to a community care provider.  The VA sent me to this provider, which means they knew the prices beforehand and agreed to the fees.  The declaration declared the VA was charged $2,000 and paid $120, not actual amounts, but close enough to communicate the problem.  With inflation, or without inflation, if you were paid less than 1/10th of what you billed (invoiced), would you continue to conduct business with that company or organization?  Now add the unopened mail problem to the mix.  Would you continue to conduct business with this entity?

America, the Department of Veterans Affairs is sick.  All of the other alphabet agencies in the Federal Government are sick.  We continue to elect people who actively refuse to care enough to act according to their mandated duties.  We cannot afford the government we currently have, which is part and parcel of the problem with inflation in America right now!  Debt is entered into to pay for this bloated feckbeast called government; from the city to the federal government, the bloat is too great to be sustained!  Why is the VA able to skirt responsibility, accountability, and improvement?  They can hide behind the size of their convoluted and twisted organizational shield.  Why can the Post Office and the IRS get away with deplorable, at best, customer service?  They are protected by the congress refusing to scrutinize and hold people accountable.  When your head is done exploding, please remember and act in the ballot box to hire better representatives!

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Economic Warfare – Your Liberty, Rights, Freedoms are at Risk!

Bobblehead DollMany pundits have made the following statement, in one form or another, driving a car is the ultimate expression of freedom in America.  Yet, your freedom to drive a vehicle is endangered by the political left and the neo-socialists who want to steal and destroy your freedoms.  Mention economics, and most people’s eyes gloss over, brains disconnect, and they hope the pain will end shortly.  Please, fight this impulse.  I will attempt to make a highly complex topic simple and easily understood.  While I might not get all the specific details correct, I aim to communicate economics to a general audience that is free and empowered to further research the topics for themselves.  My links are reflected in the article for more information.

What is Money?

Money was discussed in a previous article and found here.  In simple terms, money is the tool used to transfer goods from one entity to another, showing a legal purchase was made to change ownership, hence opening the first crucial role of money, legally transferring ownership of goods and services from one person to another.  Unfortunately, legal ownership transference is where the government exercises its first controls, regulating cross-border commerce.  When the government went on a growth spurt in the 1930s, ballooning into the behemoth, we have right now, the government used the excuse of maintaining cross-border commerce to steal products grown by farmers, regulate prices, and set up means and methods to ensure the government was the only winner.TOP 25 QUOTES BY JOAN ROBINSON (of 54) | A-Z Quotes

The 1930 legal battles that wound up in the United States Supreme Court over price controls saw the citizen’s first attempt to reign in the government and failed miserably.  Worse, these first moves by the citizen were the first exchanges in an economic war that has raged ever since—money stores value.  Think of the money found when you do laundry.  You have no idea how long that money was lost, but the value of the money has not changed, you presume, and you celebrate finding the money.  Except, the value of that money has changed through inflation, and the government’s hidden tax (inflation) has robbed you of value.

Let’s say you found $20 in the laundry.  When you first lost that $20 bill, it had more value, e.g., you could purchase more with that money than you can now.  Sure, the value printed on the money still has $20 worth of goods or services, but the cost of those goods and services went up, restricting your ability to purchase.  Hence the economic warfare being waged by your government.  The government essentially said we would not worry about inflation.  Meaning they will devalue the money you hold for their own political purposes.Steve Keen Quote: "Economics is too important to leave to the economists." (12 wallpapers ...

An idea was floated by an economically challenged person to print a $5 trillion bill and use this to pay off the Chinese debt.  The problem is the devaluation of the money printed will capsize American citizens due to the hidden taxes of inflation.  Making that $5 trillion bill or bills would devalue the dollar and crash the American economy.  The stored value in the printed bill would not stand up to and be accepted, as a medium of stored value sufficient to pay the debts incurred.  Is the problem more clear; when money is printed, each dollar, pound, euro, etc., devalues the stored purchasing power of the money you currently hold in hand.Economics Funny Quotes. QuotesGram

Stored value is the second tool for waging economic warfare by the government against its citizens.  Consider all the money printed to pay for the supposed Coronavirus Tax Relief and Economic Impact Payments the world’s governments made to their citizens.  If you had $100,000 in savings when these monies were printed, your savings were devalued by the inflation rate, which is currently at a 40-year high in America.  The government is reporting inflation at 7.9%, so your $100,000 in savings lost the equivalent of $7900.  But, the government does not ever report inflation at the actual level, and the actual level of inflation is ranged between 8% and 45% depending upon the purpose or product you are trying to purchase.  Meaning your $100,000 could have a value of $92,000 to $55,000 in real value.  A hefty tax indeed!

Stored value, the number printed on different bill faces of currency, is static.  The actual value, e.g., the number of goods and services purchasable, is not fixed, and the government allows an annual inflation rate of 2% as “normal and acceptable.”  Thus, your $1 will have a purchasing power of $0.98, which is compounded year-over-year.  Thus, over a decade, that 2% inflation rate is now reducing your $1 to $0.80.  Multiply that for the $100,000 and a decade of saving, receiving interest that does not equal inflation to compensate means your money in your savings account has lost $20,000, just from the government allowing inflation at 2% annual growth.  Let’s say your bank is generous for savings account holders and provides a published interest rate of 3%, subtract the inflation taxes of 2%, and you are only earning 1% interest on your money.  Is this the bank’s fault or the government’s?Amartya Sen quote: Economic growth without investment in human development is unsustainable...

Do you see how the government is robbing you through economics?  Your 5% raise is only 3% once the inflation devaluation has been factored into your budget.  Play the lottery; the taxes alone might kill you, but the devaluation of the money reduces the actual purchasing power of your winnings.  If you do not understand the economic warfare being waged against you by your government, you will lose more than you ever gained in winning the lottery.  Yet another reason why lotteries are a tax on stupid people, for even when you win, you lose!

Cash has another problem beyond inflation, money supply.  The money supply is the technical term for ensuring banks can replace worn-out, ripped, and damaged money.  Money supply plays a role in how much money your local store has on hand to provide change and cashback to customers.  For employers who pay employees in cash, the money supply is a significant problem with extremely high costs.  The government regulates those costs and passes them onto consumers through banks and lending institutions.  Are you struggling to get a loan; this is another by-product of money supply woes.  Paying higher fees to change money to another currency for your trip is another money supply product.  Money supply remains another weapon of the government to affect economic warfare, and many people do not understand this principle, making the government’s policies more effective.Mahatma Gandhi quote: Economics that hurt the moral well-being of an individual or...

Have you noticed the decline in the availability of $10 dollar bills?  I asked for two $10.00 bills when I broke a $20.00 at a Walmart recently, I was denied because Walmart has instituted a policy to only accept $10.00 bills, not give them.  Albertson’s, Staples, the in-store bank in Walmart, and the local credit union, all have a similar policy.  What is the government doing forcing a reduction in $10.00 bills in circulation?  In researching this single policy, I can find no written information on this issue; yet the evidence is clear, there is a manual currency reduction in process and the government needs to explain why.

Before 1980, the basic money supply was measured as the sum of currency in circulation, e.g., cash, traveler’s checks, and checkable deposits.  Currency serves the medium-of-exchange function but denies people any interest earnings.  However, as discussed, interest earnings are not all they are cracked up to be due to inflation.  Cash under a mattress, lost in pockets of clothes, stuck in a book in your library is black money; it is as dead as yesterday’s fish and constantly devalued by inflation.  The money supply tries to regulate the cash on hand to lend as a tool to protect your money from inflation.  Except, the government constantly allows a 2% inflation rate, negating a lot of savings accounts and other interest-earning propositions.

Want a new car, consolidate your credit card debt, or try to buy a house; all of these loan products are an extension of the money supply and the regulation of money supply by the government.  Important to note that your credit cards and bank-issued or employer-issued debit cards are not affected by the money supply, and this is another reason why credit cards and debit cards are so dangerous.  These tools are agreements between you and the issuer, where money is transferred when the tool is used, and the consumer is responsible for all the fees the government insists upon to help pay for the money supply.Economy has frequently nothing whatever to... - Quote

Conclusion

In waging economic warfare, it remains imperative to know about economics, identifying what money is, its role, and the fiduciary controls the government exerts to attack its citizens.  Some may call my language inflammatory, but tell me, do the inflationary costs right now not feel like your taxes have skyrocketed?  Inflation is a hidden tax, a tax fully controlled by the government, and the value of your money decreases yearly because the government says 2% inflation is acceptable.  Who made this decision, an unconstitutional entity called the Federal Reserve Bank.  Since its inception, Congress has tried to obtain transparency and accountability from the Federal Reserve Bank to no avail.  Do you understand why I take umbrage with the Federal Reserve Bank?LIC

The governors of the Federal Reserve Bank decided your money could be taxed at 2% inflation annually as a normal condition of doing business.  These people set the interest rates you pay for your credit cards and are not paid for your savings accounts.  Looking into the history of interest rates since 1900, there is always volatility; the Federal Reserve’s actions have since the 1980s to not allow savings rates over 5%.  When adjusted for inflation, that’s a 3% interest rate for those trying to save money.  What does this mean; fewer people are saving money.  Look where those trying to beat the 3% have invested their money, the stock market, where volatility is a minute-to-minute occurrence, higher risks against less interest, where your money remains subject to taxes, fees hiding other taxes, government fingers, and inflation.

Your government did that to wage economic warfare against you, to empower them to steal your rights, freedoms, and liberties.  There is no other way to describe what is happening globally in all governments.  China plays games with the value of its currency to power trade deficits.  This, in turn, changes prices and increases costs.  These actions are taken to “compete,” when in reality, the activities cover massive debt problems in China.  If the CCP cannot keep the tap turned wide open on trade deficits, their money supply drys up, and debts come due in a bankrupting tsunami!Milton Friedman: The Most Quotable Economist - Capitalism.com - Create the Change

The European Union has never been fiscally sound because the various members of the European Union are taking advantage of the productive members to cover the costs of the fiscally useless members.  France cannot survive as a country without the European Union’s largesse; Greece, Portugal, and several other countries are all in the same boat.  Their governments did this intentionally as political games to stay in power.  When these countries run out of other people’s money, they will be forced to change socially, and the tsunami of debt to the World Bank and other nations will not be pretty.

Knowledge Check!Economics drives these problems mainly due to the lack of knowledge of the lines of congruence between economics and the psychology of governing.  The enemies of freedom understand economics, and this is why these tools have been so successful in waging war and stealing freedom, rights, and liberties through monetary policy.  Until we, the rightful owners of government, understand what is happening, we will all be at the whims of our enemies.

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

“That’s Crazy!!!” – More Chronicles from the VA Chapter 6

I-CareI promised a follow-up article after Chapter 5; it took me the better part of 48 hours to cool down sufficiently to write coherently to effect an update.  On 18 March 2002, I wrote about an appointment with my Primary Care Provider (PCP) being tardy, unprepared, and bureaucratese in supposedly holding a phone appointment with me.  01 April 2022, not an “April Fools Joke,” at 0731 hours, lasting 9 minutes, my PCP called me to get my approval to have me changed from her PACT team to another provider’s team.  Apparently, in the highly red taped world of PCPs at the El Paso VAHCS, there must be an hour-long handoff call when a provider initiates a change of PACT team.  I have my doubts and smell designed incompetence!

Let me pause here for a moment.  I generally need two hours to write an article after conducting research.  18 March 2002, it took a bit longer to draft that one due to the need to blow off steam with some choice words and choke down the urge to beat a few brick walls with my fists.  I am generally a very controlled person, and the fact that this PCP was so stunningly incompetent, rude, and HIPAA clueless, I admit I lost my cherub-like demeanor!  That the patient advocate was able to get my secure message, upload the comments into the electronic medical record, and contact the provider before the provider had even logged the patient notes, speaks volumes about the ineptitude of the PCP.  Worse, in the call on 01 April, the PCP was still on speakerphone, still disregarding HIPAA security, and quoted lines out of context from my message to the patient advocate.  Speaking volumes about the processes and procedures of the patient advocate’s office to investigate patient claims without breaching confidentiality.  Another topic for another day entirely!PACT_model

28 March 2022, I received the following from the patient advocates office, quoted completely:

We have received your secure message addressing your concerns.  I will be sending a Patient Advocate Tracking notification with your concerns to our Primacy Care Service for review.  They will be contacting you via telephone to discuss your concerns.”

I never heard anything from this mysterious “Primary Care Service” group/team.  01 April 2022 was the first response, and that was from the PCP.  Sourcing the Department of Veterans Affairs (VA) and the Office of Inspector General (VA-OIG), the PCP is the second most important member of the Patient-Aligned Care Teams (PACT) at the VA; the patient is the essential member and an actively engaged and knowledgeable patient is preferred.  I promise the VA-OIG has not even scratched the surface of the problems with recalcitrant, snowflake, and bureaucratic PCPs endangering patient health with the VA.  Not my first run-in with an inept PCP; I sincerely hope it is my last!PACT 3

In returning to the 01 April call, we find another interesting piece of data.  The PCP affirmed that abdominal pain could radiate from, say a hernia, to other parts of the abdomen, but this is for a specialist to diagnose, not a Family Practitioner.  Get that; the PCP is directly reversing all the published documentation by the VA and the VA-OIG by declaring that a specialist is the only person who can adequately decipher and detail why pain is occurring—putting all the PCPs in the VA Health Administration under the bus as merely button pushers and drug dealers.  Then the PCP has the temerity, nay the chutzpah, to suggest a trust deficiency existing between myself and the PCP.  Is it any wonder that people are detested, forlorn, melancholy, madder than a wet chicken with a raging case of hemorrhoids with the care they receive from VA healthcare providers?

Again, I repeat, only for emphasis, when any updates arrive on this issue, I will publish them in their entirety to allow the VA the opportunity to rebut, refute, or explain.  Like the ongoing saga with VISN 22, the Phoenix VAMC, and being arrested and injured three times by the VA Police, I am not holding my breath and awaiting a logical response.  If this were the only problem in the two weeks since the PCP shenanigans, the VA would be in pretty good shape.  Alas, we know, dear readers, that the VA is in dire condition, and the elected leaders need to be scrutinizing the VA a LOT more closely than they are.VA 3

We begin the latest chapter of VA-OIG reports with yet another physician bilking the government:

Robert Clay Smith, a Louisiana physician, pleaded guilty to conspiracy to commit healthcare fraud, wire fraud, and illegal remunerations (taking kickbacks).  According to court documents, the scheme, which ran from 2013 until 2017, involved individuals associated with a medical supply and billing company recruiting Smith to dispense pain creams and patches to his workers’ compensation patients by offering him a split of the profits.  The company acted as the billing agent for Smith, handling all the paperwork and submitting the allegedly fraudulent claims to the US Department of Labor, Office of Workers’ Compensation Programs, and private insurers.  In exchange, the company paid Smith 50 to 55 percent of the profits collected from successfully billing insurers, at markups of 15 to 20 times what the medications cost.”

Plus the following:

Robert Schneiderman of Langhorne, Pennsylvania, admitted to participating in a massive compounded-medication kickback scheme that he and others ran out of a pharmacy in Clifton, New Jersey.  Schneiderman pleaded guilty in federal court to one count of conspiracy to commit healthcare fraud and one count of conspiracy to violate the Anti-Kickback Statute.  From 2014 through 2016, Schneiderman and his coconspirators used Main Avenue Pharmacy, a mail-order pharmacy with a storefront in New Jersey, to run a fraud and kickback scheme involving compounded drugs like scar creams, pain creams, migraine mediation, and vitamins.  Schneiderman was the president of Main Avenue Pharmacy and was a founder and CEO of its corporate parent.  Main Avenue Pharmacy received over $34 million in reimbursements from healthcare benefit programs on compounded medications alone.  Approximately $8 million of that total was paid by federal payers.  Schneiderman himself earned over $400,000 through the course of the scheme.  This case was investigated by the VA OIG, FBI, Department of Defense OIG, Defense Criminal Investigative Service, and Department of Health and Human Services OIG.”

Don’t forget this one:

Dr. Harry Doyle, a psychiatrist from Philadelphia, Pennsylvania, and his wife, Sonya Doyle, have agreed to pay $3 million to resolve alleged violations of the False Claims Act.  The alleged violations include submitting false billing to the US Department of Labor Office of Workers’ Compensation Programs (OWCP) for psychiatric services that were not provided and upcoding and double-billing patient claims.  The Doyles have also agreed to be voluntarily excluded from federal healthcare programs for 25 years as part of the settlement.  This is the largest recovery against a single psychiatrist in the history of the OWCP.  A multiagency investigation of Dr. Doyle’s practice revealed that from January 2013 through April 2021, the Doyles allegedly billed for services not rendered, some of which occurred when they were not physically present in the United States.  This case was investigated by the VA OIG, the Department of Labor OIG, and the United States Postal Service OIG.”

More is coming on this one:

Ten Texas doctors and a healthcare executive have agreed to pay more than $1.68 million to resolve False Claims Act allegations involving illegal remuneration in violation of the Anti-Kickback Statute and Stark Law.  According to a multiagency investigation, from 2015 to 2018, the doctors allegedly received thousands of dollars in illegal remuneration from eight management service organizations (MSOs) in exchange for ordering laboratory tests from Rockdale Hospital doing business as Little River Healthcare, True Health Diagnostics LLC, and Boston Heart Diagnostics Corporation.  Little River funded the illegal remuneration to the doctors in the form of volume-based commissions paid to independent contractor recruiters, who used the MSOs to pay numerous doctors for their referrals.  The MSO payments to the doctors were disguised as investment returns but were based on and offered in exchange for the doctors’ referrals.  As part of their settlements, the defendants have agreed to cooperate with the Department of Justice’s investigations of other parties involved in the alleged law violations.  To date, 17 doctors and two healthcare executives involved in this scheme have agreed on settlements totaling more than $2.7 million.  The civil settlements resulted from a coordinated effort between the VA OIG, Department of Health and Human Services OIG, Defense Criminal Investigative Service, and the US Attorney’s Office for the Eastern District of Texas [emphasis mine].”

Elected officials, the next time you are asked about the incredible amounts of fraud in government-provided healthcare and insurance, do not buy the media talking points that the fraud is minimal, contained, or anything but designed incompetence on the part of the bureaucrats to act as a jobs program for investigators!  The same investigators who are refused sufficient tools to investigate shenanigans by employees in the Federal Government adequately.?u=http2.bp.blogspot.com-fGEUjJsJ2h4VcJgswaisnIAAAAAAAABcsoFqEewPF_E4s1600quote-if-the-freedom-of-speech-is-taken-away-then-dumb-and-silent-we-may-be-led-like-sheep-to-the-george-washington-193690.jpg&f=1&nofb=1

Frankly, all of these cases need the government workers to be held accountable, and the myriad of red tape loopholes CLOSED!  I remember an election; I forget who and the exact when, but a significant election plank in the platform was healthcare reform, promising to clean up the swamp and bring accountability to Washington and the government.  The public is still waiting, and I know enough of you have run on this topic from both parties to repaper the walls (inside and outside) of the White House.

Yet, even if only outside providers and executives were scheming, the VA might not be in too bad a condition.  Except for the employees of the VA, VHA, and VBA, which continue to be caught up in ethics violations at a minimum:

The VA-OIG conducted an administrative investigation that included a congressional request to look into allegations that Charmain Bogue, former executive director of the Veterans Benefits Administration’s Education Service, committed ethical violations arising from her spouse’s consulting work for Veterans Education Success (VES).  VES is a nonprofit advocacy group that regularly had business before the Education Service.  The allegations also pointed to possible incomplete financial disclosures by Ms. Bogue concerning her spouse’s consulting business.  In their work, investigators uncovered evidence of other potential conflicts of interest and related misconduct by Ms. Bogue [emphasis mine].”

VA-OIG finding:

    1. Bogue participated in Education Service matters involving VES without considering whether it raised an apparent conflict of interest and acted contrary to the ethics guidance she received from her supervisors.
    2. Bogue sought résumé feedback from the president of VES to aid in her search for career advancement without considering whether this raised apparent conflict of interest concerns in subsequent VES matters. VES also endorsed Ms. Bogue for presidential nominee positions.
    3. Bogue provided insufficient detail about her spouse’s business in 2019 and 2020 public financial disclosures; VA ethics attorneys had found them compliant. She remedied the subsequently identified deficiency in her 2021 disclosure.
    4. The OIG found that Ms. Bogue refused to cooperate fully in the OIG’s investigation by refusing to complete her follow-up interview. Her husband and VES president also refused to participate in OIG interviews, and the OIG lacks testimonial subpoena authority over individuals who are not VA employees.   Bogue resigned from VA in January 2022.VA 3

UPDATE: 14 April 2022Sen. Grassley was hoodwinked by the VA on this issue and The Daily Signal (linked) has more of this report.  I covered this before, I repeat only for emphasis, when you are discharged from the VA, you lose your ability to be a “whistle-blower.”  As a point of fact, this is how the VA is able to hide a lot of their shenanigans, get rid of the person rocking the boat, invent the paperwork, cover the whole incident over as a “bad-apple” and keep you collective heads down and mouths shut until the VA-OIG investigation concludes.  The VA’s ability to abuse whistle-blowers is further compounded by Federal Attorneys who cherry-pick the cases they know they can win.  Which further protects the VA’s shenanigans and disheartens and mystifies those who have been wrongly terminated.  The Daily Signal reflects this pattern of corruption perfectly citing the records obtained by Empower Oversight.

Some commentators have claimed that blaming elected officials for not scrutinizing or not providing tools to investigate entirely is unduly unfair to the congressional representatives.  Really?!?!?!  The VA-OIG conducts an investigation, the people being investigated refuse to comply, and the VA-OIG is toothless to enforce a full and complete investigation to initiate Attorney General and FBI investigations and actions to recompense the defrauded taxpayer.  Ms. Bogue and the VES have invalidated any trust the taxpayer should have in their respective activities, but this, like so many other investigations into VA employees, will die of apathy before anyone is held accountable.  Even though a congressional representative demanded an investigation, nobody is being held liable.  Nobody is forced to compensate the defrauded taxpayer, yet the taxpayer is still expected to elect the same old representatives to their jobs.  Blaming the congressional representatives (legislative branch) for not scrutinizing the executive branch, one of only two jobs these people have, is somehow unfair?  NO!Exclamation Mark

Remarkably, between the 18 March disaster with the PCP and 01 April’s compounding idiocy, the VA-OIG published an ironically titled investigation report.

Improved Governance Would Help Patient Advocates Better Manage Veterans’ Healthcare Complaints.”

Imagine that, more designed incompetence negatively impacting the veterans seeking care at a VA medical facility, stating the obvious by the investigators.  Who on earth would be responsible for seeing that regulatory agencies had the tools needed to scrutinize and demand corrective action?  Calling all elected officials, did you notice that one of the prima facia tools a veteran has to report problems, conveniently called “patient advocates,” does not have the sufficient authority, adequate oversight, and tools to execute their jobs?  The VA-OIG reports the following:

The Patient Advocacy Program helps advance the Veterans Health Administration’s (VHA) efforts to improve customer service, support veterans’ access to quality care, and provide a mechanism to resolve healthcare issues.  Patient advocates document veterans’ concerns, communicate the resolution, provide follow-up and feedback, and identify trends for potential opportunities to improve medical facilities.  In FY 2020, VHA tracked about 162,000 serious complaints in its patient advocate tracking systems.”

Angry Wet ChickenOn a side topic, VA-OIG, how do you define a “significant complaint” and separate it from other types of complaints?  Honest question, the information was, to quote my PCP, “remarkably” missing from your investigation report!  Would the VA-OIG like to know why so many veterans’ complaints have risen to a “serious” level?  You reported the exact problem:

A complaint is considered resolved when the complainant communicates the outcome, and the record is closed in the tracking system.”

Maybe, the VA-OIG merely overlooked the logic problem, but complaints increase when the solution pushed down the throats of the veterans does not fix the actual situation.  Honest question, no sarcasm involved.  Is a “serious” complaint one where significant harm or death to the patient has occurred?  Is a serious complaint one that breaks federal laws, EMTALA, comes readily to mind??u=https3.bp.blogspot.com-fYRTNk48SCwT8ua0IRDWPIAAAAAAAAFZUpexSmJsN2Kos1600overcoming-adversity-help-yourself-believe-cubby-motivational-1289878102.jpg&f=1&nofb=1

Having had “solutions” forced down my throat, speaking only for myself, I am thoroughly sick of having the patient advocates bureaucratize my complaint, then fail to act, and then compound the problem by quoting policy to me as a reason to close the complaint, when the VHA never have written policies and procedures!  Maybe, you might want to look into the root causes of some of those “closed” complaints and ask root causation questions!

What did the VA-OIG find when they investigated the patient advocates?

    • VHA lacked adequate governance of the Patient Advocacy Program.
    • VHA did not effectively issue and implement adequate policy, monitor complaint practices, and provide guidance to medical facility directors responsible for local program management.
    • Patient advocates did not always enter complaints into the system.
    • Even though complaint records generally appeared to be closed on time, patient advocates did not always document the communication of the outcomes to the complainants.
    • The VA-OIG substantiated an inadequate program policy to identify clear expectations and responsibilities.
    • The VA-OIG found that they (patient advocates) did not always adhere to the documentation requirements to show full complaint resolution.
    • At the local and VISN levels, responsible personnel did not consistently analyze patient advocate tracking system complaints about trends.

Feel free to read the complete abomination of designed incompetence for yourself.  Essentially the VA-OIG concluded that the VHA has been burning taxpayer money in a patient advocacy program, and the designed incompetence is so apparent it can be tracked from L2, where the James Webb telescope is located!  Worse, you won’t need the James Webb telescope to see the designed incompetence!James Webb Space Telescope

Unfortunately, I could have guessed the first three findings without looking.  Every VA program is designed so ineptly, reprehensibly led, criminally incompetent, and with such dastardly deceptive doings that fiction writers’ storylines have to be written better to sell books.  You cannot make this stupidity up and make a profit.  Hollywood would run screaming into the night if they made a true story about the ineptitude found at the VA!

Knowledge Check!Elected officials, where are you?  The VA-OIG presents copies of their findings to you, and I have yet to witness a single one of you holding the VA Leadership criminally responsible for the failures at the VA.  Even when the VA is killing hundreds of veterans, the US Congress refuses even to act upset, let alone scrutinize for a change!  Remember how many veterans were intentionally killed in Phoenix waiting for treatment?  How many VA employees lost their jobs and pensions or were forced in front of a judge for murder?  It is a fair question, where are the elected officials in the legislative branch working to end the criminal “fraud, waste, abuse,” and designed incompetence in the executive branch?

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Continued Inanity from the US Government – Where are the Elected Officials?

Angry Wet ChickenI made the mistake of ranking the various government agencies on how intractable, unintelligent, and irresponsible they are.  I ranked the IRS based upon previous experience more competent than the VA.  That is a mistake I will not repeat any time soon, as the VA and the IRS are in a neck and neck race to the bottom!  Consider how the IRS sends you paper mail notifications; if you have questions, you are referred to a website for answers and provided several customer service numbers.  Except, when the website fails, you call the notifications’ numbers and are told that you need to visit the website for faster service.  The website refers you back to customer service, whose phone queues are always so full you are automatically disconnected after being reminded to use the website for faster service.

As my mind experiences a total meltdown, I begin twitching, and my head eventually explodes; check out this cat picture:Funny Cat Backgrounds, Pictures, ImagesDignified Stray Cat Photos Celebrate Their Unique Beauty

Some will declare this is a one-off incident; surely, the IRS is not this dysfunctional.  Try it for yourself sometime.  I never ask anyone ever to, believe me, experience this for yourself.  Check out the IRS website https://irs.gov.  Try to get solid and reliable information, and see how fast your head wants to explode.  I have been trying to appeal a decision the IRS made arbitrarily since 21 March 2022 and gotten nowhere fast.  Best of all, I have a deadline of 20 May 2022 to register an appeal, yet the website cannot answer my questions and points me back to the phone number on my notification.  The phone number auto-answer assistant refers me back to the website shortly before disconnecting my call.

As a small business owner, I had trouble getting my Tax ID number; the website said to call customer support, the phone number referred me back to the website and then disconnected my call because the queues were too full.  Ad Nauseum Ad Infinitum, but the joke is undoubtedly on me; the IRS proclaims they respect my time and are anxious to resolve the concern.  Can’t you just feel the concern and anxiety emanating from the IRS?  Where are the elected officials who need to be scrutinizing the Executive Branch and demanding better returns on the taxpayer’s investment?

As my mind experiences another total meltdown, I begin twitching, and my head eventually explodes; check out this cat picture:Cats wallpaper - Cats Wallpaper (5194935) - FanpopJust say nope | Grumpy Cat | Know Your Meme

If you’re keeping count, this is the third recent article on the culture of corruption at the Department of Veterans Affairs (VA) in as many weeks.  No, I am not behind; the rate of the frequency of VA – Office of Inspector General (VA-OIG) reports has legitimately been this overwhelming.  Never forget, an indictment is not a conviction, and perpetrators remain innocent until proven guilty in a court of law and the trial and sentencing have been completed.

Hunter Matthew Burroughs and Stephen Keith Andrews were indicted by a federal grand jury in Fort Smith, Arkansas, for their roles in three separate conspiracies to defraud the US government and private workers’ compensation insurers.  Their alleged crimes include a billing and kickback fraud scheme with multiple physicians and medical clinics and separate fraud schemes involving the shipment of medications from Arkansas to two Louisiana physicians, who then distributed those medications from their clinics in violation of Louisiana laws.  Additionally, Burroughs was charged with wire fraud for allegedly falsifying emails he provided in a civil lawsuit involving his sale of the company.”

Not to be outdone:

Robin Calef of Brockton, Massachusetts, was sentenced to one month in prison followed by three years of supervised release after pleading guilty to one count of theft of public funds in November 2021.  She was also ordered to pay restitution of $102,289 to the VA.  In December 2006, Calef’s sister was receiving VA monthly benefits, passed away.  She failed to inform the VA of her sister’s death, and the VA continued to deposit monthly benefits into a joint bank account held by Calef and her sister until September 2017.  Bank records revealed that Calef made monthly withdrawals of approximately the exact amount of VA benefit funds deposited into the joint account.”

And:

Derrick Brewer of Enfield, Connecticut, pleaded guilty to one count of theft of government funds.  In March 2018, Brewer submitted paperwork to the VA offices in Hartford as part of an application for service-connected disability benefits.  Specifically, he submitted form DD-214, which indicated that his discharge from his former service in the US Coast Guard was characterized as “Honorable.” However, the form had been altered before its submission.  According to official Coast Guard records, Brewer’s discharge was characterized as “Other Than Honorable Conditions” following his convictions under the Uniform Code of Military Justice.  There is no record of the discharge characterization ever being upgraded.  As a result of this submission, Brewer collected nearly $70,000 in VA benefits from March 2018 through September 2020.  Sentencing is scheduled for 27 May 2022.”

And:

Sarah Jane Cavanaugh of Warwick, Rhode Island, was arrested on charges of using forged or counterfeited military discharge certificates, wire fraud, and fraudulently holding herself out to be a medal recipient to obtain money and property or another tangible benefit, and aggravated identity theft.  It is alleged that Cavanaugh claimed to be a wounded US Marine Corps veteran and recipient of a Purple Heart and Bronze Star and schemed to collect hundreds of thousands of dollars in veteran benefits and charitable contributions from organizations that provide monetary aid; to veterans in need.”

And:

From 2002 to 2019, Terrie Lynn Christian of Newaygo, Michigan, engaged in a fraudulent scheme that targeted children’s benefits programs administered by VA and the Social Security Administration (SSA).  This scheme, which involved obtaining benefits for two fictitious children, resulted in government losses of over $660,000, including approximately $110,000 for VA.  Christian was sentenced in US District Court to 30 months in prison, three years of supervised release, and restitution of over $660,000.  The VA OIG and SSA OIG investigated this case.”

Do you notice anything odd in these stories of fraud; the documents did not stand up to scrutiny, but fraud was still perpetrated.  I have authentic documents proving service; I have had to present original documents several times and sign affidavits testifying these documents are my documents.  I am a veteran, and under the threat of severe penalties, I swore that I was not attempting to defraud the US Government.  Would someone please explain how these people, and so many others, can commit fraud so frequently?  Would someone please explain how the VHA and the VBA accepted clearly doctored documents and fraud executed?  Finally, where are the VBA and VA employees being held accountable for failing to do their jobs and allowing this fraud to be perpetrated with complicity?Mediocrity Joke

Time after time, I have been denied help, been given the bureaucratic runaround, and refused assistance until my documentation can be certified.  Then after my documents are approved, they are still rejected by bureaucrats who refuse to do their jobs.  Yet, crimes and fraud are perpetrated with the same bureaucratic inertia and complicit behavior.  Elected officials, do you understand why taxpayers are frustrated?

What reignites the explosion of my head is that these are only two of the multiplicity of government agencies.  Nobody knows how much fraud is perpetrated by employees and customers, and worse, even fewer care.  Elected officials, will you please explain why you are not more concerned and avidly involved in ending the fraud?

Let me cast your mind backward to 2005.  United States v. Alvarez, 567 US 709, is a case in which the United States Supreme Court ruled that the Stolen Valor Act of 2005 was unconstitutional.  The Stolen Valor Act of 2005 was a federal law that criminalized false statements about having a military medal.  Elected officials, when the judges legislated from the bench, overstepping their authority, why didn’t you immediately go back to work and redraft legislation to end the theft of valor and penalize people committing fraud?  Instead, you rolled over like a dead, bloated, floating body, and valor theft has worsened!Plato 3

Elected officials, why have you not drafted new legislation to curb government theft?  Why have you consistently refused to act to curb the bureaucrats from abusing taxpayers?  Why do you remain silent on the shrinking morals in America that open the doors for more abuse of the law?  We elected you to the office to take action; what are you doing?  Yes, mayors, city councilors, judges, dog catchers, school board members, county commissioners, and every other single officer elected, you are included in this plea for action!

Dont Tread On MeAgain, I implore you, the voters, to scrutinize your elected officials for their continued employment.  Yes, start today.  I know the elections are months away, but it requires time to evaluate performance, become knowledgeable, and prepare to act on election day.  You deserve a better government, and those in office deserve to be unemployed!

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Fed UP! – More Detestable Bureaucratism from the VA.

I-CareI hate being lied to!  More than I hate being lied to, I detest, with every fiber in my being bureaucrats and the inanity they promulgate to excuse their stupidity and throw a wrench into the works.  Today I suffered through yet another call with my VA-appointed primary care provider (PCP).  Not an online conference, but a phone call.  Who was in the office with the provider and why?  How can I guarantee my HIPAA information during a phone call on an unsecured line?  How do I know who I am talking to?  These concerns and more arise when you receive a phone call to discuss important medical information, and my PCP does not care!  My PCP refuses to use the VA’s tools to conduct patient appointments and instead creates workarounds; what an ingenious method for telling lies and spreading falsehoods as bureaucratic inertia; I’m so thrilled!

The PCP continuously claimed all my imaging is “normal” and “unremarkable.”  The pain experienced cannot be related, and the sources are questionable.  In polite speak, the PCP is trying to tell me it’s all in my head; a previous provider from the VA already used this as an excuse for not performing their job.  For more than 10-years, I have been fighting the VAHCS for help in reducing pain and in getting to root causes for the problems experienced.  Yet, today’s call was just more of the same BS wrapped in feel-good words, platitudes, and bureaucratic non-answers.  Honestly, after the third time the doctor related, the imaging was normal and unremarkable; I lost my cherub-like demeanor!  I did not swear until I got off the phone, but I am not anywhere close to a happy patient.

Honest question, does the VAHCS troll medical school for the bottom of the barrel, those people who can barely pass a class, let alone qualify for medical privileges?  I need competence, and I get useless lumps.  I ask questions, and the snowflakes pop out of the woodwork like ticks on a deer or fleas on a dog.  I am thoroughly sick of being treated like a know-nothing inconvenience.  The most important person in the VA marketed PACT Team is the patient who will be active, engaged, and informed.  The second most important member of the VA Marketed PACT team is the Primary Care Provider.VA 3

Since 2002 I have had a problem in my gastro-intestinal system; since 2010, the pain has been debilitating, and four years ago, I was diagnosed with non-alcoholic fatty liver disease.  Today, 22 March 2022, the PCP reviewed the problems area on my electronic health record (EHR), which coincidentally resides at the top of the electronic health record and was mentioned four different times by myself, and noted that non-alcoholic fatty liver disease is not listed.  Tell me, how would that make you feel?  The PCP ordered today’s call before the recent imaging appointment on my abdomen and pelvis, but the provider, who called me almost 30-minutes late, did not even look up my record before calling.  Had not studied the imaging results and formulated a plan of action to move forward, yet as the second most important member of the PACT team, I am supposed to trust this bureaucrat; I think NOT!

Through the miracle of modern technology, I had read and researched the imaging results more than 24 hours before the scheduled appointment to discuss the results.  I came prepared, but the provider could not be bothered to prepare for a call they demanded, then had the sheer effrontery to keep repeating that the imaging is “normal” and “unremarkable.”  Then the provider has the gall to tell me, repeatedly, that I was yelling, when in fact, she only did not like being spoken to with emphasis and insistence that she do her job!  Yes, I called her a bureaucrat and a snowflake, whereupon she threatened to hang up the call, but I disconnected first.  I miss those old rotary phones you leased from AT&T, they had heft, and when slammed, they made you feel better about disconnecting a call.PACT_model

From research, it is abundantly clear that pain from hernias can show up or be felt in areas far removed from the hernia site.  Constipation is both an indicator and a symptom of hernias.  Muscle weakness in the legs, burning sensations, and much more are all indicators of a hernia.  Yet, when I asked about all the other pains and problems experienced in my abdomen, I was told the hernia could not be the root cause, and the imaging is “normal and unremarkable,” but the PCP could not answer why these other symptoms are unrelated when asked.  Where is the research, seeing as “Dr. Google,” is discouraged; Johns Hopkins and the Mayo Clinic, plus I have access to the medical libraries at the University of Phoenix and Grand Canyon University.  With less than five minutes of research, I can locate and read data from reputable sources to form the basis of questions to ask a PCP, which is encouraged of patients by the VA.  Yet, the doctor cannot be trusted to provide any intelligent data, do any preparation, or knowledgeably speak to a symptom list; when will the VA answer why their PCP cannot do their job?PACT 1

If only I were the only person experiencing these problems and issues with the VA.

Former VA cardiologist John Giacomini of Atherton, California, pleaded guilty to one count of felony abusive sexual contact.  In the fall of 2017, Giacomini repeatedly subjected a subordinate electrophysiologist to unwanted and unwelcome sexual contact, including hugging, kissing, and intimate touching while on VA premises.  On 10 November 2017, the victim explicitly told Giacomini she was not interested in a romantic or sexual relationship with him.  Nevertheless, Giacomini continued to subject his subordinate to unwanted sexual advances and touching, culminating on 20 December 2017, when Giacomini turned out the lights in an office, pulled the victim out of her chair, and fondled her until a janitor opened the office door and interrupted the encounter.  The victim later resigned from her position at the VA, citing Giacomini’s behavior as her principal reason for leaving.  Sentencing is scheduled for 12 July 2022.VA 3

Will the VA-OIG troll through this former provider’s employment history seek out the other victims, or will this be swept under the rug not to tarnish the VA?  Having been an employee of the VA, will anyone, EVER, look at how employment law is abused by the leaders in the VA and correct the problems?  This incident should never have occurred, nor should it have taken years of abuse to end this despicable behavior.  Yet, what does the VA do, shut both eyes and pretend it does not occur in consequence of the designed culture at the VA.

Why did the victim have to tell another adult that their behavior was unwanted, and quit their job, before the VA took action?  Will there be an inquiry from congress?  Will any lawyers stand up and demand the VA correct this detestable hole that allows this behavior to promulgate?  I am not holding my breath!

Speaking of electronic medical health records, the VA-OIG has issued three separate reports on this topic, and none of them paint the VA with anything that shows competence.  In the report titled:

Medication Management Deficiencies after the New Electronic Health Record Go-Live at the Mann-Grandstaff VAMC in Spokane, Washington.”  The following findings were related:

Deficiencies in medication data migration and management resulted in patients having inaccurate or incomplete medications in their records or made filling prescriptions accurately more difficult—all of which can affect patient care and safety.  Areas of concern included:

(1) Data migration
(2) Medication formulary availability
(3) Medication order processing
(4) Provider notification and alerts
(5) Controlled substance tracking
(6) Prescription drug monitoring program documentation
(7) Medication reconciliation
(8) Medication list accuracy.”VA 3

As previously stated, I am not as nice and never politically correct.  VA-OIG, please allow me to correct your assertion, “Deficiencies in medication data migration and management resulted in patients having inaccurate or incomplete medications in their records or made filling prescriptions accurately more difficultall of which DO negatively affect patient care and safety.”  Trust is the first casualty in war and in dealing with the VA in ANY form, manner, or method.  When you cannot trust your data to remain confidential, the entire electronic medical record system can only be rated as UNACCEPTABLE!  The upgrading of the electronic medical records system at the VA is a 10-year, multi-billion-dollar fiasco, and as a taxpayer, I am done paying for this system!

Not to be outdone by the medication side of veteran care experiencing failures, the following VA-OIG report was issued:

Care Coordination Deficiencies after the New Electronic Health Record Go-Live at the Mann-Grandstaff VA Medical Center in Spokane, Washington.”

The EHR rollout caused problems in coordinating veterans’ care, ranging from the flags for patients at high risk for suicide not transferring to veterans and their care providers having trouble accessing video appointments and patient portal messaging.  Tracking outcomes were sometimes lost, and disappearing laboratory orders also resulted.  Although the OIG did not identify associated patient deaths, future deployment of the new EHR without resolving identified deficiencies could increase risks to patient safety.”VA 3

Again, the VA-OIG is practicing political correctness instead of being specific, and upfront, the entire EHR is a disaster, the cost is prohibitive, and any fool should see it is time to pull the plug, cut the losses, and hold the leadership accountable!  Yet, what do we see; the EHR is progressing into infinity and beyond at a snail’s pace!

The final nail in the VA’s EHR coffin should be that nobody involved can communicate with the IT helpdesk for the EHR as the IT ticketing system is unreliable!  Form the VA-OIG, we find the following:

Ticket Process Concerns and Underlying Factors after the New Electronic Health Record Go-Live at the Mann-Grandstaff VA Medical Center in Spokane, Washington.”

The failure to process and respond to VHA staff ticketing requests for help or report concerns resulted in reporting, tracking, and resolving problems.  These deficiencies made it difficult for clinicians and administrative staff to serve patients and impeded EHR fixes that can affect future sites.  The inspection team also identified five factors contributing to the deficiencies identified in the two companion reports above: usability, training, interoperability, needed fixes, and problem resolution.”VA 3

Imagine for a moment, you are responsible for a multi-billion-dollar IT project, and one of the first issues discovered by the users is the inability to reach out for IT help; how long would you remain employed?  Would you ever expect to ever work again if any of these problems were your legacy for leading the IT improvement on a multi-billion-dollar project?  As a consultant, I know how fast you would be fired and taken to court for business losses.  Why are these leaders exempt?  Where are the blue-ribbon panels and committees demanding people be held accountable for this fiasco?EHR-VA-OIG

When the VA-OIG casually mentions that PCPs are untrustworthy and not using the current tools correctly, should the providers be issued new tools; NO!  Yet, this is the opposite of what common sense declares.  Are you, dear reader, as a taxpayer, fed UP yet?  My wife reminds me, “These problems happen in civilian hospitals.”  No, in fact, they do not.  If data migrated from one patient’s EHR to another patient’s HER, that hospital would be sued and shut down so fast by congress at the federal and state level, all before the media firestorm would have barely begun.  If a patient were jeopardized because their provider could not track medications, that patient would sue for malpractice and possibly a class-action lawsuit.  If an IT project was occurring in the civilian world, and the users could not contact the IT helpdesk, the project would be overhauled so fast, and people fired, new records would have been set.

Knowledge Check!It is time we end this charade and money pit call the Department of Veterans Affairs, and every other agency of the Federal government bloat!  The government should be leading, not lagging, where operational efficiency and fiscal sanity are concerned.  I repeat, only for emphasis, are you fed UP yet?

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

Iconoclasts – Know the Enemy!

?u=http3.bp.blogspot.com-CIl2VSm-mmgTZ0wMvH5UGIAAAAAAAAB20QA9_IiyVhYss1600showme_board3.jpg&f=1&nofb=1During the Summer of 2020, the world watched in horror as a group of people became unhinged.  They destroyed statues, wreaking images and ripping apart the social fabric of nations, destroying years of history all for purely political reasons and personal satisfaction.  These iconoclasts did not spring up suddenly; they were carefully groomed into existence.  The anger they expressed had been carefully tindered, fed, and fueled into the raging inferno observed on the nightly news.  Nothing is sacred to an iconoclast.  Any image, including statues, paintings, murals, buildings, everything man has ever created for social, religious, or political expression, was on the table of destruction, and these ignorant savages were going to destroy it.

Please, do not delude yourself.  The iconoclasts did not “suddenly come to themselves;” no, they are still out there, waiting for the next opportunity of convenience to become unhinged and destroy again.  But, you say, it is peaceful now; surely these people deserve dignity and should be offered the grace of justice.  No, a thousand times no, and a thousand times again, NO!GRE Word of the Day — Iconoclast. Today's GRE Word of the Day is… | by Team Bootcamp | Team ...

As a youth, I was told a story about an American Indian and a rattlesnake.  The rattlesnake had been captured by an eagle, flown high into the mountains, and was dropped.  The Indian was on a quest for enlightenment and happened upon the rattlesnake who begged for help and to be carried down to the desert so he would not die.  At first, the Indian said no.  He was wise.  He knew the snake would bite him and told the snake no.  But over time, the pitiful cries of the snake could be heard, and eventually, the Indian left his quest and carried the snake down to the desert below.  Always with the most solemn promises from the snake to not bite him.  As the boy removed the snake from his tunic upon arrival in the desert, the snake bit him in the chest.  As the boy lay dying, he asked the snake why; the snake replied, “You knew what I was when you picked me up.”

A snake does not become a toothless grass eater or honors his promises merely because he is begging for his life, and a terrorist does not become a law-abiding citizen by wishing and hoping.  The iconoclast is a terrorist, and a terrorist, at heart, has thrown off all compunction, all morals, all ties to society for the personal pleasure of watching it burn.  The terrorist wants to promote terror, is a political monster, and destroys for pleasure.  The iconoclast attacks and seeks to overthrow traditional or popular ideas and institutions.  Terrorists use violence.  The iconoclast uses violence—both delight in the mayhem they cause.The imposition of belief does not separate a terrorist and an iconoclast; in fact, the desire to force beliefs upon a population brings terrorists and iconoclasts more closely aligned.  The only significant difference between an iconoclast and a terrorist is the weapons of choice.  To a terrorist, the weapons are paid for through third parties who want to watch the destruction unfold (LIC).  The iconoclast will use whatever weapon is available.  Look at the toppling of statues, were they toppled using the proper equipment or whatever was available?  The iconoclast is an opportunist who takes advantage of situations, whereas the terrorist, a political monster, will create incidents, not take advantage of incidents.  Not that both are not committing acts of violence or spreading terror, but the terrorist wants to replace the system with one more their liking, and the iconoclast merely wants to see things destroyed.https://i.scdn.co/image/ab67616d0000b273af0aa6f49c0a4cf0ff28917a

The terrorist is different from an iconoclast in one other major way; the terrorist does not hide in society to pull down that society.  The iconoclast, as an opportunist, will wait, plot, scheme, and take advantage of every opportunity to create mayhem through the destruction of icons, symbols, images and has no problem becoming president, a teacher, a preacher, or any other job where they can act as a slow poison on a social body.  One of the best and most famous iconoclasts of the 19th century were Frances Fox Piven and Richard Andrew Cloward.  These two failed at being terrorists but have integrated themselves so thoroughly into American Society that they have been able to blind minds as iconoclasts and accomplish goals they could not achieve as terrorists with Weather Underground.

Frances Fox Piven’s book, “Challenging Authority” How Ordinary People Change America,” outlines the complete plan of this iconoclast, and yes, a line of congruence does exist between Mein Kampf and this book and author.  All tyrants will tell you their goals before they implement them.  As a freedom-loving person, I find this book to be incredibly difficult to read, and when compared with the history from the 1960s to today, I remain sickened by the success of these iconoclasts.  02 May 1966, the publication “The Nation” prints an article written by Cloward and Piven called “The Weight of the Poor: A Strategy to End Poverty.”  Don’t worry if you missed this article, “The Nation” celebrated the 50th anniversary of this garbage.  That the Cloward and Piven team were better iconoclasts than terrorists should not come as a surprise, frankly, nor should their drivel be published, but I digress.

Cloward and Piven’s iconoclastic theory was to force chaos on the body politic to keep impoverished people poor and angry, take advantage of their anger, and gain political power through riotings and disturbances.  The theory also begged for a massive expansion of the welfare rolls to build an ever-larger class of permanently aggrieved people.  Consider the elected officials who keep pushing for socialized medicine in America; they are iconoclasts, straight out of Cloward and Piven’s theories.  Recently the media has discussed the need for a guaranteed income, paid for by the government through the forced taxation of others.  This is another iconoclastic idea that finds roots in Cloward and Piven.  Look at every single political talking point from criminal justice reform to immigration, and you will find an iconoclast tearing away at the icons and fabric of America for personal profit and individual enjoyment.

Lots of media ink has been spilt on homosexual rights, privileges, and changing the nuclear family and marriage laws.  Would you be surprised to learn that those championing these talking points are iconoclasts taking their script from Cloward and Piven?  Would the “Woke Agenda” shock you to know that those who pitch this idea are iconoclasts and take their cues from Cloward and Piven’s theories and writings?  What about increasing the minimum wage; would you be interested in knowing that even a minimum wage is iconoclastic?  Forget about those pitching for an increased minimum wage to $15 an hour being iconoclastic.  The mere philosophy of having a minimum wage is iconoclastic and anathema to American history and the US Constitution.Plato 3

Iconoclasts are a secret society, but the secret is open and in full view.  The confusion these people generate helps them gain power, provides the fodder for their abhorrent behavior, and promotes them higher in power.  Why is the government so intransigent; the iconoclasts acting as “good bureaucrats” make the government intransigent and are held in control by other iconoclasts.  The iconoclasts tear down and destroy using plasticized terms like empathy, democracy, helping, support, dignity, and more.  Criminal justice reform punishes the victims of crime.  Welfare reform further strips those receiving welfare benefits of pride, honor, and the satisfaction that work provides, ever-widening the gulf between those who need and cannot obtain and those who receive welfare benefits.  Immigration reform is labeled as dignity, but in reality is nothing more than spitting in the eye of those who followed the rules, sacrificed, and acted appropriately.  The iconoclast always looks to how they can destroy something good and leave a void or replace it with something that perpetuates the further destruction of a society.

In a recent case, Pete Buttigieg took the money sent by Congress for roads and bridges, and designed plans to spend it on climate change and make roads less racist.  A road cannot be racist, but those in control are iconoclasts, and if they can further frustrate the road and bridges problem, they can sit back and watch the daily commute of millions of people and laugh hysterically.  The iconoclasts imposing this madness are called “innovators,” “innovation leaders,” and “forward-thinkers.”  All words plasticized to erode further and eventually destroy the American government, trust in government, and continue the eating away of the social glue holding America together.  Using laws to punish the innocent, protect the guilty, and make good and right evil, while evil is heralded as proper and transformative.President Adams

Iconoclasts did that, and we, the American people, need to know our enemy.  We need to understand what we are seeing.  You are not racist, homophobic, regressive, or any number of other names for asking questions or dissenting to the actions the iconoclasts are imposing.  You need to know who and what the enemy is and does to thwart the enemy properly.  It is good to stand for truth, justice, and the American way!  It is expected that the iconoclasts and terrorists in our Constitutional Republic would want to damage and destroy.  Not acceptable, but expected, because a Constitutional Republic, to ensure freedom for all, does not have natural freedom crushing antibodies in the system to rid the body politic of these types of people.Patriotism

Would you like some weapons in your arsenal to fight iconoclasts; ask for proof.  Remember, research does not provide proof of anything.  Looking at the fruits of the ideas and asking about the evidence that what they are proposing is beneficial.  For example, has the minimum wage been helpful; no, the minimum wage has not been beneficial.  People made more money, but the government increased inflation, borrowed more money, and charged more money for taxes, increasing the cost of living and then increasing the minimum wage to “assist the poor.”  Socialized medicine has this practice borne positive or negative results; the answer is resoundingly negative, and implementation of socialized medicine destroys too much!  Immigration reform has any immigration reform improved the plight of Americans ever; again, a resoundingly negative response occurs.  Crime went up, illegal immigration went up, social ills went up, moral decline, welfare rolls increased substantially, and much more happened.

Knowledge Check!Iconoclasts can only be fought when we:

                        1. Stand together
                        2. Learn
                        3. Act in unity
                        4. Never settle

What will you learn today that improves your tomorrow?  How will you use this information?  Does America die on your watch from the thousands of cuts the iconoclasts have made?  Today, let us resolve that America does not die on our watch.  No matter the difficulties, we must fight the iconoclasts!

© Copyright 2022 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.