NO MORE – An Open Letter to the People of Arizona

To The Citizens of Arizona:

ArizonaIt has been my pleasure to have lived in Arizona four separate times since 1996.  Employment and pleasure have brought me relocation opportunities, and I have enjoyed my time in Arizona. However, since my return in 2005 to the present, I have feared for the soul of Arizona.  I have watched as despicable and detestable politicians have won political races that never should have been won.  I have witnessed governors act in cowardly and craven methods to thwart the people’s will.  I have witnessed those elected to Federal Offices from Arizona stop being held accountable to the electorate until the politicians have set up a hegemony and no longer fear the ballot box.  Most egregious of all, I have witnessed the veteran community become increasingly abused as every day ticks past.Patriotism

In April 2021, I wrote about my interactions with Rep. Greg Stanton (D) and his staff, where the VA is concerned.  For almost an entire year, I have been injured, cited, and arrested, denied care, had untold HIPAA violations, and other disgraceful conduct taken against me by the administration and leadership of the Carl T. Hayden VAMC.  In December 2020, I reached out again to the federally elected representatives, asking for help to clear my name and remove the atrocious behavior of the VA, all to no avail.The Duty of Americans

All four Senators rejected my pleas and never bothered to respond.  All of the members of the House of Representatives from Arizona refused to reply, save the staff of Rep. Greg Stanton (D).  Except, Rep. Greg Stanton (D) and his staff, did nothing!  Had no priority, refused to communicate, could not maintain pressure, and bought the lies and excuses of the Carl T. Hayden VAMC administrators.  These are the same administrators who create a crisis for veterans through inaction, duplicitous action, poor behavior, and refusal to perform the jobs they were hired to perform.  I have made it clear that the Administrators of the Carl T. Hayden VAMC and VISN 22 are but one dead veteran from another scandal to dwarf the death list scandal that originated with the VA administrators in 2012 and repeated in 2016.

VA 3No VA Administrator has addressed the root causes of those scandals, and without proper persuasion from Washington, D.C., they never will!  Worse, without continuous scrutinization, the bureaucrats will continue to exemplify the duplicity and failures, hiding behind designed incompetence and tissue paper-thin excuses for poor behavior.  Yet, what do we find from those enjoying elected office?  Zero interest, half-truths, straight lies, misinformation, smoke and mirrors, and plain laziness!  We, the electorate, find the politicians sitting on their hands, engaging in hopeless and stupid legislation that will go nowhere, and we find lackadaisical meandering in the House and Senate leadership.  I have witnessed amoebic life with more robust spines than the current political leadership in Arizona!Image - Quote Poltics is Dirty

It is true, Arizona is not the only state suffering from political abuse of the basest sort and blackest hue, but Arizona is where I have personally seen the destruction hit the hardest.  During Senator McCain’s tenure, my requests for help were rebuffed, but I could still obtain assistance from the House of Representatives members.  Now, the political party doesn’t matter, the politicians have plastic ears, and plastic lips, and their hearts are full of desire for political gain and not the electorate’s support.  Who loses, the electorate!  Who wins, nobody!

America, I ask you, in the year and change between today and the next election cycle, what will you do to change America’s government?  Arizona, you have been duped, lied to, and dishonored by those elected to power.  What will you do to reclaim the honor, integrity, and political government you deserve and pay so much for?Apathy

Personally, I have been betrayed, and I am sick to death of pleading for reprieve only to have lackluster performance, at best, provided so I would just go away.  I know of no honorable politician representing Arizona, and their respective staff is worse than the politician!  From the Mayor of Phoenix to the Governor, including the school boards, judges, and so many others, the fear of the ballot box is shrinking, and the bureaucrat is winning.   In contrast, the scrutinization of bureaucrats and other duties are dodged to win another term, always with a complicit media running interference.LinkedIn Image

I did not elect the media to their position, and since the media is not elected, they can be removed. However, while the politicians are elected, the fear of the ballot box needs to be retaught to the politicians.  How does a citizen get a politician to fear the ballot box; you first buck the trends and stand like a rock in a stream. Then, as additional rocks begin to stand, a dam is built, forcing change to that stream.Plato 3

If we are to change the government and retain our freedoms and liberties under the Rule of Law, we, the electorate, must first get the politicians to fear the ballot box!  We, the electorate, need to also teach accountability and responsibility to those who claim power but who only obtain power from those choosing to be governed!  We, the electorate, hold power over these politicians and the bureaucrats spawned in the legislative branch of government. So claim the power that is yours, and join your friends, neighbors, and communities in demanding better from those elected.

Knowledge Check!I heard the mayor’s office in Phoenix complain that they have no power over the Federal Government.  To think this is treason of the vilest kind.  Let me reiterate something discussed in several previous articles.  The local government stands as a bulwark against the county government overstepping its legal boundaries.  The city and county stand against the state encroaching against the freedoms and liberties of the state government.  The state government defends its citizens from the Federal Government’s encroachment, and the individual citizen is the most potent force in our Republican form of government.

Plato 2Cease the sophistry of plastic language and do your job!  End the tyranny of plastic words and work to aid the citizen in protecting their rights and freedoms from the ever-encroaching thieves of government and the bureaucrats spawned in the darkest pits of legislative fiat! So stand, every American citizen needs to stand and refuse to be governed until those elected are replaced with people willing to take action and honor the Rule of Law, holding previous politicians accountable and responsible for the mess America is currently suffering under.  Enough is enough, and I have reached the end of my tolerance, and my cherubic demeanor has been replaced with a hunger for justice!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: Have You Heard? Chapter 2

QuestionThe first week of June is often a period of recovery.  I have no idea why, but the first week of June is usually a recovery time.  Maybe it was all those years in school; I honestly do not know.  However, the world does not stop, and while the media goes 24/7 over the Memorial Day Gun Violence, stories are evolving that need your attention more.  I do not say this lightly, as I understand those wounded and killed in gun violence are tragedies and cause for grief, but the corporate media has always used these “major stories” to allow other things to slip past.

WhyHave you heard Dr. Fauci’s emails from while he was a name in President Trump’s councils reflect a different story than the lies he peddled for political purposes?  “The emails from the first half of 2020 reveal Fauci’s skepticism early on about masks to ward off COVID-19, his dismissal of the notion that the new coronavirus escaped a lab in China, and his vague reference to researching how to make the virus deadlier.”  Why is this spineless invertebrate still a media mouthpiece, a paragon of dirty virtues and political connections?  Fauci’s research from 1990 through 2020 was in Coronaviruses, and he still hyped, pushed, and peddled lies to obtain a political payoff.  Knowing masks were useless, he pushed lies.  Knowing the survival rate, he still pushed draconian government takeovers of liberty, freedom, and common sense.  Knowing he could orchestrate a catastrophe, he pushed lies to initiate a public health emergency and stood back to reap the windfall in the chaos created.  Of all the government officials with hands in the pot stirring the government mandates, I blame Fauci more than others!

Nuclear FamilyHave you heard the Federal Government remains hell bound and down on destroying the family but is explicitly targeting black families?  Would a minority please help explain why under a Republican President, the Federal Government’s actions are racist, but under a Democratic President, the same actions are “beneficial, needful, helpful, and not in any way demeaning?”  Frankly, I do not care about the race factor; the fact that the US Government, from the Mayor and School Board to the President, seems bound and determined to destroy the foundation of society, the nuclear family, remains highly suspect and needs to be investigated!  Ever since the US Government stole State’s Rights where Welfare Programs were concerned, the family has been directly targeted.  Look at any race, and you will see the same hit in the data, where families went from working to be self-sufficient to the government dole.  Unfortunately, black families have suffered some of the worst impacts.  Now we are three generations into the destruction of the family as a government program, and I want answers!

Have you heard, the data is inescapable, the conclusions self-fulfilling, and the results are incredible.  When you want more economic freedoms, which lead to more overall liberties, it is best to start by ending corruption in government.  Who would ever believe that economic freedoms lead to individual liberty, and the best place to start is reducing government?  I am absolutely… nonplussed!  The founding fathers of The United States of America, a Free Republic (if we can keep it), understood these connections intimately and established the US Constitution to provide future generations the best chance of keeping the American Republic.  So, who would like to start firing and cutting government?  I am first in line; join me!Plato 3

The Department of Veterans Affairs – Office of Inspector General (VA-OIG) released a report on 02 June 2021, detailing crimes so horrific and obscene, I can find no appropriate adjectives to describe this negligence and criminality of all administration leaders involved.  January 2021, Dr. Robert Levy, who was a pathologist, who over his 12-year tenure at the VA Hospital in Fayetteville, Arkansas, made over 3000 diagnostic errors, manipulated the quality control process, and caused severe injury to 34 patients, received 20-years in what can only be called a “plea deal” that should never have been allowed!  The good doctor admitted to long-term alcohol use.  Now, will someone please hold the leadership teams accountable for this doctor’s behavior?  This story makes me especially sick!  Where are the politicians who were elected (hired) to scrutinize the government?  Where are the “Blue-Ribbon Congressional Committees” to hold those accountable and responsible for 34 veterans severely injured over the actions of a VA provider?  Who will speak for the victims and demand, then oversee and insist upon corrective actions by an executive branch of the government through the work of the legislative and judicial branches of government?VA 3

I was an operations manager, the safety of my workers was my paramount responsibility, and I could be held legally accountable for what happened on my manufacturing floor.  I had two people go for lunch, lifting 40oz curls, and returned to work for the afternoon soused!  I had to shut down my manufacturing facility, I had to keep these two from driving away, I had to call in the temporary employment agency to collect these gentlemen, and they could not have their keys back, for as soon as they returned to work in an alcoholic stupor, I was responsible under the bartender law.  This incident still brings some emotional baggage and resentment at these two morons.  How in the world was the good doctor able to be alcoholically impaired on the job, and nobody was aware?  Impossible!  Where is the accountability of the leaders in this situation?  I could have been jailed for allowing employees to operate their vehicle under the influence; when will the administration be held responsible for allowing a drunk employee to operate a vehicle?  Read the VA-OIG report; it is a criminal list of what not to do from day one of this doctor’s employment!Plato 2

Have you heard, the Department of Veterans Affairs (VA) killed a veteran in the emergency department of the Malcom Randall VAMC in Gainesville, Florida.  Worse, the veteran should never have died, and the reason they did was due to inefficiency, inadequate care, and processes and procedures in the emergency department triage of patients.  The patient had experienced hemicolectomy surgery, and between days 10 and 15 post-op recovery, he went to two outside ER’s and the VAMC ER, where he passed.  Drunk employees for 12-years are abysmal, fail to recognize patient distress, delay care, and cling desperately to outdated and inefficient processes in patient care in an emergency room, are execrable, horrific, and so vile to have exceeded repugnant!VA 3

Again, one must ask, where are the elected officials in pushing changes to the VA Administration; Oh, I know where they are; they are trying to kill history and remove President Lincoln’s mission statement for the Department for Veterans Affairs.  We need to understand priorities: Is a veteran’s life more important than being woke and having a small group of citizens begging for less sexism, who are always going to choose to be aggrieved, be satisfied for a small amount of time?  I know what my priority is, and it has nothing to do with the permanently dissatisfied and everything with saving lives and honoring patients who deserve the honor!

Knowledge Check!I implore you to please join your voice to mine, and let’s remember Memorial Day 2022 as the day marking how in 2021 we changed the VA, we limited the government, and seized our liberties and freedoms, as the founding fathers intended!  We can make a difference in the government, provided we band together without the petty names and distinctions currently being used to separate and divide.  We, the American Citizens, deserve better from the government we pay for, even if we must use every legal tool in our arsenal to cull the politicians and take the freedoms they have stolen.

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

 

NO MORE BS: Climate Change is GOVERNMENT CONTROL!

Angry Grizzly BearTo some of you, I am preaching to the choir; but sometimes the choir sings better when they have more knowledge.  Please help sing louder.  To others, what I am about to say is so far out of your current understanding that your brains might hurt; I am sorry.  You will never understand snowflakes and trolls, but I am willing to take that chance!

According to the Wall Street Journal, the fraudulent president, President Biden, is taking the same plan President Obama used to restrict America to a Climate Change job-killing pogrom!

Mr. Biden is essentially doing an end-run around the Constitution, which requires approval by two-thirds of the Senate for the President to enter a treaty. The emissions reductions that foreign leaders pledged on Thursday aren’t legally binding, but Mr. Biden intends to use regulation to bind Americans.”

This single statement should scare every American, whether you believe in Climate Change Hype or not.  President Obama and now President Biden refuse to act within the law where climate change is concerned.  This means there are nefarious problems, greedy hands, and legal issues the sitting president is trying to keep hidden from American citizens.  Unfortunately, this is just the beginning of the Climate Change Pogrom Plans that have been made public.Problems

What is a Pogrom?

A pogrom is a violent massacre or destruction by a government entity against its own citizens.  Nazi Germany changed the law, then massacred legally their Jewish, Catholics, Handicaps, mentally handicapped, and other aspects of undesirable citizens.  Stalin and Mao have used pogroms to murder, execute, and destroy their own people, neighbors, and many others.

Why is Climate Change a Pogrom?

From the Wall Street Journal, “Businesses will be conscripted as foot soldiers in the progressive war on fossil fuels.  America’s founders believed that the Constitution’s separation of powers would safeguard individual liberty, but this assumes Congress guards its power” [emphasis mine].  The separation of powers was supposed to stop this madness.  As President Obama demonstrated, there are loads of chicaneries the legislative branch can get away with, and Congress and the Judicial Branch refuse to exert their powers.

Millstone of Designed IncompetenceNow, let’s talk about the 10-year plan, a $2.3 Trillion plan that is a “more-than-infrastructure proposal” but is nothing but the Green New Deal in disguise.  So far, the best record for the details that have been released comes from DailyMail.com.  We need to be clear, not all the details have been released, but those released details should scare every person in America into action against this power seizure!

  1. Biden vowed that America would be “on a path of a zero-emissions economy by no later than 2050.”
      • Where is the US Congress in agreeing to this plan?
      • Where is the complete plan laid out for the American People to review and approve?
      • America is a Republic (if we can keep it), and I do not see anything that reveals this information, neither does DailyMail.com.
  2. From experts, to reach a zero-emissions economy, the following will have to occur within the next 10-years:
      • All meat consumption, especially red meat, will have to drop to less than 4 pounds a month per American, or roughly 90% of today’s consumption rates for red meat and a 50% cut in all animal consumption. Essentially, America would be on a 0.18 ounce of meat per day for protein.
      • Every single American will have to buy an electric car, currently a $55K investment.
      • Electric heat, solar panels, windmills, and more would have to be drastically increased, increasing the cost of electricity to roughly $5700 a month for heating and cooling your home.
      • The costs of the plan, to start, begin at $2.3 Trillion. If ObamaCare is any indicator at how fast cost estimates by the government are surpassed, a closer cost estimate is around $500 Trillion!  Don’t forget the farrago that was the ObamaCare Website!  Including:
          • $85 Billion for infrastructure modernizing public transit.
          • $174 Billion replacing lead pipes and modernizing drinking water and sewer systems.
          • $100 Billion to protect nature-based infrastructure.
          • $40 Billion for housing infrastructure.
              • What does this mean?
          • $100 Billion for upgrades to the electrical grid.
          • $100 Billion for new public schools.
              • Why?
              • Isn’t this a state issue?
              • Aren’t I, and every other American, already paying for school modernization?
          • $10 Billion for upgrading federal buildings.
              • Why isn’t this already occurring?
          • $35 Billion for investing in climate science.
          • $10 Billion for an enforcement arm, called the Civilian Climate Corps.
  1. How many dairy farms, ranches, and other animal husbandry jobs will be lost to reduce protein intake to 0.18 ounces daily?
  2. How many restaurant jobs will be wiped out due to the costs that will disproportionately fall upon the reduced middle-class and lower class of people?
  3. How many American jobs in Natural Gas and Oil fields will be lost to other countries that do not have to follow the same plan to reduce emissions?
  4. How much of the economy will be sacrificed for science projects and liberal pipe dreams?
      • Public transit systems are a colossal waste of tax dollars just for inner-city transit; how about intra-city transit?
      • AMTRAK hasn’t been able to turn a profit on carrying people between cities ever; how does modernizing public transit improves the loss of taxpayer dollars down this well of liberal insanity?

Andragogy - LEARNRemember, our pattern for this insanity is from President Obama, who had a comfortable first two years due to a friendly House and Senate. They could not do these enviro-legislation issues due to US Constitutional problems, so President Obama used executive orders.  Again and again, climate science has proven to be a money-sucking black hole for taxpayers while the limited few buy new jets, new luxury yachts and force restrictions upon everyone else.

ApathyHow many people will die from the cold or the heat due to the cost of electricity, electricity failure, and not having a backup or tertiary source for heat or cooling?  Every year America sees people die from the cold and excessive heat.  Want a pattern for how higher electricity costs and liberal-brain dead solutions work; let’s look at California.  Last year, loss of power killed people on medical equipment, where electrical lines were not properly maintained, sparked fires, and rolling brownouts are common.  Now that you see the middle and lower class sacrifices, ask yourself, did Speaker Pelosi (D) or any of here Hollywood and political buddies suffer any inconveniences from brownouts and loss of electrical power?

LookHey Speaker Pelosi, how big are your freezers and refrigerators again?  How many do you have in your walled mansion?  How much electricity do you consume?  Climate scare is a method for an unconstitutional power grab, plain and simple, and every single American needs to be actively engaged in fighting these restrictions!  The fight for liberty is cloaked in “Climate Science,” and every nation on earth has been infected with this power-grabbing sickness where politicians win and the citizens lose!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: Legislative Branch, The Role of Elected Officials – US House of Representatives

DutyIn democratic society’s, there is a representative form of government, knowing and understanding the duties the elected officials are expected to perform will aid in measuring those currently holding office, and those seeking office more precisely.  While this article is steered more towards the Republic of the United States, the principles are still the same for every democratic society across the globe.

The Role of the Elected Representative – US House of Representatives

Important note, the United States House of Representatives, by US Constitutional direction, is “The People’s House.”  This representative body is the general body where specific duties are demanded.  Article I, section 5 of the Constitution provides the House with the authority to determine whether Members-elect are qualified to be seated.

      1. A congressional representative is elected to a two-year term serving the people of a specific congressional district.
      2. Elected congressional representatives have two duties: making laws and scrutinizing the work of the Government.
      3. To be elected, a representative must be at least 25 years old, a United States citizen for at least seven years, and an inhabitant of the state he or she represents.
      4. Congressional representatives conduct a broad scope of work to best represent a set number of constituents.

Those are the four duties of an elected representative to the US House of Representatives.  Do you, personally, feel “represented” by your elected representative?  Personally, I do not!

Theres moreWhy; the constitutional qualifications for office originate in British law, where members of the House of Commons had to live in the shires or boroughs they represented.  Although that was rarely done in practice; see a pattern?  The founders used that example to motivate the requirement that Members of the House live in the state they represent, which would increase the likelihood that they would be familiar with the people’s interests there.  But there was no mention during the debates about living in the same district. The district system appeared later as states dealt with how to fairly organize their congressional delegations.  If location, and time of living in that area, proves residence, can a person trust their representatives when they live in DC, work in DC, but claim to represent your local area?

Even during a nation-wide pandemic, it has been most unusual to observe any congressional representative living in their home state, let alone their own congressional district.  Hence, it appears that congressional representation is following the example of the British House of Commons, rather than the US Constitution.  Before technology, I might have bought the need to be in Washington to conduct committee business, but with technology, I do not buy the excuses!  Leaving the question wide open, do you feel represented by your elected officials in the US House of Representatives?

Duty 2The entire job of an elected congressional representative is to represent their district.  That is the Summum Bonum of their elected duties.  Yet, can you even get a straight answer from your elected representatives in a timely manner?  Case in point, Rep. Debra Haaland (D), could not be bothered to help people in her district, but she sure blew her own trumpet declaring her work for her district.  I have written letters to several representatives of the house over the years, and each year the response takes longer, the response is less useful, and the platitudes and emails proclaiming their work become more loquacious, braggadocio, and plastic.  Where the words mean one thing, but the actions conducted are not in line with the words.  I was once a member of Paul Ryan’s district.  Rep. Paul Ryan (R), was considered to be a fiscal hawk, but he refused to perform his job of protecting America’s checkbook.  Yet, in all the emails I received before his retirement, he was always talking about his skills and work in cutting the Federal Deficit.  Despite his past fiscal conservative rhetoric, Speaker Ryan’s tenure as Speaker of the House—most of which coincided with periods of unified Republican control of the Federal Government—saw significant increases in Federal Government deficit spending.  Hence, the question asked, do you feel represented by those elected to represent you?

InertiaWhile Speaker Ryan (R) was spending our children’s, children’s, children’s, money, his district saw massive job losses from the automotive industry, manufacturing tanked, and lob losses mounted, during which much of the rest of the country enjoyed a booming economy!  When I asked Speaker Ryan why the disparity between his district financially failing, and the rest of the country booming, I received a letter discussing his fiscal genius and government cost cutting measures.  My response was not worth the paper it was printed on, I left his letter in an outhouse, on a closed job site!

Using your powers of observation, can you trust your elected congressional representative to, “make laws” and “scrutinize the work of the Federal Government?”  I know I can’t!  When was the last time an elected representative made a law that passed the smell test?  Created legislation that did not contain enough Pork to choke a Chinese Buffet?  Scrutinized the efforts of the Department of Veterans Affairs to cease killing veterans?  Scrutinized the IRS to ensure that those charged with collecting taxes, actually paid their taxes?  Scrutinized the Department of Defense so that $23 Trillion Dollars just does not disappear?  I remember watching on TV (mid-1980s), the House Speaker had business to conduct and finish, so the elected officials stopped the clock so they had time to finish their work.

Government LargessOn the subject of scrutinizing the Federal Government, and handling with legislation the duties needed to clean the Federal Government workers from posts where they weaponize government for personal gain, the Department of Veterans Affairs – Office of Inspector General (VA-OIG) just reported some incredible examples of elected officials not scrutinizing properly!

The VA-OIG used an outside consultant, to examine 24 patient cases of concern, and the outside consultant found 16 of the 24 cases had quality of care concerns.  Yet, the VA-OIG did not substantiate that the quality of care fell below standards accepted by the VA.  Tell me, why hire an outside consultant to review the cases?  Why are the standards lower for quality of care in VA Hospitals than in community-based hospitals?  Long have I asked these and many other questions, of elected representatives, and crickets have been my answer!

Detective 2The VA-OIG investigated a urologist in Des Moines, Iowa who did not have the proper authority to issue controlled substances in an operating room environment (DEA Registration).  A Department of Veterans Affairs – Veterans Hospital Administration (VHA) memo had been received but never acted upon, the doctors were not notified in a timely manner that they needed the new authority to issue controlled substances, and the doctor is blamed for failure to obtain the proper authorities.  Yet, how many administrators failed to perform their jobs and were never censured, held accountable, or required to suffer punishment for not timely notifying the practitioners of new requirements; none!  If the doctor is censured, why not the administrative staff?  The need to scrutinize the efforts of the employees of the Federal Government has never been more apparent, but the elected officials whose sworn duty it is to scrutinize, is being neglected en masse!

The VA-OIG has reported a VA Employee, Respiratory Therapist, was also a thief who stole government property and sold that property on eBay for personal profit.  How many times will this story repeat before the VA is scrutinized by the elected officials, who have a sworn duty, obligation, and job requirement?  Where was this employee’s supervisor, director, and hospital administrator while this theft was going on?  One of the biggest problems the VA has is with beating and destroying whistle-blowers and coddling and supporting criminals.  Where are the elected representatives?

LookHow many other Federal Government Agencies and NGO’s, need scrutinized and are not being scrutinized because of the refusal to properly represent their districts by elected officials?  Elected representatives to the US House of Representatives, is the template upon which every state house of representatives is formed; thus, the state legislature has only two duties, scrutinize the federal government and state government, and make laws representing their state districts.  In Arizona and New Mexico, both state legislatures are failing miserably in scrutinizing, because of the example set by the Federal Government’s elected representatives.

Under the US Constitution, States have the right to censure the Federal Government for failure to act.  Anyone remember this happening since 1900?  The way the government works, the highest holder of control is the individual, not the Federal Government.  The order of control over government and the holder of the most freedoms is:

      • Individuals
      • Cities/Towns
      • Counties
      • States
      • Federal

Scared Eyes!Yet, for my entire lifetime, I have seen the exact opposite occur, and fail miserably!  The Federal Government needs elected representatives who will censure, scrutinize, and demand the bureaucrat’s obedience; but the elected representatives are not performing their job.  Thus, the state legislature’s need to censure their Federal brethren and demand change.  But that is not happening either.  The mayors of America refuse to act to protect their citizens, and the citizen just keeps being abused by those who are legally bound to help the citizen!  Thus, the question, based upon the performance of your elected officials to perform two jobs, make laws, and scrutinize government, do you feel represented?

© Copyright 2021 – 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.
All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:
https://www.linkedin.com/in/davesalisbury/

Department of Veterans Affairs Chronicles of Shame

I-CareAs a veteran who struggles with post-traumatic stress disorder (PTSD), stemming from military sexual trauma (MST), where a first-class petty officer jumped on my back and tried to rape me.  When I see the Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports on PTSD from MST, I pay close attention.  Since the Department of Veterans Affairs (VA) continues to deny my MST claim because MST does not happen to men, I get agitated when I see these VA-OIG reports repeating year-over-year with the same excuses and designed incompetence.  Designed incompetence is all about creating ready-made excuses for failing to perform correctly the role one has been hired or promoted to perform.  Consider the following:

“In 2018, the VA Office of Inspector General (OIG) reported that nearly half of disability benefit claims that were denied service connection for post-traumatic stress disorder (PTSD) and were related to military sexual trauma were not processed properly.”

That is the first sentence of the VA-OIG report released on 08 December 2020 declaring that the improvements suggested by the VA-OIG in 2018 had not occurred.  The following statistics come directly from the report issued.

      • 18,300 claims or approximately 16% were processed incorrectly in Fiscal Year 2019
      • 118,000 claims were submitted

Why were the claims processed incorrectly; because of designed incompetence by the Department of Veterans Affairs – Veterans Benefits Administration (VBA).  From the report, we find the following five root causes, or excuses: emphasis mine.

    1. Most errors occurred because claims processors did not verify or ask veterans to provide the disorder’s cause, known as an in-service stressor.
    2. In other cases, claims processors did not request a medical examination, medical opinion, or clarification of inconsistencies in the examination as required.
    3. Claims processors made these errors because they did not fully understand PTSD stressor types and the stressor verification process.
    4. VBA’s Compensation Service did not mandate any national training for claims processors on these subjects except during the first year in the position.
    5. In addition, VBA’s procedures manual was not effectively organized to allow staff to locate this information and lacked specific guidance for some aspects of PTSD claim processing.

VA SealWhy are the causes of the problems considered designed incompetence, because they never change!  At the VBA, the processors all need constant training to remain current in their positions; but never receive the training.  The VBA never holds value-added training sufficient to train the employees on their jobs, but this remains the number one excuse to justify poor performance in VA-OIG inspections.  Failure to perform the job is also not a new excuse, where the VA-OIG reports are concerned.  Not understanding how to ask for help is also not new, and frankly astounds and mystifies observers that those hired remain employed when their performance clearly remains insufficient to the job expectations.  While it is unique to the VA to see a procedure manual, it is only natural and expected that the manual is poorly organized, poorly executed, hard to follow, difficult to find, and generally useless.  The VA is famous for this designed incompetence trick.

You say, “Big Deal;” everyone knows the VA is messed up, full of failures, and is generally known for poor performance.  Why this is a “Big Deal” stems primarily from the costs associated with poor performance.  An annual salary is paid for the processors, the adjudicator, and the entire chain of command, totaling in the hundreds of millions of dollars.  The veteran has to pay for lawyers and other services to appeal the original decisions, which take time.  The veteran has to pay for a third-party Nexus Letter to accompany the claim to declare the original claim was faulty.  All of this requires substantial time investments and other resources, all because the original work has to be duplicated.  How many times the claim is duplicated depends upon the processors’ abilities to do the job they were hired to perform.

Your car breaks down; the tow truck driver only secures your vehicle 84% before driving to the auto repair facility, is this satisfactory performance?  Your surgeon has an 84% success rate where his patients will live after surgery for tonsil removal, is this satisfactory performance?  You are in hospital; your nurse only gets your pain medication to you 84% of the time or is only 84% accurate in providing the right patient the proper medication; is this satisfactory performance?  Of course not, but for government employees, this level of performance is “award-winning.”

Military CrestsCongress mandates VBA claim error rates; there is supposed to be a quality assurance check to reduce the error rates.  Yet, with all the checks, the balances, and the quality assurance programs, the VBA continues to surpass the error rates and physically harms veterans due to their inefficiencies.  Yes; a failure rate of 16% is a “Big Deal!”

Want to know how bad the VA is managing your taxpayer monies; read the audit released 14 December 2020.  In that audit, you will find comments like the following:

      • The material weakness involving information technology security controls has been reported for more than 10 years.
      • VA did not substantially comply with federal financial management systems requirements and the United States Standard General Ledger at the transaction level, as required by the Federal Financial Management Improvement Act.
      • [The] VA’s complex, disjointed, and legacy financial management system architecture no longer supports stringent and demanding financial management and reporting requirements.
      • VA continued to be challenged [with] consistently enforcing established policies and procedures throughout its geographically dispersed portfolio of outdated applications and systems.

In light of the recent computer hacking issues the Federal Government is experiencing, knowing that the VA has dumped hundreds of millions of taxpayer dollars to patch and repair, and sometimes replace (sort of), legacy (old, expired, useless, insecure, unreliable, etc.) technology over the last 20-years, how is the VA able to keep getting away with these designed incompetence excuses?  Congress, when will you hold the administrator’s feet to the fire for making progress on these glaring issues?  Congress receives these VA-OIG reports and audits before they are made public, yet the elected representatives cannot take a moment to check this poor behavior.  Why not?

Police and Government Lines of CongruenceFor the first time in more than a decade of chronicling the VA-OIG reports, I am mentioning a monthly highlight (lowlight) condensed report.  This report is unique due to the insanity of criminal investigations mentioned, the results of audits, and the healthcare inspections.  When you have 18 defendants in a bribery scheme, where 15 plead guilty, who defrauded untold Millions of dollars in Florida, the problem is not so much with the employees, but the organization that allowed this to occur since 2009!  A noteworthy criminal investigation indeed.

The highlights (lowlights) of November 2020 also include a VA physician from West Virginia being indicted for abusive sexual contact and simple assault and a surgical supervisor in Northern Ohio who defrauded the VAMC of approximately $3.2 Million in two separate schemes.  Regarding financial audits and the importance of improving that ancient technology, a VA Fiduciary has been indicted for misappropriating government funds from Pennsylvania to the tune of more than $155,000.  Best of all, a husband and wife team from California, technical school owners, bilked the GI-Bill of more than $29 Million since 2015.

The criminal issues the VA is facing regularly are not a one-off issue, but an organizational design problem as the frauds, thefts, and malfeasance reported is ever only the very top 1% of the problem that is ongoing and systemic in the Department of Veterans Affairs!  The November 2020 report discussed an incredible number of canceled patient appointments because veterans and COVID mask mandates do not play well together.  Yet, the VA Federal Police cannot stop persecuting veterans for their physical inabilities to wear a mask.

Thus, where are the elected officials from the legislative bodies who possess oversight and funding responsibilities?  Where is the executive branch of government in correcting and demanding specific action from the legislative branch?  Where are the administrators at the Federal, VISN, and Local levels in performing their jobs?  The designed incompetence must cease forthwith to allow for practical changes to be made and the organizational design to be corrected.  For the VA-OIG to be forced to accept the same tired, lame, and detestable excuses, year-over-year is the epitome of abuse to the taxpayer and veteran alike!

The Duty of AmericansWorst of all, this condensed version did not even scratch the surface of the issues reported in just three VA-OIG reports.  Shame!  Shame! Shame!  Shame on the elected officials, Republican, Independent, and Democrat, who have allowed this problem to grow and done nothing!  Shame on the myriad of presidents who have done nothing but throw good money after bad, without demanding progress and holding real people responsible for real results!  Shame on every single VA employee who shirks their job for easiness to the pain and suffering of a veteran, dependent, or spouse!

© Copyright 2020 – 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.
All rights reserved. For copies, reprints, or sharing, please contact through LinkedIn:
https://www.linkedin.com/in/davesalisbury/

Realities and Uncertainties – The Paradigm at the VA

I-CareThe Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports they are returning to a more regular schedule of release for the inspection reports with the Department of Veterans Affairs (VA) recovering from COVID-19.  Congratulations are in order, to the VA, as they begin returning to normal operations and procedures.  The reality is that standard operating procedures (SOP) are regularly missing at the VA, this absence causes uncertainty, and forms the crux of this report. A question for the VA-OIG, “How can you assess employee competency without SOPs?”  To the VA VISN leaders, “How can your directors and supervisors, conduct employee evaluations without written SOPs?”  The short answer is you cannot!

Congratulations are in order, for the Marion VA Medical Center (VAMC) in Illinois.  The Marion VAMC experienced a “comprehensive healthcare inspection” and were generally praised for the excellent work being conducted, the happiness of the patients, and the overall condition of the facilities.  While there were recommendations made by the VA-OIG (29 in 8 different areas), the overall report was satisfactory, and this is mentionable.  Hence, my heartfelt congratulations for your success in this inspection.

VA SealThe Marion VAMC VA-OIG report raises a common theme, and this is a reality the VA appears to be incapable of addressing training and two-directional communication.  From the hospital director to the patient-facing staff, training always appears as a significant issue in VA operations.  Having experienced the training provided by the VA for employees, and as an adult educator, I know the uselessness of the training program and have several suggestions.  Perhaps the problem would be best addressed if more evidence was provided of a systemic failure in training employees at the VA.

In 2017 Congress mandated a change in research operations for the VA, specifically where canine research was concerned.

The OIG found VHA conducted eight studies without the former or current Secretary’s direct approval, resulting in the unauthorized use of $393,606 in appropriated funds.VA continued research using canines after the passage of the funding restrictions, in part, because VHA executives perceived that then VA Secretary David Shulkin had approved the continuation of the studies before his departure.”

The cause of the problem, the VA-OIG discovered was, “Unclear communication, inadequate recordkeeping, and failure to ensure approval decisions were accurately recorded and verified all contributing to VHA’s noncompliance.”  The researchers and executives relied upon two leading causes for not following regulations, designed incompetence, and a lack of training through clear and concise communications.

Congress mandated the documentation to assure approval was obtained before research commenced; yet, the researchers and administrative staff collectively failed to do their jobs and were able to hide behind the bureaucracy they established to excuse their poor behavior.  Loopholes for designed incompetence and lack of training need closed; but, two incidents do not clearly illustrate the reality of the problem.

ProblemsThe VA Southern Nevada Healthcare System in North Las Vegas, in response to a referral from the U.S. Office of Special Counsel (OSC), was investigated by the VA-OIG after a community healthcare worker was attacked.  The VA-OIG findings are appalling, but the reasons for the problem are worse.

The OIG determined that facility managers failed to timely respond after the social worker reported an assault during a home visit and did not address the social worker’s health needs after the assault. The social worker’s supervisor failed to immediately report the incident to the community and VA police. The facility’s policies lacked specific guidance regarding employee emotional and mental health injuries. Further, the OIG substantiated that the social worker was not informed by a supervisor of a homicidal threat, occurring subsequent to the assault, until two weeks after facility leaders became aware of the threat.”

The facility leaders knew there was a problem, yet did nothing before or after the event, that could have cost this healthcare worker their life!  VA-OIG recommendations boil down to a need for clear communication and staff training.  The recommendations highlighted another issue entirely that forms the reality and creates uncertainty at the VA, communication is not a two-directional opportunity to share information.  Single directional communication is useless, and those leaders supporting the bureaucracy to only allow communication to flow in, need immediate removal from the VA.  During my time at the VA as an employee on the front-lines, facing patients, I regularly experienced the lack of communication, and this issue is systemic to the entire VA as witnessed and observed at VA Medical Centers across the United States.

The Nevada incident is deplorable, reprehensible, and the potential for loss of life cannot be overlooked by VA leadership in Washington, at the VISN, or at the Medical Center any longer!  The problems of communication cannot explain this incident, and failure for training cannot excuse this behavior!  Since the OSC initiated the complaint, I am left to wonder, did the employee reporting this incident get fired and needed to appeal to the OSC for remediation?  I ask because the knee-jerk reaction to problems at the VA is to fire the person reporting the issue, as previously observed and personally experienced, and as described to Congressional representatives during televised hearings.  A more thorough investigation into causation needs to be concluded and reported to Congress for this incident reeks of politics and CYA.

Leadership CartoonThe Harry S. Truman Memorial Veterans’ Hospital in Columbia, Missouri, and multiple outpatient clinics was recently provided a comprehensive healthcare inspection, and the leadership team provided 14 recommendations in 7 different areas for improvement.  While congratulations are in order, for the patient scores, the employee scores, and the overall conditions discovered.  Yet, again staff competency, e.g., training and communication, remain critical articles requiring targeted improvement.  Is the pattern emerging discernable; in Nevada, an employee is assaulted and training and communication are blamed, comprehensive healthcare inspections are conducted in three different geographic areas and the same causation factors discovered; training and communication are systemically failing at the VA.  But, the evidence continues.

The John J. Pershing VA Medical Center in Poplar Bluff, Missouri, recently underwent a comprehensive healthcare inspection.  The VA-OIG issued 17 recommendations in 6 fundamental areas, including staff competency assessments, e.g., training and communication, as well as the inadequate written standard operating procedures.  When discussing designed incompetence, the first step to correcting this problem is writing down the standards, operating methods, and procedures.  Then the medical center leaders can begin training to those standards.  Barring written instructions and published standards, employees are left to ask, “What is my job? and “How do I perform my job to a standard?”

The Oscar G. Johnson VA medical center, and multiple outpatient clinics in Michigan and Wisconsin recently underwent a comprehensive healthcare inspection, 11 recommendations in 3 critical areas.  As did the Tomah VA Medical Center and multiple outpatient clinics in Wisconsin, 4 recommendations in 3 crucial areas.  Both facilities are to be congratulated for their continual improvement and their success during the inspections.  In case you were wondering, staff competency assessments, e.g. training and communication, are vital findings and variables in improving further for both facilities.

The VA has what it calls “S.A.I.L” metrics that form the core standard for performance.  S.A.I.L. stands for Strategic Analytic (sic) for Improvement and Learning.  Learning is a critical component in how the facility is measured and yet remains a constant theme in the struggles for improvement.  Thus, not only is two-directional communication a systemic failure, but so is the poor training results found on all the comprehensive healthcare inspections performed by the VA-OIG.  Poor communication almost cost a healthcare worker their life, and staff training was a key component for recovering from this incident in Nevada.  How can the VA consistently fail at two-directional communication and training, designed incompetence?  Those in charge require an excuse for not doing their jobs, and the most common excuse provided is a lack of training and poor communication.

I-CareIt is time for these petulant and puerile excuses to be banished and extinguished.  The following are suggestions to beginning to address the problems.

  1. Easy listening is a musical style, not an action in communication.  By this, it is meant that the VA needs to stop faking active listening and engage reflective listening.  Reflective listening requires reaching a mutual understanding and is critical to two-directional communications.  In the world of technology, not responding to email, not responding to text messages, and untimely responses to staff communication are inexcusable on the part of the leaders.
  2. Staff training remains a core concept, but before staff can be properly and adequately trained, standards for performance, operational guidelines, and procedural actions must be clearly written down. The first question I asked upon hire was, “Where are the SOPs for this position?”  I was told, “Do not mention SOPs as the director hates them and prefers to work without them.”  Do you know why that director preferred to work at the VA without SOPs because she used it as an excuse to get out of trouble, to fire those she deemed trouble makers, and to escape with her pension and cushy job to another VA medical center?  A repeatable pattern for poor leaders to spread their infamy.  Shame on the VA Leaders for promoting this director to a level beyond her incompetence.  Worse, shame on you for creating an environment where many like her have excelled and done damage to the VA reputation, mission, and patients, including killing them while they awaited care.
  3. From the VA Secretary to the front-line patient-facing employee, cease accepting excuses. The private sector cannot hide behind immunity from litigation and act in a more responsible manner.  Thus, the VA needs to benchmark what private hospitals do where staff training and SOP’s are concerned.  Benchmark from the best and the worst hospitals for an average, then implement that average as the standard.  One thing discovered in writing SOPs for the NMVAMC, the committee for approving SOPs, and the process for writing SOPs were so convoluted and time-intensive that the SOP was outdated by the time it could be implemented.  Shame on you VA leadership for creating this environment!
  4. Training should be an extension of an organizational effort and university. The VA is not properly training the next generation of leaders; thus, the problems multiply and exponentially grow from generation to generation.  Launch the VA Learning University concept, staff that university with adult educators, and allow lessons learned from the university to trickle into operational excellence.
  5. Form an independent tiger team in the VA Secretary’s Office who has the authority to travel anywhere in the VA System to conduct investigations with the ability to enact change and demand obeisance. The Nevada incident was a failure of leadership and needs a thorough reporting and cleansing of the bad actors who allowed that situation to occur.  Worse, in my travels, I have heard many similar stories.  I heard of a patient getting their ear chopped off when a veteran assaulted another veteran after becoming irate at waiting times in the VA ER.  I have heard and witnessed multiple incidents of furniture being thrown, employees being assaulted, employees harassing and assaulting patients, staff property trashed, and so much more.  These incidents need direct intervention and investigation by a party not affiliated with that affected VAMC and the leadership’s political policies.

Carl T. Hayden04 October 2016, the VA-OIG released a report on dead veterans after the comprehensive investigation into the Carl T. Hayden VAMC in Phoenix, Arizona.  The same event occurred in 2014, at the same hospital, with the same causes and the same conclusions.  The core causes for the dead veterans, no written procedures, poor to no training, and reprehensible communication practices.  The Phoenix VAMC went out of their way to fire all the employees who reported problems at the Phoenix VAMC before the veterans began dying in 2014, I can only speculate that the same occurred in 2016.  Staff was frightened in 2014; they are demoralized in 2020.  Nothing has changed at the Carl T. Hayden VAMC in Phoenix, Arizona, after two successive hospital directors, if anything the problems have worsened.  The problems worsened because leadership failed to act, failed to write down SOPs, failed to communicate, and failed to train.  The hospital directors since 2014 have been appointed from the same pool of candidates who created dead veterans in the first place, and that is a central failure of the VA Secretary and Congressionally elected representatives’ failure to act!

How many more veterans or staff must die before the VA is willing to act?

© Copyright 2020 – 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 pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Fiscal Insanity is not Fiscal Responsibility – Reports From the VA

I-CareConsider your home finances, you and your significant other are working hard for the paycheck.  Your significant other comes in and reports they have improperly paid the mortgage company, the electric company, the car loan, the gas company, and the credit cards over the last year to the tune of $100,000.  These funds are not recoverable, did not reduce your balances, did not pay ahead, did not apply to your account, and your significant other expects to be praised for improperly paying the bills.  What is your response?

The Department of Veterans Affairs – Office of Inspector General (VA-OIG) released a report on how the Department of Veterans Affairs (VA) remains out of compliance with the Improper Payments Elimination and Recovery Act (2010) for fiscal year (FY) 2019.  The report is replete with the obvious, the VA refuses to be fiscally responsible for American Taxpayer dollars.  Consider the following from the VA-OIG report:

In FY 2019, VA reported improper payment estimates totaling $11.99 billion for 14 programs and activities, $2.74 billion less than the total reported in FY 2018 for 12 programs and activities.

The quote is supposed to be good news, and a major gain, and deserving of applause.  Except, two programs were added between FY 2018 and 2019, thus reducing the overall performance.  The VA-OIG report states something that should be obvious to every household in America, “Improper payments are any payments that should not have been made or were made in an incorrect amount.”  Please keep in mind, the VA is not being tasked with eliminating improper payments, simply following the legislation, and reducing those payments.  The VA has legislatively mandated targets they are “strongly suggested” to meet.

VA did not meet annual reduction targets for a program considered at risk for improper payments and did not report a gross improper payment rate of less than 10 percent for six programs and activities as required. VA satisfied the other four IPERA requirements.”

The VA-OIG inspection for improper payments was not an audit, does not demand full and open books to be reviewed by third-party auditors for accountability of taxpayer dollars, reading the VA-OIG report is simply looks like the VA, including the Veterans Health Administration (VHA), Veterans Benefits Administration (VBA), and the National Cemeteries, self-report compliance estimates for meeting the targets.

Wrapped up in the VA-OIG report is the following gem of bureaucrat complicity.

“… Identified that four programs and activities have been noncompliant for five consecutive fiscal years, and two activities were noncompliant for three years.”

Thus, further reducing the overall adherence to Congressional oversight and fiscal sanity in properly handling the American Taxpayer money.  The VA-OIG reported that the VA is required to submit to Congress plans to come into compliance, and it was considered good news that the VA was able to do this for two high-priority programs with a monetary annual loss of $100 Million; but overall, I have to rate the VA’s ability to self-identify and self-correct fiscal problems at a very low F-.  The audacity of the VA Bureaucrats to not even follow all the VA-OIG recommendations, on such a softball legislative requirement mystifies.  From FY 2018 to FY 2019, the VA refused to comply with a VA-OIG recommendation, and this same recommendation has been carried over into FY 2020 in the hopes that the VA will come into compliance.

Blue Money BurningReturning the original analogy, if your significant other was reporting these failures to comply, how long would that person remain a significant other?  Yet, somehow, we, the American Taxpayer, accepts this type of poor performance from government bureaucrats.  The legislation is not working to improve performance after 10 consecutive fiscal years of trying.  Leading to the following recommendations for immediate Congressional action.

  1. Order a full, open, and transparent audit of the VA.  I don’t care what is found in FY 2019, just perform a complete audit and bring all the books and budgets of the VA into a single source.
  2. Set mandates for compliance with hard deadlines to meet. Without accountability built into a system for improvement, you cannot expect improvement.  Deadlines insist upon compliance.
  3. Start holding actual people accountable for not acting fiscally responsible. The charade has to end, the suggestions for improvement should never have started, and you, the elected Congressional Representatives, are responsible for correcting the fiscal ship of state!
  4. Insist upon adherence through personal liability. If a bureaucrat cannot handle the position they have been hired to hold, they need to be removed.  Not coddled, not protected, not another paycheck!

Congress demands every business in America be held accountable to basic accounting practices; why then does the VA get a pass?

© Copyright 2020 – 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 pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

The Department of Veterans Affairs: The Liars and Thieves Edition

I-CareIn December 2019, I witnessed an employee of the Department of Veterans Affairs, Hospital Administration, create rules to inconvenience a veteran, lie to a veteran, obfuscate, and generally mock a veteran.  The incident included the employee threatening the veteran with throwing away documentation, the primary care provider needed because the veteran was not mailing the forms to the doctor as the employee demanded of the veteran.  The veteran must travel and thought dropping off the forms would be acceptable; until he met this employee.  23 January 2020, I was the veteran being lied to, and my “cherub-like demeanor” evaporated faster than dew in a July sun.  For the December incident, I signed my name to a letter going to the Hospital Director Andrew M. Welch, written by the abused veteran, and testified that I witnessed the treatment this veteran received.  To the best of my knowledge, no action was taken by the hospital leadership where this employee is concerned, I asked.  A copy of this article will be sent to hospital leadership.  If any additional information comes available on this issue, I will write an addendum and update this article.

23 January 2020, 1505-1510, I went to my primary care provider’s clinic at the Albuquerque, New Mexico VA Hospital.  I had another appointment, was early, and went to ask why I am receiving letters claiming the primary care clinic is “having difficulty” contacting me.  The employee is titled “Advanced MSA,” which means they are a Medical Support Assistant who has been promoted.  For my other appointment, I have received two text messages, one automated call, and three appointment emails.  For my next appointment, 24 January 2020, I have received two text messages, one automated call, and three emails.  For my appointment in December 2019, I received two text messages, one automated call, and three emails.  I regularly receive calls from other clinics in the VA Hospital.  My cellphone has voicemail, and the voicemail is regularly checked and responses made.  Yet, the MSA claims, “I have tried calling you, and you do not have voicemail.”  I checked my recent calls, and showed the MSA where I had not received any calls from the VA on the days indicated, and asked why I can receive all these other calls from the VA, including the text messages, but only his calls are not showing up.  The MSA then became intransigent, resolute, and adamant, raised his voice, and told me our conversation was done.  After observing the ways and means of this VA employee over the course of many months previously, I wonder, “how many other veterans are not being contacted in a timely manner, while this person lies, cheats, and steals?”

Quality of FindingsUnfortunately, this is the standard, not the exception for the MSA’s in the HAS (Hospital Administration Services) Department, led by Maritza Pittore, at the Albuquerque VA Hospital.  I have witnessed multiple MSA’s committing HIPAA violations through record diving, gossiping about veteran patients, acting rudely, ignoring veteran patients and their families to complete conversations, and refusing to do their jobs.  As a point of fact, one assistant director one told me, “if what the VA does was replicated by a non-government hospital, they would be closed down and sued.”  While employed from June 2018 thru June 2019, I brought this to the attention of the leadership, including multiple emails and voice conversations with Maritza Pittore, Sonja Brown, and several other high-ranking leaders and their assistants, all to no avail.  I have had nursing staff tell me confidentially that they cannot do anything where the MSA’s are concerned because “it’s none of their business and outside their job duties.”  Yet, the VA continues to proclaim the MSA, the Nurse, and the doctor, along with the patient, are a “healthcare team.”  Upon being discharged, without cause, reason, or justification, I brought this information to the OIG, my congressional and senate representatives, among many others, all to no avail.  The level of customer service, especially at this VA Hospital, is far below the pale because the leadership refuses to engage and set standards for customer service, with enforced penalties. I-CareMore to the point, the employees mimic the customer service they receive from the leadership team.  Thus, even though the Federal VA Office has launched “I-Care” as a customer service improvement initiative, the customer service in this hospital continues to fall and will continue to fail until the leadership exemplifies the standards of customer service expected.

As a dedicated customer service professional, I have offered multiple solutions to the continuing problems veteran patients experience in the Albuquerque VA Hospital at the hands of the MSA’s and other front-line customer-facing staff; but the suggestions all continue to fall upon deaf ears.  I do not paint all the MSA’s and staff as liars, thieves, and cheaters, because there are some great people working at this VA Hospital.  Unfortunately, the rotten apples far exceed the good workers by multiple factors and powers, to the shame of the leadership team who continues to ignore the problem, deleting emails, and generally lying when placed on the spot about the problems.

An example of this occurred recently where a member of the staff of a congressional representative asked about communications sent from an employee to the Director of VISN 18, with carbon copies being sent to Maritza Pittore HAS Director, Ruben Foster MSA Supervisor, and Sonja Brown Associate Director of the Hospital.  None of those emails “magically” exist when asked for, and the verbal conversation included outright lies, misdirection, and complete fallacies.

Since the VA-Office of Inspector General (VA-OIG) continues to appear disinterested, I can only ask, “what does a person do to see action taken to correct the problems, right the abuses, and bring responsibility and accountability to the employees of the Federal Government?”  President Trump is providing great leadership, VA Secretary Wilkie is doing a good job and needs more help, but the elected officials in the House and Senate refuse to do their job, and the middle management of the VA is entrenched, obtuse, and inflexible.  The US Media treats veterans’ issues as a punchline to a bad joke.  Still, the problem worsens; still, the abusers maliciously treat people abhorrently; and still, those placed in leadership positions stall, obfuscate, and hinder.

My treatment at the VA Hospital in Albuquerque includes being physically assaulted by an employee, my medical records perused by, and then gossiped across at least four separate clinics, and still that MSA remains employed.  In fact, this employee was promoted for her “good work and dedication to helping veterans.”  I am sick and tired of the poor treatment, the harassment, and the vindictiveness served to veterans of all types, sizes, and colors, at the hands of petty bureaucrats as they visit the Department of Veterans Affairs.  The Albuquerque VA Hospital is one of the most egregious examples of bad behavior and nepotism in the country and it is past time the leadership was replaced and the assaults and crimes brought into the sunshine for some “sunshine disinfectant.”

cropped-snow-leopard.jpgUpdate to this article, 10 May 2020: By the first week in April 2020, the Advanced MSA in the clinic was moved to a less customer-facing post and a new MSA hired.  The quality of that individual was never experienced due to relocating.  The supervisor of the MSA was not very interested in correcting the problems and that showed when I visited with them while trying to obtain an appointment that the Advanced MSA refused to schedule.  Change must come to the VA!

© 2020 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Uncomfortable Truths – Procedural Breakdown and Leadership Failures

I-CareOn the 5th of August 2019, a VA-OIG report was delivered, but I was unable to comment due to the tragic incident documented in that VA-OIG report.  A veteran died, and while this of itself is troubling, the tragedy was how that veteran died.  Thus, the delay in writing about this veteran’s death and the VA-OIG report.

For the record, I worked at the Albuquerque VA Medical Center from 2018-2019.  From my first day to my last, I asked for, begged, pleaded, and reported that a lack of written procedures opens the VA to avoidable risks.  I was instructed several times by employees who had a minimum of five years in the administration of the hospital, who led the hospital mainly after hours, that writing anything down means responsibility.  But, responsibility is avoided at all costs by the leadership who are keen to keep from losing their power and job if something went wrong.  I countered that written procedures, where training on those procedures is documented, means that responsibility and accountability do not, automatically, result in lost employment, all to no avail.  Thus, the VA Medical Center in Albuquerque operates by gentlemen’s agreements, verbal directives, gossip, and personal opinion.

How is this accountable leadership?  What will it take to change this culture of irresponsibility?

The VA-OIG report documents that a nurse inappropriately labeled the patient as dead and did not commence resuscitation efforts.  Documentation was not completed, appropriate processes and procedures were not followed, and proper training was not conducted.  The crash cart, for a Code Blue emergency, was unlocked and deficient.  The leadership teams and committees did not correctly follow procedures and review the incident.  Reprehensible, detestable, and criminal are just some of the adjectives I have been using on this incident; but, the VA-OIG made nine recommendations.  Why does this not comfort me, comfort the family who lost a loved one, or suggests to America the problem will not be repeated?

I know the written procedure problem exists in the Phoenix Arizona VA Medical Center, the Cheyenne Wyoming VA Medical Center, and the Albuquerque New Mexico VA Medical Centers as I have been a patient of all three.  From the VA-OIG report, I must presume this problem is VA-Medical Center-wide, and I have to ask, why?  The military believes in writing everything down, redundancies, and accountability for records and documentation are taught from day one.  How is the VA able to operate without documentation, written processes, and documented procedures?

A running theme in the VA-OIG reports delivered since I began tracking VA-OIG reports in 2015, continues to be that documents are not properly completed, not maintained correctly, not audited timely and appropriately, or missing entirely.  Missing written procedures detailing how to perform tasks, and leadership were not forthcoming with the written procedures and policies needed to complete the tasks appropriately assigned.  A hospital in the private sector with these problems would be inundated with malpractice lawsuits, Federal inquiries, and threatened with closure; yet, the VA can operate without document controls, written processes and procedures, and escape any consequences, why?

The VA-OIG report detailing the death of a veteran in a behavioral health unit is not the first, nor will it be the last; but it should be!  This veteran’s death should be a clarion call for every hospital director in the Department of Veterans Affairs, Veterans Health Administration, to demand an immediate correction, that leads to written procedures, clearly defined directions, and training in following those procedures — then monitoring those procedures for updates and shelf-life.  This veteran’s death doesn’t even raise the eyebrows or curiosity of the lowest congressional staffer, and that is shameful!

Senators and Congressional Representatives, what are you doing to support Secretary Wilkie and his team in demanding answers and implementing corrective action?  Hospital directors, what are you doing to fix this abhorrent behavior in your hospitals?  Hospital directors, what are your directors, supervisors, and leaders doing to improve performance and follow Secretary Wilkie’s leadership to enhance the VA?  There is no excuse for another dead veteran at the hands of the providers and nursing staff in the VA Health Administration.

America, please join me in mourning another veteran’s passing.

This veteran did not have to die!

 

© 2019 M. Dave Salisbury

All Rights Reserved

The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.