“That’s Crazy!!!” – More Chronicles from the VA Chapter 5

I-CareI had originally planned on writing something else today, but my mental train was derailed, caught on fire, and I had to change my plans.  18 March 2022, I received an email signed from Sonja Brown of the Albuquerque VAMCS, who discussed how it takes 10-20 years for the VA to make a decision about which clinics to close, how to build new clinics, and the possibility of change (not) occurring in the New Mexico VA Medical System.  Doesn’t that warm your heart; two decades is a maximum timeframe for ending unprofitable clinics to save the taxpayer money.  Now multiply this problem by every government agency, and we find the reason for reducing the government bloat!VA 3

Luckily, I still have VA-OIG reports to discuss, not that I got behind, but February and March have been especially prolific.  In January, the pace set appears to be sustained, at least for the first quarter of 2022.  Some have commented that I do not write very often about the National Cemetery side of the VA’s voluminous bureaucracy.  Your wish is granted; a whistleblower reported that the Houston National Cemetery was not being operated properly.  The VA-OIG substantiated “some of the claims made by the whistleblower.”  However, the leadership at the Houston National Cemetery had, for the most part, already begun making changes before the VA-OIG arrived.

Thus, I congratulate the Houston National Cemetery leadership for being almost proactive and 100% more responsible than any leadership in the VHA and VBA.  My heartiest gratitude to you and your staff.  May you continue to show initiative, forward-thinking, and attention to detail, and may the rest of the VA’s hegemonically impotent leaders learn from your example.VA 3

A Comprehensive Healthcare Inspection (CHIP) was conducted at the James J. Peters VAMC in the Bronx, NY.  While a lot of the report is cookie-cutter, similar to all the other CHIPs that cross my inbox, I remain fascinated with a frequently used term from the report, “Servant Leadership.”  From the website linked, we find the following to define “servant leadership” at the VA:

We are all leaders, all of the time.
Servant Leadership is an approach for optimizing the delivery of client-centered services by strengthening employees to be an engaged and empowered workforce.  The philosophy and practice of Servant Leadership is one that emphasizes caring, authenticity, and putting clients and employees first, and ahead of personal goals or leadership aspirations.  Servant Leaders strive to meet both organizational objectives and the growth / development of their workforce.”

Please note ALL the grammar and punctuation errors are included in that quote.  Far be it for me to pass along any advice on grammar, spelling, punctuation, and proper communication techniques.  But, even this quoted material reflects the fact that there is a Grand Canyon-like chasm between DC leadership and the worm’s eye-view in a VA Hospital, VBA operations center, or the National Cemetery.  Be a leader at the VA, and you will NOT last your probationary period after hire; I have experienced this personally!VA 3

Worse, try and help the VA from the worm’s eye to see the problems and fix the issues, and the VA Leadership will chop you into little tiny pieces and feed your carcass to the fishes.  Yet, every single CHIP report mentions problems with “servant leadership” as opportunities for growth and development.  More bureaucratese for designed incompetence as an excuse, the VA-OIG will believe.  How sick to death I am of these shenanigans!  Don’t believe me; check out the full CHIP report, it’s linked above, read a few of the other CHIP reports from the VA-OIG, and discuss the actual problems you think the VA is experiencing.

Servant Leadership is officially defined, by Purdue University, quoting Robert Greenleaf from 1970, as:

The servant-leader is servant first.  It begins with the natural feeling that one wants to serve first … a philosophy and set of practices that [enrich] the lives of individuals, builds better organizations and ultimately creates a more just and caring world.”

Notice a problem between the two definitions of servant leadership?  Recognize an issue yet with the entire concept of servant-leadership?  Let me give you a hint through a question, What does a “just and caring world” really define?  The whole concept of servant leadership is easily twisted, plasticized, and framed in a way that removes liberty, destroys justice, and wrecks havoc on a free society, all because the philosophy sounds good, but the practice leaves chaos and destruction in the name of creating a more just and caring world.Servant Leadership and Health Care: Critical Partners in Changing Times

I am not condemning anyone who wants to try and improve their leadership skills through learning servant leadership or applying some of the servant leadership philosophies in their leadership toolbox.  I am merely stating that care and caution should be used when trying to reshape the world on such ambiguous and amorphous terms as “just and caring.”  The VA is trying to force a leadership template for all leaders to follow.  This type of leadership philosophy warps the world and makes leaders into managers with excuses for failure, e.g., designed incompetence.

On a different topic, please read the following carefully:

The VA Office of Inspector General (VA-OIG) reviews nonpharmaceutical proposals submitted to the VA National Acquisition Center (NAC) for Federal Supply Schedule (FSS) contracts valued annually at $10 million or more for high tech medical equipment, $3 million or more for all other FSS contracts, $100,000 or more based on manufacturer sales under dealers or resellers, or as requested by the NAC.”

Here is why the above is critical:

The VA-OIG determined commercial disclosures were accurate, complete, and current for only 24 of the 103 proposals reviewed.  This means 24 proposals were reliable for determining negotiation objectives and fair and reasonable pricing.  The remaining 79 could not reliably be used for negotiations until the noted deficiencies were corrected.  The OIG recommended lower prices than offered for 76 proposals.

If you, in your employment, had a 23% accuracy rate, and someone else had to come behind you, redoing all of your work, how long would you last in your job?  Note there are still 3 proposals that do not meet regulations and requirements out of 103 contract reviews.  Read the rest of this incredible report for yourself and know what your elected representatives are failing to curtail and control.  Then answer the following question: “Why should we re-elect ANY of the current elected officials?”VA 3

On the topic of designed incompetence of an almost criminal nature, we find the VBA still making headlines and breaking rules of ethics, morals, and logic with aplomb!  Before getting into the VA-OIG report, it is crucial to note that the VBA has exclusively gone to a third-party model for Compensation and Pension exams.  The most important part of the VBA’s operations, the comp and pen exam, is now conducted solely by third-party contracts companies.  A VA doctor sees a person trying to get their benefits from the VBA no longer but a third-party physician’s assistant at best, who is (supposedly) overseen by a medical doctor.  The lack of transparency and the complicated processes of the VBA are gordian, and transparency is hidden; read that as missing entirely.You know it's true - Imgflip

Here comes the VA-OIG, not to the rescue, but to rub salt into the wounds of veterans whose claims continue to be denied for lack of evidence.

“[The] VBA complied with the requirements of the law by reinstating 69 questionnaires on its public-facing website.  However, disability benefits questionnaires that were incomplete, inaccurate, or of questionable authenticity from non-VA medical providers were not always processed correctly when determining benefits entitlement—causing underpayments of about $13,900 and overpayments of $74,800 over the nine months studied.

Improper processing occurred because VBA lacked sufficient controls to ensure disability benefits questionnaires from non-VA medical providers were properly relied on when determining entitlement to benefits.”

Let’s let this sink in for a moment.  The VBA moved to a third-party model, then denied access to the VBA’s questionnaires to determine benefits, then had to be forced to reinstate the questionnaires.  Improper VBA processes and procedures led to over and underpayments of benefits, and claims processors still do not have the tools to make informed and logical decisions reliably.  Best of all, veracity (questionable authenticity) remains questioned in the process when the third-party contractor submits the forms for benefits.VA 3

You cannot make this stuff up; fiction writers can come nowhere close to creating a story this inane!  Is designed incompetence as a concept clear now?  The VBA developed a process using a more expensive model and then questioned the inputs for veracity from the contracted party, and the veteran suffered more!  Do you think the VBA intentionally designs its processes to help and create a more just and caring world (servant leadership)?  I think the VBA intentionally designed their processes to screw veterans in the hope they die before the government ever pays money on their claims.  Let me know what you think in the comment section, for this is a travesty of justice anyway I slice the data.

As a veteran who has been trying to get a compensation and pension decision corrected since leaving the service in 2004, having suffered both overpayments, which I had to repay, underpayments, and erroneous overpayments where the funds paid were (eventually) refunded, the news from the VBA designed incompetence is a particular form of hell for me to read and discuss.  I have had the third-party comp and pen exam doctors refuse to see me three times in the last two years.  Delaying a VBA decision repeatedly.  I have had the VBA reject the third-party data and a new comp and pen exam scheduled, rescheduled because I cannot wear a mask, and then conducted by a hostile and infuriating provider who refused to listen to the patient.Are you an Incompetent Developer? - Web Development & Web Design Blog

When veterans talk about fighting the VBA for a fair and honest decision, they mean a literal fight!  Don’t take my word for it; ask veterans how their comp and pen exam has gone; when you find those struggling with the VBA, listen carefully to their stories, and you will hear very similar stories.  The VBA represents government inefficiency, designed incompetence, and bureaucratic inertia to the Nth degree!

The following link might, or might not, work as intended; the link directs you to all testimony recorded from congressional hearings.  If it works, you will be able to read the statement of David Case, Deputy IG, who was testifying before the HVAC subcommittee on drafted legislation “Quality Education for Veterans Act of 2022”.  A brief synopsis from his testimony is included below:

This bill would significantly strengthen the OIG’s efforts to prevent fraud in VA’s education and training programs.  Given that more than $10 billion in taxpayer funds is expended on education and training programs each year and hundreds of thousands of veterans, service members, and family members receive these benefits, the OIG supports efforts to strengthen programmatic and beneficiary protections.  The statutory changes in the draft bill do not appear to be burdensome or costly to educational institutions or VA, and yet they have the potential to make a significant impact on the amount of education fraud that occurs.  The OIG agrees that these changes would work to lessen the harm suffered by veterans and beneficiaries and reduce losses to the government.”

Ever wonder how much a VA-OIG inspection costs or where and how the VA-OIG is funded; here is the answer and the problem.  Tell me, why is the VA-OIG not financed from the VA budget?  Simple question, not hard, and requires an explanation!  The explanation should be detailed, transparent, and I guarantee that the answer will reflect the designed incompetence and failure to scrutinize the executive branch adequately.  The VA is one of the few, if not the only, Federal Government Agency with a specialized inspectorate general, dedicated solely to independent oversight and continuous improvement of the VA.  I think the VA-OIG might be failing in its mission.VA 3

Fraud is rampant in the VA because the VA refuses to act, work, change, and improve.  How will throwing more money at VA programs alleviate the hurt, stop the fraud, and spur continuous improvement?  Almost every week, my inbox fills with accounts of fraud occurring, but the roots of the problems are never addressed, and people are not held accountable for failing to perform the work they were hired to complete.  Failing to hold people responsible promotes fraud, waste, and abuse.  Allowing whistleblowers to be fired promotes a discouraged whistleblowing culture, and the perpetrators are allowed to continue their nefarious misdeeds!  How is the VA-OIG going to tackle these systemic issues in the culture at the VA?  When will continuous improvement begin; I do not want to miss growth and development!

Knowledge Check!America, the VA is sick.  A symptom not a disease; the larger disease is a refusal to act morally upright.  The majority of those employed in the behemoth of government service have little to no moral compunction, are not servants of the taxpayer, and consider themselves “Too BIG to fail.”  We need a smaller government, and I hope this message helps enlighten and support shrinking the government!

© 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.