It IS ALL About Leadership – More Shameful VA Chronicles

I-CareRecently, guardianships have been in the news, and I doubt this story will make the lawyers very happy.  The department of Veterans Affairs – Office of Inspector General (VA-OIG) reports that an Albuquerque couple has been sentenced for defrauding guardians, which included veterans.  The criminal report claims:

Susan Harris acted as president and was the 95-percent owner of Ayudando, while Moore acted as chief financial officer and was a five-percent owner. They engaged in a pattern of criminal conduct from November 2006 to July 2017 that included unlawfully transferring money from client accounts to a comingled account without any client-based justification.  They wrote and endorsed numerous checks, often of more than $10,000, from these comingled accounts to themselves, family members, cash, and other parties where payment would benefit their families.”

For the better part of 11 years, this couple has spent money not their own, abused their charges, and defrauded vulnerable clientele.  While the federal attorneys and investigators crow about catching this couple and ending this situation; what about all the rest of the guardianships where abuse is occurring?  I have read horrific stories about victims of guardianship abuse and hope more will be done on this topic very shortly!VA 3

For 11 years, where were the VA and the Social Security Administration?  Where were the local hospital leadership, social workers, and other federal employees who had to have known something fishy was going on?  Where are these Federal Employees now?  Where are the politicians scrutinizing this incident to ensure that protection for vulnerable citizens never happens again through legal guardianships?

Now traveling to Eastern Oklahoma VAHCS in Muskogee where an audiologist provided poor care and billed for unrendered services.  Pay close attention to the VA-OIG report; the leadership failures on this report alone are voluminous and unforgivable!

A facility fact-finding review revealed the audiologist provided poor care to eight of 43 patients reviewed, including misinforming patients who needed hearing aids that hearing aids were not needed. Although the audiology leaders reported the fact-finding results to the OIG, they failed to evaluate whether patients needed clinical follow-up; determine whether additional patients were affected by the audiologist’s poor care; evaluate whether clinical disclosures were required for the affected patients; and communicate the fact-finding results to the Facility Director, who was, therefore, unable to initiate the process to determine the necessity of a large scale disclosure. The instances of poor care were also not reported to the Patient Safety Manager, who was, as a result, unable to assess the adverse events to determine if patient safety interventions were indicated. The VA-OIG also found that performance monitoring of facility audiologists was not conducted as required. Annual competency assessments and annual performance appraisals were not consistently completed and did not contain adequate performance standards. Audiology leaders failed to consider whether the audiologist’s actions warranted a report to the state licensing board due to a lack of understanding of the requirements for reporting and, therefore, the Facility Director was not informed of the need to initiate a state licensing board review” [emphasis mine].

Will, someone please tell me, were the audiology leaders who failed to perform their jobs removed from Federal Employment?  What about the audiologists causing the problems?  Are they removed from Federal Employment?  Were their licensing practices curbed to protect other populations of patients?  The leadership failures here read like a Steven King horror story but do not have the satisfaction of finishing the story.VA 3

Yet, the Department of Veteran Affairs (VA) will continue to market that they are “defining quality in healthcare.”  The jokes write themselves but cannot be fired from Federal Employment!  Politicians, why can these jokers not be fired from Federal employment for such egregious abuse of their positions and failures to do their jobs?

I-CareTraveling further to North Carolina, we find that the perpetrator of this fraud has pled guilty, but again responsibility, accountability, and correction of the VA is being skirted.

John Paul Cook, 57, of Alexander, North Carolina, pleaded guilty to defrauding the VA. After enlisting in the Army in 1985, Cook sustained an accidental injury and complained the injury worsened a preexisting eye condition. In 1987, Cook was discharged, and he began receiving benefits that would increase over the next 30 years due to Cook’s repeated false claims of increased visual impairment and unemployability. In 2005, the VA declared Cook legally blind, and he began receiving disability-based compensation at the maximum rate despite repeatedly passing vision screening tests to obtain or renew his driver’s license and purchasing vehicles that he routinely drove.”

1987 to 2020, we will be generous in counting the years here; regardless, we are looking at 30+ years this fraud continued.  Where were the verification protocols?  I have had to produce a valid driver’s license at the VA to obtain and keep current my VA identification card.  How did this fraud go on for so long?  What is the VA doing to stop, or at least hinder, those who would defraud the government before the problem becomes 10 years old, let alone 30?!?!  I cannot fathom how this fraud went on for so long without a routine checkup, a routine exam, a follow-up exam, etc.VA 3

Going north from South Carolina, we find more fraud, this time in New Jersey, where a man did not report his mother had deceased and continued to claim her benefits for a total of over $200K.

Melvin Greenspan, 72, of Perrineville, New Jersey, pleaded guilty to defrauding VA of over $200,000 in survivor’s pension benefits. After the death of his mother in 2006, who had received survivor’s pension due to his father’s prior military service, Greenspan failed to notify the VA about his mother’s death and made withdrawals of the benefits through 2018.”

Where was the leadership?  Where are the leaders now?  Another fraud case, older than a decade, and still the VA cannot be held accountable for facilitating the fraud.  I am stunned!  How did this one continue for so long?  Doesn’t the VA check local newspapers, the Social Security Administration, other Federal Agencies?  Since the culprit was not held on defrauding SSA, one can only presume the mother’s death was reported there.  Why did the VA not get notified to ask the family questions?VA 3

On the topic of guardians and leadership, the following story makes me angry!  However, I will withhold further elaboration since those accused remain innocent until proven guilty by a trial of their peers.

Johnny Ray Gasca, 51, was arrested for allegedly abducting a 68-year-old woman with dementia from the West Los Angeles VA Medical Center in California. A witness recognized Gasca and reported he might have previously taken money from the woman’s bank and retirement accounts. Following his arrest, Gasca described the victim as his girlfriend and told agents that they stopped at a bank where the victim made a $15,000 withdrawal after leaving the medical center.”

In the first report from the VA-OIG discussed, we found guardianship rules being violated to the Nth degree.  In this story, we have no information of an assigned guardian, and we have a dementia patient being abused.  The dementia patient was traveling with a friend; who is the legal guardian for a dementia patient?  Where are the family or friends legally bonded to render aid for this patient and monitor finances to protect them from abuse?  How can the VA operate one way in one locale and 180-degrees differently in another locale and the leadership not held accountable?VA 3

Speaking of missing leadership, the following VA-OIG report is a beauty!  The Department of Veterans Affairs – Veterans Health Administration (VHA) has a program to help homeless veterans, where contractors are used, and the VHA uses case management documentation to verify the veteran is receiving the assistance being paid for, the program is called the contracted residential services (CRS) program.

The VA-OIG found facility staff did not consistently document case management and monitor the progress of veterans in the program.  Further, four of the 14 CRS contracts reviewed had performance deficiencies, with one resulting in improper payments of $592,000. These deficiencies may affect the health and safety of veterans living in transitional settings. Moreover, VA lacks assurance that veterans received required services. There were also contract administration problems in 13 of 14 reviewed contracts. Contracting officers did not always properly delegate responsibilities to staff functioning as contracting officer’s representatives. Further, one facility’s representative did not ensure contractors provided meals or the means to purchase them, as required, and another lacked invoice supporting documentation for approval. The VA-OIG audit team estimated that 107 of 119 contracts had monitoring and administration deficiencies. Furthermore, the team estimated that VHA made $35.3 million in improper payments, of which approximately $21.6 million was technically improper because the individuals authorizing payment were not delegated authority to serve as contracting officer’s representatives.”

If your accomplishment rate in your employment was 48%, would you retain your job for very long?  If 90% of your documentation claiming how well you do your job was missing or fabricated, how long would you maintain employment?  If you delegated people to complete your work who were unauthorized and you were contractually culpable, how long do you think you would stay out of prison?  How long would your boss stay out of jail?  How long would your company exist?  Now, answer me this riddler, why does the government get a pass on these questions?VA 3

Finally, we have Deputy Inspector General David Case’s testimony regarding the failure of VA leadership where the implementation of a new electronic health record (EHR) is being stalled.  If you care, the VA leadership and the VHA leadership are failing the EHR initiative.  Not that this was not expected, and not that this is not surprising, the IT and IS departments of the VA and VHA are so hopelessly lost it amazes me the VA is even using computers and not written records!  But, do not take my word for it, Case himself claims,

“Detailed in this statement, we have repeatedly found unreliable and incomplete estimates for upgrades and costs, inadequate reporting affecting transparency to Congress, and stove-piped governance with decision making that does not appropriately engage Veterans Health Administration (VHA) personnel who are the end-users of the new EHR system.”VA 3

Knowledge Check!Get that; the leadership failures are obstructing Congress and hindering the EHR progress!  What can we conclude from this batch of VA-OIG reports:

        1. The VA, VHA, VBA, and National Cemetery leadership are actively missing, like the Democrats from the Texas Legislature.
        2. If the leaders are present, the leaders are the problems in progressing.
        3. The leaders have created a system where fraud and abuse of the veterans and taxpayers can be achieved with ease.
        4. Nobody in the US House of Representatives or US Senate scrutinizes the legislative branch sufficiently to effect changes.
        5. When in doubt about where your leaders fall, check to see if they are in their offices. Oh, wait, that won’t help, their offices have locks on the doors!

If this is how the VA defines quality healthcare. In that case, the veterans are screwed, the taxpayer is sunk, and the leaders will enjoy their magnanimous federally approved retirement packages, ad nauseam ad infinitum!

© 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.

 

Whiskey-Tango-Foxtrot: The Illinois Edition

Exclamation MarkThe story is linked in case you missed the news on 09 July 2021; Illinois has become the first state in AMERICA to mandate ASIAN History be taught in K-12 education.  Let that sink in for a moment.  AMERICAN History has been abused, twisted, contorted, and NOT taught in AMERICAN schools in ANY of the 50-US States.  But Illinois wants students to learn Asian History.  Whiskey-Tango-Foxtrot Illinois!

What is the reported reasoning for this move?

According to a statement from Governor JB Pritzker, the reason for this move is as follows:

With the recent rise in acts of violence and bigotry against the Asian American community, teaching students about the rich culture and important contributions of the Asian American community throughout history will help combat false stereotypes” [emphasis mine].

For your information, the legislation is called the “Teaching Equitable Asian American History Act,” and the special interest group pushing this legislative nightmare is Asian Americans Advancing Justice-Chicago.  The website includes a Los Angeles branch, the Asian Law Caucus, AAJC, and an Atlanta branch.  Another special interest group involved in this legislation is PAVE (Pan Asian Voter Empowerment). My first question about this legislation comes from the name, “What is equitable Asian American History, especially when American History is not being taught?”Lemmings 5

What is in the curriculum?

The curriculum declares it is compliant with Common Core standards, which doesn’t mean anything as teaching masturbation to first graders is compliant with Common Core Standards.  However, PBS Learning media has a website dedicated to the curriculum plan for teaching Asian American History, even though the curriculum does not describe “equitable.”  PBS Learning media claims to be “pleased to present over 30-lesson plans based on a fiver hour documentary Asian Americans in American History.  While the Illinois legislation claims that K-12 will begin learning about Asian History, the reality on the PBS Learning media is that the published lesson plans only go from third grade to twelfth grade.  Leading to my next question, “Where is this push for historical teaching coming from?”

Plato 2I have not viewed the series; I have barely scraped the surface of the curriculum offered.  What I have seen of the curriculum worries me.  I call it “whitewashing” history, to glance over the actions of one group to reflect how other groups were treated, with the intent of stirring the racial divides and creating more chasms based on race alone.  What I see in this curriculum does nothing to “ … teach students about the rich culture and important contributions of the Asian American community throughout history” or to “combat false stereotypes.”  I ran a search engine using the string, “Violent migrant worker strikes, involving Asian people,” and the first item on the list returned originates with the Seattle Civil Rights & Labor History Project, sponsored by the University of Washington.

The context, labor union organizing, which everyone should know, includes the growth and development of Marxist ideology in America.  How did the labor unions create a space for themselves?  They drove wedges between groups of people based solely upon race, creating contention, becoming violent, and hiding behind equity and fairness to escape responsibility and accountability for laws they sundered.

Let me be clear!

Knowledge Check!Let me be clear; every group across the skin color spectrum has historically had problems in American society.  Any time race separates, chaos, confusion, and violence are bred!  I am proud that America has grown out of oppressing people based on the color of their skin and do not judge American history as racist just because historically, people acted out of fear when treating their fellow men fairly.  History is full of people who made terrible choices, and teaching that these choices were poorly made is important, but race, religion, handicap, etc., should NOT be the focus on the content in history.  The focus of history should be on what grew out of specific actions in specific epochs of time.

America IS better for the Civil War, even though the US Government continues to hinder economically and is biased against the states that formed the Confederate States.  A dumb historical decision that has kept many states from achieving greatness is due to President Lincoln’s death and the hostility in the US House of Representatives, the US Senate, and President Andrew Johnson.  All of whom believed that the Confederate States needed to be mightily punished.  In contrast, President Lincoln was pushing for national forgiveness.  Thus, we need to focus on the events, not the race, color, lines of separation and division, but on the outcomes and the fruits from those decisions when teaching history!The Duty of Americans

State’s Rights

I affirm in clear language that a state has the right to set the curriculum of government-mandated schools.  I support state’s rights to the fullest and would see each state prepare their students to meet the world and win!  Paradoxically, I also affirm in language clear that this legislation will do NOTHING to “combat false stereotypes” but will only increase racial division and disharmony in Illinois and any other state who refuses to learn the lessons from history.

History and Racial Focus

Content of their CharacterThink about this quote for a moment, who are the biggest race hustlers in America?  History has taught that when race is the only concern worth knowing people care only about race, to their demise.  Focusing on race is the sole reason why I have questioned, and continue to question, the validity of the arguments for National “Name your Favorite Minority” Month celebrations.  There are absolutes in this world; focusing solely upon race as a choice, will breed racial tensions as a consequence, is an absolute.  Recent history under President Obama reflected this exact issue to the Nth degree, yet nobody wants to have that discussion.  Why; because of race!

Bob MarleyWhen your focus is solely upon an individual’s race, race will be the only thing learned, the only lesson absorbed, and the fruit of that lesson are bitter.  Have people from various races achieved great things; absolutely, but why should their achievements be diminished by focusing solely upon their race?  Why should their achievements only be mentioned during “Name your Favorite Minority” monthly celebrations?  Has the 1960s taught us nothing about the character, knowledge, talents, curious minds, and the work performed where race was NEVER an issue?  I have books galore in my home; I continue to collect books about famous people of great accomplishment; I have never cared a whit about that person’s sex or gender.  Why; because their sex and gender, race, skin color, religion, handicap, or heritage have never been a factor.  As a kid, a thrill ran through me when I read the preamble to the US Declaration of Independence:

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness [emphasis mine].

Even today, these words continue to guide me.  Show me; where in the Declaration of Independence does it discuss sex, race, heritage, religion, handicap, etc.?  NOWHERE!  A lesson America needs to relearn if she is to survive.  What hinders the pursuit of happiness, capturing inalienable rights, and stops liberty; focusing upon that which divides instead of that which unites!

PatriotismFrom the National Archives website, we find the following regarding the Declaration of Independence:

The Declaration of Independence states the principles on which our government, and our identity as Americans, are based. Unlike the other founding documents, the Declaration of Independence is not legally binding, but it is powerful. Abraham Lincoln called it “a rebuke and a stumbling-block to tyranny and oppression.” It continues to inspire people around the world to fight for freedom and equality” [emphasis in original].

Think about this for a moment.  The American Identity, the bedrock principles upon which America was built, the power cell for liberty and freedom across the world, begins with a simple truth:

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness [emphasis mine].Image - John Wayne Quote

A document that is not legally binding holds power to inspire actions that unite people, provided our focus is not on those things which separate us.  Cementing the lesson discussed herein, focus on race and racial division is the only lesson learned, and the resulting fruit is bitter, chaos ensues, and problems abound in violence.  Why have we not learned these lessons from the 1960s, the Watt’s Riots, the death toll in Chicago that makes war zones safer than the streets of Chicago; the focus is on race, not the potential.  The focus is on the sex, the invented genders, the handicaps, the religions, the heritages, etc., not on what is essential, character and potential, freedom, liberty, and equality under the law.

Knowledge Check!We need to get back to teaching history, where the focus is on how the decisions and actions from the past hinder or help the present so that the future can be better.  Failing that, we desperately need to cease focusing upon race, gender, sex, religion, handicap, and heritage as these things only matter to the individual and not to historical records.  Failing that, America fails, and the light of liberty and freedom will be lost to the annals of history forever.  So, gather the fruit you choose, focus on race if you prefer, focus on gender, sex, handicap, veterans status, and every other line of separation.  Your fruit gathered will be most bitter indeed, for you will miss the rich tapestry of human interaction, for the dirt caught in the fabric.

Powering my third and final question to the legislative and executive branches of Illinois, “Knowing all this, why are you focused on race and forcing students to focus solely upon race?”

© 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.

Absurdity so Repugnant it Takes Your Breath Away – More VA Chronicles

Angry Grizzly BearThe Department of Veterans Affairs – Office of Inspector General (VA-OIG)-released six investigation reports in the last two days.  Each one is mentally breathtaking at the egregious behavior of bureaucrats!  Stupidity that is so repugnant it breaches the laws of morality and leaves the reader stupefied.  Every year, for the last decade-plus, the behavior of the Department of Veterans Affairs (VA) has become more obscene, more outlandish, more detestable, and more openly hostile towards veterans; it sickens me to read the investigation reports, write, and catalog these abuses!

Beginning in Queen’s, New York, we find another dead veteran that should never have died the way they did.  Improper feeding by a registered nurse (RN) at the New York Harbor Health Care System’s Community Living Center (CLC) contributed to the death of a patient.  Let that sink in for a moment, for the rest of the report only goes downhill from this point.  My time in medical training was replete with the following aphorism, “If it is not written down, it NEVER happened.”  The nursing staff failed to document meals properly. The electronic health record (EHR) was inaccurate and flawed, hindering resuscitation, which was poorly documented, and institutional disclosure acted more like CYA than a medical file.  People should have been fired and up on trial for this type of scandalous behavior, especially since a veteran died from this abuse and neglect.  But the VA-OIG made their recommendations, the leadership accepted the recommendations, and nothing else will happen.  Nobody but the family cares the veteran died needlessly and at the hands of the medical professionals.VA 3

Adjectives elude me.  The behavior in Queen’s is appalling, even for the VA.  Unfortunately, the list of ineptitude only gets worse!

VA SealNext, we travel to Austin, Texas, and discover yet another office of information technology (OIT) failing to work, secure data correctly, and protect veterans’ information, as demanded by legislation!  The VA-OIG and the local OIT used the same tools, and the local OIT only identified 150 problems, whereas the VA-OIG OIT inspectors found 246.  Improper sanitization of media was a pronounced issue, where patient load is upward of 300,000 annually.  Inventory practices were noticeable and apparent.  Worse, patch and vulnerability programs were practically non-existent if I understand this report correctly.VA 3

If you have read any of these VA Chronicles, you will know that the VA has not passed a Federal Information Security Modernization Act (FISMA) audit, ever!  The head of IT was recently in front of Congress to testify why, and the explanations were milk toast adequate at best!  But, the elected officials bought the excuse, hook, line, and sinker, as always, and the president wants to spend more money on the VA.  What a cathartic example of why elections matter!

Next, we travel to Detroit, Michigan, where a “comprehensive healthcare inspection (CHIp)” was performed at the John D. Dingell VAMC.  Before I even read the report, I knew it would say; opportunities exist to improve employee and patient experience.  Knowing veterans who are “served” at this VAMC, this was an obvious guess!  Again, we find “moral distress” in the workforce, signifying that the employees feel pressured to do everything but what is ethical, legal, moral, and appropriate for the patient at this VAMC.  Yet, the leadership team was rated as stable and doing a good job!  Quoting Colonel Potter from M*A*S*H here, “HORSE HOCKEY!”VA 3

I will be explicitly clear if a single employee feels “moral distress,” there is a leadership problem, and the leadership is criminally negligent in their duties to oversee staff leaders, supervisors, team leads, and training personnel!  This is not the first time “moral distress” was a point of discussion in a CHIp; but, the fact that this problem remains widespread and apparent does mean the problems are originating at a level higher than the VISN, and all the VA and VHA leadership should be losing their jobs!  Enough is enough, and the elected officials need to be scrutinizing the government before they lose their next election!

Survived the VAHaving been an employee of the Department of Veterans Affairs, working in the Emergency Department of the Albuquerque, NM., VAMC, this next story is exceptionally aggravating and extremely distressing.  The VA-OIG determined that the entire Veterans Health Administration (VHA) needs to better monitor, record, and document the timeliness of care and patient flow in the emergency department.  Having waited for more than 14 hours in a VA Emergency Department while waiting for care, I know first hand the problems of the Emergency Departments, and I know a lot of the reasons why the documentation is fouled and the flow of patients is amateurish, at best!

Raymmond G. MurphyI worked the shift where a regular, homeless veteran, wheelchair-bound, had fallen and broken his leg.  He waited with his broken leg swelling, stuck at an odd angle, and in obvious distress for more than 6-hours because the head nurse that day had a personal grudge against the veteran!  I saw how the charts were “adjusted” for timeliness of care, and I reported the problems up the chain to no avail!  I had witnessed nurses harangue patients, gossip about them, chart surf in violation of HIPAA, and never was anything done by leadership when it was reported.  A patient sat in an expedited treatment room for four hours, listening to the nurse’s gossip and joke, awaiting stitches for a bleeding wound, and never was treated.  All because the day shift was getting off and didn’t want to be bothered to treat the patient.  The patient’s family reported this behavior to me as they were leaving for a better hospital.  I reported the whole incident, included the family’s description, added my observations.  The leadership shook the whole incident off as a disgruntled employee (blaming me) making a less than desirable situation worse.VA 3

Thus, when I read this particular VA-OIG report about the inadequacies of the VA Emergency Departments across the entire VHA, it infuriates me into a mindless stupor!  Want more data on the failures of the VA Emergency Department; read the rest of the VA Chronicles.  I describe my experiences in detail and have logged other veterans who have had the same or worse problems at the VA Emergency Department!  I have witnessed doctors treat patients in a dissimilar manner based upon the political clothing the veterans wore into the Emergency Department!  So, no, I am not surprised at the record inadequacies of the VHA; if anything, I expect the problem is a lot worse than the VA-OIG was willing to report!VA 3

The VA-OIG collected data on an issue of grave significance from 58 VHA outpatient clinics’ regarding emergency preparedness for the delivery of telemental health care as of November 1, 2019. The review focused on clinic-specific emergency procedures, emergency procedure roles and responsibilities, emergency contact information of staff, and patient safety reporting methods.  Not included in the scope of the review was the quality and quantity of telehealth appointments.  I mention this oversight as the technical problems in receiving telehealth appointments are sub-par, at best, which would have seriously skewed the data.

The VA-OIG sent out 333 questionnaires, receiving a total of 187 responses, from the 58 identified clinics, and identified the following:

      1. Missing telehealth emergency plans and procedures.
      2. Emergency procedures are not specific to telehealthcare or the patient-clinic location.
      3. Lack of a process for annual updates to telehealth emergency procedures.
      4. Undefined emergency procedure roles and responsibilities for telehealth staff
      5. Missing or insufficient emergency contact information.
      6. Lack of a process to verify and communicate emergency contact information
      7. Lack of a consistent process to designate the telehealth setting in patient safety reporting methods.VA 3

Consider for a moment; you are a family member of a veteran needing telehealth mental support.  Now, how do you feel to know there are no written processes or procedures to support the telehealth provider if your family member gets into a mental health emergency.  Time is critical in mental health emergencies; I know this from personal experience as both a provider and a patient, and for these plans, procedures, and processes to be missing is the height of malpractice!  Would someone please tell me why elected officials and the media are not screaming mad at this particular report?  Especially since the proposed budget from the president wants to double suicide prevention spending at the VA.  I read this report and see that the VA-OIG made five recommendations.  Are you freaking kidding me?!?!?

Finally, we go to Hawaii and confront the most detestable, outside of the dead veteran, issue possible, failure of the National Cemeteries Administration (NCA) to properly care for the remains of veterans, qualified spouses, and dependents.  The NCA awards grants to states to build cemeteries where a veteran, qualifying spouse, and dependents can be laid to rest outside a national cemetery.  From the VA-OIG report, we find the following, emphasis mine:

Grants may be used to establish, expand, or improve veterans cemeteries. The VA-OIG audited the program to assess NCA’s governance and oversight. The audit team also assessed whether critical non-compliance issues at two cemeteries in Hawaii were addressed. The VA-OIG found grants program staff did not rank and award some cemetery grants as regulations required. After grants were awarded, program staff generally ensured cemeteries used grants for their intended purpose. However, NCA did not ensure cemeteries with grants met all national shrine standards for installing permanent markers, maintenance, and safety. The audit team observed non-compliance issues at eight state cemeteries, including critical issues in Hawaii’s Hilo and Makawao cemeteries. As a result, NCA lacks assurance that veterans and family members buried in state veterans cemeteries have been appropriately honored with timely and accurate grave markings, burial locations, and maintenance.VA 3

NCA, you have one job, ensure the remains of veterans and qualifying spouses and dependents are adequately remembered, safely entombed, and marked appropriately.  Yet, you fail at even this simple and easy job; how utterly disgraceful, disgusting, and detestable!  How many cemeteries in the Philippines are being adequately cared for?  At the last report, none of them were adequately maintained and respected.  Even here in the US, you refuse to do your jobs with competency, dignity, and professional pride.

Knowledge Check!The VA is one sick organization, where the mission is being denied, the veterans abused before and after death, and none of the elected representatives can find enough time in their day to even offer a mild rebuke or maintain sufficient interest to scrutinize.  America, we have gotten better as a culture in remembering and honoring those who serve and have served, and I, for one, am very grateful for your change of heart.  We, the voting citizens of America, need to demand the same culture change from the politicians representing us!  As a country, we have come a long way since Vietnam in honoring the military.  But those same people who spat and urinated on our troops in Vietnam are now in the Halls of Congress, and their attitudes have not changed in the interim!

© 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.

Audemus Jura Nostra Defendere – Revisiting a Principle!

Angry Grizzly BearAlabama’s state motto has been used previously to discuss maintaining and defending our inalienable rights as provided by the deity and ensconced into law.  Well, after the week America has had, it is time to revisit this principle and ask for your assistance in raising our voices in defense of American Law.

Audemus Jura Nostra Defendere” – “We dare to defend our rights,” also translated as “We Dare to Maintain our Rights.”

The second sentence of The Declaration of Independence is long but influential and partially quoted below emphasis mine:

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”

You have a right to life, and yet the government, bureaucrats, and organizational leaders are trying to do precisely this, take your life, steal your right to pursue happiness with or without a vaccine that causes death, and treats people unequally based upon the vaccine.  More than 600,000 Americans have lost their lives through failure to act and caused COVID to be worse than it should have been.  Worse, there are factors actively striving right now to continue to strip your liberties, chain your children to debt captivity, and much worse.  Do you dare to defend your rights?  Do you dare to maintain your rights?  If not, stop reading right now.  If so, pay attention, America is in the most danger it has ever faced, and your ability to stand and defend and maintain your rights is critical to saving America.Apathy

America this week learned that colleges are stripping student rights, liberties, and freedoms to demand they obtain a vaccine that is less effective due to the youth of the students and is causing heart problems in Israel, Canada, and America.  Your children are being ordered to obtain the COVID Vaccine, and none of the politicians are standing up and screaming, not for my constituents!  Does anyone else wonder why we have Constitutional liberties being stolen, and the politicians are silent?Vaccine

Now, consider what the fraudulent president assured America of, “If there’s one message to cut through to everyone in the country, it’s this: Vaccines are safe.”  Yet, at the start of their lives, young people are experiencing heart problems from these “safe” vaccines right now!  What will we learn in 5 or 10 years about the long-term health effects of the COVID Vaccine?  The AstraZeneca vaccine is not permitted in America, as of the president’s speech on 17 May 2021.  Yet, we are shipping this vaccine all around the world.  The same vaccine that was never “officially” tied to blood clotting problems in Italy and other European countries.  Why?  The clinical trials for the vaccine strictly refused pregnant women or those women wishing to become pregnant, but all women are being encouraged to get vaccinated.  There is a health danger, and the vaccine is the root of the threat.Life Valued

I repeat myself only for emphasis; I am not “Anti-Vaccine.”  I am a concerned American who is already taking several prescription drugs. Unfortunately, none of the manufacturers can answer simple questions about the vaccine and how these drugs interact with my medication.  My wife sent me the following; want to know more information, watch the video.  It is well worth your time.  Plus, the video opens more questions about the mRNA vaccine technology, whether the COVID Vaccine is a vaccine, and whether you should exercise your right not to inject something questionable into your body.  I am not telling you to act one way or another, but I encourage you to ask providers tough questions before allowing the jab.Plato 2

In a pretty hushed-up report this last week, we learned that prices were up almost 6% from a year ago when inflation was problematic enough to be part of the presidential races.  Now, inflation in April was up 4.6%, and the Federal Government was still throwing cash into the marketplace.  Debt continues to skyrocket; your local political leaders are debating who has the authorization to spend the money the Federal Government just threw at them.  Yet, no one asks how high inflation will be by year’s end or where the money is coming from.  The only way to maintain our rights is to ask more challenging questions and demand answers from those supporting the flagrantly destructive policies of the current political leaders!

Knowledge Check!The powers who think they can control the government consider themselves above the law, and they are responsible for the more than 600,000 direct COVID-19 related deaths and the more than 14,000 COVID Vaccine deaths.  Is your right to life sufficiently strong enough to motivate you to action?  Will you defend your family and extended family’s rights to life?  Look at the links, look at the data, ask questions, and then make your mind up regarding your right to life and your pursuit of happiness with or without the COVID Vaccine as well as the soon-to-be rolled out boosters, updates, and additional chemicals.

NO FearYou have a right in America; you and I possess the right to refuse our consent to be governed.  I have publicly stated I have rejected those in power my consent to be governed.  Join me; let’s demand the government stop before America is lost!

References

Flythe, J. E., Assimon, M. M., Tugman, M. J., Chang, E. H., Gupta, S., Shah, J., … & Zonies, D. (2021). Characteristics and outcomes of individuals with pre-existing kidney disease and COVID-19 admitted to intensive care units in the United States. American Journal of Kidney Diseases, 77(2), 190-203.

Mahajan, P., Dass, B., Radhakrishnan, N., & McCullough, P. A. (2020). COVID-19-Associated Systemic Thromboembolism: A Case Report and Review of the Literature. Cardiorenal Medicine, 1-8.

© 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: Come, Let Us Reason Together, Chapter 6 – Pride

Male v. FemaleHetro- or Homo- sexual, I do not care.  If you and your partner are over the age of consent, generally accepted as 18 years, you may do as you like.  All I ask is that you keep your bedroom theatrics in the privacy of your own home.

I realize family dynamics have changed; we have single parents, nuclear families (a female and a male parent), we have dual sex parents (two females or two males), and a host of imaginative genders, as well as polymorphous parenting.  In each of these parenting relationships comes the risk for divorce, death of one or both parents, long and short-term disease, extended family, and abuse of all types and sizes.  No single parenting relationship is immune, especially to death and disease.

Nuclear FamilyWe can find the same family organizations, the same risks, and the same problems with abuse throughout history.  Nothing in the modern family is new or unique.  Greece, Rome, Egypt, Babylon, Israel, all communities of ancient date report the same problems in family dynamics, mainly to the detriment of the society practicing any family relationship except nuclear families.  I am not the morality police, I am not the thought police, and I am not going to tell you how to live your life and handle your consequences.  Heck, I have enough trouble just keeping my consequences dealt with; you may do as you see fit.

June has been taken over by “Pride” month, and the entire month set apart for the expression of sexual freedom and taking sexual freedom to parade bedroom lifestyles in public.  Frankly, as long as your partner is over the age of consent, you may act as you want; please keep your lifestyle in your bedroom and out of the public square.  However, “Pride” month refutes this plea, demands attention, and refuses to allow the privacy of choices to remain private.  Herein lay the problem.  Imagine a heterosexual “Pride” parade; would it even be allowed; I have my doubts.  Celebrations honoring the role of the nuclear family in society would be and have been attacked by the same people preaching Pride, unity, fairness, and demanding their rights to act foolishly in public.Plato 2

Here is the problem, opportunistic people have made and continue to make a lot of money detailing their lifestyles and bedroom practices.  I do not mind, provided the adult restrictions remain in place on adult topics.  But, when specifically peddled to children, in schools paid for through forced taxation, the schools should not be grooming children and providing materials that are more specifically adult related topics.  K-12 education has sexualized the children of the world so much that it is being reported that first-graders are being taught how “good it feels to touch themselves.”  Essentially, children barely able to walk, talk, and sit still, are being taught masturbation.  Their organs have not developed, their understanding remains cloudy, and they are being groomed for sexual perverts and abuse.  Either from themselves, family, or strangers.  We should weep for the lost innocence of the children!

Want the true horror story of long-term studies on sexualized children; support the facts that many of these toddlers will commit suicide, attempt suicide, or fall into destructive relationships and cycles of abuse.  All because from their earliest memory, their lives have revolved around some mystical belief regarding sex being the answer to all of life’s problems.  When the reality of sexual accountability, responsibility, and the dangers and damage sex can bring to a body, it will be too late.

Virtuous Woman 3Childhood depression is up, anxiety, PTSD related to sexual encounters and personal abuse is up, drug use is out of control, and the root causes are the disconnect between reality and personal belief that sex comes without cost or consequence.  Entire smut markets have become open to the youngest of children selling sex and sexual lifestyles, and many times the child is not ready for these consequences.  Tom Sawyer is banned reading material, but 50-Shades of Gray is not; consider what else is in the child’s library at school.  As a substitute, I was appalled when a box of suggested reading materials was delivered to the classroom, where 99% of the books were about homosexual relationships, coping with homosexual feelings, and discovering homosexual lifestyles.

WhyTo fully understand the sexualization of children, one must first cut through the hype.  The Centers for Disease Control (CDC), which is another topic entirely, was cheering the drop in statistics of live births of children to mothers in the 10-14-year-old age range from 8,500 in 2000 to 2,200 in 2016.  Would someone please tell me why the CDC counts live birth statistics in the 10-18-year-old range as if a pregnancy was a disease akin to chickenpox, malaria, Ebola, while the Health and Human Services (HHS) report pregnancies for adults?  Next, why aren’t pregnancies, including abortions, in 10-14-year-olds considered what they are, a tragedy of epic proportion?  A ten-year-old girl should not be having sex as her body is not ready for the burdens of pregnancy, her mind is not prepared for the hormone dump, and she runs a considerable risk of just having sex, let alone getting pregnant.

Question 3I have reports from family court proceedings where young girls are pressured into having sex and getting pregnant as early as possible to increase welfare funding—taking a moral issue and making it a legal matter and a social problem.  Where is the criminal justice system in holding the parent/s responsible for pressuring children to become grown-ups?  Why is the education system, paid for through forced taxation, allowed to groom children for sex but cannot be held accountable for failing to teach reading, writing, and arithmetic?

I am not a girl, obviously, but all through junior high and high school.  I watched my friends who were girls suffer over when to have sex, how to have sex, and the resulting depression, anxiety, pregnancy, sexually transmitted diseases, and other consequences of active sex lives.  More than one girl suffered abusive relationships or sexual partners who left physical wounds, emotional and mental wounds behind after sexual captivity.  I had acquaintances with guys who suffered from fathering a child, but the mother went and had an abortion.  The psychological and physical pain of being excluded from this decision destroyed the fathers.  Yet, the father’s rights are never part of the equation in making these decisions, even though it took two to create the pregnancy.Modesty

High school, Camden, Maine, Senior Year; I became good friends with a bi-sexual couple.  Together they were lesbians, but their relationship allowed sleep-overs with guys.  One member of this couple discussed how she became a lesbian and the physical pain she endured to become “comfortable being sexually active in a lesbian relationship.”  In fact, the horror stories she related are not anything new in the homosexual community, as I discovered over the years in counseling people both inside and outside the military.  The grooming of young boys for adult men is even more tragic and heartbreaking!  Yet, the LGBTQ+ communities refuse to discuss these experiences, the consequences, and the lasting mental and emotional scars, especially during June’s Pride celebrations.

Knowledge Check!What is worse, none of the literature discussing physical, emotional, mental, and spiritual injuries is not allowed in public schools. It would disturb the mythical instruction and grooming of innocent children about the realities of having sex too early or the problems with homosexual sexual relations.  Parents, celebrate June Pride month if you want, but please watch your children and teenagers.  Please, for the love of your children, help them to make intelligent and informed decisions.  Better still, remove them from the perverts in K-12, so your child has a chance to learn how to read, write, and think logically through mathematical equations before it is too late.

© 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: Multi-Drug Intoxication and George Floyd – Speedballing

WebMD.com details specifically what multi-drug intoxication is, and a portion of the definition is quoted below:

Combined drug intoxication (CDI) occurs when two or more substances are taken simultaneously and can result in serious life-threatening conditions, including death.  While some medications can be safely taken together, combined drug intoxication happens when the toxicity of two or more substances negatively affects the body.”

Knowledge Check!Multiple drug intoxication can occur accidentally and purposefully to counteract the adverse effects of one drug by including another drug, for example, extending a Heroin high through adding Cocaine.  First responders, including police, paramedics, and others, stand on the front-line of a chemistry experiment gone wrong and never know until blood toxicology reports are returned what they are walking into.  Not excusing unprofessional behavior from those responding; but, I am placing blame upon those choosing to inject, smoke, snort, or pop the pills.  The professionals on the front-line deserve the benefit of the doubt, especially when multi-drug intoxication is suspected.

Thin Blue LineDirect from the trial records, covered by the New York Post reporters, we find the following in a second search of the vehicles involved in the George Floyd legal trial.

“Forensics investigators found two pills in the center console of the Benz that proved to be methamphetamine and Fentanyl, Anderson said.  Also found in the vehicle was a pipe with traces of THC and packets of Suboxone, a drug used by patients addicted to opioids.”

For those uneducated in street drug terms, speedballing is covered in a publicly available PowerPoint put together by the Florida Alcohol and Drug Abuse Association, the Florida Department of Children and Families, and JBS International.  I encourage you to review this PowerPoint, as it explicitly details what happens to the human body when multiple drugs are consumed, including meth and Fentanyl.  Knowing truly is half the battle as G. I. Joe proclaimed all through the 1980s.Millstone of Designed Incompetence

I make no accusations, but I find that Politifact.com used other media sources to debunk a Facebook claim instead of actual documents, revealing and embarrassing to all media outlets.  Long have I searched for and wanted to read the toxicology report from the George Floyd Autopsy.  Again, I am not a medical professional nor a chemist, and I use publicly available tools to investigate.  The George Floyd Toxicology report clearly states the following were present in George Floyd’s body on his day of death:

      • Caffeine – Positive
      • Cotinine – Positive
      • 4-ANPP – 0.65ng/ml
      • 11-Hydroxy Delta-99 THC – 1.2ng/ml
      • Delta-9 Carboxy THC – 42ng/ml
      • Delta-9 THC – 2.9ng/ml
      • Methamphetamine – 19ng/ml
      • Fentanyl – 11ng/ml
      • NorFentanyl – 5.6ng/ml
      • Cannabinoids – Presumed Positive
      • Fentanyl/Metabolite – Presumed Positive
      • Morphine – Free – 86ng/ml

Detective 4The “Reference Comments” at the bottom of the toxicology report is very revealing.  When he chose to attack police and resist arrest, George Floyd was a walking timebomb of chemicals.  We have nicotine from tobacco use, NoDoz, THC from smoking marijuana, plus the strong suspicion of a speedball containing meth and Fentanyl, among other chemical substances.  Consider this for a moment; the Florida PowerPoint states that Fentanyl and Meth would act as a “push/pull” on the brain and body.

Abusing two or more drugs simultaneously increases adverse side effects and increases health risks.  Negative side effects could include all or some of the following:

      • Anxiety
      • High Blood Pressure
      • Strong or Irregular Heartbeat
      • Suppressed Breathing Abilities
      • General Confusion
      • Incoherence
      • Blurred Vision
      • Stupor, Drowsiness
      • Paranoia
      • Mental Impairment
      • Uncoordinated Motor Skills
      • Death from Stroke
      • Death from Heart Attack
      • Death from Aneurysm
      • Death from Respiratory Failure
      • Death from a rapid change in Heartbeat pace from Depressed to Overspeed
      • Death from Cardiac Arrhythmias

Knowledge Check!Important to consider, when depressants and stimulants are mixed, the combination of lethality is challenging to judge, and fatal overdoses occur from misjudging the amounts of drugs being consumed.  Because no one is reporting how long George Floyd was speedballing, or if he was speedballing, we could not judge the severity of cognitive, physical, and psychological effects from these drugs being used/abused.  Unless it was never reported, George Floyd’s family has never been asked about his behavior when sober or on this multi-drug cocktail; I have found zero records investigating George Floyd.  These records could still be in the defense lawyer’s hands due to the coming defense of Derek Chauvin in appeals court.

Question 2Regardless, America has two problems represented in the George Floyd case.  Neither problem involves how police do their jobs, and everything to do with the media and Hollywood representing drug use as popular and risk-free, and the continued drug problems America has been facing since the 1960s explosion of illicit drugs.  Illegal and illicit drug use is fueled by social acceptance, which Hollywood and the media empower.  The statistics from 2020 and the COVID-Farrago are still being calculated and gathered.  However, the preliminary numbers show increased alcohol and drug use up significantly during the lockdowns, reflecting the second method that increases illegal drug use and abuse, government intrusion, and restrictions.

When the press goes above and beyond to punish the police and honor and glorify a criminal, criminal activity increases due to media protection and the desired payday through the judicial process.  How much money has the family of George Floyd been able to gather? Just from the city, we find a payday of $27Million!  Those are tax dollars being paid for political purposes, and the taxpayers in Minneapolis, especially after all the terrorism, should be just as mad as the rest of the country.  Why was the payday made, the media!  Why the rush to pay off the family, the press!

Wasting TimeThe media fact-checked using their echo chambers, quoted each other instead of asking real questions and obtaining real answers, and the politicians caved like a cheap suit!  Take a minute and read the different stories from the George Floyd incident or any other major media circus.  You will find the echo chambers, the faux emotional investing, the pandering to audience emotional investment, and the media trying to be judge, jury, and executioner long before all the facts of an incident are known.  I have heard others describe the media circus as “stage-managed” with copied talking points, locked-in themes, and punishment for everyone who doesn’t toe the line the media is managing.

I will never say someone has to be perfect all the time.  Mistakes happen!  How those mistakes are handled defines the professionalism of the parties involved.  The media make things worse, and while I will not see the press muzzled, I consider their unethical, immoral, and borderline illegal behavior to be reprehensible and worthy of judicial punishment until behavior improves!  The media is a part of the problem, Hollywood is part of the problem, and both parties feed off each other to the detriment of American society.Never Give Up!

Yet, let’s discuss the 800# Gorilla in the room openly.  Drug use is climbing; when drug use climbs, drug abuse follows like moonlight to sunlight.  Worse, when drug use increases, social problems increase dynamically, families are destroyed, and the drugs usually make friendly people into beasts capable of eating another person’s face.  Lest you think the 2012 and 2013 incidents were singular, “… a stun gun and K-9 dog were initially unable to stop [the suspect] from continuing to attempt to eat the victim. Four deputies eventually pried [the suspect] off and arrested him. … [the suspect], a former high school football defensive lineman and wrestler, may have been on hallucinogenic drugs when he attacked.”  “A former teammate told The Palm Beach Post that coaches were frustrated with [the suspects] aggression, even at 6-feet tall and 200 pounds. “The coaches would always try to get him mad and play angry, and he never had it in him. I didn’t think he would hurt a fly.”

Knowledge Check!America, we need solutions to the drug problems in our country.  We need to find and develop new solutions to this age-old problem.  Worse, we need the politicians to stop throwing money at problems and start looking for solutions that will work.  Let us begin to look at drug addiction, use, and abuse, which includes all drugs and alcohol, where those addicted can receive support in breaking the habit but are still held accountable for the problems their drug use/abuse caused.  I am interested in hearing your thoughts on fixing the drug use/abuse problems; I know I do not have all the answers.

© 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: The Rule of Law – A Primer

ApathyAll advanced human actions, the weather, the natural world all operate on the law.  Understanding the rules of that law enables all the sciences, arts, music, and advanced human action the world has witnessed as humans have gained and lost civilization throughout history.  The following is a primer on the rule of law, a concept oft mentioned in these articles, to advance our collective understanding and provide impetus towards correcting the government.

Consider electricity; it exists in nature in uncontrolled ways and means.  Static electricity, lightning, other discharges exist when electrons get free and need to be grounded.  It took millennia for man to understand and harness electricity in the crudest of manners and methods.  It took another millennium for man to understand the laws of electricity, create, harness, and purposefully use electricity to improve the human condition.  Ancient examples of electricity exit in Egyptian tombs and other sites of antiquity that amaze and mystify us in the current history of man, for we do not understand the why behind the ancient uses and make guesses as to why electricity was used.

The critical part in our discussion of electricity is discovering and then living obediently to the rules and laws governing electricity.  Without exception, if you abuse the power of electricity, harm occurs, and death is ever-present.  I have witnessed surges of electricity start fires, throw people across rooms, and stop hearts as effortlessly as I type.  Speak with an electrician or engineer, and you will hear tales of inexperienced, uneducated, or fool-hardy people breaking the laws of electricity and the amazing results that transpired.  Speak to these same people, and you can see the advantages and blessings of obedience to the laws of electricity and the power of electricity to improve lives, heal the sick, and raise the dead; all, because the rule of law is adhered to by practitioners and electricity, is safely harnessed and used according to the understood laws.

Image - Quote Poltics is DirtyTesla understood electricity’s laws and rules better than any other person in history and died too soon for his knowledge of those rules to be both accepted and applied to the human condition.  Edison, Westinghouse, and Tesla had a unique and troubled history and relationships.  Due to the desire to make money on delivering electricity, Tesla’s Tower for providing electricity through the air without a delivery network of wires, substations, and generators, was forced to be suspended, and Edison and Westinghouse beat Tesla into obscurity almost.  Edison, Westinghouse, and Tesla’s relationship is not the topic; although highly interesting and an excellent example of capitalism working to destroy people, the rule of law and obedience to the understood rules and laws is the topic.

Consider the internal combustion engine.  I have heard it postulated on more than one occasion that after gravity, the internal combustion engine is continuously being researched and debated by engineers, physicists, and other scientific people in an attempt to improve human understanding.  Electricity remains on this list as we are learning more laws and rules that expand knowledge, which then develops human applications.  Hence, when we speak of the rule of law, we speak of current law, future discoveries, and historical application.  The historical applications of laws and rules often lead to insights into everyday situations and predict where the future may lie on a particular topic.

The Duty of AmericansSome may complain; I  am speaking only about natural laws, and man’s laws, as applied through government, are different from natural law.  To those who suggest this, I say, unequivocally, “Hogwash!”  How did man form the government; they watched the natural order and created a mimicry of the natural order into society, and then began working to improve that social order to achieve what nature, or the natural world, does automatically.

Consider the starlings, little birds, that fly in concert so intricately and beautifully, acting in a harmony of motion that appears to defy the social order and government of bird flight.  Yet, the starlings’ rules and laws allow for their society to fly and mystify humans.  Deer, Elk, Moose, Mice, and so many other animal societies have been mimicked by humans into a form of government and social order, bringing with it rules and laws that apply, strictly, to that society.

Editorial - Educational TruthAmerica has a lot of rules and laws.  In an attempt to capture the width and breadth of laws and rules in America, the following statement is made, “Congress has enacted approximately 200–600 statutes during each of its 115 biennial terms so that more than 30,000 statutes have been enacted since 1789.”  A more straightforward explanation is made on a different source, “Nobody Knows!”  The first and most fundamental law is the US Constitution and US Bill of Rights.  Under the rule of law, the judicial and legislative branches of government are expected to follow and closely adhere to these fundamental documents when creating laws and rules.  However, the legislative branch has abdicated its role to the judicial branch.  The judicial branch has become infested with activists and militant and mutton-headed pillocks from both current political parties’ extremes until the law has become defiled, and American Society suffers.

The same pattern has been observed in every democratic society across the globe, with the United Kingdom, France, Greece, and Germany, leading to diminution of the understanding and governance of law.  Hence, according to just laws and rules, the social orders that used to mimic natural orders have become lost in the morass of bias and opinions forming a legal quagmire where even obeying the law has become too difficult no one knows the laws sufficiently.  Even though the legal premise remains, “Ignorance of the law is no excuse.”

PatriotismAmerica, consider the number of “Executive Orders” written by the current and fraudulent president?  The UK, consider how long it took to leave the EU and the bureaucrats who continue to thwart the people’s will?  Israel, how many elections will it take for you to have a stable government again?  German, you get the same question as Israel, and we all know how France and Greece could not form a cohesive government even though their lives depend upon a functioning government.

Citizens of Democratic governments, and America, a Republic, must understand the basic role and functioning of government to not cradle-to-grave care for a citizen, but to protect the national boarders and do as little harm as possible.  That is the government’s entire function; look at any social order in the animal kingdom, and this truth becomes evident very quickly.  Yet, humans continue to try and shape government into an instrument to beat and betray their fellow men in the name of plastic terms like “fair,” “equity,” and “New,” among many others.

Andragogy - LEARNWhat does a citizen of these governments do?

I have some suggestions, but the leading and most crucial request is to understand and then act.  We must fundamentally shift our understanding of, and then actions of, the governments that have grown beyond control.

      1. Observe natural order and consider your current government. If they do not match, you have a problem.  Acknowledge that problem exists!
      2. Understand the role of the “Rule of Law.” As the natural order goes, so should human government.
      3. Without a doubt, when natural laws are broken, death follows. Governments are dying because they have disregarded this simple principle.  Awake and arise before the globe enters another World War; because we all know how those turn out!
      4. Once you know, ACT! Vote!  Raise your voice!  Disclaim that in no uncertain terms, you are refusing and refuting the government’s power to rule you!
      5. As you learn, teach, so you may learn more succinctly, thus empowering your ability to train more powerfully. Your neighbors need this same information so you can act in concert.  Consider the starling; how fast will a starling die if they do not fly in formation properly; not bloody long.

Never Give Up!Remember, this is but a starting point in changing government, but we must start!  Embrace a “Liberty FIRST Culture,” and let us citizens act, for we own the government, not the other way round!  Never stop trying, learning, and reaching out.  When the government breaks the natural order, death becomes a real possibility, either through war, rebellion, or simply anarchy as government dies.

© 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.

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.