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

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

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

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

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

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

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

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

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

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

Plus the following:

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

Don’t forget this one:

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

More is coming on this one:

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

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

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

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

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

VA-OIG finding:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Fed UP! – More Detestable Bureaucratism from the VA.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“That’s Crazy!!!” – More Chronicles From the VA Chapter 3

Bobblehead DollIt is no secret I am on several prescription medications.  I take these under strict medical advice, and three of these prescriptions regard mental health improvements.  However, my prescription reasons were subtly shifted because Phoenix’s last two primary care providers did not listen to the patient.  Since the El Paso primary care physicians appear to be utterly incapable of even attempting to listen, I have now been without a mental health prescription for an entire week.  This is called bureaucratic cold-turkey prescription stoppage!

Not the first time this has happened, especially for this particular medication, a serotonin blocker.  Here’s the rub, the physical and mental withdrawal symptoms of cold turkeying the drug; includes, but is not limited to, the following symptoms, of which I have ALL of the problems!

      • Nightmares
      • Suicidal Ideation/Thoughts/Visions
      • Headaches
      • Heart Palpitations, radiating chest pain
      • Anxiety
      • Depressions
      • Mood Swings
      • Irritability
      • Tinglings and Prickling sensations of the skin
      • “Brain Saps”/”Brain Shivers”/Spaced-Out Zombie Spells
      • Fatigue
      • Dry Mouth
      • Insomnia and Sleepiness – Which is a major whiplash feeling!
      • Pain and neurological events in every part of my body!
      • … and more… Much…  Much… More!

I have been without this medication due to bureaucratic stupidity for several days in the past due to pharmacy issues.  But, this is now the longest I have been without this medication since getting prescribed this medication.  I wish, like anything, I had known some of these withdrawal symptoms before I went to the ER earlier this week for pain and neurological problems; I would have raised the refill issues as part of the ER visit.  I went online looking for other people’s experiences; I want some medical advice before continuing this medication!!!

PACT_modelI am a root cause kind of person; why do I bring this up?  I have had three primary care providers since arriving in the El Paso VAHCS in May 2021.  None of them have gotten any of the medications correct due to a blatant refusal to LISTEN to the patient with the INTENT to understand!  Nurses with VA-provided primary care providers are expected to communicate with patients between 24 and 72 hours post any ER visit.  Since moving to Las Cruces, I have visited the ER twice and have not spoken to the nurse yet!

I have initiated the conversation with the nurse through phone and secure messaging, and the nurse has refused to engage.  Through secure messaging, I am advised, “Secure messaging is not the place to triage a patient, and no question can be answered as this requires triage of a patient.”  No direct phone contact is possible with the clinic.  One must call, get routed to a call center, leave a message, and then hope the clinic calls you back sometime before you die!  Don’t forget; I am the same patient told, “The clinic will not see you in person because you “WILL NOT” wear a mask.”  Completely refusing to understand, accept, and believe that I cannot wear a mask due to medically documented (by the VA medical providers, which medical records they possess) reasons.  Best of all, the veteran is then sent letters and marketing materials urging the veteran to use secure messaging through “MyHealtheVet as a safe and secure way to access your medical team and get your questions and concerns addressed by your PACT team!”  If the VA were a mental health patient, they would have schizophrenia and at least a dual-personality.

PACT 1Snide, rude, and disrespectful staff, all made possible by, supported through, and legally accepted under federal government fiat.  Do you realize that the nurse not doing their job will have any number of valid and acceptable excuses, and these excuses are accepted because of designed intentional incompetence allowed under federal employment laws, regulations, and directives, established by and supported through Congressional oversight?  In Disney’s “Princess Diaries 2: Royal Engagement,” Viscount Mayberry has a line,

Your staff is incompetent and unreliable!”

The VA is incompetent and unreliable, and the victims are the veterans and their families.  We are talking about dangerous drugs, forced addictions, and then the ineptitude of incompetent and irresponsible bureaucrats who refuse to do their jobs in a timely and responsible manner.  But do not take my word for it.  Let’s review what a watchdog organization, the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG), has to say on this matter.

VA 3

  • Tracy McNeil, of Raeford, North Carolina, was sentenced to one year and one day in prison and ordered to pay $90,003 in restitution for committing wire fraud involving an elderly veteran in her care. From February 2015 to February 2017, McNeil fraudulently obtained benefits from the VA and the Office of Personnel Management by executing a power of attorney over a disabled veteran who served in the Army and worked for the US Postal Service. The investigation revealed that McNeill arranged for the victim, who had dementia, to move into her home in February 2015 and then directed the VA and OPM to deposit the veteran’s benefits into her bank account. Between April 2015 and December 2016, the VA deposited $11,151, and OPM deposited $61,318 into McNeil’s account. Further, OPM disbursed the veteran’s life insurance for $17,533 to McNeil. Financial analysis showed that most of the funds were spent on McNeill’s expenses, including rent, utilities, credit card payments, and personal purchases.

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  • Strock Contracting, Inc., of Cheektowaga, New York, has agreed to enter into a consent judgment with the United States for $4.7 million to resolve claims that Strock violated the False Claims Act. The United States filed an action in federal court alleging that Strock Contracting profited financially after fraudulently obtaining federal contracts intended to benefit service-disabled veterans. The United States alleged the company, which was not owned or controlled by a veteran, recruited a service-disabled veteran to create a pass-through company, known as Veterans Enterprises Company, Inc. (VECO), which the Strock Contracting its owner, Lee Strock, controlled. The company allegedly directed VECO to submit false eligibility certifications to the government, obtaining substantial profits on numerous federal contracts.
        • Where are the VA Employees who should know what “fake eligibility certificates” look like?
        • Where are the supervisors who should have been providing training?
        • Where are the Congressional oversight teams in holding the VA accountable?

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    • William Rich, of Windsor Mill, Maryland, was arrested for allegedly obtaining more than $1 million in veterans and Social Security Administration disability benefits by falsely claiming that he had paraplegia. Allegedly, Rich misrepresented his physical condition in VA disability compensation claims, in communications with the VA, and during medical examinations in pursuit of VA disability benefits. While serving in Iraq in 2005, Rich sustained injuries that resulted in the loss of use of both lower extremities. However, approximately six weeks after his injuries, he made substantial progress toward recovery and was no longer paralyzed. Later records show the VA rated him one hundred percent disabled following an examination in 2007. The examining physician noted that he did not have access to Rich’s complete claims file, so he did not review Rich’s medical history or observe the earlier report. In 2018, the VA OIG conducted an audit of specific claims and learned of conduct by Rich inconsistent with his purported condition. Over the next two years, VA OIG special agents conducted surveillance. They observed Rich walking, going up and downstairs, entering and exiting vehicles, lifting, bending, and carrying items—all without visible limitation or assistance of a medical device, including a wheelchair [emphasis mine].
        • OK, let me be clear, I am glad this veteran got better; I do not in any way condone theft. But, where is the VA in being culpable for FAILURE to do their job correctly?
        • Will the doctor who failed to do their job be held liable for the malpractice performed?

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    • William H. Precht, of Kent, Ohio, was sentenced to 37 months imprisonment and ordered to pay $1.25 million in restitution after pleading guilty to theft of government property and participating in a bribery and kickback scheme. In October 2010, Precht registered a purported vendor, a company he controlled, as a small disadvantaged business and veteran-owned small business in the VA vendor system. He then used his VA purchase card and other employee cards to purchase over $1 million in alleged medical supplies from the vendor. In addition, from May 2015 through January 2019, he conspired with Robert A. Vitale, a medical sales representative for multiple companies that conducted business with the medical center, to devise a scheme in which Precht would receive kickbacks and other items of value in exchange for steering VA business and other monetary awards to Vitale.VA 3

Speaking of staff being “incompetent and unreliable,” did you know that the VBA is using “COVID-19” as an excuse for being backlogged in cases, AGAIN?  Did you know that COVID-19 was so powerful that it caused the VA to fall 200,000+ cases behind, in an inventory of 600,000+ cases requiring decisioning, with 70,000+ needing additional review for entitlement, and needs to hire 2,000+ new employees to help correct the problem?  Since the VBA continues to fail in staff training, exactly how will hiring new employees help?  Honest question!  With the current staff rated as incompetent and unreliable, not by me only, but by the VA-OIG who has regularly taken these issues and more to Congress asking for additional scrutiny and assistance in improving the VBA, VHA, and National Cemetery specifically and the VA collectively; what exactly can new employees do?VA 3

The VHA cannot plan construction projects and put planned maintenance into proper categories to execute maintenance tasks correctly.  Congress refuses to scrutinize budgets and fiscal compliance for just maintenance of facilities.  How in the world can anyone expect more when the VA cannot even hit the basics of planned maintenance tasks?  I can; I do!

I-CareWhen the VA publishes marketing materials claiming they set standards for excellence and lead the industry, I want them to prove their competence and abilities!  Right now, their failures scream louder than the voices in their own ears, and they refuse to listen to anyone, and I am not happy!  You, the taxpayer, should not accept the performance of ANY government agency, including the entire legislative, judicial, and executive branches of government at the local, county, state, and federal levels, until they correct their behaviors!  It is time to end the charade and put paid to this contemptible behavior and abuse!

© 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.

More Repugnant VA Chronicles! – When will this Insanity END?

I-CareMonday and Tuesday this week, 28 and 29 June 2021, the Department of Veterans Affairs – Office of Inspector General (VA-OIG) returned three more investigations, inspections, or criminal reports.  While no veteran is dead in this batch of reports (Thankfully!), the behavior exhibited remains egregious and blatantly criminal, and the bureaucrats and bureaucracy remain intact to continue to commit malfeasance, misfeasance, and malpractice!

Before getting into the VA-OIG reports, I want to hand out some praise.  The El Paso VAHCS was the focus of a major problem just a couple of years ago when the VA Police attacked a veteran and ended up pulling his arm out of his shoulder socket.  I am now a patient at the El Paso VAHCS, being seen at the VA Out-Patient Clinics instead of the Las Cruces Community Based Outpatient Clinic (CBOC).  While the fallacious claims of the Phoenix VAMC continue to dog me, I am very happy to report that the VA Police in El Paso were professional, polite, and the customer service displayed was top-notch.  Growth has occurred since the veteran incident mentioned, and I, for one, am grateful!VA 3

The VA-OIG has announced that Dr. Kenneth C. Ramdat has received one year of probation after being allowed to “plead guilty” to touching two women’s breasts without permission.  When the VA is compared to a criminal syndicate, where the administrators are actively against the employees and the patients, I can see the connection!  What else happened at the Louis A. Johnson VA Hospital in Clarksburg, West Virginia, while this doctor was on staff and is not included in the criminal trial?  West Virginia keeps coming up as another morally distressed VA Health Care System; what is the VISN doing to improve the environment for illegal activity?  If Phoenix and VISN 22 are an example, nothing, which is negligence worthy of criminal investigations!VA 3

How can employees trust each other when plea deals are allowed, and behavior worthy of criminal punishment exists?  I was physically attacked, as an employee, by another employee, and the administration swept the incident under the rug.  After being discharged during probation, I learned that the employee who attacked me had done this previously with no punishment and the revelation that the administration was gunning for my removal for reporting the attack.  How many VA Employees lost their jobs before Dr. Ramdat was finally forced to be held accountable for sexual assault?  Why the plea deal?  Doesn’t this plea deal re-injure the victims, the perpetrator got off, essentially?

Sexual assault pled down to simple assault with probation – criminal syndicate indeed!Plato 2

Kristopher M. Voyles’s trial ended with a sentence of 27-months in prison, 3-years supervised release, and restitution of $20,502.  While this is a good sentence for theft of medical treatment, Mr. Voyles was never charged and investigated for the actual crime, identity theft of a veteran!  Mr. Voyles stole the name, date of birth, and social security number of a veteran fraudulently created documents, and then obtained care.  Thus, theft of medical care was criminal activity.  Until we read, “Subsequent investigation revealed that Voyles had previously been prosecuted by Atlanta, Georgia authorities for using the same veteran’s identity to obtain prescription drugs from the VA Medical Center in Atlanta.”VA 3

Do the veterans targeted know that Mr. Voyles stole their ID and used it fraudulently?  How did Mr. Voyles repeatedly target and steal the identities of veterans?  Is the ID Theft related to any VA data breaches, losses of veteran identities, or IT problems consistently occurring at the VA?  Were any of these questions asked during the “subsequent investigations?”  If so, where are those VA-OIG reports?  This criminal intentionally targeted veterans, stole identities, used those identities; how many other veterans’ identities does he have or have access to?  The Department of Veterans created the problem of ID Theft; when will they be held accountable for the loss of ID?  Better still, when will the data theft from the VA end?

Knowledge Check!Our final example (today) for the repugnant and criminal behavior of VA Employees needs a little background to be fully understood for those outside the military and government employment.  In government, contracting officers liaison between the facility receiving goods and services, the government paying for goods and services, and the third-party hired to provide goods or services.  Some third-party contractors receive government-issued identification cards similar to an employee identification card, both of which are called a “Personal Identity Verification” (PIV) card.  These cards act as keys to the facility, prove identification and authorize the contractor to be doing what they are doing.  The contracting officers are the end-all in the responsible party for that third-party contracted vendor.

VA SealContracting officers and third-party contractors act under Federal Regulation called “Federal Acquisition Regulation (FAR).  FAR is like the Bible; it has everything in it outlining duties, responsibilities, and authorities.  Contracting officers are supposed to know the regulations before contracting goods and services, and they teach the contractor their responsibilities.  Especially where a PIV has been issued, the contracting officer, as the liaison, IS THE Responsible Party, not the contractor.

Now, gauge the following VA-OIG report with these facts in mind.

The VA-OIG “… examined a random sample of 46 professional service and healthcare resource contracts. None of the reviewed contracts had adequate evidence to demonstrate FAR requirements were met. VHA contracting officers’ noncompliance with PIV card requirements occurred because they were unaware of their responsibilities and the requirements. In addition, VHA did not have policies or procedures detailing supervisory oversight of contracting officers’ duties regarding PIV cards, the internal audit office did not review compliance, and there was no automated tool for continuous tracking and monitoring of PIV cards issued; to contractors’ personnel.”VA 3

Did you catch that; a 100% failure in a random sample of contracts, contracting officers, and oversight supervisors were unaware of their roles and responsibilities.  How long has this failure been occurring?  How many government PIVs are available granting access to facilities where the contract has concluded?  This is not the first time the government contracting officers and offices have utterly failed to perform their roles and responsibilities; yet, this is one of the most dangerous to the PIV system’s security, safety, and reliability.  This is just an investigation from the VA, how bad is this problem across the entire government contracting establishment?

QuestionI cannot understand how a contracting officer, with all the training, re-training, and refresher training that is mandated, could use the excuse, “I didn’t know that was part of my job!”  As a person who has worked around contracting officers, I knew this was their job, and I am not a contracting officer.  It is simply common sense; if you facilitate obtaining identification, keys, and access codes, you are responsible for getting these things back!

While the behavior of the contracting officers is part of the problem, the culture of passing the buck and dodging responsibility is readily apparent in the following statement from the VA-OIG list of recommendations.  “The OIG also recommended VHA assess whether the existing and planned information systems could have the functionality to allow effective and routine monitoring of contractors’ PIV cards or a new system is needed.”  Designed incompetence will allow the IT failure to be the problem, to finagle more money from Congress for IT infrastructure upgrades and new systems, as the legacy systems were purposefully designed not to accommodate regular, daily, routine activities!VA 3

I refuse to believe the VA has ever designed a system that works, is cost-effective, does its job, and can be useful.  Why; because, having worked at the VA, been a patient at VAMC’s across the country, and reading the VA-OIG reports, the VA has proven their utter incompetence!  If a local hospital allowed this type of failure in their contracting department, heads would roll, and Congress would be demanding investigations to ensure HIPAA was not breached.  Yet, the VA can get away with murder, and Congress cannot even care, let alone issue a mild rebuke or increase scrutinization.

Angry Wet ChickenThus, I call upon every American to share my disgust and demand action!  Stop allowing this detestable behavior, paid for by taxpayers, to thrive.  End the abuse!  Not just for veterans harmed by the VA bureaucracy, but for your hard-earned tax dollars and the disrespect the elected officials display towards you, the boss!  Tell me, if your employees displayed the same behavior witnessed by elected officials and bureaucrats of all stripes, how long would they keep their jobs?  If your boss showed you the same disrespect, how fast would you be looking for new employment and telling everyone not to apply there?  Now, answer this question, “Why do we accept this abuse by government officials and elected representatives?”

© 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.

How Do I Know? – An Update on the VA Mandatory Mask Policies and VA Leadership Failures

Question24 May 2021 – 1200-1500 I visited the Las Cruces Community Based Outpatient Clinic (CBOC) in Las Cruces, New Mexico.  Upon entry, I was asked to wear a mask.  I described I could not wear a mask, and the employee said I might be required to wear one but left the decision to those working more closely with me.  I waited in line and was called to the Team 2 window, where a gentleman was more than happy to assist me in getting the paperwork started to change VA hospitals after relocating.  About 45-minutes into my time in this CBOC, the gentleman asked me to wear a mask.  I told him I could not and had brought my VA Doctor’s note as proof.  The gentleman read the letter, confirmed I was good to receive care without the mask, and provided exceptional customer support.

After the past year at the Phoenix VAMC, where my every movement on the property was shadowed by VA Police officers looking for a reason to injure, arrest, cite, and force me from the property, the employees here in Las Cruces was a breath of fresh air.  However, the experiences in Las Cruces provide further evidence of the following facts:

      1. The Hospital Director has statutory authority for adapting and creating policies and procedures that benefit the safety of the employees and the patients. A point I stressed to the leaders of VISN 22 and the Phoenix VAMC to no avail.
      2. The Federal Mask Mandates can be situationally applied for the circumstances of the individual. Yet, another point I have repeatedly stressed since July 2020, and the first time I was injured, arrested, cited, and forced from Federal Property. At the same time, I was being denied emergency care under EMTALA and having my HIPAA information repeatedly violated by the VA Police Officers.
      3. The bombastic and unprofessional behavior of the Federal Police employed at the Carl T. Hayden VAMC is a problem of the leadership, and the failures of leadership to instill professionalism, proper attitudes and behaviors, training, and tactics in approaching and handling situations in the Phoenix VAHCS. At the behavior of the Federal Police Officers in the Phoenix VAHCS, Che Guevara, Mao, Stalin, and Fidel Castro would be proud!VA 3

How can a person be sure the problems caused are a direct result of leadership failures?

ApathyBy tracing behaviors, attitudes, and influence to their source, the police chief acts as he considers appropriate, but the underofficers generationally multiply and mirror his behaviors.  The same is true for the chief who takes his example from the assistant director, director, and hospital leadership.  Chains of command always have this consequence; the example of those above are mirrored, replicated, and multiplied to impress the higher officers to gain attention and promotion opportunities.  Want to take a measure of a leader; look to the most junior person in the chain of command and watch them for behaviors, attitudes, and actions that originate in the leadership.

GavelCase in point, long have I detailed and described the failures of leadership at the VA.  The latest is a wire fraud scheme in Jackson, Mississippi.  From the Department of Veterans Affairs – Office of Inspector General (VA-OIG), we find the following:

Anthony Kelley, the owner of Trendsetters Barber College in Jackson, Mississippi, pleaded guilty to two counts of wire fraud in a scheme to steal federal funds. From October 2016 through March 2019, the college offered a master barber course that was not accredited by the state’s board of barber examiners. Kelley fraudulently represented that this course was approved and, as a result, was allowed to collect GI Bill money from veterans enrolled in the program.”VA 3

As the lowest person in the chain of command, Mr. Kelly was allowed to attempt to commit fraud by the VA.  Never in these reports is the VA employee, their supervisor, and their manager, who were complicit in allowing fraud to occur, mentioned and held accountable.  Somehow, we, the taxpayer, must presume that those committing frauds could hoodwink the Department of Veterans Affairs without any inside help.  Help coming directly or indirectly from government employees charged with investigating, ensuring, and following proper protocols and procedures to protect against theft and fraud.

Angry Grizzly BearLet the US Attorney and VA-OIG special investigators crow about catching the person perpetrating fraud.  Before they break open the champagne, they need to be looking into the leadership that either overtly or covertly allowed this fraud to occur.  The elected officials need to be demanding why fraud opportunities are so rampant at the Department of Veterans Affairs that criminal proceedings are being reported almost every week and asking about the culture of corruption and leadership failures allowing these behaviors to thrive.

Is it a “Culture of Corruption?”

Absolutely; the VA is sick with a culture of corruption!  It is my sad duty to report on another employee who was able to steal from the VA, stealing hydrocodone and oxycodone prescriptions from the VAMC mailroom and mailboxes at some 40 locations in Kerrville, Ingram, and Center Point.

Scott M. Brown, a pharmacy technician at the Kerrville VA Medical Center in Texas, was charged with one count of theft of US mail for stealing hydrocodone and oxycodone prescriptions from the medical center’s mailroom as well as from residential mailboxes between March and April 2021.”VA 3

Currently, Mr. Brown is being held in custody and remains innocent until proven guilty in a court of law by a jury of his peers.  However, the fact that Mr. Brown has been charged and is in custody speaks volumes to the lax leadership that allowed these prescription thefts to occur.  Where is the VA-OIG in asking how the robbery was possible?  Where are the special investigators demanding answers from the leadership on policies and procedures that an employee could easily violate to obtain these drugs?  Who else was involved, or had to know, what was happening and said nothing?Plato 3

The Department of Veterans Affairs has been overtaken by those without skill, knowledge, and ability to understand cause and effect and properly interrupt the cycles of corruption.  Worse, these same people will bleat about how they need more money for technology solutions when their personal example, leadership failures, and human-to-human relationships are the actual problems.  The leaders will bleat like sheep in a corral about engagement, customer service, and industry buzzwords because they have no substance and even less desire to see things change.Plato 2

Recently I detailed the failures at the Department of Veterans Affairs on information technology.  The fallout from the deplorable designed incompetence in the IT/IS infrastructure at the VHA continues to represent just how incompetent the current leaders genuinely are.

To promote compatibility with the Department of Defense’s electronic health record system, VA is replacing its aging record system. This requires VA medical facilities to upgrade their physical infrastructure, including electrical and cabling. The OIG determined from its audit that the Veterans Health Administration’s (VHA) cost estimates for these upgrades were not reliable. VHA’s estimates did not fully meet VA standards for being comprehensive, well-documented, accurate, and credible. The audit team projected that VHA’s June and November 2019 cost estimates were potentially underestimated by as much as $1 billion and $2.6 billion, respectively. This was due in part to facility needs not being well-defined early on. The estimates also omitted escalation and cabling upgrade costs and were based on low estimates at the initial operating sites. Because cost estimates support funding requests, there is a risk that funds intended for other medical facility improvements would need to be diverted to cover program shortfalls. The Office of Electronic Health Record Modernization (OEHRM) also did not meet its obligation to report all program costs to Congress in accordance with statutory requirements. Specifically, OEHRM did not include cost estimates for upgrading physical infrastructure in the program’s life cycle cost estimates in congressionally mandated reports. Although VHA provided OEHRM with an approximately $2.7 billion estimate for physical infrastructure upgrade costs in June 2019, OEHRM did not, in turn, include them in life cycle cost estimate reports to Congress as of January 2021. OEHRM stated it did not disclose these estimates because the upgrades were outside OEHRM’s funding responsibility and that they represented costs assumed by VHA facilities for maintenance—including long-standing needs” [emphasis mine].VA 3

Angry Wet Chicken 2Did you catch that; the office specifically tasked with handling estimates intentionally low-balled estimates, did not include all necessary contractual requirements, and then lied to Congress to cover their hides, and fell back upon designed incompetence to skirt blame, responsibility, and accountability when the VA-OIG came investigating.  Lying to Congress is a CRIME!  Yet, these federal employees can break the law with impunity, and all the VA-OIG can do is make recommendations for improvement!  If you want to read the full report of shame, you can find it here.

Leadership is change; management is stagnation and corruption.  When will the VA start hiring leaders to enforce, demand, and execute change to benefit the taxpayer and the veteran community?  Where are the elected officials willing to work with newly hired VA leadership in establishing legal frameworks for evicting employees who refuse to change from the federal workforce?  When can the veteran community and the taxpayer expect to see real and tangible change at the VA?

Knowledge Check!I am not asking these questions and not expecting an answer!  I am asking these questions looking for and expecting real results to begin immediately, if not sooner!  This is a national embarrassment with a global impact, and it is time for the United States to lead in correcting their detestable government workforce!

© 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.