“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.

VA 3

  • 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?

VA 3

    • 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.

Whiskey-Tango-Foxtrot – The VA Edition: More Shameful VA Chronicles

Angry Grizzly BearThe Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) has released the details of an investigation into a veteran’s death.  The scope of the investigation included several key items, but the main point was that a nurse failed to contact the patient, the patient went without medication for four days, and on day five, died.

The facility conducted an internal review of the patient’s care. The OIG found that the review was incomplete and included inaccurate information, and leaders were unable to determine if an institutional disclosure was warranted.”

Failing to coordinate care is a leadership issue, and the leader’s failures caused a veteran’s death.  With more veterans using community-based care options, VA leaders must coordinate care more specifically, that medical records are shared timely, and communication occurs.  We are several years into expanded community-based care options for veterans; why has the VA not made progress on this issue to date?

Personal storytime, no VA-OIG investigation.  I was forcibly moved from the Las Cruces community-based outpatient clinic (CBOC) to the El Paso VAMC due to the felonious and fallacious charges of being a behavioral problem in Phoenix VAMC because I cannot physically and safely wear a mask.  My new primary care provider, a nurse practitioner, sent me a letter dated 23 July 2021, almost a month after I submitted documents for completion, informing me they do not feel capable of making a medical determination on my ability to drive.  I had submitted some documents from the NM DMV to get a handicap placard and medical clearance for diabetes and my neurological condition.  A medical professional is not capable of making a medical determination.  Oh, the irony is thick with this one!

Irony Examples in Literature That are Just Perfect for a Lazy Day - PenlightenThe El Paso VAMC spearheaded a program for the VA to begin using nurse practitioners and clinical pharmacists as primary care providers to “reduce the burden” on actual medical doctors.  If the nurse practitioner felt medically incapable of making a decision, where was his supervisor?  Where was his leadership support team?  Is the problem with using no medical doctors clear?  Leadership issues abound, and nobody in Congress is taking any action.  Nobody in the VA’s highest echelons of leadership is taking any steps to correct the local and VISN level leadership problems.  Who suffers; the veterans and their dependents!

Back to recent VA-OIG investigations, we find a doctor from Florida sentenced to six years in the federal prison system, plus restitution and asset forfeiture.  From the record, we find the following:

To attain such high volumes of claims, the conspirators used bribes and kickbacks. Specifically, Davidson and his conspirators illegally purchased thousands of DME claims from so-called “marketers.” The marketers, for their part, had generated the claims under the guise of “telemedicine,” but no telemedicine had occurred. Instead, the “marketers” had bribed doctors to sign the DME brace orders that supported the claims. Davidson and his conspirators paid millions to secure the illegal DME claims for submission to Medicare and CHAMPVA.”

GavelHow many conspirators are Federal Employees?  How many are leaders of Federal Employees?  Who else knew and profited, and when will they be held culpable for the crimes committed?  Dr. Richard Davidson (42) had a lot of help to build a $20 Million healthcare fraud scheme; a lot of that help had to come from Federal Employees.  When will government employees finally start being held responsible for the problems they perpetuate?  Where is Congress in scrutinizing this case and demanding the legislative branch take action to stop the fraud?

Traveling to Puget Sound Healthcare System in Seattle, Washington, we find the VA-OIG neck-deep in conducting a comprehensive healthcare inspection (CHIp).  “The Director and the Chief of Staff had served since 2017, the Deputy Director for Patient Care Services and Associate Director had been in their positions since 2018, and the Deputy Director had served since 2019. Survey data indicated opportunities to improve employee satisfaction and reduce feelings of moral distress. Patient survey results showed that individuals were generally less satisfied with their care compared to VHA averages” [emphasis mine].  More thick irony is being dished out here.  Never will the VA-OIG find employees feeling morally distressed and patients being highly satisfied with their care.  There is a causal relationship between the level of moral distress in employees and lack of satisfaction from patients, and the problem is found in the leadership at the local VAMC/VAHCS level!

Knowledge Check!Never forget, the Puget Sound VAHCS is where the wait-list death scandal began before that hospital director was moved to Phoenix.  Thus, to hear of employees still feeling morally distressed in this VAHCS is not surprising, alarming, but not surprising!  To hear that patients still feel cheated is expected, as the VA leaders who took over after the wait-list scandal had been raised in a culture of corruption, where the honest left and the dishonest and disrespectful remained.  Some of the VA-OIG’s recommendations include patient follow-up and exit reviews, care coordination, medication management, and patient safety.  All of which are symptoms of poor leadership!

My wife just asked me a pertinent question, “Can you trust the VA to provide you honest care?”  No, I cannot.  Yet, due to ObamaCare, the cost of seeking outside medical service is so astronomical I cannot afford to participate in my company’s medical insurance plans.  The VA has a dearth of leadership, coupled with too many managers, lawyers, and labor unions.  Yet, who does a veteran complain to?  Congress is deaf to our pleas.  The VA in Washington is missing in action 100% of the time.  The veteran service organizations are all geared to helping get veterans enrolled into VA benefits.  Lawyers cost too much.  The VA-OIG is limited to making recommendations, and the government protects its own against litigation.

ElectionIn a representative government, the highest authority is the people electing officers to government.  Well, I continue to appeal to my fellow veterans, their dependents, and ordinary citizens.  Please, help change the VA!  Vote new blood into a public office dedicated to correcting and scrutinizing, not writing endless legislation that costs too much and increases debt.  Vote new judges into office who will see the problems and not employ judicial overreach to handle issues.  Demand accountability from elected officials.

© 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.

I Hate Being Lied To – Follow-Up on Diabetes and Dieting

Angry Grizzly BearEarlier this week, I went to a doctor’s appointment that included diabetes boot camp and was instructed by Dr. T., a clinical pharmacist for the El Paso VAMC.  At the time, I thought the only liars were the Food and Drug Administration and the food pyramid I have been living for 40+ years.  After some additional research, I have to add Dr. T. to the list of liars using peer-reviewed sources.  Well, at least he is in good company.  The list of liars includes a neurologist who claimed all calories are the same and reducing caloric intake and caloric burn will help a person lose weight.  The advice I have been following for the better part of six years to no avail.

Cave Man Foods

The “Cave Man Foods” pitched by Dr. T. were sourced from Keto-Diets, not “14-years of research at the VA.”  The problem with the Keto-Diets is Ketosis, and if you have a liver problem, which I do, you can do serious damage to the liver by eating eggs.  Eggs are a staple of the Keto-Diets; do you see the problem here?Gravy Train 2

I have a friend, and he and his spouse went Keto about 16 months ago.  Earlier this year, his wife had liver failure, and the Keto-diet helped create a liver problem for someone who has never had liver problems in their life.  The correlational relationship between consuming eggs and non-alcoholic fatty liver disease (NFLD) is pretty solid based on my research.  However, as I am not a dietician, a medical doctor, or a food researcher, I can only rely upon medical advice and encourage you to seek medical opinions (plural) before starting any diet regimen!

Calories are not the same!

Let us establish a base of information.  A calorie is a unit of energy defined as the amount of heat needed to raise the temperature of a quantity of water by one degree.  In Junior High School, we used peanuts, sugar cubes, and other home ingredients to explore calories in chemistry class.  I still remember setting foods on fire and measuring water temperature correctly to get the caloric burns right.  However, dieticians never discussed then and not discussed now that one calorie is not the same as another calorie.  Just like rocks are not all the same size, have the same value, or can be used in the same manner.

RocksFor example, calories from sugar are not the same calories from kidney beans, even though both are units of energy, and 2000 calories of chocolate are not the same as 2000 calories of carrots.  If we are clear on this, let’s discuss why this is important.  2015, a neurologist told me all my problems with my nerves lay in how much fat I was carrying around.  He claimed that if I reduced the amount of calories I consumed and increased the number of calories burned, I would quickly lose weight.  Losing weight never happened, nor could I keep any weight lost off for any length of time.

Three years after this meeting, I was told I had developed diabetes and a non-alcoholic fatty liver, as well as gallstones, and my GERD was out of control.  This was when I was first introduced to the notion that not all calories are equal, even though all calories are units of energy.  I did not understand this discussion totally then; after Dr. T.’s discussion, I still do not fully understand the entire argument.

Lemmings 3I am sure that energy sources are not equal, even though calories are simple units of energy, per the laws and rules of physics.  However, I am not a chemist, a physicist, nor exceptionally well versed in diet and health.  I am not a dietician and am left to try and figure out the best advice and live that advice.  As a foodie, I have yet to find any diet, as the first part of a diet is “die” dying of hunger!  Before you ask, yes, Garfield is a hero of mine and has been my whole life.

Complications to Weight Loss

2017 thru 2019, I had been more active and had lost a little weight.  July through December 2020 come along, and all the weight lost is back in spades; why, the injuries sustained at the hands of the VA Police in arresting me for not wearing a mask at the VA Hospital in Phoenix, AZ.  According to research conducted on people with spinal cord injuries, the following are key variables in weight loss:

      • Age
      • Race
      • Marital Status
      • Employment Status
      • Family history of overweight/obesity
      • Level and duration of injury
      • Cholesterol level at baseline.

Thus, it is only logical that since my fallacious arrests and injuries at the hands of the VA Police at the Carl T. Hayden VAMC in Phoenix, AZ., exercise and weight loss would be impeded, acting as complicating factors in improving my health.  Why is this important; because, my new primary care provider does not think I have any problems and refuses to renew medication until other specialists claim the medicines are needed.  I find it interesting that the doctors would vary so significantly between VISN 17 and VISN 22.Lemmings 4

Mask Policies

While the following is not a variable in weight loss, it is part and parcel of the lies and problems I have experienced since Feb 2020.  The Las Cruces, NM., VA Community Based Outpatient Clinic (CBOC) had no problems accepting my doctor’s note regarding my inability to wear a mask.  When I arrived at the El Paso VAMC, the VA Police had no problem with my doctor’s letter regarding my inability to wear a mask, handed me a face shield, and then provided protection for me with other bureaucrats who took umbrage that I was not wearing a mask.

cropped-bird-of-prey.jpgMeaning that what I have been declaring about the mask policy, the mask mandates, and the hypocrisy of zealot VA Police Officers at the Carl T. Hayden VAMC is 100% true, and my treatment was not in accordance with the mask policy (emailed directive) from Washington DC.  I hate being lied to, detest being arrested and injured when I am right and refuse to be silent about how poorly the VA is treating veterans!  Does anyone know a lawyer who is willing and hungry enough to take on the VA?

References

Chen, Y., Henson, S., Jackson, A. et al. Obesity intervention in persons with spinal cord injury. Spinal Cord 44, 82–91 (2006). https://doi.org/10.1038/sj.sc.3101818

Gundry, S. R. (2017). The plant paradox: The hidden dangers in “Healthy” Foods that cause disease and weight gain. HarperCollins.

Joshi, S., Ostfeld, R. J., & McMacken, M. (2019). The ketogenic diet for obesity and diabetes—enthusiasm outpaces evidence. JAMA internal medicine, 179(9), 1163-1164.

Mokhtari, Z., Poustchi, H., Eslamparast, T., & Hekmatdoost, A. (2017). Egg consumption and risk of non-alcoholic fatty liver disease. World journal of hepatology, 9(10), 503.

Taubes, G. (2008). Good calories, bad calories: Fats, carbs, and the controversial science of diet and health. Anchor.

Taubes, G. (2011). Why we get fat and what to do about it. Anchor.

© 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
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