Tag: Executive Branch

Legitimacy and Consent – Principles Governing Power

In the book 1634: The Baltic War (Ring of Fire Series Book 3), a point was raised:

“A ruler needs legitimacy before all else, and legitimacy, in the end, must have its base in the consent of the governed.”

Bobblehead DollIn reviewing the US Constitution and Bill of Rights, a person will find the term consent a mainstay of constitutional law, foundational to establishing and solidifying the legitimacy of the citizen in this Constitutional Republic.  Let’s be specific here and take a moment to understand the principles of consent.  Consent occurs when one person voluntarily agrees to a proposal or desires of another.  It is a term of common speech, possessing specific definitions used in law, medicine, research, and sexual relationships, to name but a few.

Consent does not dictate or imply legitimacy; legitimacy is independent of consent, but actions of those in charge must be legitimate, or the governed’s consent makes the government’s actions illegitimate.  Hence, the need to understand legitimate activities and how these actions are either legitimate or illegitimate.  Legitimacy depends on the root word legitimate; if something is legitimate, it complies with the law, follows established or accepted rules or standards, and must be valid and logically sound.

Using a piece of recent legislation, we can more fully understand the point about something being legitimate and appropriate to the consent of the governed.  40-years ago, the US Congress (The Senate and the House of Representatives) stopped passing budgets to authorize and oversee federal government spending, and the holders of America’s checkbook began using continuing resolutions (CR) instead of appropriating funds as part of a national review of expenditures to a published budget.?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

Consider with me, no CR appropriates money, merely extends a previous CR approved by Congress.  40 years of making the same mistake doesn’t legitimize the actions of Congress not to pass a budget.  The original CR was illegitimate and was against the consent of the governed, so every single CR replacing a balanced budget since has been against the consent of the governed as the actions were illegitimate, even if those making the decisions claimed they were needed or legal.  Thus, the CR fails the sniff test for government spending.  A historically wrong decision does not legitimize the current actions of the elected.

The law clearly states the US House of Representatives must pass an annual budget.  Part of that budget process must include evaluating the spending previously and determining if those writing the checks performed their jobs appropriately.  This is why independent audits of government agencies, including each of the members of Congress, are desperately needed to maintain the economic health of the United States.  For the Department of Veterans Affairs, the Department of Defense, and every other agency to continually fail audits is 100% illegitimate and against the consent of the governed.

Does this make sense?  Your personal and family financial fiduciary health requires an end-of-month audit of spending, a balancing of the checkbook, and an evaluation of expenditures to meet budgetary restrictions and fiscal goals and objectives.  At the end of the year, you evaluate all the past year’s spending in preparation for the annual tax deadline.  Yet, the example of the executive, legislative, and judicial, both at the state and federal levels, is not reflected in the daily struggles of the governed.  Making the government’s actions illegitimate and against the consent of the governed.  These two principles, legitimacy and consent, reflect a significant portion of the basis of the anger many in America feel but cannot express.Plato 2

Why do we struggle to express this anger?  We have not understood the principles of consent and legitimacy.  In a constitutional republic, if what those elected are doing hurts one portion of the populace, it hurts the entire population.  We do not have a democracy where a mere 51% of the people benefiting can justify destroying the other 49% of the population.  Why does the US Constitution require what the media calls a “supermajority” erroneously?”  Because in a constitutional republic, the rule of law protects all citizens equally, thus providing legitimacy to follow the law, an impetus to adhere to the law when no legal authorities are directly observing you, and allows for the consent of the governed to be honored and upheld even if a small minority disagrees with a decision by the elected authorities.

Hence the difference between a democracy and a constitutional republic.  We are encouraged under the rule of law to disagree, petition the government peacefully, and insist the elected representatives follow and live by the same laws they enact.  Nothing in the US Constitution allows for an elected representative to play the stock market for personal gain, to abdicate their duties by voting via proxy, disregarding their legally authorized obligations, or many of the methods for abusing the citizenry that have become “accepted” because a vocal minority pushes an agenda.

Speaker Pelosi cannot claim that something is acceptable merely because she was the house speaker.  The president cannot break the law simply because they are the commander in chief of the armed forces.  Elected representatives cannot, and should not, be making money trading stocks with insider information.  The list of what has become acceptable behaviors of elected officials is long and egregious.  Always the same two principles balance as a means to judge those behaviors and actions.  Is what they are doing legitimate and consensual to the expressed opinions of the governed?  If the answer to one is negative, the elected representatives have no power to govern.Apathy

Consider the crime of rape.  If consent is withdrawn, the intercourse is non-consensual and illegitimate, and a legal charge of rape can be investigated for criminal activity.  The same is true for speeding; the laws clearly state speed limits are acceptable, breaching the limit in a motorized vehicle is unsafe, and simply because the occupants of the car consent don’t make speeding legitimate.  Both consent and legitimacy must be approved to make an action acceptable.

If the driver operating a vehicle demands that speeding is legitimate, will a judge or police officer agree?  Does a passenger screaming about the need to go faster legitimize the illegal actions of breaking speed limits?  If a passenger suddenly replaces the driver, even though they own the vehicle, is responsibility for actions moved to the new driver or remain with the owner or original driver?  These are easily understood questions when consent and legitimacy principles are fully understood in context.

Consider the ramifications of neglecting legitimacy and consent.  Does a make-out session between two consenting adults mean the sex was consensual?  No, because if one party does not want sex, merely wants to make out, provided both parties have reached the legally determined age of consent, the make-out session is consensual, but not the sex.  This is not splitting the proverbial legal hairs.  If making out and sexual intercourse are two separate actions, which they are, then the legal need for consent legitimizes sexual intercourse.

Now using this analogy, let’s evaluate the legislation for not passing a budget.  Not passing a budget is one action, but not passing a timely budget does not justify a continuing resolution to authorize government spending.  Not passing a budget, not conducting audits, and not demanding fiscal responsibility are all separate actions but never legitimize the continuing resolution.  The root cause does not justify the stop-gap spending.  Just like consensual necking does not legitimize sexual intercourse or speeding on a highway.

The courts have been very clear actions supporting lawbreaking do not imply permission or consent.  Consider the laws of drunk driving, the rights of the injured victim, or the families of those killed.  Society has allowed, through legislation, the ability to drink alcoholic beverages provided the consumer is over a specific age.  Does the legal permission to drink automatically legitimize the consumer to operate any motorized vehicle after drinking; of course not, and laws have shaped and changed drunk driving behaviors since 1910.  The consumer is granted consent based on age and legal limitations to drinking alcoholic beverages but is not legitimized to drive, ride a horse, operate a bicycle, boat, etc., while intoxicated.  Those injured or killed did not grant consent for the consumer to ruin their lives.  Hence the consent of the governed and legitimacy of drunk driving laws are established, and the consumer’s responsibility to drink responsibly is solidified in society.The Duty of Americans

Returning to the continuing resolutions, the fiscal insanity of the government and the bureaucrats’ fiduciary irregularity contradict the governed’s consent.  Taxes are paid, but the taxpayers still hold responsibility and accountability for the money they earn to pay those taxes.  Through electing representatives to oversee how tax monies are spent, the responsibility to provide an accounting for those funds is exchanged by the citizenry electing to the elected.  The citizen cannot be held directly responsible for the actions of the elected representative.  Still, through fair, transparent, and legal elections, accountability for the actions of the elected is expressed.

By failing to provide clear and logical, transparent, fiscal accounting to the electorate, the elected representative is discounting the consent of the governed and delegitimizing the concerns and investment of the voters who paid the taxes.  Precisely like the consumer who drinks alcoholic beverages and then insists they can drive home safely.  Understanding the principles of legitimacy and consent is a prerequisite to clearly identifying the problems in government and then correcting course to right the ship of the state.Patriotism

Does anyone want to return to the legal days when a rape victim is blamed for exciting the mind of the rapist who took sexual advantage and committed an act of violence?  Does anyone want to return to 1900, when drunk driving was socially acceptable if you were rich enough?  Does anyone want to cancel the speed limits and try to declare the lack of speed limitations makes roads safer?  Of course not, so why do we, the electorate continue to allow for fiscal insanity with our tax dollars?  Why should we ever accept another continuing resolution?  Why should we even pay taxes when those spending the money have so egregiously spent our money until how many umpteenth-great-grandchildren are in debt to their eyeballs?

Please allow me to specify I am not advocating a person stop paying taxes and risk judiciary action!  I am advocating understanding consent and legitimacy as keys to government power and how the power being exercised currently needs to be evaluated.  You are free to reach opinions different than mine.  I implore you to understand how legitimacy and consent of the governed lend the right to rule, in our constitutional republic, to the elected representatives.

Legitimacy and consent must be the number one motivating factor for every decision of those elected.  Until we, the electorate, demand they change course, we will be forced to wash, rinse, and repeat until America is left an empty shell, her people driven into captivity by her enemies, and the American Dream is shattered for personal political power by those who we elected.

Detective 4Returning to where we began, “A ruler needs legitimacy before all else, and legitimacy, in the end, must have its base in the consent of the governed.”  Whether a ruler is a hereditary monarch, an elected representative, or a despotic tyrant, legitimacy and consent remain principles upon which power is derived.  Absent either legitimacy or consent, the ruler has no power to govern; lacking power, that rule is either quickly deposed or will shortly be destroyed by those being abused in the name of governance.  History is replete with examples of citizens who have rejected their consent after actions were taken that delegitimized the ruler’s power.

No, this is NOT a call for violence, merely a plea for understanding consent and legitimacy, evaluating what you see in each branch of government, and then making a personal decision to continue to grant consent or withhold consent from those who claim to “represent” you in the halls of government.  How you choose is your choice, and you are free to make that choice.  I know my choice and have already withdrawn my consent to be governed by the current elected representatives.

© 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.

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Scrutinize the Executive Branch – The Charge for the Legislative Branch: Part 1

In what has become typical and usual, the following stories arrive:

“From 2019 to 2021, Ira Westbrook of Bozeman, Montana, served as the fiduciary of an elderly relative who had suffered a stroke and became disabled.  A multi-agency investigation found that, during these 16 months, Westbrook stole more than $57,000 in Social Security and VA benefits and used the stolen funds to purchase personal items, including a Jeep Wrangler, a travel trailer, and other day-to-day expenses.”

“From 2016 until 2018, Sloane Signal-Debose of Slidell, Louisiana, served as the fiduciary of a veteran who needed assistance managing his finances.  During that time, she took more than $100,000 from the veteran’s accounts, used it as the down payment on a home in her name, and used additional funds from the veteran to pay contractors working on the home.  Signal-Debose then submitted false records to VA to hide her misuse of the veteran’s funds.  The former fiduciary pleaded guilty to misappropriating funds and faces up to five years in federal prison.  The VA OIG conducted this investigation.”

“In 2013, Brandi Goldman of Jonesboro, Arkansas, was married to a US Army reservist who suffered a severe traumatic brain injury in a service-connected accident.  As a result of this injury, her husband had many serious physical challenges, and Goldman was appointed as his guardian and fiduciary.  Between April 2015 and November 2017, Goldman received more than $258,600 in VA disability payments and $36,000 in Social Security payments.  During that timeframe, she withdrew close to $200,000 in cash and accrued about $900 in ATM and overdraft fees.  Goldman admitted to spending much cash to fund her methamphetamine habit, spending $150 on methamphetamine two to three times per week.  She also admitted that five other people moved into the residence with her and her husband, none of whom paid rent or contributed to expenses, some of whom she regularly gave cash to.  She also admitted to paying $68,000 in cash for another home, furnishings for the home, multiple vehicles, and a motor home.  Goldman was sentenced to 20 months in prison, three years of supervised release, and $143,000 in restitution after previously pleading guilty to misappropriation by a fiduciary.  The VA OIG and Social Security Administration OIG conducted the investigation.”

Why are these stories of particular interest to the supreme legislative body in the United States of America?  The executive branch has refused to police its branch of government, and crimes like this have become all too familiar.  You, the Congressional bodies of these the United States, are duty-bound and sworn to perform two jobs, scrutinize the executive branch (harshly when necessary), and write laws.  You have recently failed too often in monitoring the executive branch, and this story perfectly represents what happens when the executive branch is not examined minutely!  Tell the US Public who put you in elected office, how these crimes continue and what programs and processes they MUST change to prevent them in the future.

By pleading for the legislative branch to scrutinize and audit the executive branch minutely, I am in no way condoning or diminishing the personal accountability of those who committed crimes.  These three examples are from the October and November press releases of 2022.  The widespread ability to commit fraud is a symptom of a more significant problem at the VA.  Their leaders have consistently been able to boondoggle, evade, and profit from abusing veterans through designed incompetence, criminal neglect, and obtuse actions.  When will Congressional leaders take action to clean up the Federal Government in general and the VA specifically?

The US House of Representatives holds the purse strings for the executive branch; use this leverage to claw back your powers and authority to balance the Federal Government and demand accountability from those empowered to lead their designated branches of the executive branch of government.  Let’s talk about patterns; in less than 45 days, three cases of fiduciary fraud were closed, and the speed of closing these cases has escalated throughout 2022.  The American people will see more, not less, of these fraudsters being underreported by the US Media before the year ends.

Shifting slightly, let’s talk about government employees and the need for more scrutiny of the executive branch.

“Bruce Minor, of Philadelphia, Pennsylvania, was sentenced to two years in prison, three years of supervised release, and ordered to pay $462,256 in restitution for his scheme to embezzle money from the Philadelphia VA Medical Center.  Between December 2015 and September 2019, Minor, a former travel clerk, created fraudulent travel reimbursement claims in the names of at least three other VA medical center employees.  He then diverted the funds into bank accounts he controlled.  The VA OIG investigated this case.”

“Kyhati Undavia, of Houston, Texas, was sentenced to 27 months in federal prison after previously pleading guilty to conspiracy to commit healthcare fraud.  From December 2012 to December 2018, Undavia hired employees to market Memorial Pharmacy, which she controlled and operated, to physicians as a place to submit compounded drug prescriptions.  Instead of providing prescriptions directly to the patients who could select a pharmacy of their choice, physicians sent the prescriptions directly to Memorial Pharmacy.  Then, Undavia paid the physicians illegal kickbacks for the prescriptions.  Beneficiaries often received medicated creams that they did not need or want.  Undavia received approximately $22 million from TRICARE, Department of Labor Office of Workers’ Compensation Programs, and CHAMPVA for the prescriptions.”

These stories also fall into the same timeframe mentioned above.  But, they are not the only stories from 2022 where VA employees conducted long-term fraud for personal profit.  Here’s the rub: hundreds of additional employees knew of these schemes, were probably running their schemes, and haven’t been caught, and nothing is being done by VA leadership to cease the fraud and abuse of veterans by VA employees.  There is a culture of corruption at the VA, long hidden by scheming and abusive leaders and condoned by previous Congresses, that must be stopped!  What will you, the congressional leaders of the United States, do to halt this insanity, demand personal accountability, and clean house of the designed incompetence that allows these criminal activities to flourish?  The American People are waiting!

The following site holds press releases for the VA specifically, but investigations often cross into Social Security, the Department of Defense, state investigatory bodies, the FBI, and more.  Suppose nothing else is learned from only perusing this site, that more scrutiny needs to be done to every single department of the executive branch.  In that case, we, the American People, might count ourselves lucky.  However, this is not the case.  The rot from poor leadership, criminal mismanagement, and supreme dereliction of duty is etched deeply into the workings of the executive branch operations, and more needs additional discussion.

03 November 2022, the VA-OIG released a report titled, “VHA Progressed in the Follow-Up of Canceled Appointments during the Pandemic but Could Use Additional Oversight Metrics.”  The report only covers the time from 2020 to the present, and regular readers know that the VA has been failing on every measurable metric for over a decade.  To couch in politically correct non-threatening jargon, how designed incompetence continues to hamper and hinder is not surprising.  That the current Congress has bought the excuses hook, line, and sinker, from the inept VA leadership, was not surprising either.  This article is about the future, and the next Congress MUST take immediate and direct action to root cause and improve VA performance!

31 October 2022, the VA-OIG released the following: “Review of VA’s Staffing and Vacancy Reporting under the MISSION Act of 2018.”  This is a report about how the VA continues failing to report improvements in hiring practices to the legislative branch.  The report details VA leadership’s continued failures through designed incompetence.  Tell me, if you were in charge of a report for your business that is essential to receiving funding, would you keep your job if, from 2018 to the present, you still cannot report what is happening and why and be held personally accountable for a report to a legislative body?  Don’t take my word for it; read the report, and be careful of the temperature of your blood boiling!

Unfortunately, this behavior is the normal operating procedure for the VA.  The same can be easily and quickly witnessed in every other Federal Department of the US Government under the executive branch.  As the legislative branch, you are duty-bound to investigate and demand compliance in a timely manner.  Where have you been; more importantly, will you allow these problems to continue or kill them?

Do you doubt designed incompetence is a standard operating procedure?  Let’s discuss another part of the MISSION Act of 2018 that the VA-OIG recently reported on, “Additional Actions Needed to Fully Implement and Assess Impact of the Patient Referral Coordination Initiative,” dated 27 October 2022.  The Referral Coordination Initiative (RCI) is a program to improve timely access to care using community providers.  RCI sounds good in theory, but as usual, in the practical application, the program is full of self-serving charlatans, unsupervised or poorly supervised people, weak policies and procedures, and zero accountability!  Plus, when the veteran runs into problems with local providers, reporting these problems is so time-consuming as to be ineffectual at best!

A personal example that was reported to the VA when it happened, and nothing was done but to issue the provider a check.  Dr. Herekar, Neurologist, clinic: Advanced Neurology Epilepsy & Sleep Center, El Paso, Texas.  A VA Primary Care Provider wrote to my employer on VA Letterhead with a wet signature, declaring my inability to wear a mask.  Dr. Herekar’s office was presented with this letter and hassled me before both appointments for not wearing a mask, becoming hostile, argumentative, and a nuisance over the mask issue, even after I complied with putting on a face shield.  23 September 2021, over Facebook messenger, I was informed that I would be invited to find a different provider due to my refusal to wear a mask.  Imagine that; Facebook Messenger became the medium of choice for ending a patient’s relationship with a medical provider.  What did the VA tell me to do; file endless paperwork with TRICARE and then disregard the problem’s urgency.  Worse, the medical care for the neurological issues decreased, and I have had to wait, sit, and hope for future consideration and possible treatment.  Does this sound like an aberration; it is, unfortunately not!

The VA Leadership realized if community care succeeds, they lose power to control the destiny of veterans.  Thus, they implemented the MISSION Act of 2018 with such feet dragging, designing incompetence into every facet of the program, to promote more complaints to Congress, and hopefully to squash the MISSION Act of 2018 and end community care.  07 November 2022, while waiting to speak to representatives of Community Care Services at the VA Out Patient Clinic in EL Paso, the veteran being served ahead of me was told, “The provider does not fax documents, so you will need to go to the provider, and then walk the paperwork back to us.”

The normalcy of reporting providers not submitting paperwork was beyond the pale.  Not having secure document transfer processes between the VA and local providers is technically abysmal and unacceptable.  Are we in the 1990s, where the cream of technology is sending and receiving a fax?  The designed incompetence includes Luddite-like technical disciplines, and the VA_OIG and the Congress should be furious; I know I am!

Before the MISSION Act of 2018, I was making 5 and 6 trips to local providers to retrieve hard copies of medical records, going to the VA Records office, submitting the documents, and then following up 7-14 days later to find out I had to repeat this process as my VA Providers still had not received the records of my interactions with community providers.  Interestingly, in 2020 I discovered the treatment records still had not been submitted from community providers into my VA eHealth Record, from treatment received from 2012-2016.  Is the pattern of designed incompetence clearer?  Is the VA Leadeship’s intransigence more apparent?  How about the fraud, waste, and abuse of VA resources?

You, the congressional leaders, must take immediate action, not wait, not hold hearings, concrete action to demand compliance from the executive branch leaders to the congressional leaders who are held accountable to the citizens.  America is a representative republic, and it is time the bureaucrats learned the citizens are awake and interested.  You, the congressional leaders, are the people’s tool for correcting government abuses; you have two years to show you are dedicated to that principle, or you will be replaced!

© 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 8

I-CareI fully admit I got behind in April.  Dear reader, my apology.  I have been whipsawed between emergency room visits, depression, extreme pain, and other issues.  Not offering an excuse but a tiny peek into my world as a disabled veteran.  Luckily, I have maintained employment because my employer allows me to work from home.  My driving privileges are threatened again with removal due to the neurological issues I suffer, and this will dynamically change my life, but this article is not about me, but the continued catastrophe called the Department of Veterans Affairs (VA) and the Inspector General (VA-OIG) reports published.

We begin with a financial efficiency review reported from the inspection of the Durham VAHCS of North Carolina.  I know the jokes write themselves when we discuss any government agency and financial efficiency, but I digress.  This is a head exploding report of leadership failure in the observation and governance of employees who did not perform the functions they were hired to perform.  The VA-OIG found the following from October 1, 2020, through March 31, 2021:

    • The healthcare system had 309 inactive obligations totaling $81.7 million.
    • Of these 309 obligations, 200 (totaling over $74 million) had no activity for 181 days or more.
    • In a subsample of 20 obligations, VA staff had not reviewed 17, as required.
    • Contrary to VA policy, healthcare system staff used purchase cards instead of contracts for 21 of 40 sampled transactions (53 percent), totaling approximately $328,000. These 21 transactions were missing required supporting documentation to verify that the transactions were approved and payments were accurate, resulting in $308,000 in questioned costs.
    • 105 more administrative full-time equivalent staff than the expected number, all not doing their jobs as required under Federal Law!

While not all of the findings, those mentioned are the most egregious and in need of corrective action.  Would the citizens of Durham, North Carolina, please tell me, has this been reported in the local news?  Has anyone lost their jobs as the VAHCS right-sizes the financial department?  I can find no additional information that this problem has been corrected, and I am really curious!VA 3

Oh, the irony is thick; consider the following:

“The Department of Veterans Affairs Office of Inspector General Training Act of 2021 would help ensure that VA employees continue to be empowered to assist the OIG in improving VA’s operations and using taxpayer dollars to the greatest effect; helping protect patients and improving their care; and ensuring veterans and others receive services and benefits for which they are eligible.”

The above-quoted material originates from Chris Wilber, who testified to Congress’s HVAC Subcommittee on oversight and investigations.  What is the number one failure on every comprehensive healthcare inspection (CHIP); the lack of staff training, the inadequacy of staff training, or adequately trained staff.  Yet, the statement by the VA-OIG indicates that training has met a threshold for providing adequate training.  Let’s talk about a specific action, “the VA secretary signed a directive in September 2021 mandating that all employees complete a one-time training within one year—an important step in improving VA’s culture of accountability.”  It is now May 2022; the VA-OIG is pushing for training directives to be legislated, not dependent upon any single VA Secretary.  Are you freaking kidding me?  Where is the congressional oversight and scrutiny that allows VA training to continue to be subpar and threaten the lives of veterans?

Long have I wondered how the VA could frustrate VA-OIG actions, investigations, inspections, etc.  Guess what; the answer has become available:

“… there have been instances in which the OIG has been informed that staff have been told that they cannot share information with OIG investigators without first clearing it through supervisors or leaders—contrary to the Inspector General Act of 1978 (the IG Act), as amended.  Under that authority, VA employees at all levels have a duty to cooperate with OIG personnel, including providing information and assistance in a timely manner.”

Employees have been caught lying to the VA-OIG regularly, and what action is taken to remove those employees promptly and efficiently from government service?  From direct observation and employee conversations, it is clear that plans are carefully laid before a scheduled VA-OIG visit to present what the VA-OIG wants, but to gloss over the problems, and nothing ever happened to the managers, supervisors, and employees who lied and misdirected the VA-OIG.  All contrary to established Federal Law!VA 3

Want a specific example of employees intentionally misrepresenting information to the VA-OIG?  Look no further than the statement by Chris Wilber, and this incident was covered as a failure of leadership in a previous article.

“Hospital staff at a VA facility in Fayetteville, Arkansas, had concerns about potential substance abuse by the chief of pathology that were not heard and promptly acted on by local management, which allowed him to work while impaired for years.  He misdiagnosed about 3,000 patients with errors resulting in death or serious harm and is currently imprisoned.  The OIG found a culture in which staff did not report serious concerns about the chief pathologist, in part because they assumed that others had reported him, or they were concerned about reprisal.”

From personal experience, I reported problems to the VA-OIG concerning patient abuse, fraud, waste, and other issues.  Never were my concerns acted upon promptly, and I was removed from employment for being a whistleblower.  The culture of corruption at the VA is incredible.  The examples mentioned by the VA-OIG only further sustain the problem with leadership and how sick the VA truly is as an organization!VA 3

We next turn our attention to the VA-OIG report on the inspection of information technology security at the VA Financial Services Center, another head exploding example of leadership failure bordering on criminal!  The findings include:

    • component inventory
    • vulnerability management
    • flaw remediation
    • Identifying 252 vulnerabilities, of which 228 the local IT team could not identify.
    • the VA-OIG team identified access control deficiencies, as 107 of the 278 FSC systems failed to generate or forward audit logs for analysis.
    • the video surveillance system was not fully functional. Ineffective monitoring and recording facility activities supporting information systems minimize the FSC’s incident response capabilities.

How do you spell failure; these findings spell failure to me rather pointedly and dramatically!  Want to laugh; staff training remains a concern, but not a finding, of the VA-OIG inspection team.  Frankly, with this level of incompetence, staff training should have been a finding.VA 3

To be concise and illustrate further the poor leadership, convoluted processes, and brazen noncompliance of VA officials, the following discussion is about two different VA-OIG reports that reached similar conclusions.  First, we have the VA-OIG report on “Noncompliant and Deficient Processes and Oversight of State Licensing Board and National Practitioner Data Bank Reporting Policies by VA Medical Facilities.”  Second is the VA-OIG report on “Concerns with Consistency and Transparency in the Calculation and Disclosure of Patient Wait Time Data.”  Nothing says convoluted processes more than having two written policies, both originating from Washington DC.  The superseded policy does not have an expiration date.  This means that employees have a designed incompetence excuse ready for not adhering to the most current and applicable policy.  Don’t believe me; one of the key findings was, “VHA has presented wait times to the public without clearly and consistently disclosing the basis for their calculations.”  Designed incompetence does not come more blatant than this, and who suffers, the veteran.  Worse, wait time correction and policy clarification has been stalled by COVID-19, the neverending excuse paying dividends to bureaucrats everywhere!Timelines for Wait Time Calculations

However, both reports are substantially summated by the VA-OIG; thus, “The lack of programmatic oversight contributed to the failure of VHA leaders to detect and intervene upon facility noncompliance.”  Meaning that due to COVID-19, the VHA has refused to do their jobs in deference to the pandemic, and since this is a good enough excuse, the VA-OIG has bought the designed incompetence, lock, stock, and barrel.  The VHA leadership is failing; doctors or dentists let go for poor performance were not reported to state and federal boards, so these providers lacking can continue to harm patients.  It is a federal law (42 US Code § 11151, US Department of Health and Human Services, Health Resources and Services Administration Bureau of Health Workforce, NPDB Guidebook, October 2018, chap. A., 8 USC ⸹ 7462(a), 38 USC ⸹ 7401(1), among others) that providers let go for cause must be reported within 7-days to the regulatory boards at the state and federal levels.  Wait times are hidden because they are so bad; the VHA is embarrassed, so the leaders fall back on designed incompetence to shield themselves while looking for another excuse for poor performance!  In both reports, the ramifications of noncompliance are putting people at risk for sentinel events (death, injury, disability, etc.), and the leadership is at best lackadaisical in the performance of their duties.  VA 3

Where are the congressional overseers in ending the abuse?  When will this insanity and bureaucratic inertia end?  How many “sentinel events,” including deaths and permanent injuries, will it take until those tasked with scrutinizing the executive branch finally take committed action and hold people accountable?  When will the elected representatives stop throwing good taxpayer money at problems that money cannot fix?  If these questions are too difficult to answer, please stop running for elected office, for the citizenry is not happy!

We conclude with two related reports so astoundingly obtuse they defy logic and sanity.  The first is the annual CliftonLarsonAllen LLP (CLA) audit of the VA’s information security for 2021.  The second is the continuing failure of the new electronic health record modernization (EHRM) program.  The VA has failed the CLA audit for more than a decade, with many of the hits repeated year-over-year.  In fact, the CLA audit is so bad this year; it has taken my mental breath away and stunned me into a gibbering idiot!  Reading this report was infuriating; describing it as my head exploding is akin to comparing an M-80 to a nuclear bomb.  How in Dante’s Inferno can this level of incompetence be allowed to remain employed?  But, as bad as the CLA audit is, the continued failure of the new electronic health record system pales in comparison.  The new EHRM continues to suffer from reliability weaknesses, which is polite speak from the VA-OIG for the new system fails to do the job.  We are three years from the new extended deadline, we are already past the original deadline, and the system is worthless today than it was a year ago.  With this success rate, the new EHRM will be utterly bereft of value and need replacement before the year’s end.  How many millions (billions, or trillions) of good dollars must chase this ineptitude before the plug is pulled and those involved held accountable?VA 3

Join me in having your head explode:

“Additional deficiencies included known tasks not being reflected on schedules, no risk analysis, lack of longer-term actions scheduled, and no complete baseline schedule or overall schedule that fully integrated individual project schedules. VA also did not comply with federal regulations when it paid its contractor for deliverables before accepting them (reviewing compliance with contract requirements).”

Consider this other gem from the VA-OIG report, “$1.95 billion in cost overruns per year” are estimated, meaning the final tab will be significantly higher and compounded year-over-year.  In plain speak, the contractor is being paid for products delivered that fail, the products offered are not usable, there is no schedule of completion, there is no schedule for deliverables, many of the products paid for have never been delivered, and costs are overrunning like a plugged toilet. Worse, no one is being held personally liable for these problems, which were apparent in the last EHRM update from the VA-OIG a year ago!  Like the CLA Audit, I am thrilled the VA agrees with the VA-OIG findings, but what are they DOING to fix the problems?

FYI: the image below is a year old, and comes from the last major update to the EHRM.EHR-VA-OIG

?u=https1.bp.blogspot.com-aqaqk18MHoEWRHHsCi_TyIAAAAAAAAAXc7hY4JQuyylIQHYudoR8sbezGZntic4SSwCLcBs640Betrayal2BSayings2Band2BQuotes2Bwww.mostphrases.blogspot.be.jpg&f=1&nofb=1There is no excuse for behaving like the VA’s bureaucratic legions behave.  Bureaucrats, from the city government (including the school board) to the Federal Government, you hold a sacred trust to act better than you are currently performing.  I refuse you any leeway for acting like pompous overlords when you are paid through forced taxation!  You have trespassed upon my patience and kindness long enough, and the day of reckoning has arrived.  You work for me; you work for every taxpayer and citizen in this country, and you have violated our trust, charged us too much and too often, and if you do not begin to show yourself worthy of the sacred trust, we will force you from your cushy jobs and hold you liable for the monies you have squandered!  The law is on our side; you need to begin showing you honor our trust and investment forthwith!

© 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 7

Oh, how I wish and long for, and am working for, the day when the VA is cleaned up, cleaned out, and corrected completely!  The Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) has been busy reporting more on the failures of the VA to act.  Yet, where is Congressional action in scrutinizing the executive branch’s actions?  Honest question, repeated only for emphasis; we elected you to do two jobs, write fair and equal legislation for all citizens, and scrutinize the executive branch; when are you going to do your jobs?

Let’s begin with some softball issues repeated from previous VA-OIG comprehensive healthcare inspections (CHIPs), specifically how employees report feeling morally distressed while working at the VA.  Moral distress is a leadership failure and is widespread enough to reflect the problem is not limited to a single VAMC/VAHCS.  From Virginia to California, Maine to Florida, and Montana to Arizona, too many VA facilities are poorly led, poorly administered, and poorly executed.  The VA is actively abusing the veterans for political gain; some have asked why I consider the VA is actively abusing veterans; let me see if additional disclosure can explain the problem.

“VHA Directive 1004.08.  VHA defines an institutional disclosure as “a formal process by which VA medical facility leader(s), together with clinicians and others as appropriate, inform the patient or personal representative that an adverse event has occurred during the patient’s care that resulted in, or is reasonably expected to result in, death or serious injury, and provide specific information about the patient’s rights and recourse.”

The above quote is from the regulations governing VA care.  The VA-OIG quotes this directive, which has been published and is openly available, yet repeatedly the VA-OIG finds directors.  Hospital administrators who are informed and able to repeat this directive.  Who repeatedly refuse to follow this directive or train their staff to follow this directive.  When sentinel events occur (death, permanent injury, non-permanent injury, disability, etc.), the families report having no idea what to do because the disclosures were never provided to the veteran or designated caregiver.  Is this not abuse of the patient?  Is this abuse not driven by ideologues who gain from the harm they cause others?  Should this abuse not be scrutinized until it is eliminated?  Please feel free to read some of these comprehensive healthcare inspection reports from the VA-OIG, see the resulting injuries and problems caused by the failures of government medical providers, and then tell me whether these atrocious actions need more or less scrutiny and qualify for the title abuse.

North Carolinian veterans, VISN 6 is all yours, and would you be shocked to learn that even with newer leadership, moral distress remains a persistent problem in the VA employees throughout VISN 6, which just happens to include Durham, Asheville, Fayetteville, Hampton, Richmond, Salem, and Salisbury North Carolina?  Probably this is not unfamiliar as the patient experience survey scores remain persistently below VA averages, reflecting that new leadership is akin to putting lipstick on a pig.  Interestingly, medical staff credentialing remains a significant concern in North Carolina.

Western New York veterans, especially those receiving patient services in the Buffalo VAHCS, do you agree with the VA-OIG report?  The Buffalo VAHCS includes Buffalo, Batavia, Jamestown, Dunkirk, Niagra Falls, Lockport, West Seneca, and Olean, and the comprehensive report is mystifying to me.  For example, the VA-OIG reports that “Patients generally appeared satisfied with their care.”   At the same time, “Employee survey data revealed opportunities for leaders to improve workplace satisfaction and reduce feelings of moral distress.”  This is a combination not generally found in these CHIP inspection reports.  Something is definitely off, and I would love to know what, especially since the leadership needs significant improvement in identifying and reporting sentinel events.  Do you agree with the VA-OIG findings?  Please let me know your firsthand experiences, for the double-talk in this CHIP report is above what I usually observe.

With almost identical findings and recommendations in the Syracuse NY VAMC’s comprehensive healthcare inspection, covering communities of Syracuse, Auburn, Freeville, Potsdam, Rome, Binghampton, Watertown, and Oswego, NY., I am concerned that the veterans in New York are in as bad or worse shape than Phoenix’s veteran community.  Hence, I have to ask the VA-OIG, has something changed in your measurement and analysis tools to report such disparate findings as “Employee survey data revealed opportunities for leaders to improve servant leadership and decrease employees’ feelings of moral distress.  Patients generally appeared satisfied with the care provided?”  The double-talk level is higher in these CHIPs from NY, which is rarely observed outside of Phoenix and VISN 22.  Two final thoughts on the CHIPs, staff training, continues to be a high-risk finding, and this continues to be a leadership failure for every VAMC/VAHCS/VISN in the VA; why has progress not occurred?  Training is a system, and leadership and organizational risk, system redesign, and improvement is a quality, safety, and value problem of the highest importance; why is action never taken by leadership or the congressional representatives who are expected to scrutinize the executive branch?

28 March 2022, the VA-OIG released their long-awaited annual “Comprehensive Healthcare Inspection Summary Report: Evaluation of Medical Staff Privileging in Veterans Health Administration Facilities, Fiscal Year 2020.”  I have been interested to see what, if anything, the VA had accomplished in improving their medical staff privileging.  If I were a congressional representative, knowing that medical staff continues to harm and kill veterans, I would have been anxiously awaiting to see if the repeated hits from past years had finally been rectified.  Unfortunately, the VA continues to live down to expectations (digging the hole ever deeper), suffers from failed leadership, and the veterans continue to die or suffer abuse.

What did the VA-OIG discover?  Understand, “The OIG conducted detailed inspections at 36 VHA medical facilities to ensure leaders implemented medical staff privileging processes in compliance with requirements.  The OIG subsequently issued six recommendations for improvement to the Under Secretary for Health, in conjunction with Veterans Integrated Service Network directors and facility senior leaders.  The intent is for VHA leaders to use these recommendations to help guide improvements in operations and clinical care at the facility level.  The recommendations address findings that may eventually interfere with the delivery of quality health care.”  The OIG identified deficiencies with focused and ongoing professional practice evaluation, provider exit review, and state licensing board reporting processes.  Specifically:

    • use of minimum criteria for selected specialty licensed independent practitioners’ focused professional practice evaluations
    • inclusion of service-specific criteria in ongoing professional practice evaluations
    • completion of ongoing professional practice evaluations by other providers with similar training and privileges
    • recommendation by executive committees to continue licensed independent practitioners’ privileges based on professional practice evaluation results
    • completion of provider exit review forms within seven business days of licensed independent practitioners’ departure from a medical facility
    • the signing of exit review forms by service chiefs, chiefs of staff, and medical facility directors if licensed healthcare professionals failed to meet generally accepted standards of care
    • initiation of state licensing board reporting within seven business days of supervisors’ signatures on exit review forms to indicate licensed healthcare professionals failed to meet generally accepted standards of care.

The OIG found ongoing issues from the fiscal year 2019 CHIP summary report that warranted repeat recommendations for improvement.  The OIG issued three repeat recommendations related to the following:

    • inclusion of minimum specialty criteria for focused professional practice
      evaluations
    • inclusion of service-specific criteria in ongoing professional practice evaluations
    • recommendation by executive committees of the medical staff in continuing licensed independent practitioners’ privileges based on professional practice evaluation results.

Boiling the findings of the VA-OIG down, essentially, the administrators and leadership are not weeding out poor and horrible practitioners, reporting these underperforming practitioners, and not acting in the best interests of the veterans seeking care at VAMCs and VAHCSs across the country.  I repeat, only for emphasis: Is this not abuse of the patient?  Is this abuse not driven by ideologues who gain from the harm they cause others?  Should this abuse not be scrutinized until it is eliminated?  Please feel free to read some of these comprehensive healthcare inspection reports from the VA-OIG, see the resulting injuries and problems caused by the failures of government medical providers, and then tell me whether these atrocious actions need more or less scrutiny and qualify for the title abuse.  The link to the full report is available; please feel free to make your conclusions and post your thoughts in the comments section.

On a final note for today, consider with me the problems of the Atlanta VAHCS with pallets of unopened mail containing patient health information, community care provider claims needing payment, and a plethora of other unopened mail.  Understand that when community care providers cannot obtain compensation from the VA, they go to the veterans, who then send in correspondence, which is unopened, thus causing more problems, concerns, and issues for an already abused veteran community!  Want your head to explode?  Look at the pictures the VA-OIG helpfully sent along with this VA-OIG report, and ask yourself if any other business or organization could get away with this type of abuse of the customer.

What did the VA-OIG find?  Well, prepare for your head to explode, again:

    • VA Leadership should have established a formal agreement explicitly detailing each office’s responsibilities.
    • VA HCS leaders did not include responsible managers in decision-making discussions and lacked a clear understanding of the volume of mail processing work they were accepting.
    • Atlanta VA HCS did not ensure mailroom staff was adequately prepared or trained to handle or sort the influx of mail. POM (Payment Operations Management) officials were later reluctant to help, citing the verbal agreement.

Buried in the report is this tidbit, “POM is implementing similar transitions at sites across the country; POM and medical facilities need to ensure adequate staff with sufficient training to handle the mail processing workload.  VA concurred with the OIG’s five recommendations.”  Meaning that in a VAMC/VAHCS near you, unopened mail due to verbal agreements will soon add more distress and disgust to the veteran experience.

I have documented in these articles how verbal agreements, verbal standards of work performance, and verbal processes and procedures are the problem and way of life in too many CHIPs and observed practices at the VA.  Yet, these verbal shenanigans are more apparent than in the dilemma Atlanta faces due to unopened mail.  Payment operations to community care providers are on a controlled and fixed timeline.  Failure to process these payments according to the required timeline leaves providers unpaid, which diminishes the community care provider pool of providers.  Talk to a community care provider, and they will discuss the risks of doing business with the VA and the real possibility of not being paid timely enough or being caught in sufficient red tape never to receive payment.

I know of a provider who called me three years after receiving care and was still trying to appeal and correct the paperwork to receive payment.  A provider recently contacted me who wanted to ruin my credit for failing to pay the balance due from care received, and they are charging interest.  Correcting this problem cost me 48 business hours, 20 calls, and frustrations galore.  By the way, the problem still has not been rectified, an appeal is in process, and we have to wait for the VA to make a decision; this incident was caused by the VA changing the process and the paperwork.  The provider told me they are not accepting any more veterans seeking care, the risk is too significant, the timeline to receive payment is too long, and the VA never pays what is charged.  For example, I recently received a declaration declaring payment to a community care provider.  The VA sent me to this provider, which means they knew the prices beforehand and agreed to the fees.  The declaration declared the VA was charged $2,000 and paid $120, not actual amounts, but close enough to communicate the problem.  With inflation, or without inflation, if you were paid less than 1/10th of what you billed (invoiced), would you continue to conduct business with that company or organization?  Now add the unopened mail problem to the mix.  Would you continue to conduct business with this entity?

America, the Department of Veterans Affairs is sick.  All of the other alphabet agencies in the Federal Government are sick.  We continue to elect people who actively refuse to care enough to act according to their mandated duties.  We cannot afford the government we currently have, which is part and parcel of the problem with inflation in America right now!  Debt is entered into to pay for this bloated feckbeast called government; from the city to the federal government, the bloat is too great to be sustained!  Why is the VA able to skirt responsibility, accountability, and improvement?  They can hide behind the size of their convoluted and twisted organizational shield.  Why can the Post Office and the IRS get away with deplorable, at best, customer service?  They are protected by the congress refusing to scrutinize and hold people accountable.  When your head is done exploding, please remember and act in the ballot box to hire better representatives!

© 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.

Serial Betrayal – More Government Attacks Against Citizens

Angry Wet ChickenGovernment laws, rules, regulations, and the tyrannical thumb of bureaucrats upon the scale of justice mean citizens lose, not gain, freedoms.  Consider the oppression created by the European Union to “protect” wine industries but, in so doing, eradicated competition and locked-in prices to which the government takes through taxes, tariffs, and trade.  The cost, though, is to stop the majority of innovation, the role of technology, and the promotion of class warfare.

For example, in reviewing the history of wine, there are several events where a member of the royalty got into a particular product, and the upper classes adopted the same tastes, regardless of costs, and to the detriment of all citizens.  Tea, Port wine, Champagne, and so many other products through history repeat this process, and the government is used to protect the product, to the detriment and cost of all citizens.  Consider this for a moment; similar tactics would be considered protectionist, monopolistic, and highly illegal in any other industry.  Yet, because the government takes these actions, they are allowed to bend the rules, act in a manner disrupting all citizens, and worse, betray the foundational anchors of a society to trust their government.  When trust in government is destroyed, the government has no moral standing to represent its citizens.  Few understand this is a precious commodity, and even fewer, especially in government, will admit to honoring it.This we'll defend. | Defender, Army mom, American flag

A few examples are required to help drive home this truth; please note those specifically named politicians represent the problem, not the only people betraying and using government jargon and bureaucrats to hide and obfuscate the citizenry.  Ridding the body politic of these examples is a small step in the right direction, but the bureaucrats are the primary source of power; thus, reducing the size of government is the answer, not merely replacing the elected heads abusing their office for personal gain and political power.

Senator Mitt Romney finds himself on top of this list of characters not deserving of his office, and who, with his family, should be as investigated as Biden and Clinton.  Sen. Romney recently changed his mind about SCOTUS Nominee Ketanji Brown Jackson.  Because of a supposedly in-depth discussion, the senator now considers the nominee “mainstream.”  Senator, what does “mainstream” mean?  Why should a judge be “mainstream?”  Finally, which stream is “mainstream?”

I have made my mind up on this disastrous nominee based solely upon her non-qualification for a judicial appointment, let alone the ability to sit on the “Court of last resort.”  Her judicial activism, her refusal to use logic and common sense in her decisions, her flaccid legal mind, and her disastrous leaning toward pro-child pornography are just a few reasons she should NEVER sit on the Supreme Court of this the United States of America.  Good senator, your Yahoo! News article fluff piece does nothing to explain why you changed your mind.  If Judge Jackson was not qualified for a district judgeship, what has changed in the last few weeks to change your mind?  I smell serial betrayal of the citizenry and more mealy-mouthed yellow spinelessness that cost you the US Presidency!

Three state governors also help to elucidate the principle of serial betrayal and deserve removal (in shame) from public office and a transparent investigation.  New Mexico, Utah, and Michigan, your governors Michelle Lujan Grisham, Spencer J. Cox, and Gretchen Whitmer, respectively, are serial betrayers worthy of Benedict Arnold, Doña Marina, or Brutus.  Consider their actions, not their words, and you will find innumerable betrayals made for personal power, political gain, and the demonization of the citizens for the promotion of those who consider themselves elite.  From mask-wearing, mask mandates, government brutality against citizens, and the passing of laws to the destruction of the citizenry, these governors do not deserve janitor’s office, let alone commander-in-chief.

Under the rule of Grisham and through a disastrous legislature, New Mexico became what is termed an“Adult-use Cannabis” state, which means that for recreational use, cannabis can be sold and consumed by adults.  In a state teeming with homelessness, poverty, and already suffering from drug and alcohol abuse problems rampant in the citizenry, the legislature, cheered on by the governor, began to sell cannabis.  The excuse sold to the people, “The state needs to expand its revenue base.”  How does selling an addictive substance to a citizenry already near collapse from the weight of homelessness, illegal immigration, and government regulation improve the tax base?  Simple question, never asked by the cheering media nor answered by the betraying elected leaders proposing another sale of an addictive and harmful substance.Ziad K. Abdelnour Quote: "Trust is earned, respect is given, and loyalty is demonstrated ...

Governor Cox ruled that when the Utah Jazz began awarding scholarships based on race qualifications, as not racist, his colors were evident as a betrayer in deed, not merely by word.  Worse, look to the wording of his first action as governor, what is known as the Utah Compact on Racial Equity, Diversity, and Inclusion: A Declaration on Five Principles and Actions to Create Equal Opportunity.  First, we need to clarify that nothing in this declaration was needed as existing laws are regularly enforced already on the books.  Yet, this new declaration adds some pretty ambiguous wording that is not clarified and will make judicial activism worse, not better.  Leading to the first question, why was this signed into law by the governor who is expected to lead a state?

What does “economic inclusion” mean, and why should all Utahns or any citizens in a direct representative government agree this wording is essential?  What is a “racially equitable state?”  Utah and every other state in America’s union are already racially equitable, only made inequitable by the bureaucrats enforcing the government’s wishes.  Consider the housing projects created by the federal government, supported by state governments, where race is inequitable by design.  Tell me why the government doesn’t just end the housing programs and the racial division they created to have a class of people always ready to riot?25 Quotes on Friendship, Trust, Love and Betrayal

What are “cultures of inclusion?”  The US Constitution already declares in words of soberness, “All men are created equal.”  The Utah State Constitution declares in Section 1 the following:

“All men have the inherent and inalienable right to enjoy and defend their lives and liberties; to acquire, possess, and protect property; to worship according to the dictates of their consciences; to assemble peaceably, protest against wrongs, and petition for redress of grievances; to communicate freely their thoughts and opinions, being responsible for the abuse of that right.”

As a point of fact, Section four of the Utah State Constitution remains an even more powerful declaration, more easily understood, supporting equal rights, where equal rights promote a society of inclusion, where cultures of inclusion are grown and sustained.

Further in the declaration on racial equity, diversity, and inclusion, we find another phrase with no meaning and lots of availability for abuse, “… equal opportunity and access to education, employment, housing, and healthcare.”  The recent COVID-Farrago saw healthcare limited based upon race, and Governor Cox did nothing!  The recent COVID-Government sponsored pandemic also saw employment and housing decisions influenced unequally, opportunities to pursue life, liberty, and happiness were restricted, and Governors Cox, Grisham, and Whitmer were leading the pack in cheering and advancing unequal treatment under the law.  Why?  Why is equality something to be turned on and off based upon skin color, obeisance to government mandates, and the cudgel of government used against citizens who have the right to be left alone?Betrayal Sayings and Quotes ~ Best Quotes and Sayings

In reading the five actions you have committed Utahans to follow, Governor Cox, I am left in a mental swamp equivalent to the Okefenokee Swamp.  Racism in America, especially in Utah, only exists because the government is building a disgruntled class of people who can be depended upon to riot explosively anytime their government benefits are threatened.  This is not equality and does not promote life, liberty, and the pursuit of happiness, but you have insisted that all Utahans are racist by default.  I OBJECT!

Action item two declares the need to invest more in creating the perpetually aggrieved class.  More welfare, not less, breeds more discouragement, anger, and racial inequity.  Since the government has created racial problems and supports racial inequality through government action, why do we not reduce government to improve racial justice and inclusion?  The remaining action items do nothing to advance anything but more government top-down actions, which further promote racism as a government action!10 True Quotes About Being Betrayed

30 April 2020, the Michigan State Supreme Court stripped Governor Whitmer of her legal basis of powers for violating the citizen’s rights to representative government.  Yet, Gov. Whitmer was able to continue to abuse, despise, and detest through government actions the rights, liberties, and lives of Michigan’s electorate for the entirety of the government-mandated COVID-Pandemic.  Is there any more glaring example of treason and betrayal by an elected official, let alone a sitting governor, on a massive power grab?  Newsom and Cuomo cannot pale the hubris of this governor, Gov. Whitmer; you deserve to be named beside Benedict Arnold, Doña Marina, or Brutus as the greatest betrayers and traitors in history.

Serial betrayal of the electorate appears to be a game; how much can a politician get away with, remain in power, and be considered honorable?  Hollywood got something right in the Pirates of the Caribbean” movies when Captain Jack Sparrow said, “The deepest circle of hell is reserved for betrayers and mutineers.”  I believe in the rule of law and so wish you your day in court, in front of a jury of your peers, where justice may be served.  I am not your judge, juror, or executioner.  I am a concerned citizen who is fed up with the gamesmanship of politics!

Knowledge Check!America is a Constitutional Republic, a democracy, and a direct representative style of government; thus, I ask, who are you representing?  The demographics of Utah reflect that the governor is not representing the majority of his constituents.  The demographics of New Mexico and Michigan are similar but also reflect that the constituents are not being represented by the governments and governors currently executing the offices held.  On the mayoral level, too many mayors are learning how to deceive, mimic despicableness, and manipulate the media to play the games and achieve elected offices beyond their maximum level of incompetence.  Why is this happening, the gamesmanship of politicians?  The bureaucrats consider themselves to possess lifelong employment in a cushy and “influential” office; they have lists of media heads to call and whisper to and lists of donors and influential people schmooze.

The answer to solving these problems is a more informed electorate and smaller government!

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

“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 2022 – Sen. 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.

Quis Custodiet Ipsos Custodes? – The Role of the Citizen in Government

Public Service Note:  The links in this article are essential to review.  If you know better resources, please let me know in the comments.  Thank you!

QuestionIn The Satires, VI, Juvenal poses a question of great importance, “Who will watch the watchmen?”  As more and more dirt on a host of politicians comes to the fore, as China expands its heinous reach in the Pacific Ocean, threatening trade and disrupting lives, as the Russia/Ukraine crisis grows, we, the citizens, are left asking this question.  There is only one answer, we, the citizens of representative governments, are charged with watching the watchmen.  A more critical and cogent point has not presented itself in these writings.

Regularly I write about the findings of the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG).  As a disabled veteran, a person falsely arrested, injured by VA Police Officers, and flagged fallaciously as a “behavioral problem,” I am a watcher of the watchmen and report on the findings.  Unfortunately, the VA has turned both a blind eye and a deaf ear to the VA-OIG and my summarizations of the VA-OIG’s conclusions.  You, the taxpayer, need to know what the government is doing in your name and with your tax dollars.  We, are the watchmen tasked with watching the watcher (elected political officials), who were hired (elected) to scrutinize the government.  Is our role in the direct representative government of this constitutional republic clear?Apathy

Did you know your neighbors sued the Baltimore Public School system for breach of public trust?  For more than 40 years, the Baltimore Public School system has intellectually abused children and misappropriated public funds through forced taxation.  The unelected school district has done this while tax revenues drop precipitously, students cannot read (yet still pass high school graduation), and the neighborhoods in Baltimore become more unsafe.  Illiteracy is directly tied to crime rates, poverty, and helplessness; yet, the school board in Baltimore cannot even be bothered to allow parents the right of school choice.  What is the role of citizens in Baltimore, the same as it is everywhere else; protect children, scrutinize government, elect different leaders, and watch more closely those elected to protect the rights of all citizens.  “Who will watch the watchmen;” you are the watchers of the watchmen, and you are being lulled to sleep!

In our constitutional republic, we have three co-equal branches of government, the executive, the legislative, and the judicial.  President Biden is reported to be in full swing of destroying the power of the judicial.  Recently the world watched aghast while a wholly unqualified person was measured for a position with the Supreme Court, the court of last resort in American Jurisprudence.  President Biden is on record claiming he would nominate the first black woman to the supreme court; after ensuring that two other more qualified women of color were refused nomination earlier in his career.  Do you sense a hypocrite, liar, and charlatan?  The judge nominated cannot tell the difference between a man and a woman, allows sexual predators to have lighter sentences as she legislated from the bench.  Yet, we, the watchers, are expected to believe she is remarkably qualified and uniquely capable of sitting on the Supreme Court.  I have serious reservations, not because she is a woman or a person of color.  My reservations rest solely upon her record as a judge, which I find detestable at best.Patriotism

Everyone is aware, COVID-19 has plagued the world since late 2019, originating in China, and the costs have been exorbitant and extreme.  Only until the Russia/Ukraine crisis came along did the global media find a new story for wall-to-wall, 24/7 coverage like feckless beasts fighting for a bone.  Repeating only for emphasis, “Where has the opposition party been during COVID-19?”  The watchers, every single one, from the mayor to the US House and Senate, went to sleep and allowed bureaucrats to overcome law and common sense to the detriment of every single citizen.  Where did the watchers go, and why did they leave the citizenry to the incautious, ineffectual, inefficacious, and abortive bureaucrats who fired professionals, broke the law without regard, and still are running free?  Liberties, rights, freedoms, were stolen without consideration, and the opposition party was nowhere to be found.  Indeed, “Who will watch the watchmen?”

The Duty of AmericansOn the topic of China, why is Marco Rubio the only member of the US Congress willing to say aloud what the citizenry is wondering?  2020 closed with China owning $1.9 BILLION or roughly 192,000 acres of prime American farmland.  Want to know where those crops grown on American soil go; I bet you can guess they aren’t traveling to US Supermarkets.  China is still buying prime farmland, and nobody in the US House or Senate is willing to listen to farmers, ranchers, and dairymen about how their land is being purchased by China and they run out of business.  Rep. Dan Newhouse was quoted regarding farmland ownership by Chinese investors as a national security issue.  “The current trend in the United States is leading us toward the creation of a Chinese-owned agricultural land monopoly.  There are currently no federal safeguards against the creation of this monopoly.”  In response to Rep. Dan Newhouse, Rep Grace Meng proclaimed, “Can we honestly say that this Amendment, which singles out one country, won’t have repercussions on Asian-Americans across our country?  Let’s include all of our adversaries.”

“Who will watch the watchmen?” An honest and fair question.  I agree that no enemy of America should be allowed to own land inside America.  Not that Saudi Arabia is an enemy to America, but it is important to note not just China is purchasing farms and ranchland in America.  Worse, fresh water in California is regularly purchased to grow alfalfa for shipping to the Saudi Kingdom.  California keeps declaring they are in a drought.  The water crisis continues with or without Saudi purchases through the government’s mismanagement of resources, the need for liquid capital to keep the debt wolves away from the door, and the silly environmental laws.  “Who will watch the watchmen; is apt and very important when discussing national security issues, the acquisitions of foreign entities inside America, and the need to meet citizen needs before foreign markets.quote-mans-inhumanity

On the topic of Biden, specifically the Hunter Biden laptop and the shady deals with China, one has to ask about the timing of China’s massive land purchases ramping up.  At the same time, Joey was Vice President, and Hunter was slipping the “Big Man” money.  The Hunter Biden laptop story has been closely followed since October 2020, and the revelations released in the various news outlets on this story leave me appalled, alarmed, and amazed.  I keep asking myself about the timing, why Joey was so valuable an investment, and the answer lies in his access to Obama.  One of the media pundits discussed how Obama and Clinton are tied into the sale of access by Joey, and not all of the financial analysis is completed even now.  Leaves me asking who got paid and why during the Obama presidency?  A careful records review shows China going on a land purchasing spree simultaneously, and more questions for Secretary of State Clinton need to be addressed immediately!  “Who will watch the watchmen?”Beware of Scam Phone Calls and Emails Disguised as Vendors : The New York City District Council ...

Detective 3The US Constitution, in the 10th Amendment, provides all the authority any citizen needs to demand the watchers scrutinize the government and, if required, replace the watchers.

“The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”

We, the citizens, own the direct representative government in America, and it is time for those elected to fear the citizenry.  Not because we have become violent, but because we are firing them, electing new representatives, and holding those removed from office accountable for their mismanagement while in elected office.  Our country is being sold out from under our feet by those elected to office, and it is time they are held accountable before the bar of justice.  Our national security is a hiss and an insult to them, all while they become enriched, and their children funnel money, and I am sick to death of seeing this nepotism.  We, the watchers of the watchmen, deserve answers from transparent and speedy investigations that conclude with people wearing distinctive clothing and permanently disgraced.

Knowledge Check!How have the watchmen become millionaires while holding public office?  This single question should be the watch cry of every single citizen in America until they are all held accountable and disgraced.  You deserve better watchers.  Our children deserve better watchers.  The world deserves better representatives of the people, by the people, and for the people.  Remember this in November!

© 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.

Continued Inanity from the US Government – Where are the Elected Officials?

Angry Wet ChickenI made the mistake of ranking the various government agencies on how intractable, unintelligent, and irresponsible they are.  I ranked the IRS based upon previous experience more competent than the VA.  That is a mistake I will not repeat any time soon, as the VA and the IRS are in a neck and neck race to the bottom!  Consider how the IRS sends you paper mail notifications; if you have questions, you are referred to a website for answers and provided several customer service numbers.  Except, when the website fails, you call the notifications’ numbers and are told that you need to visit the website for faster service.  The website refers you back to customer service, whose phone queues are always so full you are automatically disconnected after being reminded to use the website for faster service.

As my mind experiences a total meltdown, I begin twitching, and my head eventually explodes; check out this cat picture:Funny Cat Backgrounds, Pictures, ImagesDignified Stray Cat Photos Celebrate Their Unique Beauty

Some will declare this is a one-off incident; surely, the IRS is not this dysfunctional.  Try it for yourself sometime.  I never ask anyone ever to, believe me, experience this for yourself.  Check out the IRS website https://irs.gov.  Try to get solid and reliable information, and see how fast your head wants to explode.  I have been trying to appeal a decision the IRS made arbitrarily since 21 March 2022 and gotten nowhere fast.  Best of all, I have a deadline of 20 May 2022 to register an appeal, yet the website cannot answer my questions and points me back to the phone number on my notification.  The phone number auto-answer assistant refers me back to the website shortly before disconnecting my call.

As a small business owner, I had trouble getting my Tax ID number; the website said to call customer support, the phone number referred me back to the website and then disconnected my call because the queues were too full.  Ad Nauseum Ad Infinitum, but the joke is undoubtedly on me; the IRS proclaims they respect my time and are anxious to resolve the concern.  Can’t you just feel the concern and anxiety emanating from the IRS?  Where are the elected officials who need to be scrutinizing the Executive Branch and demanding better returns on the taxpayer’s investment?

As my mind experiences another total meltdown, I begin twitching, and my head eventually explodes; check out this cat picture:Cats wallpaper - Cats Wallpaper (5194935) - FanpopJust say nope | Grumpy Cat | Know Your Meme

If you’re keeping count, this is the third recent article on the culture of corruption at the Department of Veterans Affairs (VA) in as many weeks.  No, I am not behind; the rate of the frequency of VA – Office of Inspector General (VA-OIG) reports has legitimately been this overwhelming.  Never forget, an indictment is not a conviction, and perpetrators remain innocent until proven guilty in a court of law and the trial and sentencing have been completed.

“Hunter Matthew Burroughs and Stephen Keith Andrews were indicted by a federal grand jury in Fort Smith, Arkansas, for their roles in three separate conspiracies to defraud the US government and private workers’ compensation insurers.  Their alleged crimes include a billing and kickback fraud scheme with multiple physicians and medical clinics and separate fraud schemes involving the shipment of medications from Arkansas to two Louisiana physicians, who then distributed those medications from their clinics in violation of Louisiana laws.  Additionally, Burroughs was charged with wire fraud for allegedly falsifying emails he provided in a civil lawsuit involving his sale of the company.”

Not to be outdone:

“Robin Calef of Brockton, Massachusetts, was sentenced to one month in prison followed by three years of supervised release after pleading guilty to one count of theft of public funds in November 2021.  She was also ordered to pay restitution of $102,289 to the VA.  In December 2006, Calef’s sister was receiving VA monthly benefits, passed away.  She failed to inform the VA of her sister’s death, and the VA continued to deposit monthly benefits into a joint bank account held by Calef and her sister until September 2017.  Bank records revealed that Calef made monthly withdrawals of approximately the exact amount of VA benefit funds deposited into the joint account.”

And:

“Derrick Brewer of Enfield, Connecticut, pleaded guilty to one count of theft of government funds.  In March 2018, Brewer submitted paperwork to the VA offices in Hartford as part of an application for service-connected disability benefits.  Specifically, he submitted form DD-214, which indicated that his discharge from his former service in the US Coast Guard was characterized as “Honorable.” However, the form had been altered before its submission.  According to official Coast Guard records, Brewer’s discharge was characterized as “Other Than Honorable Conditions” following his convictions under the Uniform Code of Military Justice.  There is no record of the discharge characterization ever being upgraded.  As a result of this submission, Brewer collected nearly $70,000 in VA benefits from March 2018 through September 2020.  Sentencing is scheduled for 27 May 2022.”

And:

“Sarah Jane Cavanaugh of Warwick, Rhode Island, was arrested on charges of using forged or counterfeited military discharge certificates, wire fraud, and fraudulently holding herself out to be a medal recipient to obtain money and property or another tangible benefit, and aggravated identity theft.  It is alleged that Cavanaugh claimed to be a wounded US Marine Corps veteran and recipient of a Purple Heart and Bronze Star and schemed to collect hundreds of thousands of dollars in veteran benefits and charitable contributions from organizations that provide monetary aid; to veterans in need.”

And:

“From 2002 to 2019, Terrie Lynn Christian of Newaygo, Michigan, engaged in a fraudulent scheme that targeted children’s benefits programs administered by VA and the Social Security Administration (SSA).  This scheme, which involved obtaining benefits for two fictitious children, resulted in government losses of over $660,000, including approximately $110,000 for VA.  Christian was sentenced in US District Court to 30 months in prison, three years of supervised release, and restitution of over $660,000.  The VA OIG and SSA OIG investigated this case.”

Do you notice anything odd in these stories of fraud; the documents did not stand up to scrutiny, but fraud was still perpetrated.  I have authentic documents proving service; I have had to present original documents several times and sign affidavits testifying these documents are my documents.  I am a veteran, and under the threat of severe penalties, I swore that I was not attempting to defraud the US Government.  Would someone please explain how these people, and so many others, can commit fraud so frequently?  Would someone please explain how the VHA and the VBA accepted clearly doctored documents and fraud executed?  Finally, where are the VBA and VA employees being held accountable for failing to do their jobs and allowing this fraud to be perpetrated with complicity?Mediocrity Joke

Time after time, I have been denied help, been given the bureaucratic runaround, and refused assistance until my documentation can be certified.  Then after my documents are approved, they are still rejected by bureaucrats who refuse to do their jobs.  Yet, crimes and fraud are perpetrated with the same bureaucratic inertia and complicit behavior.  Elected officials, do you understand why taxpayers are frustrated?

What reignites the explosion of my head is that these are only two of the multiplicity of government agencies.  Nobody knows how much fraud is perpetrated by employees and customers, and worse, even fewer care.  Elected officials, will you please explain why you are not more concerned and avidly involved in ending the fraud?

Let me cast your mind backward to 2005.  United States v. Alvarez, 567 US 709, is a case in which the United States Supreme Court ruled that the Stolen Valor Act of 2005 was unconstitutional.  The Stolen Valor Act of 2005 was a federal law that criminalized false statements about having a military medal.  Elected officials, when the judges legislated from the bench, overstepping their authority, why didn’t you immediately go back to work and redraft legislation to end the theft of valor and penalize people committing fraud?  Instead, you rolled over like a dead, bloated, floating body, and valor theft has worsened!Plato 3

Elected officials, why have you not drafted new legislation to curb government theft?  Why have you consistently refused to act to curb the bureaucrats from abusing taxpayers?  Why do you remain silent on the shrinking morals in America that open the doors for more abuse of the law?  We elected you to the office to take action; what are you doing?  Yes, mayors, city councilors, judges, dog catchers, school board members, county commissioners, and every other single officer elected, you are included in this plea for action!

Dont Tread On MeAgain, I implore you, the voters, to scrutinize your elected officials for their continued employment.  Yes, start today.  I know the elections are months away, but it requires time to evaluate performance, become knowledgeable, and prepare to act on election day.  You deserve a better government, and those in office deserve to be unemployed!

© 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.

Shifting the Employment Paradigm – I Still DO NOT want to be an Employee!

November 2012, I wrote the first in a series of articles on shifting the employee paradigms.  These articles discussed the freelance or consultant versus the employee in the structure of the organizational design.  Multiple times, the right to control has been addressed as part of the “rights” granted by the Internal Revenue Service to Employers, so the employers will continue to play the Federal Government’s game of control and heavy-handed authoritarian thuggishness.  These topics and more continue to surface on this blog in an attempt to help the employee understand the problem and issues, the loss of freedoms and rights, in becoming an employee.

Today, Joey, the blundering president, has published the 400+ page OSHA abomination that forces you to lose the rest of your privacy to your employer—ending HIPAA, foreclosing your rights to your liberty not to vaccinate, and shaming you into wearing a mask and discriminating if you do not.  While the OSHA regulation is unconstitutional and a clear governmental overreach, Congress remains silent in its scrutiny of the executive branch of the government.  Worse, the citizens of America think that the judicial branch can be trusted to “save them” from the executive branch of government, which is always a BAD IDEA!

OSHA and Joey have declared that employers with over 100 employees have to comply.  After this is accepted, then employers over 50-employees, then 10- employees, and so forth will be targeted until nobody who employees anyone can escape.  This is how the government works, and this is why we need a different structure to operate under.

Employers, employees, I have a better idea than trusting the government to act responsibly.  It is past time to revisit the structure wars and redesign the employee/employer relationship in America.  What is the answer; knowledge vending instead of the employer/employee relationship.  Please, allow me a moment of your precious time to explain.

The idea is simple.  You have employees who know your business cold, know your customers, understand your processes, procedures, workflows, products, and services.  How many of your employees would love to brand themselves to your organization as knowledge vendors?  Ask them!  Then offer them the choice to become independent contractors using the IRS publications as a guide.  The knowledge vendor provides their tools, you provide them access, and they brand themselves and contract to serve your organization, with autonomy to work for you on their terms and schedule.

Please note, this is critical; the IRS continues to change the rules on an almost fluid and whimsical basis.  The link takes you to the designation between an employee and a contractor.  Lawyers will need to help design the necessary contracts to control the relationship.  Some assistance will be required to help those transitioning to ensure they are not killed financially in the tax tsunami the IRS likes to launch.  However, taking this step forces the Federal Government hand over OSHA and allows you and your now independent contractor workforce to return to business instead of compliance. Everyone retains their liberty, plus your privacy and medical records remain your business, not your employer’s or the Federal Governments’.

It cannot be stressed enough; the IRS should never have been placed in control over the employee/employer relationship controls.  Worse, these controls should never have been assumed by the government in the first place.  Since the Federal Government has assumed these powers, everyone needs to understand the fundamental categories that differentiate an employee from a knowledge vendor/contractor.

These topics are covered in-depth on the links, and I have covered them in various articles previously.  Until Congress removes these rights from the IRS, the contracts covering those knowledge vendors must spell out succinctly these controls to avoid the IRS meddling and penalizing the vendor and the employer maliciously.  More to the point, the IRS has, in the past, gone backward and retroactively changed its rules to penalize employers and vendors through “clarifying,” which the courts upheld.

Risky path to take; potentially!  However, all life is risk, and I cannot think of anything more perilous than capitulating to Joey and his merry band of authoritarian thugs!  Plus, America needs to join the rest of the industrialized nations in offering choices to the employer/employee relationship.  Tax laws, generally, and the IRS specifically, are choking the lifeblood out of American ingenuity and increasing the cost of compliance year-over-year.  We need real solutions to these problems and freeing the American worker is the best solution.

© Copyright 2021 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  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.

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  • 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.