It IS ALL About Leadership – More Shameful VA Chronicles

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

 

Gasoline Taxes – The Epitome of Forced Taxation and Government’s Broken Promises

Exclamation MarkI do not care that Alaska has not increased its gasoline taxes in 50-years.  Frankly, the fact that the Federal Government has gone 27.4 years without increasing the Federal Fuel Taxes is not a problem.  Nor that the Federal Government has to either get the current taxes renewed, or the Federal Gas Tax goes to $0.042 a gallon is not a tragedy, but a good thing.  Gas taxes are not the problem; the problem is that the fuel taxes, excise taxes, surcharges, and fees built into a gallon of gas that equals more than $1.00 per gallon, are never prioritized to the infrastructure projects the tax was collected initially to pay for!

IronyI find the following ironic; the Federal Gasoline Excise Tax is actually two taxes combined.  $0.01 per gallon is paid as the Leaking Underground Storage Tank (LUST) fee.  Why is this ironic; because the government LUSTs after all types of money to misappropriate.  Before creating acronyms, one would think that the government would consider how much of a joke those acronyms will make.  One of the seven deadly sins that are constantly causing scandals for politicians, LUST!  Yes, I find this tax acronym very ironic and applicable to the discussion on why the roads and other infrastructure is rated as a C- and falling.  I find LUST very appropriate to the discussion on the misappropriation of funds and how the government wants to increase taxes to pay for something already well funded but where the money is consistently diverted.

QuestionPlease note that each state will have additional taxes, fees, surcharges, and tax projects built into the cost of a gallon of gas or diesel, aviation, or propane.  Fuel taxes are a tax scheme that seems to always pay for anything but roads, bridges, and infrastructure.  Some basic facts regarding gas taxes:

      1. The average state gas tax is $0.3006 per gallon of gas.
      2. The Federal Government gets $0.184 per gallon of gas.
      3. States have added other fees to a gallon of gas, including:
          • Environmental
          • Underground storage (payable even if the tanks are above ground)
          • Inspection fees
          • Certification and other weights and measurement fees
      4. If your state taxes Ethanol, your gas taxes include the Ethanol tax, as well as a fuel tax.
      5. All fuels are hit with taxes, and some of those taxes are disproportionately assigned to heavier vehicles. For example, diesel has a different formula for taxes due to the trucking industry using roads and bridges more; at least, this is the excuse used to tax diesel differently.

Gas Tax Revenue – Poor Roads and Infrastructure

Since I was a kid in Maine, who closely observed the gas tax debate, I have wondered the same question.  “Why are the roads so poor if the government is collecting all these taxes on gasoline?”  Now, keep in mind the words of Justice Oliver Wendell Holmes Jr. “Taxes are the price of civilization.”  Meaning that to “enjoy” the pleasure of a free society, the government will levy taxes.  But, the money collected does not have to go for what the tax was intended to pay.  Hence the broken promises of gasoline taxes.

Plato 2Fuel taxes are used for a myriad of uses, and the priority is all confused about how to spend fuel taxes:

        1. Schools
        2. Pay down the National Debt
        3. Mass Transit
        4. Cleaning up underground fuel leaks
        5. Law Enforcement
        6. Environmental Protection
        7. Pension Shortfalls
        8. State Debts
        9. Federal Highway Trust Fund Deficits of all types
        10. Enforcement Costs, including weights and measurement certification
        11. Roads
        12. Bridges

Now, do not forget the other obstacle in fixing roads and bridges, the labor costs, especially if the workers are unionized.  The government bidding processes for projects, especially in all forms of construction, are obscenely complicated, which increases costs long before a shovel hits the dirt.  If unions are involved, the time for the project and expenses will, at a minimum, double before the project completes, creating deficit spending.  I am not cynical here; I have witnessed this occur too often not to admit the truth.

Working DollarChris LeDoux sings a song, “Working Man’s Dollar,” which tells the story and details the difference between a working man’s dollar and the dollar in other places.  The fuel tax was first adopted in Oregon, and the proceeds were earmarked only for fixing, maintaining, and building roads, bridges, and other travel infrastructures, like tunnels.  Except, the money never is prioritized to the failing roads, bridges, and infrastructure costs.  The working man’s dollar, collected through forced taxation, is not respected by the government authorized through the ballot box to allocate spending.

I was in Maricopa County when a stadium was pitched to the residents to be located in Scottsdale.  A gas tax hike was proposed as part of an overall tax plan to pay for the stadium.  I asked, “If the stadium was worth the investment, why not just sell bonds?”  I never got an answer.  Not every citizen was interested in the stadium, not all citizens were going to benefit from the stadium, but every citizen was being asked to help pay for a stadium.  The stadium in that election failed, but the ideas did not die; a new location was proposed, and the voters there accepted the stadium’s tax hikes.  Want a surprising non-surprise, the stadium is built, but the taxes have never gone away, including property, sales, and fuel taxes!  Where is that money going?

Bait & SwitchNow, the Federal Government has a bunch of fuel taxes and surcharges (taxes called a fee) about to expire.  The question every voter in America needs to ask themselves is this, “Did the government properly use the funds dedicated to infrastructure?”  If so, then the fuel taxes should continue at the Federal level.  If not, then the fuel taxes should cease, for the government refuses to spend money according to the purpose it was collected.  Every single state in the union should be asking the same question and answering accordingly.

I lived in Albuquerque, NM., for several years.  To get potholes fixed, you had to ruin your car in an accident involving the street, then sue the city, county, state, whatever for the insurance costs.  Only then was that particular patch of road deemed important enough to repair.  There are bone-jarring, teeth-rattling, car-destroying potholes all over Albuquerque.  These never get fixed because the city has been too busy dumping tax money into a rapid transit project that is barely used, overly expensive, and desperately not desired by the taxpaying citizens.  They had “ART” (Albuquerque Rapid Transit) crammed down their throats by a judge.  ART has been a disgrace from Day 1.  Yet, money keeps pouring into ART instead of the many roads, bridges, overpasses, and other infrastructure that desperately needs repair.  A friend of mine hit a pothole, doing 35mph, dented his rim almost 2”, ruined his front alignment, and cost him a considerable sum.  That pothole is still there, still causing dents, still eating tires, and the city cannot fix it, the state will not fix it, the county was supposed to fix it, the Indian reservation owns it, and the federal government makes the pothole worse every day by traffic of federal employees going to work.

Tax BurdenHence the reason why fuel taxes are considered a tax scheme!  If you pass the buck enough, nothing gets done, and the money collected can be used in other projects while responsibility is determined.  Except, there is no money to fix the problem when the responsibility is determined, and the wheel just keeps spinning around.  Are you sick and tired of the games politicians play, yet?  Now, imagine your electric bill going up to pay for the fuel taxes not paid for by electric car owners, and tell me about proper government action and accountability.  My friend could not sue because responsibility cannot be determined; his insurance would not pay for the damages because the road damaged his vehicle; guess who was out almost $10,000.

Tax Scheme 2Some states are changing how the gasoline and other fuel taxes, including electricity due to the rise in electric vehicles on the road, are being priced and collected.  However, the problem is not the tax; it’s the fact that the tax never pays for what it was intended to when collected.  Some states got an increase in fuel taxes through their state legislatures this year.  Other states and the Federal Government are taking fuel taxes up in the coming months or the next legislating session.  But, not a single politician, anywhere in America, has stepped up to state the obvious, the current taxes collected are sufficient to pay for roads and bridges; we have to allocate more of the current money collected to roads and bridges.

Broken Promises – Broken Roads and Bridges

Question 3Is the problem apparent?  How many of your state taxes, lotteries, and other fees are supposed to pay for education?  Yet, education always seems never to have enough money.  How many taxes and fees go into the Department of Motor Vehicles and Department of Transportation, all of which are supposed to pay for infrastructure, e.g., roads, tunnels, bridges, overpasses, highways, etc.?  How much is the pension crisis costing your state, driving taxes and fees upwards, but the money never is delivered to pay down and lessen the pension crisis?

I repeat, only for emphasis, “America does NOT have a cash collection problem; it has a spending problem.”  At all levels of government, the elected officials are acting worse than drunken sailors on a seven-day binge, and this behavior needs to cease!  We cannot spend our way out of the hole dug through deficit spending!  The answer is not allowing the government to steal more money from our pockets, but to demand the money taken is used for the purposes intended!

Tax SchemeWe must tie political decisions to misappropriate funds to the legislators and executives making the decisions.  Thus, holding accountable the people who are being poor managers of the people’s money.  More importantly, when re-election decisions are made, the media, the influencers, and the political parties need to report this information.  Being able to hide funding shenanigans and criminal activities should never occur; businesses cannot do this, the government should not be able to do this.  Audits, investigations, and transparency are critical to putting the right people out of office and into prison, and keeping the honest and faithful stewards in office and working.

Knowledge Check!The size of government must shrink to an affordable level, from the city to the Federal; every government body in America, including those non-Government agencies acting like government agencies (USPS), need to be forced onto a diet of less money!  There is no excuse for the government to be the size it has become.  There is no excuse why we, the owners of the government, cannot demand government shrink, become efficient, and keep the promises made regarding money collected, used appropriately, and ended at the time promised.

Angry Wet ChickenAs sure as carts to horses and ducks to water, a Federal tax, fee, or surcharge, will be found shortly on your electric bill to cover the costs of electric vehicles on the roads.  When the Federal government does this, the state, county, and city will jump in with both feet, claiming “fairness” and “equality” so everyone is “paying their fair share” of the costs for infrastructure.  It doesn’t matter that you do not own an electric vehicle; the government will help you finance one through increased taxes and misappropriated fees collected.  Just like the “Obama Phone” scheme being abused by many people and paid for by a small minority.  Broken promises indeed!

© 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.

Weep America! – The VA Leadership is Becoming Worse! – Part 3

I-CareIn the less than 10-days since I last wrote on the Department of Veterans Affairs (VA), the Department of Veterans Affairs – Office of Inspector General (VA-OIG) has dumped more than ten inspection results over the last three days into my inbox.  Not a record, but the recorded actions are certainly hitting record lows.  Worse, the culture of the VA remains unchanged, even through all the recorded crimes and indignities the veterans suffer under.  Recording and summating the crimes of the VA is so depressing, mainly because of the failure to reform.  But, a little depression will not slow or halt the reporting of these detestable actions of the VA!

The first VA-OIG investigation is more of a report on criminal proceedings concluding with sentencing.  A total of five people, including one VA Employee, have been stung in this investigation.  How thrilling to see accountability and justice served cold!

Francis Engles of Bowie, Maryland, was sentenced to 30 months in prison and ordered to pay $150,000 in restitution for defrauding a VA program dedicated to rehabilitating military veterans with disabilities. As the owner of Engles Security Training School, Engles falsely represented to the VA that his company was providing veterans with months-long courses when, in fact, the school offered veterans far less.”

February 2019, four other individuals were sentenced in related cases following their guilty pleas. First, James King, a former VA employee, was sentenced to 11 years in prison for committing bribery, defrauding the VA, and obstructing justice. Second, Albert Poawui, the owner of Atius Technology Institute, was sentenced to 70 months in prison for committing bribery. Third, Sombo Kanneh, Poawui’s employee, was sentenced to 20 months in prison for conspiracy to commit bribery. Finally, Michelle Stevens, the owner of Eelon Training School, was sentenced to 30 months in prison for committing bribery.”VA 3

Apparently, bilking the GI Bill is a regular fraud opportunity, and the VA employees need to be held more accountable for the loss of these funds!  The GI Bill is a precious commodity and sometimes the only lifeline for a soldier for retraining while awaiting the VBA’s decisions. Therefore, stealing these funds should come with more substantial sentences, more accountability for the employees in the know of fraud, and scrutiny from elected officials!

For the next story, we have several crimes co-occurring; the most egregious is reporting to have been a veteran, fraudulently obtaining benefits, and then trying to use veteran status for preferential contract awarding.  The VA-OIG reports:

Robert S. Stewart, the former owner of Federal Government Experts LLC in Arlington, Virginia, was sentenced to 21 months in prison with three years of supervised release for making false statements to multiple federal agencies in order to fraudulently obtain multimillion-dollar government contracts, COVID-19 emergency relief loans, and undeserved military service benefits.”VA 3

I know the Supreme Court of the United States (SCOTUS) has declared that lying about military service is a freedom of speech issue and not a crime.  However, stolen valor continues to make me sick, and the liars should lose all US Constitutional Rights, as well as be sentenced to punishment most vile!  Having served twice (US Army and US Navy), having been deployed to S. Korea (US Army) and the Persian Gulf (US Navy Multiple Times), stealing valor infuriates me into a raging juggernaut!  I hate liars and thieves, but to steal valor from those deserving goes above and beyond being just a liar and thief, and the conduct deserves punishment most vile!  No, I am not apologetic in taking this stance either!  Burn the American Flag; I disagree with SCOTUS again and becoming a raging juggernaut!  There are lines you do not cross with impunity, and if you cannot scream fire in a crowded theater as “Free Speech,” then acts of stealing valor or burning the American Flag are reasonable restrictions!

I do agree with Justice Oliver Wendell Holmes’ statement:

The ultimate good desired is better reached by free trade in ideas — that the best test of truth is the power of the thought to get itself accepted in the competition of the market, and that truth is the only ground upon which their wishes safely can be carried out.”Angry Grizzly Bear

But stealing valor and burning the American Flag is not “free trade in ideas,” and I support social shaming as part of the punishment most vile for these lepers of society!  Before you burn the Flag or steal valor, serve in uniform, watch a military funeral as a dependent, and then let’s talk about reasonable and valid restrictions upon “free speech!”

Another case, another criminal act, only this time, I am left asking, “How long has this individual been doing business with the VA?”  Regardless, as this is an ongoing case, the following firstly applies: “The charges in the indictment are merely accusations. The defendant is presumed innocent unless and until proven guilty.”  From the VA-OIG report:

Muhammad Z. Aabdin of Bronx, New York, was indicted for offering bribes to a VA contracting officer in exchange for the award of VA contracts for personal protective equipment.”VA 3

It will be interesting to watch this case and future (potential) investigations occur.  However, I have several questions needing to be answered, and the report does nothing to aid in answering the questions raised in the defendant’s arrest and the grand jury indictment.  More to come as the VA-OIG and the US Attorney produce information.  May the US Attorney NOT allow a plea deal!

The VA-OIG has often investigated improper fiscal practices at several VA sites for the VBA, the VHA, and the National Cemeteries.  I could almost quote the following investigation results, only differing on how much money is involved.

The VA Office of Inspector General (VA-OIG) conducted a review to examine whether VA’s Maryland Health Care System appropriately managed purchases and payments for medical equipment and supplies. Fiscal oversight of purchase cards and internal controls governing the use of overtime were also reviewed. The VA-OIG found ineffective processes, internal control weaknesses, and inadequate oversight in five areas: 1. The healthcare system and the Enterprise Equipment Request (EER) portal need improved controls for approving equipment purchases. 2. Healthcare system staff and the prime vendor should prepare timely and accurate planning information to ensure adequate supplies are on hand to fill orders. 3. Even though no inaccurate inventory payments were identified, VA’s inventory system needs controls to ensure correct recording of supply units and costs. 4. The healthcare system purchase card program requires closer monitoring to ensure purchases are authorized and supported by documentation. 5. The healthcare system should strengthen its overtime payment controls to ensure supervisors verify overtime hours were completed before approving timecards for payment.  The VA-OIG team also identified more than $5 million in questioned costs related to identified issues such as undocumented or unapproved purchases” [emphasis mine].VA 3

I have heard the term “Criminal Stupidity” and often wonder when “Criminally Designed Incompetence” will become adopted into common vernacular.  I am so fed up with the excuses, the missing money, and the abuse of taxpayer forbearance by bureaucrats; I could rip my hair out and scream until my voice gives out! But, unfortunately, both actions do absolutely nothing to correct the problem and would make me miserable.  The VA has problems with criminals without and stupidity masked as “designed incompetence” within, and the solution continues to be leadership!

Gravy Train 2What adds fire to my mental processes on criminally designed incompetence, the VA-OIG has two other investigations in my inbox on the need to strengthen fiscal controls, , and more correctly track accounting practices.  Under current legislation, if a private business accounted for their money like the VA, they would be shuttered, and criminal charges levied!  Yet, somehow, the elected representatives cannot apply the same accounting behavior standard to a government agency, as they mandate for private companies!  Anyone else thinks we need stronger demands for scrutiny of government agencies?

Plato 2Adding more fuel to the fire for the IT/IS Departments of the VA, the VA-OIG discovered that the VA still cannot regularly and appropriately log records into its own electronic health record systems!  Are you surprised; as a patient, I know I am not surprised at all.  Worse, the lack of medical records being properly handled influences (negatively, of course) how the VBA makes decisions on claims!

The Office of Inspector General (VA-OIG) evaluated whether VA’s community care staff accurately uploaded records for non-VA medical care to veterans’ electronic health records. Veterans receive non-VA care based on certain criteria, such as the distance from the veteran to the nearest VA facility or the wait time for a VA facility appointment. Records for non-VA care enable Veterans Health Administration (VHA) providers continuity of care and inform treatment decisions. The audit team found that staff at six of the seven VA medical facilities reviewed did not always index, or categorize, these records accurately. Inaccurate indexing of medical records poses a risk to veteran care. It increases the burden on the VHA staff who locate and correct the errors, reducing their time for other tasks. The team reviewed 209 veterans’ mental health medical records that VHA community care staff indexed between April 1, 2019, and September 30, 2019, and found 108 indexing errors for 92 veterans. (Some veterans’ records had more than one error.) Errors included using ambiguous or incorrect document titles, indexing records for non-VA care to the wrong referral or veteran, and entering duplicate records. These errors occurred, in part, due to inadequate procedures, training, quality checks, and quality assurance monitoring and a lack of local facility-level policies.”VA 3

Of course, training and local policies were blamed for the failure to log records properly!  These are automatic designed incompetence excuses that appear every single time the VHA fails, the VBA fails, or they both make significant life-altering decisions for veterans, and the VA-OIG investigates!  The VBA claims it is my duty to ensure outside providers send records to the VA in a timely manner.  The VHA claims they have the documents the VBA wants, and they should read the file.  Who is inconvenienced, not the VHA and the VBA, the veteran?  The person who cannot even look at his digital file without a “Freedom of Information Act” (FOIA) request and 30-45 days of waiting, and even then, the document is heavily redacted for privacy!  Whose privacy, I wonder, the providers, the employees, or the veterans?  Because I guarantee the VA is conducting serious CYA on the records produced!  Let alone IT’s continued failure to protect the veteran from identity theft or IS to protect the files from being accessed without reason by employees.Apathy

May 2021 was a tumultuous month for the VA and the VA-OIG.  If you would like to review how tumultuous or think you might have missed an article or two reporting the VA’s designed incompetence, feel free to review using the following link.  Frankly, I want to see action taken based upon the investigations to clean house, more fully scrutinize the VA, and improve the veteran experience at the VA.  But, I do not tell you how to think or feel about an issue. Instead, I report and summate and leave the rest to you!VA 3

As always, I report and summate upon the good and bad.  If you are a citizen of Indiana or receive your care from either Fort Wayne, Marion, or through the Northern Indiana Health Care System, please count yourself lucky, and pass on the praise to the VAHCS employees.  The VA-OIG conducted a comprehensive Healthcare Inspection and found, “The VA-OIG’s review of the system’s accreditation findings, sentinel events, and disclosures did not identify any substantial organizational risk factors” [emphasis mine].  While improvements can still be made, this is HUGE news, and the Northern Indiana VAHCS leadership team needs to be back-slapping and congratulating their employees.

Knowledge Check!Thus, my sincerest congratulations go to the Northern Indiana VAHCS, and heaps of shame and scorn remain served cold to the ineffective leadership and useless employees of the VA in general!  America, we should weep, for the VA is not alone in the government agencies in providing world-class detestable service, abuse of the customer (taxpayer), and skirting accountability and responsibility through designed incompetence!  But, when we are done weeping, it is time for action!  Changing the elected representatives, demanding higher scrutinization with actual penalties for failure, and insisting upon fiscal restraint equivalent to the private sector!

© 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.

Do You Feel Represented? – Your Government In Action!

Detective 4I have received feedback that I write about the Department of Veterans Affairs (VA) too much.  Please allow me to explain why.  As a veteran, I am duty-bound to help my fellow brothers and sisters in arms.  As the son of veterans, mother (USN), and father (USN, USARNG), I know the hardships of being dependents of active duty, reserve, and National Guard members of the military.  The enlistment contract doesn’t end when the contract says so for the military member; the families and spouses contract is forever.

The final two reasons I write about the VA are most critical; NO body should be treated like the VA treats the veterans; the actions of the bureaucrats in the VA are not representing me and what I stand for in a representative government.  As I can easily have the Department of Veterans Affairs – Office of Inspector General Reports (VA-OIG) delivered to my inbox, it makes writing about the VA much easier, benchmarking how the government has insulated themselves and forgotten who holds the reigns of power in a representative government.  While not a reason to write about the VA, this final explanation should help you judge whether your representative government appropriately represents you and what you stand for.Why

The VA-OIG reports today begin with behavior that is intolerable and worthy of public shaming.  While the defendant remains innocent until proven guilty, the criminal complaint represents behavior inexcusable!  “Daniel Devaty of Elyria, Ohio, was charged with influencing a federal official by threatening a family member. Devaty allegedly sent a text message to the cell phone of a VA social worker threatening to kill his daughters.”

Angry Grizzly BearAnytime anyone threatens the family members, their behavior is beyond the pale and deserves public shaming and the harshest of criminal penalties.  I do not care if the perpetrator is a politician, a judge, the media, or a private citizen.  Leave the families out of any business dealings!  Hollywood, take note, I am sick to death of you threatening family members in movies, TV shows, or simply as private citizens/influencers.  For too long, you have shirked your public responsibility, and families are OFF LIMITS!  Learn this lesson well!

On the topic of conduct reprehensible, the following VA-OIG report leaves me running out of adjectives to describe the behavior of this VA Employee.  “Robert Sampson of Gulf Breeze, Florida, pleaded guilty to charges of video voyeurism and disorderly conduct. Sampson secretly recorded eight fellow VA employees using a hidden camera, disguised to look like a cell phone charger power adapter, that he placed in a restroom at the VA Joint Ambulatory Care Center in Pensacola on multiple occasions from August 2019 to June 2020.”  May the judge throw the book at him and his punishment be creative and sentence well earned!

VA 3In another VA-OIG report, we have more leadership missing problems, where a fraud scheme existed for 11 years without discovery.  “Erik Santos of Georgia was sentenced to over 11 years in federal prison for defrauding Tricare of approximately $12 million through a compounding pharmacy fraud scheme. In January 2021, Santos pleaded guilty to one count of conspiring to commit healthcare fraud and wire fraud.”  While the US Attorney beats his chest and proclaims they will catch everyone involved in the fraud, how many managers and supervisors inside Federal Government employ will lose their jobs, pensions, and freedom over allowing this fraud to occur?  What processes and procedures will be changed to protect against another fraud scheme?  Who is personally accountable for contracting that permitted this scheme to bloom for more than a decade?

VA 3The following VA-OIG report details how clowns and asylum patients run the IT program for the VA and not professionals!  The VA was tasked explicitly by legislation to meet several IT deadlines on a program for family caregivers as part of the VA MISSION Act of 2018. Unfortunately, not only did the VA fail to get the IT program up and running on time, missed mandatory reporting deadlines, and delivered a software solution 2-years past due, but the “VA did not establish the appropriate security risk category and fully assessed the system’s privacy vulnerabilities.”  Amazing, with all the IT problems the VA suffers from, with all the IS problems the VA suffers from, one would think that, where new technology was concerned, the VA would be practicing better security and using the lessons learned previously.

VA 3Would someone please tell me why private industries would be sued to the Nth degree criminally and civilly for these IT failures, but the government can evade accountability and responsibility; why?  In a representative government, the citizens can, and should, hold the elected representatives and their minions accountable for failing to uphold basic security protocols. So how did the government vote themselves a “Get out of Jail Free” card?

While writing this article, three additional VA-OIG reports have been delivered to my inbox.  The newest VA-OIG report discusses a topic that the VA continues to struggle with, namely transparency.  Apparently, the goblins in Goblin Town still cannot stomach sunlight and prefer to keep their nefarious deeds hidden.  Unfortunately, the lack of transparency in hiring practices leads to more VA-OIG investigations into employee wrongdoing, cost the taxpayers phenomenal fees to rid the government of poor hiring decisions, and all this before the union becomes involved.  From the report, we find the following:

“… VHA delegated much of its data reconciliation to its local facilities, which introduced variability in the process and did not allow for consistent creation, maintenance, and verification of information. VHA also had inadequate business processes to ensure quality data were available to support effective medical facility staffing oversight. Without consistent methods and reliable source documents for managing information, VHA cannot be sure HR Smart data accurately reflect VA’s budget and workload requirements.”VA 3

Did you catch that local facilities were given authority, which increased risks in hiring, all while management cannot perform their functions properly?  I remain convinced that the VA built designed incompetence into every action to protect themselves from ever being forced to take action. But, unfortunately, like always, the news only gets worse!Plato 2

A little background is needed to appreciate the problem in the following VA-OIG report fully.  Coronavirus Aid, Relief and Economic Security (CARES) Act required the VA to report to the OMB how they spent money appropriated for America’s Veterans and the VA during the pandemic.  The following is what the VA-OIG found:

VA met monthly reporting requirements to OMB and Congress on supplemental fund obligations and expenditures. VA also submitted required weekly obligations and expenditures from supplemental funding to OMB by program activity. Of approximately $17.3 billion in medical care supplemental funds, VA reported it had obligated about $7.11 billion and had spent about $5.67 billion by December 29, 2020. The VA-OIG team noted three concerns where VA’s reporting was not complete and accurate: • Obligations were at risk of not being included in VA’s reports. • VA initially delayed the reporting of reimbursable obligated amounts for two months. • VA’s reports contained negative dollar amounts in data fields that should have only positive amounts, which misstated VA’s overall reported obligations. Those concerns indicate weaknesses in how VA and VHA internal controls are structured to meet reporting requirements. Despite the risks identified, VA performed only a limited review at the summary fund level of its COVID-19 obligations and expenditures before reporting. A review of summary funds is not detailed enough to identify potential anomalies and ensure the reliability of externally reported information” [emphasis mine].VA 3

I did not find this in the VA-OIG report. Did anyone ask why the VA failed to meet the reporting for the first two months?  After the FISMA Congressional hearings, everyone knows the VA sucks at information technology and information security (IT/IS). So why was the VA given more money and told to budget it using existing failed software, processes, and procedures?  My work in the finance field is limited; however, when a company cannot handle its finances properly and meet legal obligations, a third-party accounting firm can be hired to handle this for the organization.  OMB, why are we not using this solution at the VA?  OMB, why is a third-party auditing company not conducting in-depth analysis and audits of the VA?  With all the missing taxpayer dollars at the VA and Department of Defense, it seems that you are just as negligent as the agencies you are supposed to monitor.

Theres moreAs they say on the Home Shopping Network, “But wait!  There’s more!”  Unfortunately, the same holds of the VA, just without the enthusiasm!  Each VA Medical Center in the Department of Veterans Affairs – Veterans Health Administration (VHA) is expected to have supplies, also referred to as caches, on hand at all times to handle local emergencies and national health care incidents.  For example, a pandemic!  The VA-OIG investigated these prepared caches and found that only 9 of 144 supply stockpiles were ever mobilized.  The excuses, oh these excuses, are like butt holes, everyone has one, and they stink!

      1. “Medical facility directors reporting supplies were not needed or caches lacked sufficient quantity for meeting pandemic demands.”
      2. “The Veterans Health Administration (VHA) changed the process for mobilizing caches during the pandemic, but without clearly communicating it to medical facility directors” [emphasis mine]. – We have the blind leading the blind, in a darkened room, in a London fog!
      3. The VA-OIG, not the VHA, not the local VAMC, but the inspectors “identified problems with cache maintenance and monitoring.” – Never forget, this is a job of several people, overseen by a director, who reports to facility leaders, and inspectors had to find the maintenance and monitoring problems. Just let that sink in for a minute!
      4. Most caches contained some expired or missing personal protective equipment, diminishing their ability to support pandemic preparedness.” – This is an example of how the VHA is “Defining Excellence in Healthcare!”
      5. The “VHA had incomplete documentation on cache activations, making it difficult to know which caches would need to be restocked.” – See item number 3 above.
      6. Medical facility leaders were not always able to accurately report if their facility’s cache was activated during the pandemic.” – Is the proof sufficient that the VA leadership IS the problem with the VA; yet?VA 3

In the US Navy, a significant part of my job was to maintain and monitor emergency supplies. Additionally, to use and cycle through reserves during drills and replenish those supplies quickly and efficiently not to impair the ship’s ability to protect itself 24/7.  I did my job well enough to earn three people Navy Accommodation Medals.  I took over the emergency stores, and all consumable supplies were expired or consumed.  Within 3-months, I was winning accolades and awards.  Yet, 144 caches of emergency supplies for the VHA need more procedures, more documentation, and more oversight to fulfill the mission correctly.

Knowledge Check!I beg to differ!!!  We need leadership, active, engaged, enthused, leadership!  We need the medical facility leader to stop designing incompetence and do the job they have been hired to perform.  We, the taxpayers, need the oversight instruments of the Federal Government to become a lot more effective at demanding results.  We desperately need the elected officials we have hired to scrutinize the government!  Just imagine if you hired someone to perform a mission-critical job, and in the middle of needing emergency support, the person hired reveals, “Oops, I might not have done my job properly.”  How fast would that person be fired?  Now, why can we not do the same to the government employees?

So, ask yourself, do you feel represented by your government?

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: The Leadership at the VA Continues to Shame Themselves!!!

Bird of PreyI do not believe in coincidences, I just started reporting the VA leadership as being the problem at the VA; the Department of Veterans Affairs – Office of Inspector General (VA-OIG) finally appears to be blaming Department of Veterans Affairs (VA) leadership.  In my inbox are two VA-OIG reports where the facilities’ leadership is being called out for the detestable behavior they continue to exhibit!  In one of the VA-OIG reports, please do not allow the “YUCK!” factor to distract from the problems at hand in the VA Leadership refusing to do the jobs they have been hired to perform!

        1. Bradley Lane Croft, the owner of Universal K-9 Inc. in San Antonio, Texas, was sentenced to nearly 10 years of imprisonment for scheming to defraud the federal government of more than $1.5 million in GI Bill benefits to train service canines and their handlers. In addition to the prison term, Croft pays approximately $1.5 million in restitution.”

November 2019, Judge Ezra found Croft guilty on eight counts of wire fraud, four counts of aggravated identity theft, two counts of money laundering, and two counts of making a false tax return.  Testimony during trial revealed that beginning in 2015, Croft provided false information in applications to the Texas Veterans Commission, including instructors’ names, certifications and training documents to receive GI Bill educational benefit payments.”

VA 3If you have access to more details, please share.  This story did not make a ripple in the news, and I want to know why!  Worse, who at the VA lost their jobs, lost their retirement package, or were sanctioned for allowing this fraud to occur?  2015-2018, three years of deception, where the VA leadership and lower-level employees were supposed to investigate and research documents submitted before awarding contracts?  The court records read like this was an IRS audit for fraudulent tax filing that discovered the school fraud of GI Bill benefits.  The VA never knew until the IRS alerted them.  Hence, I ask again, where was the VA in properly executing its duties to protect the government and the taxpayer from fraud?

      1. During a comprehensive healthcare inspection (virtual) of the Aleda E. Lutz VAMC in Saginaw, Michigan, the VA-OIG was pretty vanilla, except for the following. “Selected employee satisfaction survey results indicated opportunities for the Associate Director for Patient Care Services to improve workplace perceptions and for the Chief of Staff to support an environment where employees felt less moral distress” [emphasis mine].

VA 3Now, I have never personally been a patient in this VAMC or one of its clinics.  However, “moral distress” is a pretty universal phrase meaning that employees feel pressure to commit immoral activities.  The actual term “moral distress” is found in an “All Employee Survey,” where the employees stated that they felt pressured to commit an immoral activity at least once per day.

In the past year, how often did you experience moral distress at work (i.e., you were unsure about the right thing to do or could not carry out what you believed to be the right thing)?”

If an employee feels anywhere between 1.0 and 1.7 times (on average) a day they are being pressured to commit immoral activities, surely this should raise some eyebrows and a lot of questions about the propriety of the leadership team.  Did the VA-OIG take a sample of employees and gather quantitative data on exact actions employees feel they are pressured to commit?  If so, why is the conclusion bereft of actionable items for leadership to take?  If not, why not?  Employees claiming pressure to act in an immoral manner are a significant risk to any business organization.  The VA is already on record for having inferior to worthless administrators; now the veterans and the taxpayers get to know the Aleda E. Lutz VAMC and its clinics have morality issue problems.  Nobody in the VA leadership at the Federal or VISN level cares!

        1. The VA-OIG conducted a review to assess aspects of the care provided to a patient who was struck and killed by a motor vehicle following elopement from a community living center (CLC). The patient suffered from paranoid schizophrenia and was involuntarily civilly committed to the CLC.”

Administrative failures began the day the patient was admitted to the CLC, as discovered by the VA-OIG, “… the patient’s admission to the CLC was inappropriate as indicated by the CLC’s own screening process.”  Added to these concerns, the VA-OIG expressed the following concerns, “… regarding the appropriateness of CLC admission and elopement prevention.”

The OIG determined that interventions implemented by staff were inadequate to mitigate the patient’s risk for elopement. The patient eloped multiple times, and facility staff failed to provide individualized, progressive, mental health-driven interventions to prevent the patient from eloping. The OIG also found that facility staff assigned to care for the patient were inadequately trained in mental health care, and patient safety reports were not completed as required.”

On the day of the patient’s death, the OIG found that facility staff did not follow missing patient procedures after the patient eloped. Facility staff failed to detect that the patient was missing for nearly three hours, and once the patient was noted as missing, facility staff failed to follow policy to locate the patient. In addition, the OIG found that facility leaders did not ensure the facility had a missing patient prevention policy or that staff completed annual missing patient training. The OIG expressed concern that the CLC may not have been utilized as intended, given the lack of mental health standards applicable to CLCs and the complex mental health needs of this patient.”

VA 3Take a minute, imagine you are a family member of this patient.  How are you going to feel when you see the consistent and ongoing problems with the facility?  How helpless would you feel knowing that your family member was missing for hours before it became known to staff this patient, with a history of elopement, was gone?  How frustrated would you be with the administration when you read this report and see that from Day 1 admissions, this CLC was inadequate to the task of seeing to this patient’s needs?  Now, do you understand why I, as a veteran, become so aggravated and upset with the lack of leadership at the VA?  These are my brothers and sisters in arms, and they are being abused and killed by the VA’s lack of leadership.  The only recourse we have is to try and share these horrible tales with our fellow citizens in the hopes of improving the political leadership, to demand change of the executive branch’s VA leadership!  Another needless death at the hands of the VA leadership!

Let me preface this final story a little.  First, if you have a weak stomach, feel free to skip this next story.  Second, an endoscope is an illuminated optical, typically slender, and tubular instrument (a type of borescope) used to look deep into the body and used in procedures called an endoscopy.  Endoscopes are considered reusable medical equipment, and special training and procedures are required to clean and sterilize these scopes properly.  Third, an endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inserted directly into the organ.  Again, if you have a weak stomach, feel free to skip the rest of this article.

      1. Let us travel to the Chillicothe VAMC in Ohio, where we find the VA-OIG with “concerns” over “… responses by facility leaders to a Sterile Processing Services (SPS) employee’s failure to follow endoscope reprocessing [cleaning and sterilization] procedures.” The VA-OIG report stresses the following, “… the VA-OIG also identified concerns related to actions taken by Veteran Health Administration (VHA) leaders.”  Thus, we have one (1) employee and several VHA leaders from the local to the VISN whose actions are at best “questionable” in the cleaning and sterilization processes for an endoscope.

Three separate and similar complaints were raised at this facility for this exact issue!

“… VA-OIG investigations substantiated that the employee did not follow facility reprocessing procedures and falsely documented compliance. The VA-OIG determined that the Facility Director did not develop and implement an adequate plan to monitor the employee’s compliance with SPS procedures following reinstatement to SPS duty, particularly given concerns regarding the employee’s integrity and compliance. Because multiple patients were potentially affected, facility and VISN leaders notified the VHA Clinical Episode Review Team (CERT) for review and disposition. The CERT concluded there was minimal risk to patients and that a large-scale disclosure was not warranted; however, the VA-OIG found that the CERT’s determination may have been based on an inaccurate understanding of the reprocessing equipment’s capabilities” [emphasis mine].

VA 3Here is the other side to this problem. This is not the first time or first facility having problems with employees failing to reprocess medically reusable equipment, refusing to document correctly, or risk patient complications from dirty medical equipment!  This is not the first time the CERT team has made the wrong decision not to warn the patients involved; they might have been put at risk by dirty medical equipment!  The last episode involved colonoscopy equipment, and it was not that long ago I was writing about that incident!  YUCK!!!

Why was the employee not immediately fired for falsification of official documents?  Why did the facility’s and VISN separate investigations not see the directors of patient safety and hospital director fired for failure to perform their jobs?  The Chillicothe VAMC’s entire leadership should be fired in disgrace over this incident.

PACT 1While a patient in the VA Hospital here in Phoenix, I was in a clinic where a mother was trying to gather sufficient records to hold the VA accountable for her son’s permanent disability from sepsis.  The veteran caught sepsis when improperly cleaned scopes were used during a gall bladder removal surgery.  Her son, the veteran, spent 9-months in and out of non-VA hospitals; she had pictures of his bruised and swollen abdomen from the doctors trying to treat the sepsis and keep the veteran alive!  I have no idea whether this mother was successful or not getting the VA to cover the medical expenses and increase her son’s disability.  I only know I never saw her at the VA again, and the VA Police shadowed her as she moved from clinic to clinic, gathering records.  I do not know why records release could not release the proper documents to save this mother the hassle of visiting individual clinics.  I do know I can still see this veteran in the photos his mom showed me, and my blood continues to boil!  Yet, the CERT team asserts that mass notification is not needed in these situations; I demand to know why they can make this decision!

ApathyThe leadership at the VISN levels and the individual hospital levels is sick, inadequate, and desperately in need of a complete replacement to end the culture of corruption found inside the VA.  When employees record moral distress, this should be an automatic red flag, alerting the VISN leaders poor leadership practices are happening, but the VISN never does anything!  Failure of this magnitude would have gotten any non-VA hospital or clinic shuttered and class-action malpractice lawsuits launched.  Yet, when the VA gets caught, the media cannot even be bothered to report on the problem in the local news.  Maximum endurance has been breached, and these administrator problems need immediate attention from the politicians!

Dont Tread On MeHence, I will ask you, dear reader, to please share these VA articles far and wide.  Action is needed before the next veteran to die unnecessarily is a friend or family member of yours!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: Speaking of Administration (Bureaucrats) in Government

I want to send congratulations to the US District Attorney’s Office – District of New Jersey; they have uncovered a fraud scheme worth $93 Million in kickback frauds, bribery, and theft of taxpayer monies; this is good news for the United States.  From me, you have my deepest thanks!

Some significant details are missing from this report, and I would expect these details to have been made public:

      1. How many of those charged were employees of Medicare, TRICARE, and CHAMPVA?
      2. How long was this scheme in place before discovery?
      3. How was this scheme discovered?
      4. Who was offered immunity from prosecution to turn traitor and open the doors to the scheme? Why?

One partial question was answered, “From March 2018 to October 2019, several conspirators withdrew money from the scheme approximately $1.6 Million.”  I guess this is as good a time as any to remind everyone that under the law, you are presumed innocent until proven guilty in a court of law.  Five people are charged in this case, where two others have admitted guilt, bringing the total of people involved to seven.

Some things might be slightly different from my time in government procurement, US Army, and US Navy.  I know that when you use the same provider more than two or three times in a single quarter of a fiscal year, someone should be asking a bunch of why questions and checking the contract.  Yet, to the best of my understanding of the case details as provided, this was not occurring.  Thus, more questions need to be raised:

      1. Who are the contracting officers in this case for the government agencies most affected by the fraud?
      2. Who are the supervisors of the contracting officers who allowed these abnormalities to exist without question?
      3. Who is reviewing the contracts to improve protection against fraud in the future?

Remember, no employment details were provided for those charged to see who was/is a government employee and who was/is not.  But, with Medicare, TRICARE, and CHAMPVA all involved, there should be a lot more details coming forth, and as of today (28 April 2021), there is nothing more available.  Bringing more questions to the front:

      1. Where is the media covering another government fraud case? Surely this should be of interest to every media outlet since the scheme covered at least some of President Trump’s tenure.  You would presume the media’s Trump Derangement Syndrome would have kicked-in to plaster this news nationwide.
      2. Where are the investigative reporters tasked with finding the details, rooting out the causes, and spurring politicians to action to “fix the government?”
      3. Where are the politicians, those who had to be notified about this case, in praising the DA’s office, clambering for justice for the taxpayer, and promising that these people involved will face stern justice? Or are these politicians silent because it doesn’t allow them to play a race/sex/gender card?

Healthcare fraud remains the number one issue for Medicare and the VA to tackle, as well as TRICARE, Tri-West, CHAMPVA, and every other government healthcare agency.  The problem lies in how the administrators do their jobs, affect policy, and scrutinize their employees.  Yet, every government healthcare fraud case leaves out the details of what the agencies will change to avoid future problems and prevent similar schemes.

      1. When will the heads of these government healthcare agencies be hauled in front of Congress to testify about healthcare fraud, and why they continue to refuse to follow the law laid down by Congress?
      2. When will Congress develop a spine and hold these bureaucrat administrators accountable for the failure of their agencies to protect the taxpayer from fraud, bribery, theft, and other healthcare scams that only make problems worse and cost billions in dollars annually?
      3. Where are the politicians who are sick to death of seeing fraud occur and not seeing action by those placed to head these organizations?

As an employee, two other employees and I signed a letter claiming that the processes being followed by the Emergency Department of the VA Hospital in Albuquerque, NM., were violating the Fraud, Waste, and Abuse of the government.  We proposed changes that would improve patient care, increase employee productivity, and increase the security of patient HIPAA information.  The HAS Administrator refused even to consider the letter, even with favorable approval from the supervisor.  I sent the letter to the hotline, the specific place every poster in government buildings tells people to contact when you witness fraud, waste, and abuse in government.  My answer was crickets!  Then, I was terminated from employment; that is how the VA administrators treat employees who try to raise the bar in performance and reduce fraud, waste, and abuse.  See, if you are not an employee, you cannot be a whistle-blower.  Nice loophole for administrators to employ to threaten, cajole, Quid Pro Quo, and protect themselves from accountability!

      1. When will the administrators be held accountable for the fraud, waste, and abuse experienced in their agencies?
      2. When will the taxpayer be vindicated and receive just consideration of rights and accountability for taxpayer dollars wasted, stolen, and debt increased without cause?

Please do not allow the tone of this article to produce a fraudulent thought; I have no problems with the government helping its citizens.  But I demand better accountability and responsibility from those few selected to lead the agencies involved.  I demand higher accountability from the politicians, who chose to run for office, and whose job it is to scrutinize the government!  I demand a complete and accurate accounting for my tax dollar, and this should not be a complex action for any government to make.  When fraud is your number one issue and has been since your agency was launched, I would expect some progress to have been made in processes, procedures, and standards by now, and I do not see any of this occurring!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: VA Administrators – Heaping More Shame

Angry Wet ChickenI believe in public shaming; I am an equal opportunity shamer.  Where the VA is concerned, well, I tend to be more motivated to pass out shame than any other government entity.  Not that I won’t pass along shame, or congratulations, when warranted, the administration of the VA deserves a few more scoops from the shame bucket today!

The Department of Veterans Affairs – Office of Inspector General (VA-OIG) passed along two issues today, and I have to weigh in on serving more shame, cold, hard, and well deserved.  Long have I maintained that the administration and administrators of the VA are the problems in the Department of Veterans Affairs (VA).  Today’s VA-OIG reports provide more justification for demanding cleaning of the house for administration officials at all levels in the VA.

      • Rita Copeland, 59, of Portsmouth, Virginia, pleaded guilty today to wire fraud and aggravated identity theft in connection with a scheme to defraud veterans. Copeland operated an entity known as Veteran Services of the Commonwealth and purported to provide various services to veterans from 2016 through 2020. She caused a number of victims to apply for VA home improvement grants and then used a portion of the grant payments to her own benefit instead of performing the promised work.”
      • Sophia J. Quill, 60, was charged with defrauding the VA and the Michigan Department of Treasury out of $470,000. Quill and her co-conspirator Melissa Flores, who was arraigned last year, allegedly created aliases and obtained or created fraudulent documents to make it appear that they were heirs to various individuals who died.”

VA 3If this is VA Excellence in action, we all need to be concerned!  Do you notice anything missing from these reports?  Let me help; where are the approving officials expected to do due diligence in being held culpable for allowing the fraud to thrive?  I fully admit I have limited experience being a document reviewer and approving authority.  I cannot help but ask about these approving officials who have been trained and gathered experience for their employment role.

ApathyI submit documents to the VA all the time, and every time I have to submit anything, the intake “officer” has to certify the document’s validity.  Heck, the VA had my NGB Form 22 and both DD 214’s, and I still had to submit valid copies to ensure I was not defrauding the government.  Forget innocent until proven guilty; submit forms to the VA, and you are guilty until they begrudgingly claim you are innocent.  Submit documents to Social Security for a claim, same thing, same process, same everything.  Yet, somehow three different people were able to defraud the government, stealing money, and are now hosts of the government.

Detective 4Now, returning to the VA-OIG reports, who authorized accepting the fraudulent documents?  Where were the inspectors?  How many veterans had to complain they were being cheated before anyone took notice of Copeland’s crimes?  How many congressional members were contacted for help that never arrived?  How many letters to administrators were written that were never answered?  How long did veterans suffer before the VA took action, especially in Copeland’s case?  How many evidence intake specialists lost their jobs in either case?  Were any held accountable for failing to do their jobs?

Congress, you have two straightforward jobs, write laws that are constitutional and scrutinize the legislative branch to protect the citizen from runaway government.  After the last two weeks, I have to ask, where are you in performing either role?  Passing District of Columbia Statehood for the “umpteenth time” is unconstitutional!  Overlooking the scrutinizing of the legislative branch is unconstitutional and criminal negligence of your sworn duties.

The administration of the Department of Veterans Affairs is rotten to the core!  Yet, even when directly responsible for fraud, negligence, and dead veterans, the administrators are given a “Get out of Jail Free Card.”  Wasn’t Speaker Pelosi pretty upset with CEOs and “Golden Parachutes?”  Yet, the VA Administration has precisely this and more, and the veterans and taxpayers cannot even get your attention for a second of work!  Where is the corporate media taking the politicians and the VA administration to task for criminal negligence and failure to protect the citizen?  It seems to me we can add a culpable third party to the needs a dish of shame, the media, who are also criminally negligent in performing their duties.The Duty of Americans

Where are the lawyers?  Copeland’s case undoubtedly deserves a Class-Action Lawsuit to help those defrauded get the money they need.  Where are the lawyers, hungry to see change and willing to risk becoming known for taking on the VA and winning?  The actions of the VA Administrators need to be corrected.  If Congress refuses to scrutinize appropriately, the lawyers need to begin processes in all 50-states and US Territories and Districts to demand the VA get fixed!

Bird of PreyThe time for kid-glove treatment and soft-shoe approaches is past and dead; more positive and forceful measures are required.  Where are the lawyers?

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

NO MORE BS: Cease the Trump Derangement Syndrome

The Duty of AmericansTop news stories across the world for the past four years generally, and the past week specifically, reflect the incredible amount of ludibrium verius malum Speaker Pelosi and her left-leaning liberal leftists show, all of whom are reflecting her incurable case of Trump Derangement Syndrome.  Trump derangement syndrome (TDS) is a pejorative term usually for criticism or adverse reactions to United States President Donald Trump that are perceived to be irrational and have little regard towards Trump’s actual policy positions or actions undertaken by his administration.  For more than four straight years now, we have heard nothing but invective, poison, and utter stupidity flow from these sources, all lies, innuendo, and half-truths to the damage of America and America’s duly and legally elected president.  Biden/Harris, the Clinton Machine, and so many others have heaped scorn upon President Trump as if all the other American issues have been fixed magically.

Speaker Pelosi, you and your ilk have been craven, resentful, envious, and more pusillanimous than every single person in history combined, who have committed treason and other acts of vengeance against America.  When the history books are written, may the truth about how horribly you have not done your job be fully revealed to the reader, and shame be heaped upon you eternally!

PatriotismWhy doesn’t America have a budget; Speaker Pelosi has refused to do her job as Speaker and as minority representative of her party!  Why is COVID being used as an excuse to betray America and seize freedoms; Speaker Pelosi has refused to do her job and stand for individual rights.  Is Speaker Pelosi alone in her tyrannical rule; absolutely not.  But, as the most prominent target and the leader of a host of liberal-leftist minion’s hell-bent on America’s destruction, she deserves the most credit and disdain!  Why has America’s military suffered: Speaker Pelosi and her followers have refused to act, have promoted scum into leadership positions, and refused to do their job.  Why have governors been able to interrupt interstate commerce; Speaker Pelosi has abdicated her responsibilities.

I heard an excellent question over the weekend, “What happens when the media and the liberal leftists can no longer blame TDS and President Trump for all their problems?  This is an excellent question, and I demand an answer before President Trump leaves office to a fraud filled Biden/Harris weak-kneed, spineless, and treasonous presidency.  What happens when the blame can no longer be shifted from problems and issues, and the focus changed to the president?  Will Pelosi blame COVID next?  While I expect Speaker Pelosi to continue to dance away from the blame, what about the media?  Will they hold any other politician accountable?  What about the Republican Party, the GOP used to be called the “Grand Ol’ Party,” will they remain as puppets in Pelosi’s back pocket as liberal leftists in all but name?  Will the GOP find a backbone and begin to represent America again?

CaptivityWhat about the governors who have spent the last 10-months stealing freedoms under the false guise of COVID as a “health emergency?”  Will they begin to relent, reopen, and support America because President Trump is no longer in office?  What about the freedom stealing mayors who are absconding with money and power from taxpayers who are struggling under the mandates, orders, and police state invented over a simple viral infection?  Will they be held accountable and begin to act in a manner that honors their office and the electorate’s will?

We are less than 10-days to the Biden/Harris fraudulently acquired presidency.  Speaker Pelosi, your mental health disease makes you unfit for public office, let alone third in line for the presidency.  Worse, your media facilitators and enablers and staff are just as bad at injuring America for personal gain and cannot be trusted.  Do you understand the depth of your complicity in breaking America?  The rot you represent is directly proportional to your responsibility in this execrable affair, but your enablers share just as much objurgation and cannot escape.  Thus, when addressing you, Speaker Pelosi, I am addressing all of your enabling hordes!  Those hordes you supported by remaining silent while America burned, those hordes who stole private and public property while you ate ice cream and blamed President Trump, those hordes in and out of political office who follow your lead like blind and deaf lemmings to America’s destruction!

LinkedIn ImageThe depth and breadth of the rot in America is as real as the sunrise and needs desperately to be exposed to sunshine disinfectant.  Where the creatures involved are held personally responsible for creating the problems, the debt, and the abuse of constitutional law witnessed since President Clinton was inaugurated.  Not that America was perfect under the first President Bush, but America was undoubtedly a lot more free, independent, and able.

Speaker Pelosi get off the train to Abilene, you have reached maximum crazy, and your minions will always be insatiable.  Enough of this detestable TDS behavior.  America deserves better than you as third in line for the presidency; retire already!

© 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.
All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:
https://www.linkedin.com/in/davesalisbury/

Symptom, Not Disease – A VA Chronicle

Carl T. Hayden10 December 2020, The Carl T. Hayden Phoenix VA Medical Center (VAMC), I was arrested for the third time, hassled for the fifth time, and injured for the third time at the hands of the VA Police over my physical inability to wear a mask. The zealous supervisor of the COVID Screening staff threw a fit, for the second time (first in October, again in December), when I asked him about his authority to refuse me care at the VA under EMTALA. Thus, for the third time, I have been denied emergency care under EMTALA by the Phoenix VAMC. I was taken to Holding Cell 2, where multiple officers of the VA Federal Police Force decided that making jokes about my injuries, claiming I was faking my injuries, and insisting they knew more about my injuries than my doctors was an acceptable VA Policing policy. Major Kratz is the bitter cherry on this “crap sundae,” by entering the room, shaking his sausage-like finger in my face, and accusing me of lying about having created an action plan with Jennifer, the supervisor of Patient Advocacy. A symptom, not the disease!

The Department of Veterans Affairs – Office of Inspector General (VA-OIG) has made some startling reports to Congress. Consider, “U.S. Attorney Justin Herdman announced on 20 November 2020, that a grand jury sitting in Cleveland has returned a 28-count indictment charging William H. Precht, age 53, of Kent, Ohio, with theft of government property, conspiracy to commit wire fraud and honest services fraud, wire fraud, and false statements relating to health care matters.” Let me stress; the defendant remains innocent until proven guilty in a trial of his peers. Still, I also stress this incident cost the Department of Veterans Affairs (VA) more than $1,066,348. The scheme was in place from 2010 to 2019, is but another symptom, not the disease, endemic to the VA.

The VA-OIG continues to report, “the owner of a for-profit trade school has been charged with defrauding the U.S. Department of Veterans Affairs and student veterans, announced U.S. Attorney for the Northern District of Texas Erin Nealy Cox.” The defendant, who remains innocent until proven guilty in a court of law by a jury of his peers, defrauded veterans seeking education to the tune of $71 million in GI Bill benefits from the VA and is facing up to 184 years in federal prison. Symptom, not disease, and the VA is full of this type of rot.

VA SealI would never expect a person to believe that the entire VA is full of these symptoms from three examples. Consider that electronic wait-lists, and wait-lists in general, has been a leading cause of death for veterans awaiting care and that the Phoenix VAMC has been in severe trouble on this single issue twice in recent years. Yet, the VA-OIG found, “… wait-list entries were not reviewed and validated as required. Patients were not removed from the wait-list when appropriate, indicating that employees at medical facilities did not review entries daily, and supervisors did not validate the wait-list weekly.” Supervisors not doing their job to oversee work is appropriately performed is the symptom that led to the first two incidents reported in this article. Again, symptoms, not disease.

Another recent example that was buried in “COVID-Media Hysteria,” “Ergonomic office furniture maker Workrite Ergonomics LLC, a Delaware company, and its parent, Knape & Vogt Manufacturing Co. (collectively, Workrite), have agreed to pay $7.1 million to resolve allegations under the False Claims Act that they overcharged the federal government for office furniture under General Services Administration (GSA) contracts, the Department of Justice announced on 3 December 2020.”  This settlement is over a contractual obligation clause to lower prices. “The settlement resolves allegations that Workrite did not fulfill its contractual obligations to provide GSA with accurate information about its commercial sales practices during contract negotiations and did not subsequently extend lower prices to government customers as required by the GSA contract’s price reduction clause.” Not mentioned here are the VA Employees whose job is to monitor the purchases made under the contract, ask questions during contract negotiations, and oversee the contractors and purchasing contracts. Fascinating that the employees responsible for catching these issues early never seem to be held liable for their failures to perform the jobs they have been hired to perform. Symptom, not the disease.

Speaking of symptoms, where supervisors and employees are not performing their jobs properly. “U.S. Attorney Andrew Murray announced on 2 December 2020 that John Paul Cook, 57, of Alexander, N.C. is facing multiple federal charges for defrauding the U.S. Department of Veterans Affairs (the VA) by receiving veteran benefits based on fraudulent service-connected disabilities from 1987 to 2017.” Thirty-years of VA Disability payments, but no VA employee ever asked if he had a driver’s license or other proof of disability. How is this possible; symptom, not disease!

Military Crests“A Florida attorney, on 1 December 2020, admitted his role in a scheme to extort $7.5 million from a California bank, Attorney for the United States Rachael A. Honig announced. Richard L. Williams, 73, of Miami, Florida, pleaded guilty by video-conference before U.S. District Judge Susan D. Wigenton to an information charging him with conspiracy to transmit an interstate communication with the intent to extort.”  Symptom, not disease!

“A Michigan woman was sentenced on 4 December 2020, to three years and five months in prison after pleading guilty to carrying out a scheme to defraud the U.S. Department of Veterans Affairs (VA) of more than $1.7 million in veterans benefits, announced U.S. Attorney Nicholas A. Trutanich for the District of Nevada.” Where were the IT and IS Controls to check for doubled veterans claims? Where were the employees asking for more information when blood types and other medical records mismatched? Administrative controls at the VA are a symptom, not the disease, and the VA Employees who have aided and abetted in allowing this type of trickery need to be held accountable.

Consider the following quote “VA employees are public servants with a solemn duty to care for our nation’s veterans,” said David Spilker, Special Agent in Charge of the VA OIG’s Southeast Field Office. This quote comes from the following case of fraud where the defendants have pled guilty. “Miller Wilson, Jr. (50, Sparr), his daughter, Myoshi Wilson (26, Citra), and his ex-wife, Erica Wilson (43, Ocala) were sentenced today by Senior United States District Judge James D. Whittemore for their roles in a scheme to defraud the U.S. Department of Veterans Affairs health care benefits.” The VA Employee Miller Wilson, Jr., was in charge of VA Payments for non-medical transportation. He established a company to transport VA Patients, received kickbacks for steering work to other companies, and got the other two family members involved in the scheme. Where was his supervisor during all of this “irregular behavior?” Symptom, not the disease.

ProblemsThe VA’s disease comprises numerous large organizations, especially those in the government sector, disconnections between leadership and front-line service providers. This disease goes by several names, but all have the following characteristics:

    • Lack of training
    • Lack of supervision
    • Lack of interest
    • Lack of caring
    • A socially shared sense of entitlement

Frankly, the disease is apathy, compounded by generations of knowledge in protecting oneself to the detriment of all others, including other employees. For example, as an employee, I was physically and verbally assaulted by a senior employee. When another employee and I complained of the maltreatment, the assistant director gave patently false information on how to report the problem, promoted the employee doing the assaulting, and then castigated those who reported this employee’s malbehavior. As the behavior intensified, the director became involved and used other employees on a quid pro quo to remove everyone who reported the employee doing the assaulting.

I-CareBecause this behavior is so ingrained, it has become a defining characteristic and is part of the organizational design. Correcting this behavior requires the same tactic used in pruning trees. Start small, get a core group of people who can work, act, and lead.

  1. Start in the local clinics and hospitals, for the Veterans Benefits Administration and the National Cemetery. Start local, where the worst rot is the most visible.
  2. Write down processes, procedures, operational standards, and behavior guidelines. Once written, begin training, publishing, and speaking about this new managerially acceptable behavior by first living these behaviors.
  3. Start setting organizational examples as fraud and malfeasance raise their heads, remove those involved, promote from within, and train the new leaders using the small core group as mentors.
  4. Cut out the obviously poor growers, first. For example, remove employees for cause, and publicize why. While publicizing why they were removed, communicate the new standards of managerially acceptable behavior.
  5. Train, train, and train. That training is a powerful organizational behavior, cannot be stressed enough. Set exacting standards, do not deviate for the easy and quick, and train others to meet those standards. Training includes mentoring and coaching. Use this opportunity to train, mentor, and coach as tools for encouraging managerially acceptable behaviors that meet the new standards, which begins new growth when the old rot is removed.
  6. Be Brave! Change in an organization requires the same type of bravery that wins soldier medals in battle. Standing when you want to sit is key to pushing back against organizational cancer represented in the current leadership.
  7. Do not quit! Too often, the VA has good intentions, uses valuable marketing tactics, and then drops the delivery ball, and the desired organizational change fizzles. Why does the change fizzle; because the leaders tasked with implementation run out of steam before the entrenched management runs out of excuses. Ending this requires smaller steps and people invested in making the change happen.

Image - Eagle & FlagThe VA has become detestable and is absolutely failing in the VA’s mission, as President Lincoln provided. Get outside the regular hiring pool, demand legislation that allows for change, and begin to prune. The veterans in America are counting on you, the leaders of the VA, to act! Do not let these veterans die because of your apathy and fear!

© Copyright 2020 – 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.
All rights reserved. For copies, reprints, or sharing, please contact through LinkedIn:
https://www.linkedin.com/in/davesalisbury/