“That’s Crazy!!!” – More Chronicles from the VA – Chapter 2

I-CareAs bad as the last several months have been, I hate adding more bad news; but the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) keeps reporting, and I keep summating.  Due to the absolute overabundance of incredible bureaucratic insanity, today’s article format will necessarily shift to report more and comment less.  Don’t worry, I will still comment on the more egregious examples, for some of these VA-OIG reports are scarier than Joe Biden dressed as a mall Santa at a Fourth of July celebration feeling up little children!

  • 2020 Pre-award reviews of contracts totaled $81 million; guess what:
      • 24 of the 31 contracts awarded contained conflicts of interest.
      • 25 of the 31 contracts had problems with overcharges for hourly rates of services rendered.
      • 6 of the 31 price gouged Medicare.
      • 25 of the 31 contracts, if they had adequately followed the contract process, would have saved taxpayers $16 Million. – Would it shock anyone to hear this is just the “tip of the VA-OIG” report iceberg?

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  • Financial Efficiency Review of the Southeast Louisiana VAHCS in New Orleans; guess what:
      • The VAHCS in New Orleans scored 75% out of 90%. The VA does not try to get a 100% because they regularly fail financial audits as a fact.
      • Actual costs are difficult to relate in dollars and cents because the leaders intentionally hid costs from the VA-OIG, then blamed the new medical center director.
      • Avoidance costs, Purchase card abuse, prime vendor program abuse, and more were employed to avoid proper fiscal practices.
      • Audit, FAILED! No accountability, no person held responsible, and the taxpayer is left holding the bill!

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  • Followup to VAHCS Ozarks Pathology Failures From Dr. Levy Scandal; guess what:
        • Levy Scandal for those who do not remember. – Intentional misdiagnosing, VA coverup, refusal to discuss with patients affected. The report is ghastly!
        • 5% of the patients have now been contacted, and the VA-OIG considers this a “success.” I sure hope you are not part of the 24.5% patient population.
        • Here’s the rub in the 76.5% notification, “an absence of a clearly defined process for clinical providers to alert the Clinical Review Team if later changes in a patient’s health required reconsideration of institutional disclosure.” Does the VA-OIG still want to cheer about that notification rate?
        • Less than 5% of the severely sick patients have been notified of the scandal and the problems created by Dr. Levy. Is this how the VA admits culpability, waiting for the patient to pass?
        • Now, here’s the real kick to the balls; “The VA-OIG determined facility processes related to disclosure of the pathology errors and amending patients electronic health records generally met Veterans Health Administration policy requirements, but opportunities for improvement existed.” – Are you KIDDING ME?

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  • Speaking of fiscal inefficiency and audit failures. The VA continues to overspend and under-deliver on prosthetic devices, especially for shoe inserts.
        • In the fiscal year 2019, such items—artificial limbs, shoes, shoe inserts, and compression garments—accounted for about $318.8 million, or about 9 percent of prosthetic spending.
        • Oversight of prosthetic spending was ineffective, resulting in medical facilities sometimes reimbursing vendors at unreasonable rates.
        • Medical facilities spent about $10 million more than reasonable rates in the six months from October 2019 through March 2020.
        • Rates and data in databases remain unreliable, no oversight, and those in charge of oversight are missing in action. Yet, the VA continues to spend pell-mell.  Does this sound like fiscal responsibility to you?

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  • VA-OIG double-speak lives, and is blatantly observable in the following report, the “Contracting Officer Warranting Program.”
        • For those unfamiliar, a simple explanation: “A warrant gives federal contracting officers the authority to obligate taxpayer dollars. VA’s contracting officers help serve our nation’s veterans by procuring the goods and services required for their care and support.”
        • Never forget – There have been long-standing concerns (Never Resolved) with VA’s contracting officer warrant program. Since 2015, the VA Office of Inspector General (VA-OIG) has issued multiple reports [describing how] warranted contracting officers exceeded their authority and made decisions that put veterans and VA facilities, resources, and information systems at risk.
        • Never forget – The VA-OIG has documented multiple times, and the VA has never resolved, that the VA’s acquisition management has been included on the Government Accountability Office’s (GAO’s) high-risk list for fiscal impropriety and poor contractual adherence.

BUT…

        • The VA-OIG found that while VA’s contracting officer warrant program complied with Federal Acquisition Regulation requirements, opportunities exist to strengthen the program and that the VA lacked assurance that all contracting officer warrants were justified and necessary. – Essentially, this is bureaucrat double-speak for, continue to lie, cheat, steal. We like our job and want to continue, and since Congress doesn’t care, neither do we!

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  • The VHA continues to suffer from employee shortages. I have written about this shortage until I am blue in the face and my fingers ache.  I am fed up telling the VHA how to fix this problem.  If they want answers, call me!

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  • Nurse Bethann Kierczak of Southgate, Michigan, was charged with theft of government property and theft or embezzlement related to a healthcare benefit program. She allegedly stole authentic COVID-19 vaccination record cards from a VA hospital—along with vaccine lot numbers necessary to make the cards appear legitimate—and then resold those cards and information to individuals within the metro Detroit community. – Frankly, with the way the Federal Government is acting, this theft is almost understandable and acceptable.
          • No! I am not condoning an illegal action!  I am simply stating that Pelosi and her ilk do 10-times worse hourly by Congressional standards and get away with those crimes!

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  • Donald Peter Auzine of Baton Rouge, Louisiana, pleaded guilty to conspiracy to commit health care fraud. Bonnie Jean Lawless Diaz of Slidell, Louisiana, pleaded guilty to misprision (or knowing concealment) of the commission of a felony. From March 2014 through October 2016, Auzine, the marketing manager at Prime Pharmacy Solutions, defrauded TRICARE and other benefit programs. Diaz concealed the fraud by knowingly submitting compounded medications for which there was no medical necessity. Both will be sentenced on January 4, 2022.

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  • Amanda Dawn Rains of Fayetteville, Arkansas, pleaded guilty to conspiracy to commit mail, wire, and healthcare fraud, obtaining federal employees’ compensation fraudulently, and paying kickbacks. Rains, a former executive with a Rogers medical supply and billing company, participated in 2013 to 2017, defrauding the US government and private insurance companies.

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  • Robert Seifert of Utica, New York, was sentenced to two years in prison for making telephonic threats to Albany Stratton VA Medical Center employees. He admitted that on January 14, 2021, he made successive calls to three separate employees and left each of them threatening voicemails in which he used demeaning and offensive language. Seifert’s threats caused the employees to fear for their safety and property. He will also serve one year of post-imprisonment supervised release.

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  • Patsy Truglia of Parkland, Florida, pleaded guilty to two counts of conspiracy to commit healthcare fraud and one count of making a false statement in a matter involving a healthcare benefit program. From January 2018 through April 2019, Truglia and other conspirators generated medically unnecessary physicians’ orders via their telemarketing operation for orthotic devices like knee, back, and wrist braces. Truglia, co-defendant Ruth Bianca Fernandez, and other conspirators caused approximately $25 million in fraudulent durable medical equipment claims to be submitted to Medicare, resulting in approximately $12 million in payments.

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  • Larry Ray Bon, 62, was sentenced to over 16 years in prison for shooting a firearm inside the West Palm Beach VA Medical Center in Florida. Bon brought the firearm to the emergency room, and after becoming frustrated with medical staff, he retrieved it from his wheelchair and fired several shots. In March 2020, he pleaded guilty to three counts of assaulting, resisting, or impeding federal employees and one count of possession of a firearm in a federal facility with the intent to commit a crime. At that time, Bon was committed to the custody of the US Attorney General for 25 years of mental health care and treatment at a suitable medical facility. However, Bon was determined to no longer need psychiatric hospitalization and was recently sentenced accordingly.

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Finally, if you want a really good reading, you can visit the VA-OIG page and see the lowlights of the VA-OIG’s reports for yourself by visiting the page here.  Excluded from this list are the usual reports of malfeasance and misfeasance captured in the comprehensive healthcare inspection (CHIp) reports, where we find the exact carbon-copied hits from report to report.  We find moral distress, problems in staffing, continued refusals by leadership to train staff, and the ever-present refusal to attend disruptive committee meetings.  Also omitted from this summation were the inspection of veteran centers and the myriad of failures, bureaucratic ineptitudes, and abysmal behaviors.  Frankly, I could not stand being depressed more by writing and analyzing another moment’s detestable and criminal behavior.Angry Grizzly Bear

What curdles the food in my stomach, this is just the VA.  What about all the other official and unofficial government agencies in the alphabet of the executive, legislative and judicial branches of what we collectively call “the government.”  To all the freedom-loving people in America, please awake and arise; we need you!

© 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: Come, Let Us Reason Together – Chapter 5

Bait & SwitchIn Chapters 2 and 3 of this series, the discussion regarding money and the $350 Billion dollars COVID relief monies were discussed.  As this is a continuing discussion, I would encourage you to read those missives as well for a fuller understanding of the principles being discussed.  Regardless, several facts remain pertinent:

      1. The states accepting this money will be bound to spend it in a manner the Federal Government specifies.
      2. The money being given to the states as a “stimulus for COVID economic growth,” will not spur anything but inflation and poor fiscal policies.
      3. The strings attached to this money are a noose on individual state economic growth long after the deadline to spend the money (31 December 2026) comes and goes.

Doherty (2021) writing for the NCSL (National Conference of State Legislatures) provides some clarity on the Treasury Department’s rules and regulations regarding this $350 Billion albatross being forced down the state’s throats.  The funds being discussed originate in the $1.9 Trillion American Rescue Plan Act, and the Treasury Department has released operational guidance to the states and cities receiving the funds.  Never forget, while the Treasury Department claims there is an algorithm for sharing the money, politics and political connections will be the final determinant in who receives how much of the funds being doled out.

The Duty of AmericansPensions are the first point of discussion as to where these funds can go; never forget, pensions remain the largest single expense for states in the United States.  Those bloated governmental salaries, negotiated by unions, and put in place by legislative fiat, keep the taxpayer on the hook for poor financial planning long after the initial beneficiaries of the union retirement pyramid scheme and dead and buried.  Read carefully the pension data provided by USAToday for a full and detailed discussion on just how big the pension problem is for the states of the United States.

Millstone of Designed IncompetenceJust as important, look at the total number of government workers as a share of the total workforce, and you will discover just how big your state and local governments have become.  For example, two states selected at random from the 50-state list, New Jersey, and New Mexico are displayed below, and sourced from the article:

New Jersey

  • Funded ratio: 38.4%
  • Total pension shortfall: $130.7 billion shortfall (3rd largest)
  • Gov’t workers as share of total workforce: 13.3% (20th lowest)
  • Avg. annual payout per public retiree: $32,148 (9th highest)

New Mexico

  • Funded ratio: 61%
  • Total pension shortfall: $18.2 billion shortfall (18th largest)
  • Gov’t workers as share of total workforce: 18.6% (4th highest)
  • Avg. annual payout per public retiree: $20,907 (15th lowest)

ApathyConsider New Jersey for a moment, if you met 100 new people in one day, more than 1/10th of those met will work for the state or local government in some capacity, and those 11 people are earning $32,148 taxpayer paid dollars a year for being retired.  Worse, New Jersey is kiting checks on your children’s future to the tune of $130.7 Billion dollars every year.  Raising taxes cannot help closing the funding gap in the pension.  Want more news, the majority of those retired are not living in New Jersey, so all those taxpayer monies are not being recouped in sales taxes, property taxes, and other taxes.

Yet, the Federal Government just borrowed $1.9 Trillion to give the states $350 Billion, and the monies provided will not even pay a years’ worth of pension payments in most cases.  Let alone pay for all the other accounts that have been stripped to pay for the pension gap.  For example, infrastructure (Roads, Bridges, Highways, Broadband Internet, the Electrical Grid, etc.), Teachers, Community Colleges, Unemployment Insurance, Water and Wastewater Treatment facilities, and Health and Human Services, just to name a few cash strapped state programs.

Plato 2A few days ago, I was discussing broadband Internet grids, and there susceptibility to failure with people who work for a major Internet Service Provider.  In Umatilla County, as an example, the Internet either currently, or previously, went down nightly for 5-6 hours at a time.  Read the outage reports and you will find regular large geographic areas of the country suffering with Internet latency and connectivity issues.  Yet, your state legislators must focus not upon the potholes damaging your car, not upon shaky bridges and overpasses prone to failure, but upon pensions for retirees.  All due to labor unions and promises that should never have been made in the first place!

Pensions are the number one reason I, personally, think that government workers should not be able to unionize, and that the government pensions should be as rigidly controlled as the private sectors pensions.  Yet, the inverse is true, unions growing in the public sector, shrinking in the private sector, and the taxpayer is left with the bill.  Since the government can continue to kite checks, our children’s great grandchildren are already up to their necks in debt that is unsustainable.

Plato 3Come, let us reason together for solutions that actually work.  I offer below the following suggestions, feel free to agree, disagree, add more, and discuss openly in the comments.  We, the owners of government, must re-take control of the government, and to do so, we must communicate and act.

      1. Reduce the size of government immediately to the size posted on 31 December 1999. This is an immediate and interim step.  To be followed by a position by position, value discussion, where technological solutions to replace workers is decided.  Eventually culling government size back to a Pre-1930’s level.
      2. Automate as many functions as possible. The processes of how government function are necessarily complicated to justify a jobs program.  This culture of complication must cease forthwith, the processes cleared of unnecessary complications, and streamlined to allow for automation of the processes.
      3. Take the pensions and eradicate the unions. Privatize pensions should be the letter of the law for all, public and private sector employees.  Thus, creating a new market and investment industry.
      4. Privatize public maintenance of roads, the fuel taxes are sufficient to pay for this and improve road maintenance immediately.
      5. Privatize wastewater and water generation and distribution.
      6. Privatize and deregulate all utilities, allowing for maximum competition, and ending the private geographic monopolies the tech companies and Internet providers have established.
      7. Privatize K-12 and Community Colleges changing the pay structures for teachers and reducing the “staff” positions. Get focused on delivering a product, the product is an educated student who can read, write, and do math, thinking logically, and critically.  This means ending the surplus of standardized tests and putting the teacher in charge of the classroom.

PatriotismNever Give Up!Not every child should be forced into college.  Not every job requires a college degree.  Opening the community colleges produces certified, trained, and non-debt laden students that are workforce ready.  Workforce ready means able, willing, and skilled in working, be that in academia for a degree, or in the workforce as a tradesman the requirement is the same and the distinction needs removed from the leaders of K-12 educational leadership.

The aim and the intent of all government programs is to get out of the way and let people act as they think best for themselves and their families.  Not pushing children to college for a degree and a life of debt payments.  Not forcing them into the military because you are too lazy to teach them how to read, write, think, and speak.  Not forcing them into poverty to support a government jobs program.  The government will not go “quietly into that dark night.”  But, with enough insistence the government we currently know can be cut, reduced, and forced to retreat.  We, the citizens, need to take back our government through the ballot box, through the judicial branch, and through demanding change in the legislative and executive branches at all levels of the government.

Knowledge Check!First step, believe it is possible; live like it has already occurred.  Second step, join others to raise the cry and demand the changes.  Third, support only candidates who already live fiscally proper, morally upright, and ethically dedicated.  Fourth, never give up!  Never lose focus, and never relinquish the moral high ground for a bowl of pottage or 30 pieces of silver.

© 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.