Tag: Government Scrutiny

Front Office vs. Back Office vs. Oversight – Additional VA Horror Stories

Lincoln WeepsOh, the bitter tears President Lincoln must weep…

One of the most troubling issues facing many organizations is exemplified perfectly by the VA, specifically the Post 9/11 GI Bill.  Previously I worked for an online university in a position where I saw GI-Bill problems affecting students on active duty, reserve, guard, and veterans, all being treated in wildly different manners.  The school GI-Bill office was expected to be subject matter experts on all things GI-Bill, but they regularly made decisions that harmed the students.  By interpreting the regulations and operating procedures differently from student to student.  Yet, the Department of Veterans Affairs (VA) is just as confused as the universities trying to bill GI-Bill charges for students.

From a recent VA Office of Inspector General (VA-OIG) report, we find the following:

“The Veterans Benefits Administration (VBA) did not always accurately process enrollments.  An estimated 2,500 of 10,000 enrollments from August 1, 2020, through April 1, 2021.  About 790 of the estimated errors involved officials either not reporting or underreporting vacation breaks.  VBA claims examiners often mishandled enrollments even when the correct information was submitted.  The VA-OIG estimated claims examiners incorrectly processed accurately reported vacation breaks for about 1,700 of 2,500 enrollments with errors.”

Why are these enrollments not processed correctly:

“Insufficient training and guidance meant school certifying officials frequently made mistakes.”  The VA takes legislation and writes the processes, procedures, and training materials for universities to use for operations and enrollment of military and veteran students.  Front office workers interact with students, back office workers interact with internal employees, the VA keeps the records current, and the VA forms the universities’ oversight resembling the blind leading the blind.  Yet, the VA cannot write effective training materials, processes, and procedures, conduct training, and support those who support students.

Per the VA-OIG report, the VBA is looking to implement an automated system to prevent these oversight issues from continuing.  I do not expect any automated system created by the VBA to work efficiently because of a simple principle, GIGO.  The garbage the VBA will put into the system will ALWAYS result in garbage coming out, creating more problems, costing too much money, and still creating issues for students and student-facing employees at universities and colleges across the country.  Somehow, the VA-OIG continues to buy these excuses and pipe dreams and reports the same to Congress, which is also purchasing these excuses and poor performances.VA 3

Before someone tries to claim this is isolated to the GI-Bill program, and the GI-Bill program has always been confusing.  Using this logic, the health complications at birth can be blamed on the father alone, and the mother’s behaviors do not influence the baby’s health.  Here the VA-OIG is reporting on another program governing VA employees, overseen by the OMB, and is incredibly useless as this is a repeated complaint between 2020 and 2022.

“Identity, credential, and access management (ICAM) is a set of tools, policies, and systems used to ensure the right individual has access to the right resource, at the right time, for the right reason in support of federal business objectives.  In February 2021, the VA Office of Inspector General (VA-OIG) received a hotline complaint claiming the Office of the Assistant Secretary for Human Resources and Administration/Operations, Security, and Preparedness and the Office of Information and Technology have not agreed since 2016 on roles and responsibilities for VA’s ICAM program.  Failures of ICAM contribute to the VA’s inability to effectively comply with the Office of Management and Budget (OMB) policy.  The VA-OIG reviewed to determine whether VA effectively governs its ICAM program as required.”

What did the VA-OIG find?

      • The VA did not effectively manage and coordinate its ICAM program, not meeting three of the four OMB governance requirements.
      • The VA did not effectively assign roles and responsibilities, implement a single comprehensive ICAM policy, or meet its technology solutions roadmap goals for fiscal years 2020 and 2021.
      • The VA failed to implement updated digital identity risk management requirements.

Why can’t the VA obey OM oversight?

“These issues occurred primarily because leaders of the different offices performing VA’s ICAM functions have not agreed on how it should be governed.  VA risks restricting information from users who need it to perform their job functions without proper governance and leaving information vulnerable to improper use” [emphasis mine].

In this report, the OMB sits as oversight of the VA.  The employees are the frontline, and the leaders continue to fail to provide tools, policies, and resources to employees conducting the VA business.  What is still an incredibly terrible idea allowing the VA to remain self-governing.  Why isn’t the OMB more interested in demanding compliance?  Where is Congress scrutinizing how the executive branch agencies are failing and monitoring to improve conduct?VA 3

The VBA cannot still properly and timely adjudicate claims.  Again, the VA-OIG lambasted the VBA for improperly adjudicating claims, even with “Special-Focused Reviews.”  Essentially the quality assurance (QA) process in claim adjudication continues to fail to help improve claim processing accuracy.  From the report:

“The Office of Inspector General (VA-OIG) reviewed VBA’s design and implementation of its special-focused review process, including applying Government Accountability Office (GAO) standards.  The VA-OIG team assessed ten special-focused reviews completed from January 2019 through April 2021 and identified weaknesses in all five of GAO’s internal control components.  The VA-OIG also found the VBA Compensation Service’s standard operating procedure related to these special-focused reviews does not provide sufficient guidance to support disability claims-processing improvement fully.”

When I worked in QA, root causation was required to prevent future problems.  The VA-OIG found that the QA Special-Focused Reviews do not include root causes or explanations for why the claims were readjudicated, stopped, or delayed in VBA processing.  Do not repeated issues reflect the need to restrict self-governance until compliance can be observed?VA 3

Why should the VA have its self-governance restricted or prohibited?  The following VA-OIG makes clear that the VA cannot govern itself and correct the problems leadership continues to create.  Follow the timeline here, quoted directly from the VA-OIG report:

“The VA Office of Inspector General (VA-OIG) conducted this review to determine whether the Veterans Benefits Administration (VBA) accurately adjusted compensation and pension benefit payments for fugitive felons as mandated by law.  If VBA does not adjust payments, veterans who are fugitive felons will continue to receive benefits during periods of ineligibility.

In April 2012, VBA instructed regional offices to postpone making decisions on fugitive felon cases while it prepared new guidance.  During 2012 and 2013, VBA did not process fugitive felon cases.  In June 2014, VBA updated its definition of a fugitive felon to include only referrals indicating escape, flight, or violation of probation or parole conditions.  Although VBA then resumed adjusting payments, it did not review the unprocessed 2012 and 2013 cases.

In addition, due to inadequate monitoring, VBA did not process about 46 percent of cases referred by the VA-OIG in 2019 and 2020.  Finally, the team found VBA’s notification letters to veterans providing notice of the proposed action and right to a hearing did not always provide the required information.  Most commonly, VBA failed to include the reason for the issuance of the arrest warrant.”

The VA has been informed by the VA-OIG multiple times during the decade this problem has been surviving, and 46% of the cases the VA-OIG told the VA to fix still weren’t fixed in 2022.  How can any oversight agency still permit the VA to govern itself?  The leaders of the VA cannot self-govern, correct course, and make changes timely enough not to create additional expensive problems for veterans.  Each of these cases represents either an overpayment, where the VA is clawing funds back, or an underpayment, where the veteran has been shortchanged and is owed money.

When the VA claws money back from making a mistake that overpaid a veteran, dependent, spouse, or other entity, the VA-OIG has found that even here, the VBA cannot act per their policies, follow procedures, or notify veterans in a timely manner.  A veteran I got to know who served in Vietnam and caught a round in the heart that blew away a large chunk of his heart.  For 50 years or so, this was sufficient to have a 100% disability.  On the day he turned 69, his disability rating dropped to 80%, with a coinciding reduction in monthly benefits.  The VBA investigated this claim decision and found they had made a mistake, but their mistake would not significantly change the rating, so the veteran was stuck with an 80% rating and was told to go back to work.VA 3

To the best of my knowledge, the claim remains stuck in claims appeal hell, awaiting the judgment of the dark and benighted realms to act.  The veteran, who cannot hold a job due to weakness from lacking a significant part of his heart muscles, is driven into bankruptcy.  His heart will not regrow, but because his age has met the age when heart problems are actuarially known, the decision was made.  The decision was made without notification to the veteran, and the veteran only became aware of the situation when he had monies clawed back by the VA.  From the time the decision was made to the date he knew, 18 months had transpired, and the veteran was automatically sent to collections.  While this was never allowed to become a VA-OIG investigation, I have spoken to family members and the veteran while volunteering to help disabled people find employment.I-Care

To add the bitter cherry to this crap sundae, this is not the worst abuse I heard in my volunteer efforts.  Worse, this is not the worst story I have had related while talking to veterans in my travels across the continental 48 United States.  Veterans sit forever in claim hell; they cannot afford to go forward, they are abused when seeking medical help, and every interaction with VA medical providers runs the risk of being the victim of an “adverse medical event.”

To this point, the VA and the VBA have been central to proving that the VA cannot self-govern, oversight is failing, and the back office administrators are hindering the front office operations.  Surely the Veterans Health Administration (VHA), where people’s lives are at risk, would not have a similar problem.  Unfortunately, you would be wrong, and here is one VHA example, of many, to support this conclusion:

“A VA Medical Center (VAMC) community living center (CLC) staff delayed life-sustaining treatment for a patient (Patient A) who experienced cardiac arrest and died.  The VA-OIG also reviewed an allegation regarding a second patient (Patient B) who had resuscitation initiated, despite a do not resuscitate (DNR) order in the electronic health record (EHR).”

Why did one patient die without resuscitation and another get resuscitation without wanting it?  The policies and procedures were complicated, and the use of armbands confused the providers.  The providers (doctors and nurses) overseeing care had a person in the medical records of these patients and still could not properly act for patient care.  The patients had armbands and proper medical documents on file, and the providers still got confused and provided poor care, at best, to the patients involved.

America WeepsIn another long-term care facility under VA operation, the following occurred:

“The VA-OIG found that the day charge nurse’s assessment was delayed and incomplete, and the day charge nurse failed to properly document the resident’s reassessments, treatments, and interventions.  The VA-OIG substantiated that nursing staff failed to document and carry out a telephone order to transfer the resident to the Emergency Department but could not determine if this impacted the patient’s outcome.”

Let’s take a moment to allow this to sink in fully.  Failure to follow a doctor’s orders might have been part of the problem the patient DIED!  Yet, the chain of events is sufficiently blurry to mystify the investigators – this I find HIGHLY SUSPECT!  But, as the Home Shopping Network reports, “There’s more!”

“The VA-OIG determined that following the resident’s death, facility staff failed to conduct a comprehensive review of events leading up to and contributing to the resident’s death and, due to a lack of coordination of care at the time of discharge from the inpatient unit, the resident did not have the needed equipment upon admission to the CLC.”

I accept that a nurse’s role is stressful, the VA policies do not make their jobs less stressful, and the healthcare leadership (overall) is abysmal on the best days.  However, killing a patient is still a BAD thing!  I-CareYet, here we have another dead veteran at the hands of the medical care providers, and the best the VA-OIG can do is make ten (10) recommendations for change.  Does anyone believe the VA can continue to self-govern under its current misguided leadership and convoluted organizational structure?

Ask yourself, would the abuse of the veterans mean more if this was your uncle, brother, father, mother, sister, or aunt?  They are your family members for the problems which they face; we all face in our constitutional republic.  Where is Congress scrutinizing the government?  Please become interested, active, and engaged, or we will lose this constitutional republic to the tyranny of the power-hungry despots.

© Copyright 2023 – M. Dave Salisbury
The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the images.  Quoted materials remain the property of the original author.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“That’s Crazy!!!” – More Chronicles from the VA Chapter 8

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

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

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

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

Oh, the irony is thick; consider the following:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Join me in having your head explode:

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

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

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

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

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

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

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

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

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

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

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

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

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

Not to be outdone:

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

And:

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

And:

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

And:

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

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

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

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

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

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

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

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

New Year – Same Ol’ Disaster at the VA! – Are You Disgusted yet?

Angry Wet ChickenWords fail to describe how much I detest seeing the same abuses week-after-week, month-after-month, and year-over-year.  To witness the disaster known colloquially as The Department of Veterans Affairs (VA), as told from the Office of Inspector General (VA-OIG).  Not merely witnessing but also being abused by the VA leaves such a bitter taste in my mouth.

“Matthew C. McPherson of Olathe, Kansas, was sentenced to two years and four months in federal prison without parole for defrauding the government.  From September 2009 to March 2018, McPherson participated in a conspiracy to obtain contracts set aside by the federal government for award to small businesses owned and controlled by veterans, service-disabled veterans, and certified minorities.  McPherson, who is neither a certified minority nor a veteran, owned and operated construction companies that used the veteran or minority status of coconspirators to obtain federal contracts to which the companies would otherwise not be entitled.  The companies received approximately $346 million in federal contracts.  On June 3, 2019, McPherson pleaded guilty to one count of conspiracy to commit wire fraud and major program fraud.  In addition to his prison sentence, McPherson has forfeited to the government more than $5.5 million, which represents his share of the fraud proceeds.”

Honest question, how is this fraud any different from an elected official using insider trading to profit off the stock market?  On another note, does this sound like a plea deal?  If so, what was the deal, and who is being targeted?  Plea deals used to be rare; now, they are cropping up anytime the government has a shaky case.  Could Mr. McPherson have beaten the entire crime by using a better lawyer or connecting with a more powerful politician; of course, and that is disgusting!

I have applied for these government contracts, and the paperwork burden is immense, the bureaucrats authoritative and disreputable.  When will the bureaucrats face criminal charges for abuse of power in allowing for the defrauding of government?  Simple question, yet one to which no elected official will address.VA 3

Speaking of fraud and the need for bureaucrats needing to be held accountable:

“Dr. David Bellamah, a vascular surgeon who operates vein and surgery centers in Missoula and Kalispell, Montana, has agreed to pay the federal government $3.7 million to settle alleged False Claims Act violations.  According to the civil complaint, from January 1, 2015, to March 31, 2017, Bellamah performed medically unnecessary surgeries based on improper techniques and submitted fraudulent bills for payment to four federal healthcare programs, including Medicare, Medicaid, TRICARE, and CHAMPVA.  The settlement agreement between Bellamah and the US Attorney’s Office for the District of Montana, Department of Health and Human Services OIG, Defense Health Agency, VA, and a third party directs Bellamah to pay approximately $1.9 million in restitution and $1.8 million in additional damages.”

The article link is missing from the VA.gov website, reason unknown as of this writing.  I received an email about this story, which is why I know of it, but cannot link someone else to it.  Still, the questions remain, someone in the VA legion of bureaucrats had to have known and contributed to facilitating this fraud, and they are not being held accountable.  Why?

  • “Patsy Truglia of Parkland, Florida, was sentenced to 15 years in federal prison for his role in two consecutive conspiracies to commit healthcare fraud.  According to a multiagency investigation, from January 2018 to April 2019, Truglia and his coconspirators generated medically unnecessary physicians’ orders via a telemarketing operation for durable medical equipment (DME).”
  • “Ramón Julbe-Rosa pleaded guilty to 12 counts including theft of government property and introducing unapproved new drugs into the United States.  His multiple fraud schemes included defrauding the Social Security Administration and Medicare by receiving Social Security Disability Insurance benefit payments while working; fraudulently receiving unemployability benefits from VA; and falsely stating that his primary residence—purported to be in Morovis, Puerto Rico—was damaged by Hurricane Maria, leading to the fraudulent approval of a Small Business Administration Disaster loan.”
  • “Wayne Bowen of Jacksonville, Florida, has pleaded guilty to aggravated identity theft for using his estranged identical twin brother’s name, Social Security card, and military discharge papers to apply for federally subsidized housing benefits.  Due to his fraudulent use of his twin’s identity.”
  • “Matthew Smith of Palm Beach, Florida, has pleaded guilty to his role in a compounding pharmacy scheme that defrauded the Department of Defense’s Tricare and VA’s CHAMPVA benefit programs of approximately $88 million.  Smith admitted to his role in fraudulently billing the two insurance providers for expensive, medically unnecessary compound drugs.  To further the scheme, Smith and his coconspirators paid approximately $40 million in kickbacks to patients, patient recruiters, and doctors in exchange for them ordering expensive pain creams, scar creams, and vitamins without regard to the patients’ medical needs.”
  • “Seven Texas doctors have agreed to pay more than $1.1 million to resolve False Claims Act allegations involving illegal remuneration in violation of the Anti-Kickback Statute and Stark Law.  According to a multiagency investigation, from 2015 to 2018, the doctors allegedly received thousands of dollars in illegal remuneration from eight management service organizations (MSOs) in exchange for ordering laboratory tests from Rockdale Hospital doing business as Little River Healthcare, True Health Diagnostics LLC, and Boston Heart Diagnostics Corporation.  Little River funded the illegal remuneration to the doctors in the form of volume-based commissions paid to independent contractor recruiters, who used the MSOs to pay numerous doctors for their referrals.”

?u=http3.bp.blogspot.com-CIl2VSm-mmgTZ0wMvH5UGIAAAAAAAAB20QA9_IiyVhYss1600showme_board3.jpg&f=1&nofb=1Take a moment, read the full articles reporting these crimes, and ask yourself, have ALL the guilty parties been held accountable before the law, or are some parties noticeably missing?  If you reach different conclusions, please note this in the comments, and let’s discuss.  Show me your thinking, I want to learn!

Fraud, to succeed, requires willing people in positions of authority not to do their jobs properly.  Yet, for all the rules, mandates, political attention, and legislation, the fraud continues.  Why; because if you are the approving authority and have a plausible excuse, you are never held accountable!  The situation is untenable; the maze of red tape regulations preclude honest people from participating and opens the doors for nefarious actors to swindle, cheat, steal, and profit.  Simple question, when will those legally responsible for not allowing fraudulent activities be held accountable?VA 3

The VA-OIG conducted a Comprehensive Healthcare Inspection (CHIPs) of the Charles George VAMC in Asheville, North Carolina.  Want to understand more about the quagmire of the VA personally?  Read one of these CHIP reports.  Long have I wondered how leadership could be fully measured when the leader of the hospital leadership team has been in their position for two (2) days.  The VA-OIG couches this by claiming the associate director had been in the role for 18-years.  Do you see a problem?VA 3

Where and how are veterans being abused, staff training, and the “Disruptive behavior committee.”  Some might ask, how is staff training an abuse to veterans?  What do you consider “disruptive behavior?”  Did you know if you ask a doctor questions, that doctor can report you as presenting disruptive behavior to the Federal VA Police and get the veteran charged and fined?  If you request to speak to the administrators and they refuse, you can also be charged with presenting disruptive behavior, hindering hospital operations, disturbing patients, being arrested, and fined?  The bureaucrats have designed a self-fulfilling system in the VA that protects wrong-doing and punishes anyone who dares question the status quo, and this is trained into the employees.  Worse, this is about the only training they receive that is competently delivered!

A CHIP was completed at VISN 8, the Sunshine Healthcare Network in St. Petersburg, Florida.  Congratulations are for passing the CHIP with only two recommendations for improvement.  Honestly issued praise.  My concern is the low bar for success that was surpassed, but this is not the fault of VISN 8’s leadership, but the VA leadership in Washington, DC.VA 3

Long have these articles mentioned and decried the designed incompetence found in every single process, procedure, and action taken by the VA.  It is not surprising then that design incompetence is still seen and cost resources.  Nothing new, but you, the taxpayer, need to be aware of this, for the excuses have run so thin you can read contractual mouse print through the excuses!

The history:

“In October 2017, VA entered into an interagency agreement with the Defense Logistics Agency (DLA) to use its Electronic Catalog (ECAT) to order VA medical supplies and equipment not available through existing contracts.  VA created the ECAT Ordering Guide to describe VA policies and procedures for placing orders and outline the ordering officials’ responsibilities.  As of April 1, 2021, VA had spent approximately $592 million on purchases through ECAT.”

The findings:

“The VA-OIG found that the Procurement and Logistics Office (P&LO) did not govern the ECAT program adequately.

    • The ECAT Ordering Guide excludes the requirement for VA ordering officials to consider the Federal Supply Schedule (FSS) contracts for sales orders; purchasing through FSS could have saved VA up to $4.4 million.
    • The guide also incorrectly describes how to apply the Rule of Two, potentially excluding veteran-owned businesses from contracting opportunities.
    • Ordering officials did not follow documentation requirements in the ECAT Ordering Guide, and P&LO did not conduct required annual reviews of the interagency agreement.”

Do you see the designed incompetence?  The VA gets green-lighted to consolidate ordering to save time and money, then develops the processes and procedures to open the door for fraud, theft, and abuse, providing excuses for the VA-OIG to accept when responsibility and auditing occurs.  Hence, roadblocks are launched instead of saving money and reducing the government’s costs.  Instead of bringing order out of chaos, more logs of chaos are added to the fire.VA 3

Worst of all, the VA-OIG has to invest money to tell the VA common-sense solutions, couched as recommendations, to fix the problems the VA purposefully designed into the process.  That is your tax dollars at work, your neighbors losing opportunities, and your employers getting the shaft intentionally by the VA.  Again, only for emphasis, I ask, “When will the bureaucrats be held accountable for their malfeasance and culpability in abusing people, committing fraud and theft, and refusing to do their jobs properly?”

When discussing malfeasance and designed incompetence, the following inspection at the Carl T. Hayden VAMC in Phoenix, Arizona, is applicable as an example.  The VA-OIG conducted an inspection to assess allegations concerning sterile processing services.  The list of findings reveals a lot of bureaucratic shenanigans, and with my knowledge of the leadership, I deduce the shenanigans were driven by leadership at the hospital.

  • The VA-OIG found Sterile Processing Services (SPS) staff failed to don personal protective equipment in decontamination areas.
  • The VA-OIG did not substantiate that SPS staff falsified Resi-Tests by documenting the same lot number for endoscopes.
  • The VA-OIG identified missing documentation of Resi-Test results from October through December 2020 but found that the policy was followed. Leading to a question about the effectiveness of the policies and the designed incompetence in those policies and procedures, which the VA-OIG never addressed as this would have been outside the investigatory scope; more designed incompetence?
  • The VA-OIG found no infection concerns associated with inadequate reprocessing of equipment.
  • The VA-OIG did not substantiate that SPS staff failed to follow validation testing requirements for biological indicators and Bowie-Dick tests for sterilizers.
  • The VA-OIG found that SPS staff followed reprocessing steps according to standard operating procedures and instructions for use.
  • The VA-OIG did not substantiate that SPS staff did not have adequate reprocessing supplies.
  • The VA-OIG found that floor-grade instruments received in decontamination areas were discarded and not reprocessed.
  • The VA-OIG found that SPS staff reviewed instructions for loaner trays upon receipt at the facility.
  • The VA-OIG did not substantiate that SPS staff failed to receive documentation for instruments sterilized at another VA facility.
  • The VA-OIG concluded that SPS leaders were knowledgeable of the practice standards.VA 3

Again, a mixed bag of findings.  After a tumultuous year of sterile scandals, it is refreshing (almost) to observe a sterile facility operating at standard.  Draw your own conclusions about the role of the leadership in this inspection.  To me, the most critical part of sterilization of reusable equipment is the proper use of personal protective equipment, but the VA-OIG did not appear to see this as crucial as I do.  From the inspections I have experienced, failing to use personal protective equipment properly is an automatic failing grade, but the VA-OIG only made a single recommendation for improvement.

quote-mans-inhumanity-2While the above are not all the reports from the VA-OIG launching 2022, they present the bulk of the criticisms and reflect the need for greater scrutiny and improved leadership at the VA.  More to the point, these represent the danger the American public is in from a runaway government that keeps biggering (with a nod to The Lorax and Dr. Seuss)!  The VA is abusing your veteran neighbors, and you are paying for it.  Doesn’t this stir in you feelings motivating to action?  If not, please ask yourself why.  Do veterans deserve to be abused relentlessly?  Do you like being complicit in a crime perpetrated by bureaucrats, cheered on by elected officials, and paid for by your tax dollars and the future of your children through forced taxation and out-of-control debt?  The choice is yours, I know my choice, and I WILL continue to resist the government atrocities every step of the way!

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

The Kool-Aid Crowd and COVID

Bobblehead DollSince 2000, the US Federal Government has spent billions, if not hundreds of billions of taxpayer dollars to improve labels and then “educate” people into reading labels.  The laws passed have forced private businesses to spend hundreds of billions, if not trillions, of dollars in changing labeling on packaging and products to comply.  Go to any mask package and you will find similar:Mask Packaging

Recently I sought service at a Xfinity retail store and was denied service because I cannot wear a mask.  During this outing, I received severely dirty and threatening looks and attitudes from shoppers in a Walmart, all because I cannot wear a mask.  People are becoming violent, just as the government has demanded, to anyone not toeing the government COVID line, and this behavior reminded me of the Jim Jones religious cult.

President Biden is expected to force more people to listen to him threaten and try to scare Americans into getting vaccinated.  The mayors of Boston, Chicago, and New York continue to double down on activities that have not worked since February 2020.  The governors of California, New Mexico, Michigan, and others, continue to use powers not available to them in the name of “public health emergency.”  More mask mandates, more vaccination orders, and more “green passes” to exist.  Here’s the rub, how many of these solutions have worked; honestly, look at the data from February 2020 to December 2021, and tell me how many people were saved wearing masks.

People saved from these government freedom theft mandates, I guarantee, the number is NOT statistically significant!  How do I know; Australia, essentially a large island, has the strictest policies, and Omicron was still able to get onto the island.  How do I know; COVID infected children (school age K-12) have the same risks as uninfected children.  Who is the resource for this information, The New York Times!

Real numbers, Israel has one of the highest vaccinations and boosted populations on the globe; guess what, they also have the highest spike in Omicron infections!  Europe, socialized medicine, high vaccination and boosted populations, where the Omicron and Delta variants spiked infection rates.  Think of this for a moment, populations forced by government to vaccinate, and they are still passing around COVID infections, which is precisely viral science in action!

Peer reviewed researchers in the virus infection community have shown this life cycle of viral infections repeatedly since scientists began writing down what they do.  Vaccinated people pass around strains of viral mutation, which then infect other vaccinated people, until the virus mutates itself to death.  Please, do not believe me, look up this science for yourself, and you will come to a similar conclusion.  At the end of the day the viral infection community of scientists are plotting the death of COVID as a viral infection, but government elected leaders, and the bureaucrats powering the echo chamber of political thinking, will not give up the power theft committed since Feb 2020.

Jim Jones and the Kool-Aid cult suicide has been mocked, used as case studies in group think, and represents a dark time in human psychology and the abuse of religious thinking and adherence.  Guess what, the insanity of COVID-19 is as silly, irresponsible, and dangerous as Jim Jones and his cyanide-laced grape-flavored Kool-Aid.  Senator Manchin nailed it, government is beating the “living crap” out of every citizen, the beatings are intensified by the state government, and the county and city governments.  Yet, little Joey is going to continue to threaten, cajole, beat, and denigrate people using COVID as the excuse.

Did you get the vaccination just to appease government and end the beatings?  Are you able to unmask and live your life without COVID mandates, just because you got vaccinated?  I have friends here in NM who have masked, vaccinated, and done everything the government has demanded of them to avoid the government beatings.  They caught COVID, the whole family was quarantined, and extended family still caught COVID from my friends, once the quarantine was lifted, they gathered, and the extended, vaccinated, masked family caught COVID.  The repetition of this story is exhausting and provides clear proof the government beatings, mandates, and exercised powers are NOT helping but hurting, and make the Jim Jones Kool-Aid episode even more appropriate.

The science from South Africa, where Omicron variant was identified, reports the COVID virus stays in the nose and mouth region.  Guess what, so does the common cold virus, and there has NEVER been an attempt to vaccinate against the ever changing common cold.  We, the citizens of representative government, are the owners of government and it is time we take the reigns and stop the Kool-Aid massacre.  Government should never hold the power over an individual citizen’s health, welfare, or ability to pursue happiness.  Yet, this is exactly what the government bureaucrats want you to give to the government to stop COVID.  Since February 2020, has this worked?  Answer this question as well; how much faster would herd immunity have been achieved had government done what it has done for every other Chinese virus, which is nothing?

Look at recent history, Asian Flu, Hong Kong Flu, Bird Flu A (H5N1), Swine Flu, SARS, etc. the government did nothing.  NO shutdowns, no mandates, no economic stimulus, no job losses for those not vaccinating, no Big Pharma money pump for vaccinations of dubious nature, and the world did not end.  Did some people die; yes.  Did some people get sick; yes.  But herd immunity was faster and more effective than any action the government could think would have worked.  Dear reader, to you I ask, “Are you better off for the government intervention on COVID-19?”  I know my answer, but to you I leave the question and the answer.

Now, flash forward 10-years in your mind.  The real death toll of government intervention is still being hidden, but the deaths from a dubious vaccine are scaring populations silly.  When do we ask ourselves if the forced government vaccinations are the cause for infertility, for economic destruction, and for the massacre of human dreams and lives?  Who do we blame after the money is spent and the vaccines have irretrievably destroyed wide swaths of populations?  When vaccinated children whose risk from COVID remains minimal are sick, twisted with pain, or are dying in droves with reduced life expectancies, but the government continues to defend “doing something in the face of COVID.”

If the Jim Jones religious cult comparison is not appropriate now, when will it be appropriate and concerning to every single citizen across the globe?  Do you know the phrase “Judas Goat?”  The Judas Goat is the goat that befriends sheep, and then leads them to their doom in a slaughterhouse.  Belief in the omni-powerful government is a myth and a Judas Goat, yet to not blindly follow the government mandates is to be refused employment (nurses, firefighters, doctors, police officers, etc.) to be denied service (anyone unable to wear a mask), to be refused legal protection, and be castigated as heretic.  Jim Jones’ believers did similarly to everyone not believing, and they are all dead!  Those who are skeptical of the Judas Goat, are also dead, but their fellow sheep herd went first.

I admit, from day one (October-November 2019) when I first began reading of a new viral infection killing people in China, I have been skeptical, concerned, and boring the daylights out of my wife with the reports, the history, the potential ramifications of this new viral infection.  But in my most fevered nightmares I never thought the government could assume and amass so much power without citizens becoming rebellious.  Flash forward two-years, three arrests for not being able to physically wear a mask, fines, and economical losses incalculable, and my horror is just starting, when I see the vaccinated kids, the shutdown schools, the lost opportunities and potential, and the “hits just keep coming” from government and the bureaucrats.

?u=http3.bp.blogspot.com-CIl2VSm-mmgTZ0wMvH5UGIAAAAAAAAB20QA9_IiyVhYss1600showme_board3.jpg&f=1&nofb=1China is using biological warfare against the world; but the Chinese government is to blame, not the people of China.  I repeat, only for emphasis, do the research yourself.  Make your own decisions.  Unlike the government, Big Tech, and the bureaucrats hungry for power, I trust you to use your freedom and powers of critical thinking.  We might not reach the exact same conclusions, but we can still respect each other, and being better informed from reputable sources improves us both.  Political party be hanged, we are humans first and we need each other.  Please, do not go quietly into that dark night like the sheep entering a slaughterhouse, following the Judas Goat who has skipped aside to miss the consequences.

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

Jacob and Esau – The Perils of Government; An Analogy

Bobblehead DollSeveral books of scripture, in multiple religions, record the story of Jacob and Esau.  Jacob and Esau are twins male children of Isaac and Rebekah.  The boys were competitors for their entire lives.  Esau acts outside his parent’s wishes in marriage, sells his birthright to Jacob for a bowl of pottage (stew or beans; something cooked in a pot), and late in life is reconciled to Jacob even though his people continue to have animosity towards Jacob’s people to this day.  While the story of these twin brothers remains useful to those in religion and teaches several morals of importance, Jacob and Esau represent a classic tale of why government should be limited in size and scope.

Genesis 27, Old Testament, contains the story of how Jacob obtains the birthright blessing, which had been sold to him by Esau for the aforementioned bowl of pottage.  Consider with me what would have happened if the same bloated government we have right now had meddled in the affairs of Isaac, Jacob, and Esau.  The cost of meddling in the internal family affairs, the government would have taken 40% inheritance tax.  Esau would have always had the government as a millstone and ready excuse for not reconciling with Jacob, and lawyers and government officials would have further sundered the family.

Remember this, for it has importance in the following discussion, the government does not grant freedom, EVER!  As described and stated in the US Constitution and US Bill of Rights, freedom comes from a power higher than government, and government was only, ever, instituted for the benefit of man.  Ask yourself, is your government benefitting you?Plato 2

I guarantee the answer is no; regardless of the political spectrum, you prefer.  Why, because the government should not be exerting powers in areas that control or curtail the freedoms of the people.  Esau never valued his birthright, so selling it was easy, and a bowl of pottage was a rich reward for something he did not value.

How expensive is government-funded medical treatment?  Some will claim, but those receiving treatment never see a bill; really?  Costs are more than merely a statement representing the need to pay money.  What about the loss of privacy?  What about the loss of freedom to choose what treatments and providers are best for you?  What about the loss of innovation to the thumb of oppression from the government?  What about the loss of self-reliance and the health benefits of independence?  What about the destruction of your community and the connections people felt with and pride for community hospitals?  What was lost when the medical community forced, through the abuse of government intervention, the knowledge of herbs for the sterility of Big Pharmaceutical drugs?

For the hope of a prosperous retirement, what was sold; freedom and money in the now.  Yet, one should ask, where does the government get the power to take money, then give it back at some future point?  Except, how many of those government retirement Ponzi Schemes are fully funded, even with all the money flowing in?  The answer is as empty as Esau’s bowl.  Still, the government continues to steal money through forced taxation and purchase the hopes and liberties of citizens for that hoped-for bowl of pottage, prosperity in retirement.Plato 3

For the hope of reducing poverty, the government purchased a class of people whom they could abuse and ignite for political gain anytime they want or desire.  To create this aggrieved class of people, the government took over welfare programs, bought people with bread and circuses, asked them to stay in government houses, live on government food, enjoy government-provided entertainment, etc.  What was sold for this bowl of pottage; liberty, potential, freedom, upward mobility financially, safety and security, and hope.  What has been the consequences of this purchase; a permanently aggrieved class of people who look longingly at another’s possessions and desire them through theft because hard work is racist, demoralizing, and stops the government handouts.  Worse, the government had to grow in power and size to “manage” this class of people, creating those with six-digit salaries to rub the purchased people’s faces in the irony of what was lost in the purchase.

The United States has been waging a “War on Drugs,” almost since its founding.  The government considers one drug “good,” mainly due to the ease of controlling it for taxation purposes, and another drug “bad.”  Yet, how successful has it been in this “war?”  Not at all, and its failures are increasing year-over-year, even while new methods of taxation are being invented to manage “legal drugs.”

Alcohol in the United States has had a history of acceptance, tolerance, legal banning, and returned to tolerance and acceptance, all through human desires, abuse of government powers, and the need for tax revenue.  Sin taxes, the class of tax used to allow a citizen government approval to get drunk, stoned, or inject poison into their bodies, are among the highest taxes in America.  Yet, the more the taxes increase, the more people want these products, and the more the government wants people to use these products, for we see the purchase of something transitory using something highly precious to barter.  What is more precious than time and physical health, and what is purchased but something that can only temporarily ease pain or provide relief at best.Apathy

Tobacco has been a favorite drug of the government for its population to enjoy, pushing the popularity of the drug even while condemning and restricting how, when, where the drug can be enjoyed.  Tobacco farmers have played vital roles in American history, and the product has been a significant cash crop for government revenue.  Have you ever wondered where the money and research facilities originate to improve cigarette addiction?  Have you ever considered where the marketing materials originated to pitch the health benefits of smoking?  Do you realize that government is the biggest provider of money for research and marketing purposes?  Never forget the government has become flush with cash, pushing tobacco, regulating tobacco, and licensing tobacco.  Now ask yourself, why would the government give on the one hand and take on the other, because it is making money with both hands as people sell something precious for something valueless and transitory.

Do people get injured and need assistance; yes, but the government is never the answer to provide help.  Are there those who are trying to thrive and escape poverty; yes, but the government is never the answer to providing help.  A truth from time immemorial, governments do not produce anything; thus, the government must first take through legalized theft, taxation, and legal abuse to give to someone else.  Every representative government must walk a balancing act between what a government is and what responsibilities a government must shoulder.  Except, how many continue to make Esau’s mistake and sell something incredibly precious for something transitory and essentially valueless?

Worse, evaluate the consequences of allowing the purchase to occur.  First, the seller experiences buyer’s remorse, anger, jealousy, regret, and the government making the purchase laughs, making the bitterness of the sell more poignant.  Second, the seller needs an outlet for this buyer’s remorse.  In an effort to continue to purchase while appeasing, the government allows the seller to go destroy the property and goods of another less politically connected person and calls this social justice.  Third, the abused class of people who are not politically affiliated or are political rivals, whose property is being destroyed, looks on, and envy, malice, and contempt are bred, which furthers the goals and desires of the government.The Duty of Americans

Esau took a long time to be reconciled to Jacob, but it first required admitting that he had sold his birthright (something of great value) for something transitory and valueless (food).  Jacob and Esau’s story remains of great importance and a cautionary tale, especially for understanding why government needs to be smaller, less involved, and less able to abuse the citizenry.  For too long, the governments worldwide have either abused their powers to purchase or been established as a tyrannical and oppressive government.  Either way, the government is the problem, and the answer continues to be the same, curb the government!

Knowledge Check!If COVID has taught the populations of the earth anything, let us learn this valuable lesson, the government is the problem, not the solution!  The size of government is oppression, the cost of government is theft, and the loss of precious freedom and liberty for transitory and valueless gifts or benefits which come at too high a price in treasure and other precious resources.  We, the owners and the abused of government, must change how we think and feel about the role of government before all is lost to the ever-hungry maw of government and self-interests!

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

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

VA 3

  • 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?

VA 3

  • 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!

VA 3

  • 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.

VA 3

  • 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.

VA 3

  • 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.

 

Do We Understand – Important Truths From President James Madison

Exclamation MarkSometimes revisiting a topic is required to help promote urgency in learning.  Other times revisiting a subject helps to broaden the mind to more of the problem.  My intent in reviewing the topic of understanding is for both of these reasons.  President Madison provides counsel that every American should be adhering to, regardless of political flavor, as the first policy in being a responsible citizen.

We begin with an absolute from President Madison, stated two different ways, with the same meaning:

      • “The trust is that all men having power ought to be mistrusted.”
      • “All men having power ought to be distrusted to a certain degree.”

To those who would like to be female apologists and excuse women just because President Madison used the term “men” here, the President spoke of “men” as in all humankind.  As in, when power is invested in any person, they should be mistrusted.  They should be carefully watched, monitored, and scrutinized.  Not blindly trusted to act and never called out for their actions.  Hence the role of the media, the role of laws, the role of three co-equal branches of government.  Yet, what do we find today?

Honestly, take a look around, and take off the political glasses of partisan politics for a moment.  Can you honestly claim that the media is representing fairly both sides of the partisan political spectrum?  Can you honestly trust the co-equal branches of government not to be intimidated, cajoled, browbeaten, or unduly influenced by another branch?  Is the military following their civilian leaders without political influence and acting in the best interest of all Americans?  Is each of the co-equal branches of the government pulling their weight and acting in accordance with the law?

Now, look closer to home.  How about the school board, the mayor, the governor, the state legislature, the county board, the city council, the town council, and every other bureaucrat vested with public trust.  Are they obeying the duties and honoring the roles of their office and deserving of the public trust?  What about the teachers in classrooms who the school board officials directly supervise? Are your children taught reading, writing, and arithmetic, or are they being taught wokeism, sexism, and being groomed for sexual perverts?

“Public office is a public trust, the authority and opportunities of which must be used as absolutely as the public moneys for the public benefit, and not for the purposes of any individual or party.” ~ Dorman Bridgeman Eaton

Public trust remains the single most important and least discussed aspect of American culture and American politics, mainly because public trust is the most misunderstood concept.  Public trust has been intentionally misunderstood (plasticized), so it can be perverted and challenging to understand.  Yet, public trust comes down to one thing and is revealed through an easy test in its most simple form.  Would you leave your home and children alone, under the supervision of any person holding public office?  If the answer is yes, they hold your public trust.  If the answer is no, why are they in office?

Using President Madison’s quotes above, no one in a position of public trust should be “trusted” without verification, scrutinization, and they should be held accountable for their decisions made while in office.  Missouri is the “Show-Me State!”  I possess a “Missouri Mindset,” show me you have done the job correctly.  Show me; you are transparent in doing the job you were elected to perform.  Show me you can be trusted.  I am willing to give anyone a chance at leadership, but they had better show me they can do the job!Daniel S. Lamont Quote: "Public office is a public trust." (9 wallpapers) - Quotefancy

Under the heading of trust and show me comes an important principle, and President Madison elaborates this principle simply, eloquently, and precisely.

“I cannot undertake to lay my finger on that article of the Constitution which granted a right to Congress of expending, on objects of benevolence, the money of their constituents.”

Find me that article of the US Constitution.  If you cannot find that, then the Federal, State, and City governments need to get out of taking money through taxes and giving money to people who have not earned it.  Welfare belongs to charity groups and religions, not governments!  Pork barrel spending is anathema to good order and discipline and should be shunned and shamed.  Consider with me the plethora of laws that have been invented to control society just because of the government welfare programs.Soulful Musings: Don't Tell Me, "Show Me"

Food controls, including price controls, control what, when, and how much a farmer can grow, how a farmer can grow, and much more.  These controls include legalized theft of a farmer’s goods which the supreme court has upheld.

Dairy, farm, and rancher controls for grain, meat, and milk.  Then when the government has too much in store, they force price-controls, forcing dairy and ranchers out of business in support of large commercial production facilities at the expense of smaller and medium-sized operations.  Labeling laws that unfairly punish smaller and medium-sized establishments.

Larger governments manage programs through bureaucrats and bureaucratic inertia that are abused at every potential opportunity and are not scrutinized adequately for waste, fraud, and abuse.  Where systems and operations are regularly gamed to keep the benefits rolling in at the expense of society, taxpayers, and those needing assistance cannot receive assistance due to the gamesmanship and fraud of others.Show Don't Tell - Working Writers

I am all for helping people learn how to help themselves, using charity programs and religious outreach.  But, taxpayer dollars should NEVER be spent in helping one person at the cost of another person!

The following has caused many a discussion in my home.  I hope it will cause many a conversation in your homes.  May those discussions be heated, be full of lovely disagreement, and be full of fiery opinions.  For in the spirited debates come ideas and solutions that work.  Invite people who disagree with you to dinner, and may the food and conversation be a delightful experience and a gustatory wonder!

“In framing a government, which is to be administered by men over men, the great difficulty is this: You must first enable the government to control the governed; and in the next place, oblige it to control itself.”

What is the discussion in my home centered upon, “How does a citizen ‘oblige a government to control itself?’”  I will offer a couple of suggestions here.  Feel free to refute my recommendations with your own in the comments below.  Better still, suggest more ideas for topics of discussion.  I am not the only person with ideas, and we need every person to help “oblige” the government to control itself!

      1. Be an informed electorate! – The one thing a politician fears or should fear more than a ballot box is an informed electorate. Do you know why the politicians preferred Dewey’s system of functionally illiterate stooges to the informed electorate of the early 1900s?  They could get away with robbing the citizens blind!  When the citizenry is not informed, they become property, bought and sold as chattel (cows, goats, sheep).  Doesn’t this make you angry that your elected leaders and the unelected Hollywood elite think of you this way?Andragogy - LEARN
      2. Scrutinize government and demand transparency! – It is your government. Tell me something, if your neighbor went across town and graffitied buildings, broke windows, burned property, and defecated on private property, then told the authorities that you had paid him to do these acts, would you be a little concerned?  If your neighbor did these things and used your hard-earned money to pay for these crimes, would you want revenge and a criminal charge levied against your neighbor?  These are the actions of your government; why does the government get a pass?  Your name is on the check, right beside mine, claiming full financial responsibility for the actions of our intermediaries, the government.Quotes On Government Control. QuotesGram
      3. Gather with like-minded people, teach each other, learn from each other, and teach your children WHY! – Every tin-pot dictator in history has captured children, taken them from hearth and home, and “educated” them away from parents to influence the next generation. Today, we call this “education,” “state-run schools,” using “laws,” and obligations as “good parents” to shame and force parents to send their children into re-education camps.  Want to freak out the government; change the next generation!Patriotism

Finally, President Madison provides two pieces of advice for living in the American Society worthy of knowing and on-boarding.

      • “Knowledge will forever govern ignorance.”
      • “The circulation of confidence is better than the circulation of money.”

Consider a parable.  Give a person a fish, and he eats for a day.  Teach a person to fish, and he eats for a lifetime.  Teach a person to fish and sell his wares, and his children build a prosperous society.  Knowledge will always govern ignorance, but knowledge and confidence build nations!  I do not want to build small communities; I want to rebuild the American Nation, a free nation under God, with liberty and justice for all.  I cannot do this alone; our forefathers did not undertake this task alone.  It took every member of the 13-original colonies to shake off tyranny and oppression and then build America.

Knowledge Check!It will take every single American citizen, and every single person desiring to be an American citizen to rebuild America, after all the damage intentionally done to her by the political leaders, secret societies, and bitter haters who have abused American generosity and then wanted to protect their pile by destroying America.  America has been abused by countries foreign, and enemies domestic, corporations foreign and domestic, and individuals who have paid large sums to watch America burn.  Do you understand better now?  Is the mission clearer in your mind?  Is the task ahead more urgent and more desirable?  What are your next steps?

© 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.

Blood is Blood – The Logic is Flawed!

Exclamation MarkLast night, during one of my frequent periods of wakefulness, a headline blew my mind, “There is no difference between blood and blood – Horowitz removes restrictions on gay men donating blood,” as reported by the Jerusalem Post.  Using this logic, then going maskless is not a problem, and being vaccinated or not vaccinated is not a problem either, for blood is blood.  Worse, consider the ramifications; the safety and integrity of the blood supply have been a critical problem from the first day humans realized we could take blood from one person and put it into another person successfully.  Mistakes in the integrity and safety of the blood and blood product supply cost people their lives!

I am not here to discuss the political aspects of this move.  The Health Minister of Israel (Horowitz) will be measured and weighed by his electorate for good or ill.  How and when the Health Minister will be measured and weighed will be up to the people in Israel, and I hope they will choose wisely.  I have no further comments on the political side and wish Israel the best of luck on this issue.

However, on the practical aspects of blood and blood product, safety and security, I have a LOT of concerns and have some authority, knowledge, and ability; thus, I will speak to this issue.  As I begin, I will state, again for the record, I do not care about your bedroom choices (hetero-, homo-, etc.), keep them to yourself and your legal age of consent consenting partner, and I could care less.  However, medical professionals should know some risks as they handle body fluids, especially when donating those fluids for others to use in an emergency.

Pin on Signs and SymbolsDuring the 1980s, both the American Red Cross and the Canada Red Cross Society suffered blood tainted scandals due to insufficient testing of, knowledge of, understanding of, and the dimensions inherent to donating blood and blood products where sexually transmitted diseases were concerned, especially AIDS/HIV.  AIDS/HIV was not the only sexually transmitted disease that crossed through blood transfusions, Herpes, Gonorrhea, and many more all had their times in the spotlights as diseases making their ways into donated blood and thence into patients without risky lifestyles, who contracted these diseases after receiving transfusions of blood or blood by-products.  The first cases were noticed in the US Military, where patients started having problems with these sexually transmitted diseases after being wounded and receiving life-saving blood or blood by-products and then catching an infectious disease.  Even Malaria has records of being passed through blood and blood by-products, so just presuming that sexually transmitted diseases are the only diseases to worry about is not acceptable.

Claiming “blood is blood” is the height of exaggerated ineptitude for a political cause.  Yes, red stuff oozing from a mammalian host can generally be typified as blood, but not all blood is the same, nor is all blood equal.  This is why monkey blood is not harvested for use in humans, why Ape blood is not transferred into elephants, and human blood has a letter classification system.  Whale blood cannot be used in dolphins, nor is it compatible with human use; thus, claiming “blood is blood” remains a thoroughly ignorant comment of the highest magnitude!

The 17th AnnualGive the Gift of Life Holiday Blood Drive | B104 WBWN-FMTake a minute, those of us who lived through the 1980s health scares and blood scandals.  By the way, that is plural for a reason; blood scandals keep happening because blood security and integrity and politics do not mix, and every time some politician thinks they can mix safely, we have another blood integrity scandal, and people die!  Do you want to take the risk of being in an auto accident, being rushed to a hospital, receiving blood or blood by-products, and coming home with a transfusion disease?  What about dialysis patients who regularly receive blood or blood by-products; do you want to add another worry to your list of health concerns when receiving care?

Sign Donation Blood Heart Donor Icon Stock Illustration - Illustration of icon, design: 79488667Now, suppose the findings on a medical record were being made public, and the patient’s rights trampled, where disclosure of lifestyle risks kept that person from donating blood and were being published. In that case, I might believe there was a “rights” concern to be vocal about.  However, this is not the case, and refusing a population with known high risks for passing multiple communicable diseases through all types of body fluids, from donating said fluids to the general population, is just sane and common sense medicine.  It is not discriminatory to exclude those who choose a higher-risk lifestyle to participate in specific activities where the health and welfare of the general population are concerned.Blood Donation Sign Wall Poster Background Material, Love, Blood, Donation Background Image for ...

Case in point.  If I travel to Thailand, whether I engage in the sex trade or not, I am refused from donating blood for a specific period after I return home, and I will have to pass a blood test before my blood is accepted at the blood bank.  Plus, because I prefer to give plasma, I will have to prove I am clean twice before I can give plasma again.  This is not discriminatory; this is a safety precaution to protect the rest of the blood and blood by-product supply from contamination.  Now, if I engaged in the sex trade in Thailand, I would be banned indefinitely from donating blood, regardless of condom usage, and the remarks would be permanent across the entire records of the Red Cross.  All because the threat is too great to risk allowing this heterosexual male access to donate blood and run the risk of contaminating it with a disease from Thailand.  I know people in South Korea, who caught unique diseases during the Korean War, who cannot return to the United States, ever.  The United States made this decision not to run the risk of contaminating America with what they caught.  Not discrimination, simple public health policy.

Knowledge Check!Now, we return to the crux of the argument.  If “Blood is blood,” then being vaccinated does not matter because blood is blood and public health and safety are not issues where communicable or infectious diseases are concerned.  If this is correct, why do we still have COVID restrictions?  If blood is not blood, why bow to political pressure on something that is definitely not a political but a medical safety issue?  Politicians and those who cling to the government for an answer to every single problem cannot have this issue both ways.  Either blood integrity and safety is a medical issue where common sense practices trump individual rights for the common good and safety of donating life-giving fluids, or life requires taking risks, and we can shut down the regulatory boards and panels, reducing the costs of medicine.  I am all for reducing the size and cost of government; while I might not argue fully for making all those cuts in medicine regulation, a choice needs to be made and then supported.  Choose wisely!

© 2021 M. Dave Salisbury
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