Random Thoughts

Standing here typing, listening to Garth Brooks, my mind will not relax to sleep.  Reason unknown, but these thoughts seemed to need to be written, so here goes nothing:

  1. Can a person have too much experience and too varied a resume? I’ve been a Jack-of-all-Trades for so long, but is that damaging my professional brand?

With a tour active-duty Army, a stint in the US Army National Guard, and a tour of duty active in the Navy, my SMART transcripts are thick with experience.  Add in the correspondence courses, the moving from state-to-state in the guard, I have collected job specialties/Military Occupational Skills (MOS), and civilian experience to the Nth degree.

In Fourth Grade, I heard about Cracker Jacks, how they were specialists in being Johnny on the spot to fill the needs demanded.  I have turned this into project, program, and change management, and supported it with formal and informal education.  What is too much?  How do I know when I reach that point?The important thing is not to stop questioning. ~Albert Einstein #motivation #questioning # ...

  1. Garth Brooks sings a song called “Ireland.” The song is more of a saga than a song, and it tells the story of an Irish Army, on the short end of long odds and outmanned.  Since I first heard this song, it has struck those chords in my soul, reason unknown.  Having been on the receiving end of long odds and understaffed, I understand the sentiment of this song on an almost spiritual level.

I’ve been in professional situations where I was the victim of lies, physical violence, and sexual assaults from both men and women.  People who desire to make themselves feel better by making another person worse.  I’ve been fighting bullies my whole life; bring it on.  You cannot put the “Skeer” on me!  Funnily enough, I sure have the Skeer on a LOT of others, mostly without ever trying.

Recently an event from the US Navy came forcibly to mind, one of the few times I put the Skeer on another person, then kept that Skeer up to the day I left the ship.  I had a member of my chain of command physically assault me.  I stepped toe-to-toe, looked him straight in the eye, and swore to the depths of my eternal soul that if he ever thought of touching me again, I was going to stuff his lifeless body into a saltwater compensated fuel cell, and all they would find of his remains would be atomic molecules as they went through the engines and into the atmosphere.  He never looked me in the eye again, touched me, and left the space crying.  I never touched him, but I got my point across.

I have carried the injuries from that day to this, and the VA refuses to acknowledge these injuries or their severity.  The VBA continues to deny that a male can experience military sexual trauma from another male.  But I put the Skeer on the perpetrators, and this comes with no satisfaction.  The law refused to support me; UCMJ failed even to acknowledge these issues while punishing me for the smallest of infractions.  Where is justice?

I was one of a tiny minority who was sent to Captain’s Mast (UCMJ, Article 15) proceedings, whose NCOER score went up after being sent before the mast.  My lowest NCOER score was 3.5/4 during my entire enlisted period US Navy.  But I could not get promoted, refused transfers, and was denied everything because I was “Too valuable to the command,” but this did not stop the command from sending me before the mast every six to eight months.  I have scars from the bullies, but they never broke me!Invictus by William Ernest Henley - Parchment Style Digital Art by Alexander Ivanov

  1. Since June 2022, I have been pleading on my blog, LinkedIn, and Facebook for participants for my dissertation research. Unfortunately, the research participation rate hasn’t exceeded zero—more reasons unknown.

Have you ever sat through company training and a trainer made an impression, for good or ill, on your growth with that organization?  Do you train others, hoping you are influencing the students in your classroom?  Do your official duties include leading training efforts for your company?  Please click on the link to enter the survey/questionnaire:

Have you successfully been coached or been the coach to another?  What about mentoring?  Have you received mentoring or been a mentor?  Your insights are vital to my research, and I want to showcase your insights to other researchers to help improve company training programs.  Please, join, and let’s change the world.invictus logo 10 free Cliparts | Download images on Clipground 2021

  1. On the topic of the VBA, did you know you can have a VA provider diagnose you with PTSD and be denied VBA benefits? I would never have believed this was possible until it happened to me.  The civilian provider doing the PTSD exam claimed a person could not experience PTSD unless they were in combat.  If anyone knows how to successfully change the VBA’s mind, don’t hesitate to contact me.  I need some help on this claim!

The inconsistencies in my claim baffle and bewilder me to no end.  The abuse by the VA’s ineptitude and deleterious attitude leaves me thinking about running for office, if for no other reason than to stop the depredations of the VA.  Any lawyers out there looking for a fight, itching to correct a wrong, and want to join?

  1. I am almost finished with an advanced degree in industrial and organizational psychology (I/O Psych), and I am appalled by many of my colleagues. Not those in I/O Psych, but those in other psychological fields, psychiatry, and the medical field.  I am not denying that kids (age 9-18) are often confused about their bodies and have fanciful ideation about being a different gender.  Sometimes these thoughts and feelings need professional support to understand and cope.  But recommending surgery to mutilate their bodies permanently is morally, ethically, and borderline legally wrong!

In following the gender dysphoria topic, I have read the heartbreaking stories of those who transitioned, mutilated, and then eventually came to themselves and wept for that which has been lost.  Related on these blog pages are several stories of people I have known, who have experienced rape, beatings, and tremendous pain due to gender confusion, jealousy, greed, and a compliant medical industry hellbent on doing harm.  Why?

I repeat my question, only for emphasis, if your actions are so life-affirming and positive for you, why are you so hate-filled, angry, and abusive to others?  If the mutilation of healthy tissue is not immoral, unethical, and borderline legal, why the secrecy, silence, and walls of hate when approached on this topic?  These are honest questions.  The research does not support any conclusions; expect to plead for more research.  Science is not settled on any issue, let alone the alteration of young bodies and minds.

Writing these questions and thoughts down is therapeutic.  If they help you, I have accomplished my purpose.  I close with a thought:

“Ask yourself the hard questions, never stop asking, and allow your answers to change as you do.”  Colin Wright

I affirm in the strongest words I am not a victim, I am not the same person I was at 18, and I glory in the ability to continue to change.  Ask questions, learn, and change.

© 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.

Hubris Ante Nemesis – Flash from the Eternal Semaphore

Bobblehead DollAs a kid, I read a lot of Greek and Roman Mythology.  I learned some great lessons from the fates, the fabled battles, and the historical interweaving with the fictional.  One of the lessons keeps recircling, “Those whom the gods would destroy first they make proud.”  Except, the gods/God do not make men proud; men choose pride, then comes vanity, all feeding ego, until that penultimate moment when “Hubris Ante Nemesis” occurs and the bottom is pulled out from under you.

The fates are three goddesses by the name of Clotho (the spinner), Lachesis (the allotter), and Atropos (the inflexible), possibly the children of Ananke (Necessity); these fates spun out the woven lives of men and women on the tapestry of a grand design.  Out of necessity, the fates weave, and what is woven cannot be undone.  I can understand the mental comfort people might take from thinking that these weavers hold men’s destiny; thus, all success or failure is the fault of the weavers of fate.The Fates Picture, The Fates Image

Hubris, in Greek Mythology, is the god of arrogance.  Full of wanton violence, insolence, arrogance, and who actively chooses never to exercise restraint.  Hubris remains a classic example of extremes.  Nemesis is the goddess of fate and revenge.  Roughly translating Latin Hubris brings Nemesis to balance the scales.  Nemesis is the humbler of men who Hubris have enticed into taking their lives to extremes.

In Judaism, the saying goes, “Pride goeth before the fall.”  Or put another way, “Pride goes before destruction, and a haughty spirit before a fall.”  In all cultures of men, this same semaphore is flashing across the minds of philosophers and religious leaders, beware the tides of extremes, choose humility, and caution against arrogance, pride, sloth, vanity, lust, gluttony, and ego.  When did we stop heeding this call?  Why have these calls been classified as religious and minimized in all societies?Nemesis | Myth Wiki | FANDOM powered by Wikia

Consider the political leaders of the day, those who think they are beyond the reach of law merely because they think they are the keystone in a democracy and deserve to live better than those who elected them to power.  Recent examples of this pride are witnessed in Speaker Pelosi’s husband making stock choices when the company is about to get a massive windfall from the US Government.  Al Gore compared climate deniers to the police in the Uvalde, Texas school shooting while jet-setting around the globe.  He is preaching moderation and reduced lifestyles while he lives in excess.  The list is never-ending, where extreme lifestyles are flashed wantonly, and suffering continues to expand exponentially.

Marie Antoinette was made famous for the starving and suffering by losing her head after supposedly claiming, “Let them eat cake.”  Hubris snuffed out by Nemesis in a well-deserved act of humiliation.  Yet, one of the things that set Greek and Roman mythology apart from Judaism and Christianity was the ability to repent, achieve forgiveness, and change one’s life being in the hands of the individual, not the destiny of the Fate’s.

Being called to repentance is primarily the realm of religious leaders, and I would not want anyone to think I am making a call for others to repent.  Not my job, no authority, no power.  Merely, I hope to help raise the perception of those suffering from the hubris of others.  I also want to improve how I live.  I am not the example to hold up to anyone, except as a warning, but I strive to improve.  The poem Invictus by William Ernest Henley rings ever truer, “I am the master of my fate: I am the captain of my soul.”Invictus Games Foundation - YouTube

Our world, right now, is suffering greatly.  Crime is skyrocketing; theft is out of control; violence, aggression, murder, rape, and so much more are occurring at levels not ever recorded and growing.  Yet, Thomas S. Monson authored a book based on a concept of power, “The future is only as bright as your faith.”  Consider this for a moment; we can have hope and happiness in whatever circumstances we face as a choice reflecting our personal religious beliefs.  Yes, the consequences of crime hurt physically, spiritually, emotionally, mentally, etc., but the hubris of others can be healed.  Victor E. Frankl’s book, “Man’s Search for Meaning,” signals the same semaphore, your choices can heal the hubristic consequences suffered, and the future is bright!

Those who have indulged in hubristic actions can find peace, joy, happiness, and forgiveness.  Those hurt by the hubris of others do not have to stay hurt, or hurt others, to find the same joy, peace, happiness, and forgiveness.  Want to know an exciting thought?  I am not preaching religion!  Your religious choices are your own, and I respect your religious preferences, provided they do not infringe upon anyone else’s rights to freedom of religion.25 Best Hope Quotes That Build Your Confidence Again - Picss Mine

I am talking about living without extremes, not religion.  How big of a house do you need?  Due to my violent sleeping and crazy sleep patterns, my wife and I sleep in different rooms.  Because I am a proud person who, after cleaning latrines and heads for the US Army and Navy, hates cleaning bathrooms, we also have separate bathrooms.  As a married couple, these changes to the “traditional” style of a man living with a woman have led us to live in a slightly larger home, but this fits our needs.  Please note that my bathroom is not a filthy mess, but it is not the surgical clean of a military bathroom either.  Nor is my bathroom one step higher in cleanliness above the military than my spouse’s.

How many cars and vehicles does a person need?  I don’t know.  I have friends who have four-wheelers, tractors, motorcycles, and a host of other vehicular conveyances.  I am not here to tell anyone how much of anything they need.  I merely postulate that you can make better choices and exercise less hubris through careful consideration and thoughtful discussion.  The same goes for food, clothing, entertainment, and every other vice humans invent to fall into.  I am not condemning anyone!  I suggest that we can live well without the extremes and expect our political leaders and bureaucrats to do similarly.

Question 3How expensive is the government because those who claim to be public servants practice hubris with our tax dollars?  How complicated a process does a government become when government becomes a jobs program instead of a government?  How big does a government become when hubris is practiced against the citizens?

As free-thinking humans, we do not need to be ruled with a brick stick to make better living choices.  We do need a moral code to live by, and how you choose your moral code is your business.  The moral code should include things like living within our means, not being violent to others, promoting good where we see it, and disdaining socially what should be kept privately, among other things.  I cannot stress this enough choosing what you believe is your business.  However, hubris hurts others to make oneself inflated, and that is everyone’s business!

Consider for a moment the store clerk who had to take a life to defend himself in a bodega in NYC.  That man will be forever haunted by the violence perpetrated upon him, leading to the perpetrator’s death.  The hubris of the attacker led to his humiliation but had consequences for society at large.  The thieves in San Francisco, Chicago, and other places do not hurt just the business and local communities, they hurt everyone in American society, and their hubris is morally, ethically, and legally wrong!Hubris Quotes. QuotesGram

The murderer’s hubris affects society just as wholly as the hubris of a political leader who lives in excess; I see no difference between the two.  Some may complain that murder and living in excess are two different moral choices, but those hurt do not differentiate the wound, so why should I?  Is not a life lost in murder?  Is not a life lost when the excesses of others lead them to use the power of government to steal, cheat, and lie in the name of government business?

Consider illegal immigration as the theft it is, and we can see how hubris negatively influences the originating country, pushing the poor out and the host country where the poor want to reside illegally.  Does this mean immigration is wrong; absolutely not!  Immigration includes assimilation, illegal immigration does not, and those practicing illegal immigration, promoting, and facilitating are all practicing hubris for personal power, wealth, and gain.  Are there those in the illegal immigration classes who are the “Sons of Mary;” indeed.  But the majority are merely perpetuating hubris with the resulting consequences in increased drug trafficking, sex trafficking, disease spread, and a host of other social ills.

I admit the murders of millions in Nazi Germany under Hitler were terrible, but how is this any different from Mao using government powers to kill millions by withholding food, clothing, and housing from those who disagreed politically, religiously, or personally?  Or any different than Xi Jinping doing similarly to the Uyghur populations?  What is different between Marie Antoinette and Marx or Stalin?  How are these actions any other than what the government has done under the excuse of Covid?  Did not millions die while political leaders lived in excess, flaunted their hubris, and stole from those who put them in power?️ Oedipus hubris. Oedipus Rex or Oedipus the King Essay. 2019-01-31

Under communism in the USSR, the people lived in abject misery, while those who considered themselves elite grew fat and lazy, all in the name of helping, providing, caring, and progress.  Communist Cuba and the disaster called Venezuela are additional examples of what occurs when hubris corrupts governments and society is left to suffer while the leaders live lives of excess.  America used to be a capitalistic country but is now a mix of socialism and communism under the guise of capitalism.  The hubristic lifestyles of those in power, their lackeys, flunkeys, and bureaucrats, are all at the taxpayers’ expense.  What is the difference between hubris in the communist USSR and America?

I am not claiming that anyone is doing anything inherently wrong.  Our choices to live an extreme lifestyle breed pride, vanity, ego, narcissism, and a host of other social ills; these social ills breed expanses to government, creating red tape, tax increases, and socialism/communism as measures to improve equality.  What happens when the hubris grows too big, war, revolutionary governments, and destruction.  The mythological Greeks would call this the coming of Nemesis to cull the acts of Hubris.  Judaism and Christianity would discuss balancing the scales of justice with mercy.  Other religions would discuss balance, choice, and compounding accountability for choices.  All truths flashed from an eternal semaphore, where man tries to explain the loss, putting morales to the stories and trying to pass along a truth grasped at, that men make choices, and when those choices include extremes, the consequence is death.

Knowledge Check!Is the future really as bright as our faith; YES!  What we choose to believe in, how we choose to exercise belief, and the need for freedom of religion to keep men on equal grounds, are all pillars to helping man live life without extremes.  Extremes breed death; living without extremes creates life; can we at least learn this lesson?  I hope so.

© 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 (Ch 9)

I-CareThe Department of Veterans Affairs – Veterans Benefits Administration (VBA) regularly crows about reducing the backlog, improving the veteran experience, and making changes to deliver on the promise.  Every so often, another article is spread, mainly by the VA Public Relations department (PR), about how they meet the legislated obligations.  Then, unsurprisingly the truth is revealed, the curtain thrown back, and the lie exposed.  The Department of Veterans Affairs – Office of Inspector General (VA-OIG) is helping pull the curtain back, and the truth should infuriate every American.  In an investigative report dated 22 June 2022 and linked, we find the following:

“… The VBA disregarded privacy procedures so it could use a workload tracking system more quickly without receiving the appropriate security authorization.  The Mission Accountability Support Tracker (MAST) helps quantify the work VBA’s support services staff perform in response to employee requests for facility, equipment, and vehicle management; reasonable accommodation; and identification card issuance and renewal.  Because staff use personally identifiable information (PII) in their work, the information could be compromised in an unauthorized, unsecured application.  The VA-OIG found that VBA and the Office of Information and Technology (OIT) did not correctly follow privacy and security procedures.  VBA’s privacy threshold analysis was inaccurate, and OIT did not conduct a privacy impact assessment.  OIT’s misclassification of MAST as an asset resulted in insufficient security controls.  Further, VBA lacked the authority to operate MAST before using it in regional offices.”

Lacking authority equates to a leadership failure to follow their standard operating procedures (SOP).  PII being inappropriately released, nothing new at the VBA, or the VHA for that matter.  Losing veterans’ identities and taking advantage of systems for personal gain, regardless of the cost, is nothing new or surprising.  This should be where the VA organizational leadership should be focused; yet, what are they doing?  Where is Congressional oversight and scrutiny?VA 3

FY 2017, the VBA leaders devised a scheme to have third-party vendors conduct compensation and pension exams to deliver on the promise to clear the backlog on veterans’ claims.  Since FY 2017, the VBA has paid over $6.5 Billion on this scheme, and the VA-OIG found in a report dated 08 June 2022, “Some of the exams produced by vendors have not met contractual accuracy requirements.  As a result, claims processors may have used inaccurate or insufficient medical evidence to decide veterans’ claims.”  Is anyone surprised this is the result?  The compensation and pension exam is the key to accuracy in claim completion; yet, inaccurate claims are still being adjudicated wrongly, which is significantly damaging veterans and their families!

From the report, we find the following:

VBA’s governance of and accountability for the exam program needs to improve.  The identified deficiencies appear to have persisted, at least partly because of limitations with VBA’s management and oversight of the program at the time of the review.”VA 3

The VBA’s leaders designed this scheme, shackled the program with ineptitude, and hindered the improvement of the program.  Designed incompetence cannot get any better than this, and the leadership must be held accountable!  Fraud, waste, and abuse remain pillars in Federal Government governance, so why are these leaders not being held liable?

Michael Bowman, Director of IT and Security Audits, in recent Congressional Testimony, made the following claim:

Secure IT systems and networks are essential to VA’s fundamental mission of providing eligible veterans and their families with benefits and services.  VA’s information security program and its practices must protect the confidentiality, integrity, and access to VA systems and data.”

The audacity of this director to claim “confidentiality, integrity, and access” as being secure would be laughable if it weren’t so inept!  How would a non-VA Employee know the IT system is fraught with problems?  VA-OIG report regarding FISMA compliance, Dallas, Texas.  The Federal Information Security Modernization Act of 2014 (FISMA).  FISMA is a United States federal law that defines a comprehensive framework to protect government information, operations, and assets against natural and manmade threats.  FISMA OIG inspections are focused on four security control areas that apply to local facilities.  They have been selected based on their level of risk: configuration management controls, contingency planning controls, security management controls, and access controls.VA 3

What did the VA-OIG find?  “Without effective configuration management, users do not have adequate assurance that the system and network will perform as intended and to the extent needed to support the CMOP’s missions.  The access control deficiencies create risks of unauthorized access to critical network resources, inability to respond effectively to incidents, loss of personally identifiable information, or loss of life.”  All political speak for inept leaders and deplorable leadership actions.  IT/IS systems continue to fail, and the director claims the system has integrity; despicable and detestable!

Worse, the same FISMA inspection occurred at the same outpatient pharmacy mail facility in Tuscon, Arizona.  The same problems were found, in the same systems, manned by the same inept people and led by the same poor leadership.  Integrity, only if the word means sharing ineptitude between different facilities.  Access to systems and data protection, can anyone honestly trust that the IT system at the VBA or VHA is providing the fundamental tools to meet the mission?VA 3

On the topic of IT system integrity, can anyone forget the continuing problems in delivering a functional electronic health record system to the VHA?  How many billions of dollars must be wasted before Congress stops paying for this albatross?  The VA-OIG has substantiated that “… many quality, patient safety, and organizational performance metrics were unavailable, including metrics needed for hospital accreditation.  Additionally, the VA-OIG found that access metrics were largely unavailable.  The VA-OIG remains concerned that deficits in new EHR metrics may negatively affect organizational performance, quality and patient safety, and access to care.”  How’s that integrity doing?  Is it trustworthy?

05 May 2022, failures were discovered in a joint DoD and VHA review of the new electronic health record system.  The new EHR has no plan to create interoperability, yet interoperability was the main selling point for spending billions of dollars on a new EHR.  Would you believe the VA-OIG recommends the DoD and VHA review federal laws and direct the offices overseeing the EHR program to begin complying?  Would Congress please ask, why haven’t the program managers for the HER already been complying with Federal Law?  How about demanding action to recompense the taxpayers who have been defrauded?VA 3

In April 2022, VA-OIG Michael J. Missal addressed Congress in a statement entitled, “At What Cost? – Ensuring Quality Representation in the Veteran Benefit Claims Process.”  The VA-OIG’s mission is “preventing and addressing fraud and other crimes, waste, and abuse in VA programs and operations.”  General Missal then discussed the integrity of VA processes to “help ensure that veterans receive the benefits, health care, and services they have earned through their service to our country.”  Would Congress please ask how the VA-OIG is fulfilling its mission to prevent fraud, waste, and abuse?

The VA-OIG operates a hotline that receives approximately 30,000 complaints annually from veterans, family members, VA employees, and the public.”  If the 30,000 complaints are presumed to be stable, across just the years I have documented the VA’s abuses, then the VA-OIG has received upwards of 360,000 complaints over the last 12 years.  Would Congress please ask about the success in promoting change, reducing fraud, waste, and abuse, and curbing the veterans being actively harmed by the VA, the VHA, and VBA?VA 3

Congress receives these VA-OIG reports first; what is Congress doing to scrutinize the executive branch?  Where is the progress?  The VA-OIG reports annually to Congress, but improvement never occurs.  Permanent change never occurs.  The same people are making the same excuses, using the same flowery language, and nothing ever happens to improve things.  Worse, the same people maintain the same jobs, who pays, the veterans and their families, and the American taxpayer through the nose as the VA loses more and more money!

I do not know about any Congressional elected leader, but I am through buying the Kool-Aid the VA-OIG is selling:

The VA-OIG’s work is focused on protecting VA programs and operations from waste, fraud, and abuse as well as improving their efficiency and effectiveness.”

On a single topic that the VA-OIG has reported on multiple times and remains critically important to all veterans and their families, it is reporting needs for improvement in VHA and VBA suicide prevention.  From the report, we find the following:

“… Suicide prevention coordinators at VA medical facilities are required to reach out to veterans referred from the Veterans Crisis Line.  Coordinators provide access to assessment, intervention, and effective care; encourage veterans to seek care, benefits, or services with the VA system or in the community; and follow up to connect veterans with appropriate care and services after the call.”

The findings from the VA-OIG report are almost criminal in the negligence of leadership to perform the jobs they hold:

The VA-OIG found that coordinators mistakenly closed some veteran referrals because coordinators lacked the proper training, guidance, and oversight necessary to maximize chances of reaching at-risk veterans referred by the crisis line.  VHA lacked comprehensive performance metrics to assess coordinators’ management of crisis line referrals, and coordinators lacked clear guidance on managing crisis line referrals.  Until VHA provides appropriate training, issues adequate guidance, and improves performance metrics, coordinators could miss opportunities to reach and assist at-risk veterans.”VA 3

Why did the media bury this report?  Suicide prevention continues to be a significant military and veteran issue, but this program’s designed incompetence should be a major story on all media networks.  More, this VA-OIG report should be a talking point for every congressional representative seeking re-election.  Why is this not the case?  Integrity requires honesty, honesty and integrity requires action.  When will Congress take action?

How many dead veterans will it take before Congress takes action?  31 May 2022 VA-OIG report:

The VA Office of Inspector General (OIG) conducted an inspection to review the care of an unresponsive patient by Emergency Department staff and the subsequent response of leaders at the Malcom Randall VA Medical Center (facility) after the patient’s death at the University of Florida Health Shands Hospital (Shands).  The OIG determined that facility Emergency Department nurses failed to provide emergency care to an unresponsive patient who arrived by ambulance.  Despite emergency medical services (EMS) personnel having relayed, while en route to the facility, the criticality of the patient’s condition and the limited patient identifying information available, Emergency Department nurses and an Administrative Officer of the Day wasted critical time concentrating efforts on whether the patient was a veteran (which the patient was, but not so identified by the nurses) versus patient care.  As a result, EMS personnel reloaded the patient into the ambulance for transport to Shands.”VA 3

The staff failed to follow EMTALA, and a veteran died due to the inaction and inappropriate focus of the medical providers.  This is not the first or second breach of EMTALA, the federal law requiring any patient presenting at an emergency department receiving federal funds to be treated; yet, what will it take to get Congress off their thumbs?

12 May 2022, deficiencies in care led to a patient dying at the Charlie Norwood VAMC, Augusta, Georgia.  The VA-OIG substantiated that:

medical-surgical unit nursing leaders did not have adequate quality controls or training to ensure the provision of safe and effective alcohol withdrawal nursing care.”  “Primary care staff failed to provide sufficient care coordination and treatment.  A provider failed to address the patient’s abnormal chest images and poor nutrition and failed to communicate test results to the patient as required.  A primary care nurse failed to respond to the patient’s secure message request for assistance two days before surgery.

Additionally, a barium swallow test was not scheduled.  The surgical team completed a preoperative assessment but failed to detect the patient’s overall poor health.  During the patient’s hospital stay after surgery, medical-surgical nurses did not consistently assess alcohol withdrawal symptoms or administer medications as required.”VA 3

My wife is fond of saying, these oversights and failures occur in non-Government hospitals, and this incident should not be considered indicative of the whole system lacking similarly.  Yet, civilian hospitals have lawyers by the dozen looking for a reason to sue providers for malpractice, and the government hospitals protect against accountability and responsibility.  Worse, you will never know the problems unless you track these incidents.

Do you know why I keep declaring there is a problem with designed incompetence; several veterans suffered T-12 burst fractures and multiple rib fractures, all because of poor documentation and even worse communication.  This is a life-changing injury, and the VA-OIG found the VA providers to have culpability but no responsibility due to a lack of documentation.  Delays in provider documenting in the electronic health record the provider’s notes delayed care for another veteran who also suffered life-changing spinal injuries after receiving non-care at a VA facility.  The VA-OIG cannot conclusively document the tie between poor care being received and the injuries sustained by the veteran, all because of delays in the provider documenting treatment.VA 3

Tell me, does anything discussed above reflect the words of Inspector General Michael J. Missal, who claimed the following in Congressional Testimony:

VHA continues to face enormous challenges in providing high-quality care to the millions of veterans it serves.  Despite these challenges, the VA-OIG has witnessed countless examples of veterans receiving the care they need and deserve—delivered by a committed, compassionate, and highly skilled workforce [emphasis mine].”VA 3

Does a provider killing a veteran reflect a committed, compassionate, or highly skilled workforce?  How many veterans must be permanently injured by the VHA providers to reflect a committed, compassionate, and highly skilled workforce?  How often will the electronic health record fail before highly skilled workers are displayed?

Plato 2Unfortunately, the VA-OIG reports discussed are not even the tip of the iceberg of what is happening.  My apologies, dear readers; I have been remiss in my reporting duties.  Why have I been remiss, because my health went sideways since April when I had a medical procedure completed that was advised but not appropriate.  The VHA and VBA are sick organizations and desperately need scrutiny and standards, new leadership, and written organizational policies.  Help me force these nefarious characters into the sunshine for a good dose of sunshine disinfectant, and let’s change the world for the better.

© 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 Coffin Where Comedy Goes to Die – More VA Chronicles

I-CareConsider something with me: if you need to proactively reach out to a customer using a phone, would you call that customer’s or his spouse’s phone?  Customer service is all about the customer experience; in an effort to provide customer support, do you call a customer’s or their spouse’s phone?  The answer is obvious, yet the EL Paso VA Outpatient Clinic did the exact opposite of common sense, even though the customer had, within two previous hours, called the EL Paso VA OPC using his phone number on record.

Earlier in the week, a face-to-face patient appointment had to be changed to a VA Video Connect (VVC) appointment, and the provider never showed up.  Later blaming the patient for not showing up to their appointment, even though the patient was online 15 minutes early to the VVC and every 30-minutes logged back into the VVC as the provider never showed.  They are eventually blaming the patient for failing to communicate with the clinic.  Facts essential to know, at 0200 of the morning of the appointment which the provider’s nurse had responded to.  At 0900, the call center changed the in-person appointment to a VVC after contacting the provider for permission to change the appointment to VVC.VA 3

Irony remains critical to comedic gold; the irony of the Department of Veterans Affairs (VA) is the issues discussed above are how veterans are abused daily, and the bureaucrats running the VA do not realize how ironic the designed incompetence has become.  Unfortunately, irony died, and comedy is being sealed into its coffin at the VA.  Veterans are being abused to death, and I can no longer laugh at this ineptitude!

Atlanta VA, as reported by Military.com, 73-year-old Vietnam veteran Phillip Webb is filmed receiving hits and kicks from a VA Employee.  The VA Employee, Lawrence Gaillard Jr., a patient advocate at the VA outpatient clinic in downtown Atlanta, was arrested and charged on April 28 for allegedly assaulting and suspended without pay.  There is nothing to laugh at with this event.  While this event remains under criminal investigation, the abuse at the VA towards veterans from the bureaucrats has not scratched the surface!  Where are the Congressional leaders in demanding change at the VA?VA 3

The Department of Veterans Affairs – Office of Inspector General (VA-OIG) has spent another month reporting on investigations of more malfeasance, misfeasance, and designed incompetence masquerading as bureaucratic inertia.  If your job included the safe handling and storing of medicines, would you be motivated to properly refrigerate the medication, especially if it meant keeping your job?  In January 2019, the VA reported a loss of over $1 million due to improperly stored medication, e.g., refrigerated.  In 2019, the VA was told to improve their safe handling and storing of medicines to prevent additional losses.  2021 more than $1.5 million was lost for the same reason, improperly refrigerated medication.  2022 the VA-OIG has concluded that the VA has done nothing to improve the medication losses.

If we use the annual loss, rounding down to $1 Million, and then presume this has been going on since 2000, we have the potential for a loss of around $20 million.  The Federal Government is always going on about Fraud, Waste, and Abuse, curbing these losses and reporting them.  Will some congressional elected leader please tell me why Congress refuses to act to stop fraud, waste, and abuse?  The full report is nothing but fraud, waste, and abuse, and while the VA-OIG suggests the VA has taken “some steps” to improve the potential of losses, more needs to be done; yet, where is Congress?  Where is the VA Leadership in fixing the problem?

Regarding medication, let’s talk about how prescriptions continue to be delayed and shipped in wrong doses forcing the patient to cut and presume how much meets their needs and prescription level.  Let’s discuss how the providers continue to play games with medications, especially the pain management medications, using the erroneous excuse, “Fighting the opioid crisis.”  I know the political talking points; what I do not know is how these blatant excuses continue to possess traction.VA 3

The Albuquerque VAMC is back in the news due to the continued failure of leadership; why you ask is the Albuquerque VAMC in the VA-OIG reports, they are failing to help in the opioid crisis by delaying the delivery of medication.  From the report, we find the following:

The OIG substantiated that pharmacists declined early refills of buprenorphine despite prescribing providers’ documented clinical rationales, which increased patients’ risk for adverse clinical outcomes associated with interruption of buprenorphine treatment.  The OIG substantiated that justification for declining early refills was incorrectly based on a facility policy that was not applicable to the use of buprenorphine for the treatment of opioid use disorder [emphasis mine].”

Did you get the why?  Leadership at the VAMC is beyond subpar, has been failing the veterans of Albuquerque, and is protected by the ridiculously inept leaders at VISN 22, as documented multiple times over the last five years.  Yet, still, nothing is done to remove the leaders, stop the abuse, and fix the problems; thus, I ask again, why?  Where are the elected leaders in scrutinizing the executive branch?  Even the VA-OIG has reported, “actions taken by leaders did not fully address the reported concerns.”  If this is not a perfect definition of designing incompetence, I’ll eat my hat!VA 3

The VA-OIG’s recommendations reflect the inadequacy of the VA-OIG to demand change and then enforce corrective action effectively.  More designed incompetence and the crosshairs are clearly on the executive and legislative branches to act.  This means that you, the voter, have the power to demand change!

Dare you think the Albuquerque VAMC is the only VA having problems?  The VA-OIG reports the VAMC in Hampton, Virginia is also back in the news.  Consider the patient and the family in the following, “… multiple providers’ failure[d] to communicate, act on, and document abnormal test results from July 2019 until April 2021, when the patient was diagnosed with metastatic prostate cancer.”  More failure of VA leaders to act, and “… facility leaders did not initiate peer reviews within three days, and facility staff did not submit patient safety reports as required.”  Where is the outrage that another veteran is needlessly suffering, the family is needlessly struggling, and the VA Leaders keep their jobs?VA 3

We began this chronicle with a Vietnam Veteran being beaten and kicked by a VA employee who was employed to defend patients, where leaders did not act upon the incident for two months, leading to questions and concerns about the potential cover-up, hushing of witnesses, or manipulation of evidence to hide, what for all intents and purposes appears to be, employee criminal activity.  While the attacker retains their constitutional right to innocence until proven guilty, significant questions need immediate redress, and the VAMC leadership needs to answer these questions.

Continuing on the failure of leadership, the Tuscaloosa VAMC in Alabama shows more leadership failure to address patients’ safety and security in long-term care.  The VA-OIG identified that the administration could not fill critical staff positions, possibly due to the toxic nature of the leadership.  One of the more critical failures of leadership deals with the elopement of patients from the care facility, and the leaders appear to remain inadequate to improve the facility and patient safety.  Why are these leaders still in positions of power in this facility?VA 3

As an organizational psychologist, the continued failure of leadership represents a real and present danger.  The VA-OIG appears to be aiding and abetting the absence of leadership at the VA.  If you think I am exaggerating, consider the continued failure to comply with the payment integrity information act (PIIA).  The VA was failing to comply before PIIA, and the following from the VA-OIG report is telling:

In FY 2021, VA reported improper and unknown payment estimates totaling $5.12 billion for seven programs and activities.  Of that amount, about $1.97 billion (around 39 percent) represented a monetary loss.  The remaining approximately $3.14 billion (about 61 percent) was considered either a nonmonetary loss or unknown payment that cannot be recovered.  Though VA had an overall decrease in total improper payments and unknown payments, the overall monetary loss more than doubled from $892 million in FY 2020 to $1.97 billion [emphasis mine].”

PIIA was legislated and put into effect in March 2020, FY 2021 is the first year, and the investigative reports represent the VA’s inaugural failure to comply.  All facts are desperately pertinent in this report and necessary to understand just how ridiculously inept the VA leadership continues to act.  10% of $5.12 Billion is $512 Million; the VA leadership from the VA-OIG is “encouraged” to become compliant and lose less than $512 Million in FY 2022.  Tell me how “encouraging” your leadership will be losing that much money?

From the VA-OIG Report,  “VA satisfied nine of the 10 requirements; however, it is not considered to be compliant because it failed to report an improper and unknown payment rate of less than 10 percent.”  PIIA was legislated to reduce improper payments to less than 10%; tell me, if you improperly paid someone $512 Million, would you keep your job?  Never forget, every Federal Government facility must have posted a poster discussing how to Report Fraud, Waste, and Abuse; what do you call losing $512 Million?  Would someone please explain why losing less than $512 Million is an improvement?  How is losing less than 10% acceptable and not Fraud, Waste, and Abuse or credible accounting?VA 3

Finally, we conclude with additional reports of criminal enterprises by VA employees, as if anyone is surprised:

  • Bethann Kierczak of Southgate, Michigan, a registered nurse at the John D. Dingell VA Medical Center in Detroit, pleaded guilty to charges related to COVID-19 vaccination record cards fraud. According to court records, Kierczak admitted to stealing or embezzling authentic COVID-19 vaccination record cards from the VA hospital—along with vaccine lot numbers necessary to make the cards appear legitimate—and then reselling those cards and information to individuals within the metro Detroit community.  Kierczak began the scheme as early as May 2021 and continued through September 2021, selling the cards for $150 to $200 each.  The VA OIG investigated this case with the VA Police and the Medicare Fraud Strike Force, a partnership among the Criminal Division, US Attorney’s Offices, and the US Health and Human Services OIG.”
  • Melissa Flores was sentenced to two years in prison and $110,000 in restitution for her role in a scheme to defraud VA. Flores and a codefendant allegedly created aliases and obtained or created fraudulent documents to make it appear they were the heirs of various individuals who had died.  Between 2013 and 2019, the two codefendants defrauded VA out of more than $430,000 and the Michigan Department of Treasury out of more than $40,000 in unclaimed property.  Flores pleaded guilty to two counts of false pretenses last May and one count of forgery.”
  • Bruce Minor of Philadelphia, Pennsylvania, pleaded guilty in connection with his scheme to embezzle money from his former employer, the Philadelphia VA Medical Center. In April 2022, Minor was charged with theft of government funds stemming from his theft of more than $487,000 in VA travel reimbursement funds, which he helped administer as part of his official duties as a travel clerk.  To perpetuate the theft, Minor created fraudulent travel reimbursement claims in the names of at least three other VA employees and then diverted the fraudulently obtained funds into bank accounts he controlled.  According to court documents, in an email to medical center management, Minor admitted to stealing approximately $13,000 in travel funds.  However, a subsequent investigation showed that he stole upwards of $487,000 between December 2015 and September 2019.  The VA OIG conducted this investigation.”

PatriotismWhat connects all three of these criminals; the failures of VA leadership to scrutinize their employees.  Does this remind you of additional leaders, maybe those in Congress who continue to refuse to scrutinize the executive branch?  The US Constitution established three co-equal branches, the judicial protects the Constitution, the Executive operates the government, and the Legislative has two jobs write laws for the executive branch to operate and scrutinize the executive branch as it operates.  Each branch answers to the other, and all branches must operate inside the US Constitution.  America needs the legislative branch to begin doing its job, and we, the voters, are the only way to begin demanding the change we need!?u=https1.bp.blogspot.com-aqaqk18MHoEWRHHsCi_TyIAAAAAAAAAXc7hY4JQuyylIQHYudoR8sbezGZntic4SSwCLcBs640Betrayal2BSayings2Band2BQuotes2Bwww.mostphrases.blogspot.be.jpg&f=1&nofb=1

If comedy is dead, and it is, the VA is the coffin where comedy went to die.  Let’s stop laughing and start acting!  Join me?

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

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

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

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

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

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

Oh, the irony is thick; consider the following:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Join me in having your head explode:

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

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

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

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

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

“That’s Crazy!!!” – More Chronicles from the VA Chapter 7

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Serial Betrayal – More Government Attacks Against Citizens

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Economic Warfare – Your Liberty, Rights, Freedoms are at Risk!

Bobblehead DollMany pundits have made the following statement, in one form or another, driving a car is the ultimate expression of freedom in America.  Yet, your freedom to drive a vehicle is endangered by the political left and the neo-socialists who want to steal and destroy your freedoms.  Mention economics, and most people’s eyes gloss over, brains disconnect, and they hope the pain will end shortly.  Please, fight this impulse.  I will attempt to make a highly complex topic simple and easily understood.  While I might not get all the specific details correct, I aim to communicate economics to a general audience that is free and empowered to further research the topics for themselves.  My links are reflected in the article for more information.

What is Money?

Money was discussed in a previous article and found here.  In simple terms, money is the tool used to transfer goods from one entity to another, showing a legal purchase was made to change ownership, hence opening the first crucial role of money, legally transferring ownership of goods and services from one person to another.  Unfortunately, legal ownership transference is where the government exercises its first controls, regulating cross-border commerce.  When the government went on a growth spurt in the 1930s, ballooning into the behemoth, we have right now, the government used the excuse of maintaining cross-border commerce to steal products grown by farmers, regulate prices, and set up means and methods to ensure the government was the only winner.TOP 25 QUOTES BY JOAN ROBINSON (of 54) | A-Z Quotes

The 1930 legal battles that wound up in the United States Supreme Court over price controls saw the citizen’s first attempt to reign in the government and failed miserably.  Worse, these first moves by the citizen were the first exchanges in an economic war that has raged ever since—money stores value.  Think of the money found when you do laundry.  You have no idea how long that money was lost, but the value of the money has not changed, you presume, and you celebrate finding the money.  Except, the value of that money has changed through inflation, and the government’s hidden tax (inflation) has robbed you of value.

Let’s say you found $20 in the laundry.  When you first lost that $20 bill, it had more value, e.g., you could purchase more with that money than you can now.  Sure, the value printed on the money still has $20 worth of goods or services, but the cost of those goods and services went up, restricting your ability to purchase.  Hence the economic warfare being waged by your government.  The government essentially said we would not worry about inflation.  Meaning they will devalue the money you hold for their own political purposes.Steve Keen Quote: "Economics is too important to leave to the economists." (12 wallpapers ...

An idea was floated by an economically challenged person to print a $5 trillion bill and use this to pay off the Chinese debt.  The problem is the devaluation of the money printed will capsize American citizens due to the hidden taxes of inflation.  Making that $5 trillion bill or bills would devalue the dollar and crash the American economy.  The stored value in the printed bill would not stand up to and be accepted, as a medium of stored value sufficient to pay the debts incurred.  Is the problem more clear; when money is printed, each dollar, pound, euro, etc., devalues the stored purchasing power of the money you currently hold in hand.Economics Funny Quotes. QuotesGram

Stored value is the second tool for waging economic warfare by the government against its citizens.  Consider all the money printed to pay for the supposed Coronavirus Tax Relief and Economic Impact Payments the world’s governments made to their citizens.  If you had $100,000 in savings when these monies were printed, your savings were devalued by the inflation rate, which is currently at a 40-year high in America.  The government is reporting inflation at 7.9%, so your $100,000 in savings lost the equivalent of $7900.  But, the government does not ever report inflation at the actual level, and the actual level of inflation is ranged between 8% and 45% depending upon the purpose or product you are trying to purchase.  Meaning your $100,000 could have a value of $92,000 to $55,000 in real value.  A hefty tax indeed!

Stored value, the number printed on different bill faces of currency, is static.  The actual value, e.g., the number of goods and services purchasable, is not fixed, and the government allows an annual inflation rate of 2% as “normal and acceptable.”  Thus, your $1 will have a purchasing power of $0.98, which is compounded year-over-year.  Thus, over a decade, that 2% inflation rate is now reducing your $1 to $0.80.  Multiply that for the $100,000 and a decade of saving, receiving interest that does not equal inflation to compensate means your money in your savings account has lost $20,000, just from the government allowing inflation at 2% annual growth.  Let’s say your bank is generous for savings account holders and provides a published interest rate of 3%, subtract the inflation taxes of 2%, and you are only earning 1% interest on your money.  Is this the bank’s fault or the government’s?Amartya Sen quote: Economic growth without investment in human development is unsustainable...

Do you see how the government is robbing you through economics?  Your 5% raise is only 3% once the inflation devaluation has been factored into your budget.  Play the lottery; the taxes alone might kill you, but the devaluation of the money reduces the actual purchasing power of your winnings.  If you do not understand the economic warfare being waged against you by your government, you will lose more than you ever gained in winning the lottery.  Yet another reason why lotteries are a tax on stupid people, for even when you win, you lose!

Cash has another problem beyond inflation, money supply.  The money supply is the technical term for ensuring banks can replace worn-out, ripped, and damaged money.  Money supply plays a role in how much money your local store has on hand to provide change and cashback to customers.  For employers who pay employees in cash, the money supply is a significant problem with extremely high costs.  The government regulates those costs and passes them onto consumers through banks and lending institutions.  Are you struggling to get a loan; this is another by-product of money supply woes.  Paying higher fees to change money to another currency for your trip is another money supply product.  Money supply remains another weapon of the government to affect economic warfare, and many people do not understand this principle, making the government’s policies more effective.Mahatma Gandhi quote: Economics that hurt the moral well-being of an individual or...

Have you noticed the decline in the availability of $10 dollar bills?  I asked for two $10.00 bills when I broke a $20.00 at a Walmart recently, I was denied because Walmart has instituted a policy to only accept $10.00 bills, not give them.  Albertson’s, Staples, the in-store bank in Walmart, and the local credit union, all have a similar policy.  What is the government doing forcing a reduction in $10.00 bills in circulation?  In researching this single policy, I can find no written information on this issue; yet the evidence is clear, there is a manual currency reduction in process and the government needs to explain why.

Before 1980, the basic money supply was measured as the sum of currency in circulation, e.g., cash, traveler’s checks, and checkable deposits.  Currency serves the medium-of-exchange function but denies people any interest earnings.  However, as discussed, interest earnings are not all they are cracked up to be due to inflation.  Cash under a mattress, lost in pockets of clothes, stuck in a book in your library is black money; it is as dead as yesterday’s fish and constantly devalued by inflation.  The money supply tries to regulate the cash on hand to lend as a tool to protect your money from inflation.  Except, the government constantly allows a 2% inflation rate, negating a lot of savings accounts and other interest-earning propositions.

Want a new car, consolidate your credit card debt, or try to buy a house; all of these loan products are an extension of the money supply and the regulation of money supply by the government.  Important to note that your credit cards and bank-issued or employer-issued debit cards are not affected by the money supply, and this is another reason why credit cards and debit cards are so dangerous.  These tools are agreements between you and the issuer, where money is transferred when the tool is used, and the consumer is responsible for all the fees the government insists upon to help pay for the money supply.Economy has frequently nothing whatever to... - Quote

Conclusion

In waging economic warfare, it remains imperative to know about economics, identifying what money is, its role, and the fiduciary controls the government exerts to attack its citizens.  Some may call my language inflammatory, but tell me, do the inflationary costs right now not feel like your taxes have skyrocketed?  Inflation is a hidden tax, a tax fully controlled by the government, and the value of your money decreases yearly because the government says 2% inflation is acceptable.  Who made this decision, an unconstitutional entity called the Federal Reserve Bank.  Since its inception, Congress has tried to obtain transparency and accountability from the Federal Reserve Bank to no avail.  Do you understand why I take umbrage with the Federal Reserve Bank?LIC

The governors of the Federal Reserve Bank decided your money could be taxed at 2% inflation annually as a normal condition of doing business.  These people set the interest rates you pay for your credit cards and are not paid for your savings accounts.  Looking into the history of interest rates since 1900, there is always volatility; the Federal Reserve’s actions have since the 1980s to not allow savings rates over 5%.  When adjusted for inflation, that’s a 3% interest rate for those trying to save money.  What does this mean; fewer people are saving money.  Look where those trying to beat the 3% have invested their money, the stock market, where volatility is a minute-to-minute occurrence, higher risks against less interest, where your money remains subject to taxes, fees hiding other taxes, government fingers, and inflation.

Your government did that to wage economic warfare against you, to empower them to steal your rights, freedoms, and liberties.  There is no other way to describe what is happening globally in all governments.  China plays games with the value of its currency to power trade deficits.  This, in turn, changes prices and increases costs.  These actions are taken to “compete,” when in reality, the activities cover massive debt problems in China.  If the CCP cannot keep the tap turned wide open on trade deficits, their money supply drys up, and debts come due in a bankrupting tsunami!Milton Friedman: The Most Quotable Economist - Capitalism.com - Create the Change

The European Union has never been fiscally sound because the various members of the European Union are taking advantage of the productive members to cover the costs of the fiscally useless members.  France cannot survive as a country without the European Union’s largesse; Greece, Portugal, and several other countries are all in the same boat.  Their governments did this intentionally as political games to stay in power.  When these countries run out of other people’s money, they will be forced to change socially, and the tsunami of debt to the World Bank and other nations will not be pretty.

Knowledge Check!Economics drives these problems mainly due to the lack of knowledge of the lines of congruence between economics and the psychology of governing.  The enemies of freedom understand economics, and this is why these tools have been so successful in waging war and stealing freedom, rights, and liberties through monetary policy.  Until we, the rightful owners of government, understand what is happening, we will all be at the whims of our enemies.

© 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.

Things Learned About Animals: Lesson 1

MumbleAs a teenager, I worked on a dairy farm in Morrill, Maine, and later as a hired hand on a sheep ranch in Bluebell, Utah.  Often growing up, my family had chickens, ducks, geese, goats, pigs, cats, and dogs.  There are several lessons I feel we could learn from the animals.  In discussing the animals, you are left to choose whether the lesson applies to you or not.  I am not here to convince anyone, I merely relate what I have observed and the lessons I learned.  If you can use the lesson to improve your life, I have achieved my goal.  If you choose not to like the lesson for any reason, happily know you are not the audience intended, and move on smartly.

Animal Gender

Let me be perfectly clear, gender is an eternal construct, is established in the first building blocks of a body, and cannot be changed.  Consider for a moment with me the steps in the gestation process of any animal.  The egg is fertilized, and the fertilization process is self-explanatory, needing no additional discussion from me.  After the egg is fertilized by sperm from a male, the egg from the female becomes a zygote.  This clump of cells shortly gender is known, and the biological differences between a male and a female begin.Egg fertilization and development | Download Scientific Diagram

Males develop larger lungs, denser bones, and other chemical and biological differences.  Females develop smaller lung capacity, less dense bones, and other chemical and biological differences.  We had a female goat who liked to mount other female goats.  While this was highly uncomfortable for the mounted female goat and generally produced fights between the females, we never worried about the goats becoming pregnant.  Interestingly, after this female goat had been impregnated, this female stopped mounting other female goats and was a great mother of kids.  Not speaking goat, I never understood why she mounted other females in what could have been considered her teenage years; one thing was sure, gender did not change because the goat was confused.

It never ceased to amaze me that one could reliably tell the males from the females almost immediately from birth.  Due to their birth size, their growth, and their respective attitudes.  In observing a group of kittens, the males would dominate the females for momma’s attention, the best places to nurse, and innately knew they were male.  The females were smaller, leaner, and sometimes just as feisty and stubborn as the males; they knew they were different from the males.

Baby Cows and CalvesLater while tending sheep, another interesting lesson was learned regarding gender.  Ewes, female sheep, who had lost their lambs, knew somehow if a misgendered animal was placed before them and drove that animal away.  That ewe knew she had birthed a male or female lamb, and any orphan trying to feed would not do; only orphans of the same gender, wearing the skins of their original lamb, were allowed to become a stepchild and be accepted if the ewe permitted them.

Another lesson learned watching a shepherd was the decisions of the ewes.  I saw ewes stand next to a stillborn lamb until the shepherd collected that lamb for disposal.  Crying, mourning, and sometimes choosing to end their life by not eating instead of adopting a motherless lamb.  I am not anthropomorphizing an animal here, that mother losing her lamb cried, mourned, and entered a depression where the ewe chose to join her lamb in death, and regrettably it did not happen only once or twice.  I do not know if the same happens for goats, cows, or other animals.  I know it happens for mother cats and sheep as I have observed these animals and witnessed this event for myself.Cotswold Sheep. Bottle feeding orphan lambs, by Tim Macmillan | Sheep, Animals, Lamb

On the topic of orphaned lambs, I noticed something important, lambs with mothers, even adopted mothers, were less daring, got into less hazardous situations, and generally were calmer socially.  Orphan lambs were wild, got into trouble, did not come to eat without insistence, and several times did not learn from past mistakes, injured, and sometimes died.  I do not know why orphaned lambs acted this way, and without anthropomorphizing, an animal cannot dictate well what I sense is the answer.  I know for certain that ewes impart information to lambs, which is an essential aspect of the health and safety of the herd.

A mother goat, sheep, horse, cat, etc., knows their children, numbers their children, and looks after them.  I witnessed a mother goat kicking the head of a kid who belonged to another goat but who was hungry and wanted food.  Driving that kid off to find their mother relentlessly, and learned something of note.  At first, I thought this was just an ornery goat thing, but then I saw a horse, a mother pig, a mother cat, and other animal mothers repeat the lesson learned about mothers knowing and numbering their children.  A rare mother indeed will accept an animal orphan, and there is order in the animal kingdom!

Order in the Animal Kingdom

Animal Kingdom Phylum Class Order Family Genus Species - Várias ClassesConsider with me a process all herd managers perform, the castration process.  A bull castrated does not grow the female reproductive organs and becomes a cow.  A castrated lamb does not change gender after castration; even if that lamb is provided hormones from female animals, that lamb is male.  A neutered cat does not regrow new reproductive organs or change genders; from birth to death, the gender of that animal is cast, they do not change, and their instincts remain embedded in that animal.

Order is created and not disordered merely due to the loss of a few reproductive organs.  Mothers choose to allow orphans to replace their children or become their children.  Some animal fathers are part of their children’s lives; others grow merely with the input of their mothers.  Regardless, great order is found and maintained in the animal kingdom over roles assigned by gender at birth.

Allow me to elaborate with some observations.  A ewe whom the shepherd relied upon to adopt lambs refused to adopt a lamb.  The shepherd tried everything, including rubbing the lamb in the still wet lamb’s skin, skinning the dead lamb and securing the dead lamb’s skin on the orphaned lamb, and even placing the mother into a pen with her head secured to give the lamb a chance to suckle.  Nothing worked, and all of the methods had worked previously.  Several days later, the ewe died unexpectedly, and the veterinarian determined that the mother ewe had had a disease and probably sensed this when refusing that orphan to suckle.  Order is maintained in the herd, and the condition this ewe had contracted was not passed along to a new lamb.Sheep herd is walking. Animals on grassland. Good conditions for breeding livestock. Pasture in ...

Our gander had taken a spouse, and when the goose died sitting on a nest, the gander was exceedingly heartbroken—calling day and night for his spouse, all to no avail.  After a time, the gander took to liking the ducks whose drake had flown the coop unexpectedly.  Seeing as there was no drake and no female goose, the gander took to mourning his spouse but sleeping with the female ducks.  But, the gander was violently opposed to any duck sitting on a nest, and my parents could not understand why.  My parents captured some eggs that had not been smashed to pieces and tried to incubate the eggs.  The animals born were not ducks or geese, and none survived long.  There is order maintained in the animal kingdom, and the animals themselves know how to keep that order.

It never ceases to amaze me the order and respect animals have for order in the animal kingdom.  In raising goats and cows, the information gained through smell was always interesting to me that allowed animals to act how and why they did.  I could not smell the difference between herds, but the animals knew, and when herds of the same animals mingled, the order was still maintained, and herd integrity was sustained.What to Consider When Raising Sheep and Goats Together

A goat and sheep hered we knew raised the sheep and the goats together; even though both species ate the grass differently and had to be moved more often, raising them together helped protect the herd.  One day another herd was being driven through the area, and a couple of animals got into the pens.  But, the goats and sheep raised together knew the outsider was not orderly and helped keep those animals away from their young and isolated from the whole herd.  The smell is the only answer I have as the foreign herd was smelled by our herd and shunned.  Even when new animals were introduced for the herd to grow, it took several days and several smelling sessions before those new animals were trusted by the rest of the herd.

In one Herculean effort, I heard a goat herder who tried to introduce a foreign billy into the goatherd due to the death of the former billy.  The nanny goats would have nothing to do with the new billy, even when draped in the skin of the old billy goat.  The goat herder tried everything, but until that billy had spent sufficient time with the nannies and smelled correctly, the billy was powerless to lead the herd and perform the duties he had been purchased to complete.  Interestingly, a similar problem occurred for a cattle farmer when introducing a foreign bull.  The cows refused his bull-like advances until the bull had spent time with the herd.  While I do not know if these are isolated incidents, I merely know that order is essential in the animal kingdom.

Lessons for Humans to Consider:Bobblehead Doll

    1. Gender does not change merely because a person wants it. The disorder caused by trying to be a different gender has repercussions and consequences beyond that individual’s choice.
    2. Humans and animals have will and agency, but order remains an essential characteristic of the world. I have heard that scientists have found great order when the observed chaos is understood.  Through magnification, scientists have moved closer to how things move, and I find it incredible the order found that once was described as chaos.
    3. Parents have a duty and role to play. However, their children also play a role, and the order found in families is a prerequisite to good societies.  An animal analogy, the herd of sheep I moved and cared for as a hired hand was a collective society.  They had rules, expectations, and those not choosing to follow the herd society regularly found themselves in danger when the weather changed, when a threat was near, and generally were the ones you could count on to be injured or die unexpectedly.
    4. Diary cows, after milking, will run to the farthest fence in a field; if they find the fence strong, the whole herd will congregate, graze, and chew their cud knowing strong fences protect them. In a storm, trusting the fences, the dairy cows will huddle together and move as a unit to protect younger cows and warm each other.  Dairy cows are not terribly different from humans, we push at barriers (laws), and if we find them sufficiently strong, we band together for protection into social circles and groups.  Failure of laws finds society broken and easily conquered by external and internal threats.
    5. Order in human societies remains an essential element in protecting, promoting, and providing social growth and development. Herds of animals, gaggles of geese, flocks of ducks, murder of ravens, etc., all depend upon the order in their society, or that society falls apart and, like iron filings to a magnet, has to reform into new organizations.

Knowledge Check!Are humans really so different from animals?  Are human societies much different from the societies of animals?  I ponder these questions regularly and am not surprised when social problems in humans are resolved by watching animal herds.  Covering a bull in the skin of a horse does not make a bull into a horse.  Castrating a bull does not morph the bull into a cow.  We must understand better the order, the laws, and the social requirements for society.  Animals and humans choose which society (country, town, city, etc.) they prefer.  If they choose to belong to that society, they must obey or onboard that society’s rules and social expectations.Taking Advantage of the 80/20 Rule | People First

Rarely does the 80% of the herd get into trouble, but the 20% of the herd does not sway or influence into danger the other 80%.  Right now, in human societies, there is a vocal 20% who insist that their reality must become the reality of the entire community.  Do we sacrifice the safety and security of the 80% for the choices and lifestyles of the 20%?  This is the question before us, and animal societies have provided the answer if we are willing to act accordingly.

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

“That’s Crazy!!!” – More Chronicles from the VA Chapter 6

I-CareI promised a follow-up article after Chapter 5; it took me the better part of 48 hours to cool down sufficiently to write coherently to effect an update.  On 18 March 2002, I wrote about an appointment with my Primary Care Provider (PCP) being tardy, unprepared, and bureaucratese in supposedly holding a phone appointment with me.  01 April 2022, not an “April Fools Joke,” at 0731 hours, lasting 9 minutes, my PCP called me to get my approval to have me changed from her PACT team to another provider’s team.  Apparently, in the highly red taped world of PCPs at the El Paso VAHCS, there must be an hour-long handoff call when a provider initiates a change of PACT team.  I have my doubts and smell designed incompetence!

Let me pause here for a moment.  I generally need two hours to write an article after conducting research.  18 March 2002, it took a bit longer to draft that one due to the need to blow off steam with some choice words and choke down the urge to beat a few brick walls with my fists.  I am generally a very controlled person, and the fact that this PCP was so stunningly incompetent, rude, and HIPAA clueless, I admit I lost my cherub-like demeanor!  That the patient advocate was able to get my secure message, upload the comments into the electronic medical record, and contact the provider before the provider had even logged the patient notes, speaks volumes about the ineptitude of the PCP.  Worse, in the call on 01 April, the PCP was still on speakerphone, still disregarding HIPAA security, and quoted lines out of context from my message to the patient advocate.  Speaking volumes about the processes and procedures of the patient advocate’s office to investigate patient claims without breaching confidentiality.  Another topic for another day entirely!PACT_model

28 March 2022, I received the following from the patient advocates office, quoted completely:

We have received your secure message addressing your concerns.  I will be sending a Patient Advocate Tracking notification with your concerns to our Primacy Care Service for review.  They will be contacting you via telephone to discuss your concerns.”

I never heard anything from this mysterious “Primary Care Service” group/team.  01 April 2022 was the first response, and that was from the PCP.  Sourcing the Department of Veterans Affairs (VA) and the Office of Inspector General (VA-OIG), the PCP is the second most important member of the Patient-Aligned Care Teams (PACT) at the VA; the patient is the essential member and an actively engaged and knowledgeable patient is preferred.  I promise the VA-OIG has not even scratched the surface of the problems with recalcitrant, snowflake, and bureaucratic PCPs endangering patient health with the VA.  Not my first run-in with an inept PCP; I sincerely hope it is my last!PACT 3

In returning to the 01 April call, we find another interesting piece of data.  The PCP affirmed that abdominal pain could radiate from, say a hernia, to other parts of the abdomen, but this is for a specialist to diagnose, not a Family Practitioner.  Get that; the PCP is directly reversing all the published documentation by the VA and the VA-OIG by declaring that a specialist is the only person who can adequately decipher and detail why pain is occurring—putting all the PCPs in the VA Health Administration under the bus as merely button pushers and drug dealers.  Then the PCP has the temerity, nay the chutzpah, to suggest a trust deficiency existing between myself and the PCP.  Is it any wonder that people are detested, forlorn, melancholy, madder than a wet chicken with a raging case of hemorrhoids with the care they receive from VA healthcare providers?

Again, I repeat, only for emphasis, when any updates arrive on this issue, I will publish them in their entirety to allow the VA the opportunity to rebut, refute, or explain.  Like the ongoing saga with VISN 22, the Phoenix VAMC, and being arrested and injured three times by the VA Police, I am not holding my breath and awaiting a logical response.  If this were the only problem in the two weeks since the PCP shenanigans, the VA would be in pretty good shape.  Alas, we know, dear readers, that the VA is in dire condition, and the elected leaders need to be scrutinizing the VA a LOT more closely than they are.VA 3

We begin the latest chapter of VA-OIG reports with yet another physician bilking the government:

Robert Clay Smith, a Louisiana physician, pleaded guilty to conspiracy to commit healthcare fraud, wire fraud, and illegal remunerations (taking kickbacks).  According to court documents, the scheme, which ran from 2013 until 2017, involved individuals associated with a medical supply and billing company recruiting Smith to dispense pain creams and patches to his workers’ compensation patients by offering him a split of the profits.  The company acted as the billing agent for Smith, handling all the paperwork and submitting the allegedly fraudulent claims to the US Department of Labor, Office of Workers’ Compensation Programs, and private insurers.  In exchange, the company paid Smith 50 to 55 percent of the profits collected from successfully billing insurers, at markups of 15 to 20 times what the medications cost.”

Plus the following:

Robert Schneiderman of Langhorne, Pennsylvania, admitted to participating in a massive compounded-medication kickback scheme that he and others ran out of a pharmacy in Clifton, New Jersey.  Schneiderman pleaded guilty in federal court to one count of conspiracy to commit healthcare fraud and one count of conspiracy to violate the Anti-Kickback Statute.  From 2014 through 2016, Schneiderman and his coconspirators used Main Avenue Pharmacy, a mail-order pharmacy with a storefront in New Jersey, to run a fraud and kickback scheme involving compounded drugs like scar creams, pain creams, migraine mediation, and vitamins.  Schneiderman was the president of Main Avenue Pharmacy and was a founder and CEO of its corporate parent.  Main Avenue Pharmacy received over $34 million in reimbursements from healthcare benefit programs on compounded medications alone.  Approximately $8 million of that total was paid by federal payers.  Schneiderman himself earned over $400,000 through the course of the scheme.  This case was investigated by the VA OIG, FBI, Department of Defense OIG, Defense Criminal Investigative Service, and Department of Health and Human Services OIG.”

Don’t forget this one:

Dr. Harry Doyle, a psychiatrist from Philadelphia, Pennsylvania, and his wife, Sonya Doyle, have agreed to pay $3 million to resolve alleged violations of the False Claims Act.  The alleged violations include submitting false billing to the US Department of Labor Office of Workers’ Compensation Programs (OWCP) for psychiatric services that were not provided and upcoding and double-billing patient claims.  The Doyles have also agreed to be voluntarily excluded from federal healthcare programs for 25 years as part of the settlement.  This is the largest recovery against a single psychiatrist in the history of the OWCP.  A multiagency investigation of Dr. Doyle’s practice revealed that from January 2013 through April 2021, the Doyles allegedly billed for services not rendered, some of which occurred when they were not physically present in the United States.  This case was investigated by the VA OIG, the Department of Labor OIG, and the United States Postal Service OIG.”

More is coming on this one:

Ten Texas doctors and a healthcare executive have agreed to pay more than $1.68 million to resolve False Claims Act allegations involving illegal remuneration in violation of the Anti-Kickback Statute and Stark Law.  According to a multiagency investigation, from 2015 to 2018, the doctors allegedly received thousands of dollars in illegal remuneration from eight management service organizations (MSOs) in exchange for ordering laboratory tests from Rockdale Hospital doing business as Little River Healthcare, True Health Diagnostics LLC, and Boston Heart Diagnostics Corporation.  Little River funded the illegal remuneration to the doctors in the form of volume-based commissions paid to independent contractor recruiters, who used the MSOs to pay numerous doctors for their referrals.  The MSO payments to the doctors were disguised as investment returns but were based on and offered in exchange for the doctors’ referrals.  As part of their settlements, the defendants have agreed to cooperate with the Department of Justice’s investigations of other parties involved in the alleged law violations.  To date, 17 doctors and two healthcare executives involved in this scheme have agreed on settlements totaling more than $2.7 million.  The civil settlements resulted from a coordinated effort between the VA OIG, Department of Health and Human Services OIG, Defense Criminal Investigative Service, and the US Attorney’s Office for the Eastern District of Texas [emphasis mine].”

Elected officials, the next time you are asked about the incredible amounts of fraud in government-provided healthcare and insurance, do not buy the media talking points that the fraud is minimal, contained, or anything but designed incompetence on the part of the bureaucrats to act as a jobs program for investigators!  The same investigators who are refused sufficient tools to investigate shenanigans by employees in the Federal Government adequately.?u=http2.bp.blogspot.com-fGEUjJsJ2h4VcJgswaisnIAAAAAAAABcsoFqEewPF_E4s1600quote-if-the-freedom-of-speech-is-taken-away-then-dumb-and-silent-we-may-be-led-like-sheep-to-the-george-washington-193690.jpg&f=1&nofb=1

Frankly, all of these cases need the government workers to be held accountable, and the myriad of red tape loopholes CLOSED!  I remember an election; I forget who and the exact when, but a significant election plank in the platform was healthcare reform, promising to clean up the swamp and bring accountability to Washington and the government.  The public is still waiting, and I know enough of you have run on this topic from both parties to repaper the walls (inside and outside) of the White House.

Yet, even if only outside providers and executives were scheming, the VA might not be in too bad a condition.  Except for the employees of the VA, VHA, and VBA, which continue to be caught up in ethics violations at a minimum:

The VA-OIG conducted an administrative investigation that included a congressional request to look into allegations that Charmain Bogue, former executive director of the Veterans Benefits Administration’s Education Service, committed ethical violations arising from her spouse’s consulting work for Veterans Education Success (VES).  VES is a nonprofit advocacy group that regularly had business before the Education Service.  The allegations also pointed to possible incomplete financial disclosures by Ms. Bogue concerning her spouse’s consulting business.  In their work, investigators uncovered evidence of other potential conflicts of interest and related misconduct by Ms. Bogue [emphasis mine].”

VA-OIG finding:

    1. Bogue participated in Education Service matters involving VES without considering whether it raised an apparent conflict of interest and acted contrary to the ethics guidance she received from her supervisors.
    2. Bogue sought résumé feedback from the president of VES to aid in her search for career advancement without considering whether this raised apparent conflict of interest concerns in subsequent VES matters. VES also endorsed Ms. Bogue for presidential nominee positions.
    3. Bogue provided insufficient detail about her spouse’s business in 2019 and 2020 public financial disclosures; VA ethics attorneys had found them compliant. She remedied the subsequently identified deficiency in her 2021 disclosure.
    4. The OIG found that Ms. Bogue refused to cooperate fully in the OIG’s investigation by refusing to complete her follow-up interview. Her husband and VES president also refused to participate in OIG interviews, and the OIG lacks testimonial subpoena authority over individuals who are not VA employees.   Bogue resigned from VA in January 2022.VA 3

UPDATE: 14 April 2022Sen. Grassley was hoodwinked by the VA on this issue and The Daily Signal (linked) has more of this report.  I covered this before, I repeat only for emphasis, when you are discharged from the VA, you lose your ability to be a “whistle-blower.”  As a point of fact, this is how the VA is able to hide a lot of their shenanigans, get rid of the person rocking the boat, invent the paperwork, cover the whole incident over as a “bad-apple” and keep you collective heads down and mouths shut until the VA-OIG investigation concludes.  The VA’s ability to abuse whistle-blowers is further compounded by Federal Attorneys who cherry-pick the cases they know they can win.  Which further protects the VA’s shenanigans and disheartens and mystifies those who have been wrongly terminated.  The Daily Signal reflects this pattern of corruption perfectly citing the records obtained by Empower Oversight.

Some commentators have claimed that blaming elected officials for not scrutinizing or not providing tools to investigate entirely is unduly unfair to the congressional representatives.  Really?!?!?!  The VA-OIG conducts an investigation, the people being investigated refuse to comply, and the VA-OIG is toothless to enforce a full and complete investigation to initiate Attorney General and FBI investigations and actions to recompense the defrauded taxpayer.  Ms. Bogue and the VES have invalidated any trust the taxpayer should have in their respective activities, but this, like so many other investigations into VA employees, will die of apathy before anyone is held accountable.  Even though a congressional representative demanded an investigation, nobody is being held liable.  Nobody is forced to compensate the defrauded taxpayer, yet the taxpayer is still expected to elect the same old representatives to their jobs.  Blaming the congressional representatives (legislative branch) for not scrutinizing the executive branch, one of only two jobs these people have, is somehow unfair?  NO!Exclamation Mark

Remarkably, between the 18 March disaster with the PCP and 01 April’s compounding idiocy, the VA-OIG published an ironically titled investigation report.

Improved Governance Would Help Patient Advocates Better Manage Veterans’ Healthcare Complaints.”

Imagine that, more designed incompetence negatively impacting the veterans seeking care at a VA medical facility, stating the obvious by the investigators.  Who on earth would be responsible for seeing that regulatory agencies had the tools needed to scrutinize and demand corrective action?  Calling all elected officials, did you notice that one of the prima facia tools a veteran has to report problems, conveniently called “patient advocates,” does not have the sufficient authority, adequate oversight, and tools to execute their jobs?  The VA-OIG reports the following:

The Patient Advocacy Program helps advance the Veterans Health Administration’s (VHA) efforts to improve customer service, support veterans’ access to quality care, and provide a mechanism to resolve healthcare issues.  Patient advocates document veterans’ concerns, communicate the resolution, provide follow-up and feedback, and identify trends for potential opportunities to improve medical facilities.  In FY 2020, VHA tracked about 162,000 serious complaints in its patient advocate tracking systems.”

Angry Wet ChickenOn a side topic, VA-OIG, how do you define a “significant complaint” and separate it from other types of complaints?  Honest question, the information was, to quote my PCP, “remarkably” missing from your investigation report!  Would the VA-OIG like to know why so many veterans’ complaints have risen to a “serious” level?  You reported the exact problem:

A complaint is considered resolved when the complainant communicates the outcome, and the record is closed in the tracking system.”

Maybe, the VA-OIG merely overlooked the logic problem, but complaints increase when the solution pushed down the throats of the veterans does not fix the actual situation.  Honest question, no sarcasm involved.  Is a “serious” complaint one where significant harm or death to the patient has occurred?  Is a serious complaint one that breaks federal laws, EMTALA, comes readily to mind??u=https3.bp.blogspot.com-fYRTNk48SCwT8ua0IRDWPIAAAAAAAAFZUpexSmJsN2Kos1600overcoming-adversity-help-yourself-believe-cubby-motivational-1289878102.jpg&f=1&nofb=1

Having had “solutions” forced down my throat, speaking only for myself, I am thoroughly sick of having the patient advocates bureaucratize my complaint, then fail to act, and then compound the problem by quoting policy to me as a reason to close the complaint, when the VHA never have written policies and procedures!  Maybe, you might want to look into the root causes of some of those “closed” complaints and ask root causation questions!

What did the VA-OIG find when they investigated the patient advocates?

    • VHA lacked adequate governance of the Patient Advocacy Program.
    • VHA did not effectively issue and implement adequate policy, monitor complaint practices, and provide guidance to medical facility directors responsible for local program management.
    • Patient advocates did not always enter complaints into the system.
    • Even though complaint records generally appeared to be closed on time, patient advocates did not always document the communication of the outcomes to the complainants.
    • The VA-OIG substantiated an inadequate program policy to identify clear expectations and responsibilities.
    • The VA-OIG found that they (patient advocates) did not always adhere to the documentation requirements to show full complaint resolution.
    • At the local and VISN levels, responsible personnel did not consistently analyze patient advocate tracking system complaints about trends.

Feel free to read the complete abomination of designed incompetence for yourself.  Essentially the VA-OIG concluded that the VHA has been burning taxpayer money in a patient advocacy program, and the designed incompetence is so apparent it can be tracked from L2, where the James Webb telescope is located!  Worse, you won’t need the James Webb telescope to see the designed incompetence!James Webb Space Telescope

Unfortunately, I could have guessed the first three findings without looking.  Every VA program is designed so ineptly, reprehensibly led, criminally incompetent, and with such dastardly deceptive doings that fiction writers’ storylines have to be written better to sell books.  You cannot make this stupidity up and make a profit.  Hollywood would run screaming into the night if they made a true story about the ineptitude found at the VA!

Knowledge Check!Elected officials, where are you?  The VA-OIG presents copies of their findings to you, and I have yet to witness a single one of you holding the VA Leadership criminally responsible for the failures at the VA.  Even when the VA is killing hundreds of veterans, the US Congress refuses even to act upset, let alone scrutinize for a change!  Remember how many veterans were intentionally killed in Phoenix waiting for treatment?  How many VA employees lost their jobs and pensions or were forced in front of a judge for murder?  It is a fair question, where are the elected officials in the legislative branch working to end the criminal “fraud, waste, abuse,” and designed incompetence in the executive branch?

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