President of the United States
Attn: The Honorable Donald Trump
1600 Pennsylvania Ave NW
Washington, DC 20500
12 December 2019
1947 Edith Blvd SE
Albuquerque, NM 87102
Subject: The Department of Veterans Affairs
Dear Mr. President,
Please forgive my presumptuousness in writing to you directly. I have made several attempts at raising the issues contained herein at lower levels, to no avail. As the Chief Executive Officer of the United States of America, I come to you as the person of last resort. The Department of Veterans Affairs (VA), especially Healthcare and Benefits departments are sick, and in desperate need of urgent corrective action.
- The VA-OIG has documented multiple times when claims have been improperly been decided, where training was lacking, leadership failed, and the veteran suffered. Yet, never in the VA-OIG report is a discussion on correcting the past decisions. The process for a veteran to have a previous decision, more often than not improperly decided by the VA, is to produce new material evidence, and wait interminably for the VA to decide they need to act. This single issue is a leadership failure of enormous proportions, that Congress refuses to act upon; thus, the leadership failure begins and ends with the House of Representatives and the Senate refusing to do the jobs they were elected to complete.
- While the following is specific to the New Mexico VA Healthcare System (NMVAHCS), the problem is rampant throughout the entire VA healthcare system. I witnessed, 11 December 2019, a VA employee tell a veteran that they would not submit paperwork for the veteran, to the doctor, in the clinic unless the paperwork was “processed correctly.” Meaning that the veteran took an envelope, placed the VA forms inside the envelope, and then mailed that paperwork to the VA Hospital. The veteran lives a significant distance to the hospital and was trying to do in person what had failed through the USPS. The employee went as far as to claim, “If that form is placed on my desk, I will throw it away because it is not being presented to the doctor in a manner acceptable to the employee.” Never have I witnessed such blatantly disrespectful behavior by a bureaucrat. In true bureaucrat fashion, he created rules to thwart, obfuscate, and dodge work; unfortunately, this is standard practice with the majority of employees in customer-facing positions in the VA. The leadership failure, the protected status of termed (beyond first-year) employees at the VA, and the dearth of customer service skills are all aspects to the core problem the VA is terminally suffering from, bureaucratism.
- From June 2018 to June 2019 (5-days short of completing my first year) I was an employee of the NMVAHCS, working in the Emergency Room as a Medical Support Assistant (MSA). I was discharged through lies, deceit, and under the auspices of Quid Pro Quo, where my termination was required for two others to be promoted. While employed, I regularly reported to the leadership team my supervisor, the HAS director, the hospital director, the VISN 21 director, and the VA-OIG problems like HIPAA violations, a physical attack by a senior MSA on my person, fraud, waste, and abuse, as well as potential solutions to improve the ER operations. All to silence and platitudes from the leadership team. Did you know there is a loophole in the whistleblower protections if you are under term employment, (1, 2, or 3 years term) you have no whistle-blower protections, and if your job is lost, you have no whistle-blower protections? The abusers have worked out many angles to protect the dregs of society while allowing malfeasance and misfeasance to proliferate in government employment. Please allow me to elaborate upon the specific issues witnessed:
- A 14-year old is being treated in the ER. A 16-year old is turned away. The difference, the triage nurse who decided who gets seen and who gets bumped because the NMVAHCS cannot treat children. When asked what age is considered a “child” under the hospital policy, no answer in 12-months of regularly asking. I saw several times when this repeated, the most egregious was a new military spouse, 17 years old, denied treatment at the ER that services the Air Force Base next door due to being “too young” per the triage nurse. By the way, under Federal Law, this is illegal for an ER to do; yet, this was regular practice while employed.
- A health technician supporting ER patient care comes out of the ER and begins to harangue a patient currently being seen, expressing comments that made clear the health technician knew intimate details of that patients’ chart and past care and treatment received. Under HIPAA this behavior is illegal, as well as being immoral, unethical, and plain wrong. Yet, HIPAA is regularly broken by MSA’s, Health Technicians, and other care providers in this VA Hospital. Every time these HIPAA violations were brought to the attention of the HAS Director, excuses, platitudes, and professional brush-off occurred. On more than one occasion, the HIPAA violator was promoted to “treat” the problem. When these issues were brought to the attention of the VISN 21 Director, the problem was pushed back onto the assistant hospital director in NM for further consideration. When complained of to Congressional Representatives, lame excuses were generated by the Assistant Hospital Director and the HAS Director and accepted by the Congressional Representatives staff. HIPAA Abuse continues unabated!
- Homeless veterans regularly received substandard treatment when compared to other veterans. I saw nurses bad-mouth, scream, and yell at homeless patients. I saw a homeless patient with a broken leg, get delayed treatment for more than four hours because the duty nurse was tired of treating this particular patient and didn’t believe the veteran had broken his leg after a fall. I saw nurses put patients into treatment rooms and left for anywhere between 45-120 minutes because the shift was changing and the nursing staff did not want to treat another patient before their shifts ended. The nurses stood outside the patient’s door, joking, carrying on, and gossiping while the patient listened and waited to be seen. Every time these issues were raised the lamest excuses came from leadership, platitudes, and pie-crust promises that were delivered. I reported these issues and more via both verbal and email, to no avail; yet, when a member of Congress’ staff contacted the hospital, there is no email proof that the leadership was ever made aware of these problems. If these are examples of “World-Class Care” being delivered to veterans, I shudder to consider what poor service would include.
- The NMVAHCS has a reputation for killing the employment of term employees all the way up to their last day under the term. For example, a housecleaner employee, a good worker, well-liked by the staff where she cleaned, got into a disagreement with her supervisor and was terminated at lunch on her 364th day of employment in a 365-day term. Her supervisor did not need a reason to discharge her and used this to end her employment. An MSA male employee, hard worker, came in on his 361st day of term and was terminated, no reason, no excuse, no justification, simply told to scrape his employment parking sticker and leave. This pattern has repeated so often, that the veteran employment counselor at workforce connections warned me to not accept employment with the VA due to the NMVAHCS’ reputation for ruining people.
The NMVAHCS is one dead veteran from becoming the next Phoenix VA Hospital incident. I am not without hope, but it will take the House and the Senate to enact the type of change needed in the VA to truly see significant and lasting change. Towards this end, I suggest the following:
- Draft legislation, one a single sheet of paper canceling the collective bargaining agreement (CBA) of all Federal Government Labor Unions immediately, and forever sundering the death grip the labor unions have on policies and procedures that protect the criminal and steal valuable resources from government coffers through direct and indirect means and methods. The cost of labor unions in government is astronomical and removing this single cost will open funds in Federal Budgets that are desperately needed. I know this is a political hot potato, and I know the impeachment farce continues to be a mental and physical drain. But, as the German Philosopher has said, “The hard is good.”
- Draft on a separate sheet of paper, new legislation giving the Secretary of the VA plenipotentiary power, the likes enjoyed by every CEO in the private sector, to enact change. You have a good VA Secretary, but the staff is a hodgepodge of weak-kneed political cronies that should have been retired years ago! This legislation also would allow for a cleaning of house at the VA, realigning the entire organization, placing the power to positively affect veteran lives into the hands of the PACT team and out of the hands of the bureaucrats.
- Place power into the hands of a roving IG team to have benefit claims immediately reviewed after a lapse in the procedure is discovered. Meaning that the veteran’s claim affected by bad decision-making by the VA is immediately checked by the VA-OIG instead of waiting around in record purgatory for new and material evidence. Another VA-OIG team should be put to work reviewing past claims where the VA was caught, and getting this backlog cleared out. The appeals process for benefits claims needs a complete overhaul. While this legislation and action might require more than a single sheet of paper to enact, it is the right thing to do.
- The Mission Act was a good first step, but the entrenched bureaucrats are hindering and hampering the roll-out for personal gain, e.g. retirement. Encourage Congress to take up the legislation proposed, insisting that nothing else is added to these bills to protect the veracity and simplify the approval process.
I appreciate the work you do. I especially appreciate your classy wife, your well-behaved and intelligent children, and the gains made in “Making America Great Again.” I know the proposals are difficult; but I also know if we do not attempt the impossible, we can never know the realization of the legacy left to each American by those who have sacrificed before and leave a legacy of hope for our children’s children. Thank you for your sacrifice and service.
M. Dave Salisbury