“That’s Crazy!!!” – More Chronicles From the VA Chapter 3

Bobblehead DollIt is no secret I am on several prescription medications.  I take these under strict medical advice, and three of these prescriptions regard mental health improvements.  However, my prescription reasons were subtly shifted because Phoenix’s last two primary care providers did not listen to the patient.  Since the El Paso primary care physicians appear to be utterly incapable of even attempting to listen, I have now been without a mental health prescription for an entire week.  This is called bureaucratic cold-turkey prescription stoppage!

Not the first time this has happened, especially for this particular medication, a serotonin blocker.  Here’s the rub, the physical and mental withdrawal symptoms of cold turkeying the drug; includes, but is not limited to, the following symptoms, of which I have ALL of the problems!

      • Nightmares
      • Suicidal Ideation/Thoughts/Visions
      • Headaches
      • Heart Palpitations, radiating chest pain
      • Anxiety
      • Depressions
      • Mood Swings
      • Irritability
      • Tinglings and Prickling sensations of the skin
      • “Brain Saps”/”Brain Shivers”/Spaced-Out Zombie Spells
      • Fatigue
      • Dry Mouth
      • Insomnia and Sleepiness – Which is a major whiplash feeling!
      • Pain and neurological events in every part of my body!
      • … and more… Much…  Much… More!

I have been without this medication due to bureaucratic stupidity for several days in the past due to pharmacy issues.  But, this is now the longest I have been without this medication since getting prescribed this medication.  I wish, like anything, I had known some of these withdrawal symptoms before I went to the ER earlier this week for pain and neurological problems; I would have raised the refill issues as part of the ER visit.  I went online looking for other people’s experiences; I want some medical advice before continuing this medication!!!

PACT_modelI am a root cause kind of person; why do I bring this up?  I have had three primary care providers since arriving in the El Paso VAHCS in May 2021.  None of them have gotten any of the medications correct due to a blatant refusal to LISTEN to the patient with the INTENT to understand!  Nurses with VA-provided primary care providers are expected to communicate with patients between 24 and 72 hours post any ER visit.  Since moving to Las Cruces, I have visited the ER twice and have not spoken to the nurse yet!

I have initiated the conversation with the nurse through phone and secure messaging, and the nurse has refused to engage.  Through secure messaging, I am advised, “Secure messaging is not the place to triage a patient, and no question can be answered as this requires triage of a patient.”  No direct phone contact is possible with the clinic.  One must call, get routed to a call center, leave a message, and then hope the clinic calls you back sometime before you die!  Don’t forget; I am the same patient told, “The clinic will not see you in person because you “WILL NOT” wear a mask.”  Completely refusing to understand, accept, and believe that I cannot wear a mask due to medically documented (by the VA medical providers, which medical records they possess) reasons.  Best of all, the veteran is then sent letters and marketing materials urging the veteran to use secure messaging through “MyHealtheVet as a safe and secure way to access your medical team and get your questions and concerns addressed by your PACT team!”  If the VA were a mental health patient, they would have schizophrenia and at least a dual-personality.

PACT 1Snide, rude, and disrespectful staff, all made possible by, supported through, and legally accepted under federal government fiat.  Do you realize that the nurse not doing their job will have any number of valid and acceptable excuses, and these excuses are accepted because of designed intentional incompetence allowed under federal employment laws, regulations, and directives, established by and supported through Congressional oversight?  In Disney’s “Princess Diaries 2: Royal Engagement,” Viscount Mayberry has a line,

Your staff is incompetent and unreliable!”

The VA is incompetent and unreliable, and the victims are the veterans and their families.  We are talking about dangerous drugs, forced addictions, and then the ineptitude of incompetent and irresponsible bureaucrats who refuse to do their jobs in a timely and responsible manner.  But do not take my word for it.  Let’s review what a watchdog organization, the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG), has to say on this matter.

VA 3

  • Tracy McNeil, of Raeford, North Carolina, was sentenced to one year and one day in prison and ordered to pay $90,003 in restitution for committing wire fraud involving an elderly veteran in her care. From February 2015 to February 2017, McNeil fraudulently obtained benefits from the VA and the Office of Personnel Management by executing a power of attorney over a disabled veteran who served in the Army and worked for the US Postal Service. The investigation revealed that McNeill arranged for the victim, who had dementia, to move into her home in February 2015 and then directed the VA and OPM to deposit the veteran’s benefits into her bank account. Between April 2015 and December 2016, the VA deposited $11,151, and OPM deposited $61,318 into McNeil’s account. Further, OPM disbursed the veteran’s life insurance for $17,533 to McNeil. Financial analysis showed that most of the funds were spent on McNeill’s expenses, including rent, utilities, credit card payments, and personal purchases.

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  • Strock Contracting, Inc., of Cheektowaga, New York, has agreed to enter into a consent judgment with the United States for $4.7 million to resolve claims that Strock violated the False Claims Act. The United States filed an action in federal court alleging that Strock Contracting profited financially after fraudulently obtaining federal contracts intended to benefit service-disabled veterans. The United States alleged the company, which was not owned or controlled by a veteran, recruited a service-disabled veteran to create a pass-through company, known as Veterans Enterprises Company, Inc. (VECO), which the Strock Contracting its owner, Lee Strock, controlled. The company allegedly directed VECO to submit false eligibility certifications to the government, obtaining substantial profits on numerous federal contracts.
        • Where are the VA Employees who should know what “fake eligibility certificates” look like?
        • Where are the supervisors who should have been providing training?
        • Where are the Congressional oversight teams in holding the VA accountable?

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    • William Rich, of Windsor Mill, Maryland, was arrested for allegedly obtaining more than $1 million in veterans and Social Security Administration disability benefits by falsely claiming that he had paraplegia. Allegedly, Rich misrepresented his physical condition in VA disability compensation claims, in communications with the VA, and during medical examinations in pursuit of VA disability benefits. While serving in Iraq in 2005, Rich sustained injuries that resulted in the loss of use of both lower extremities. However, approximately six weeks after his injuries, he made substantial progress toward recovery and was no longer paralyzed. Later records show the VA rated him one hundred percent disabled following an examination in 2007. The examining physician noted that he did not have access to Rich’s complete claims file, so he did not review Rich’s medical history or observe the earlier report. In 2018, the VA OIG conducted an audit of specific claims and learned of conduct by Rich inconsistent with his purported condition. Over the next two years, VA OIG special agents conducted surveillance. They observed Rich walking, going up and downstairs, entering and exiting vehicles, lifting, bending, and carrying items—all without visible limitation or assistance of a medical device, including a wheelchair [emphasis mine].
        • OK, let me be clear, I am glad this veteran got better; I do not in any way condone theft. But, where is the VA in being culpable for FAILURE to do their job correctly?
        • Will the doctor who failed to do their job be held liable for the malpractice performed?

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    • William H. Precht, of Kent, Ohio, was sentenced to 37 months imprisonment and ordered to pay $1.25 million in restitution after pleading guilty to theft of government property and participating in a bribery and kickback scheme. In October 2010, Precht registered a purported vendor, a company he controlled, as a small disadvantaged business and veteran-owned small business in the VA vendor system. He then used his VA purchase card and other employee cards to purchase over $1 million in alleged medical supplies from the vendor. In addition, from May 2015 through January 2019, he conspired with Robert A. Vitale, a medical sales representative for multiple companies that conducted business with the medical center, to devise a scheme in which Precht would receive kickbacks and other items of value in exchange for steering VA business and other monetary awards to Vitale.VA 3

Speaking of staff being “incompetent and unreliable,” did you know that the VBA is using “COVID-19” as an excuse for being backlogged in cases, AGAIN?  Did you know that COVID-19 was so powerful that it caused the VA to fall 200,000+ cases behind, in an inventory of 600,000+ cases requiring decisioning, with 70,000+ needing additional review for entitlement, and needs to hire 2,000+ new employees to help correct the problem?  Since the VBA continues to fail in staff training, exactly how will hiring new employees help?  Honest question!  With the current staff rated as incompetent and unreliable, not by me only, but by the VA-OIG who has regularly taken these issues and more to Congress asking for additional scrutiny and assistance in improving the VBA, VHA, and National Cemetery specifically and the VA collectively; what exactly can new employees do?VA 3

The VHA cannot plan construction projects and put planned maintenance into proper categories to execute maintenance tasks correctly.  Congress refuses to scrutinize budgets and fiscal compliance for just maintenance of facilities.  How in the world can anyone expect more when the VA cannot even hit the basics of planned maintenance tasks?  I can; I do!

I-CareWhen the VA publishes marketing materials claiming they set standards for excellence and lead the industry, I want them to prove their competence and abilities!  Right now, their failures scream louder than the voices in their own ears, and they refuse to listen to anyone, and I am not happy!  You, the taxpayer, should not accept the performance of ANY government agency, including the entire legislative, judicial, and executive branches of government at the local, county, state, and federal levels, until they correct their behaviors!  It is time to end the charade and put paid to this contemptible behavior and abuse!

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

NO MORE BS: COVID Mask Discrimination Policies and Your Health

Millstone of Designed IncompetenceThe Atlantic published an article well worth reading, “End the Hygiene Theater.”  To summarize, SARS-COV-2 (COVID-19’s official name) is an aerosol and does not survive in the outdoors or on surfaces.  Just like 99.9% of all viral infections.  Consider how much money the government mandates had wasted on power cleaning surfaces since August 2020 when the scientific peer-reviewed journals began publishing the science of aerosol viral fighting tips.

Angry Grizzly Bear15 April 2020 was a high watermark day for me; I was forced to go to the Sandra Day O’ Connor Federal Courthouse to fight three citations for not physically being able to wear a mask at the VA Hospital here in Phoenix.  My injury at the hands of the VA Police was not allowed as evidence; the policy that continues to hinder care at the VA Hospital was not allowed as evidence.  However, it was used frequently as an excuse, and my being erroneously declared a behavior problem at the VA was inadmissible as that is an internal policy of the VAMC.  The end result, I lost more money to pay the fines.

In the US Republic of America, you have the right and freedom to wear a mask if you choose. Suppose you desire that face diaper as a safety blanket, even though peer-reviewed science has found zero evidence that masks help; feel free to wear a mask.  Please understand that thousands of people cannot wear a mask due to medical conditions, medications, and other breathing problems, which means alternative health measures are needed.  Medical policies should never be written as one-size-fits-all.  The policies writers are discriminating and putting people’s health at risk.

ApathyAs my breathing has become more labored since my spinal injuries in 2002, at the hands of a First-Class Petty Officer, I have had to exercise more healthy options to keep myself safe.  I take vitamin supplements, including C & D, at both a medical professional’s request and my wife’s knowledge.  I drink tonic water, which has quinine in it, specifically the tonic water sold at Trader Joe’s, for it has no high-fructose corn syrup and less sugar than soda, so my diabetes does not take a hit.  I was told by my primary care provider, at the VA almost 10-years ago that quinine will help my nighttime leg cramps, it worked for me.

I am not a medical professional, and am not saying everyone will have the same benefits; the quinine in tonic water has helped me, and overtime I have experienced less sick time from common colds, flues, and other aerosol borne sicknesses.  Always discuss with your doctor the vitamins and drugs being taken, this is also your right and freedom!

Historically, quinine has been used as an anti-malarial drug, and is effective in calming muscle cramps, leg restlessness, and is a base ingredient in chloroquine and hydroxychloroquine.  “Use of chloroquine (tablets) shows favorable outcomes in humans infected with coronavirus including faster time to recovery and shorter hospital stay.  US CDC research shows that chloroquine also has strong potential as a prophylactic (preventative) measure against coronavirus.  Chloroquine is an inexpensive, globally available drug that has been in widespread human use since 1945 against malaria, autoimmune diseases, viruses, and various other conditions.”  Facts are coming from multiple peer-reviewed resources since 1950, including Dr. Fauci.

Angry Wet ChickenTo arrive at court, I had to walk more than ¼ of a mile from the closest parking spot to the 2nd floor mezzanine of the Federal Court House.  By the time I got through the US Marshall security buttress, I was completely out of breath, and the first words out of security’s mouth, “Where is your mask?”  I explained I have breathing problems, and they insisted I at least carry a mask to meet the “stringent judge mandated legal requirements for mask policies.”  Thankfully, they did not insist I wear the mask, as I would have become an emergency right then and there.

Leaving me with an incredible question, “How can the US Marshall’s in charge of security at a Federal Courthouse use common sense and keen observation and make executive decisions, but the VA Police on Federal Property cannot do the same?”

The answer to that question lies with the draconian leadership and the egos inherent in the VA.  Same Federal Policy regarding masks but applied with 180-degrees of separation.  The VA Police Officer who oversaw my asset forfeiture/remediation did not have a problem with my not wearing a mask the entire time we spoke.  We maintained 6’ of separation and conducted business like adults.  Yet, in the VAMC, this officer would have been under obligation first to arrest me, which always leads to me being injured, cite me, then kick me off the property.  All Federal Property, all handled by sworn legal officers possessing arrest authority, and we have two different outcomes.

Foghorn Leghorn - MedicationAs a point of reference, there are more than several hundred thousand people like me in America right now who have breathing conditions that preclude wearing a mask for personal health and safety.  Polio victims with lung scarring are especially susceptible to COVID and should not wear a mask.  I know veterans who are missing a lung, who struggle to breathe, they cannot access the VA for medical care; this is mask discrimination!  I know cancer patients who, due to the drugs and cancer, cannot wear a mask and cannot access the VA for cancer treatment; this is mask discrimination.  I am one of several thousand people on a steroid to help breathing problems, where a mask is warned against wearing for physical safety and personal health.  However, I am still denied VA Medical Care over the mask policy.  The list of medical conditions and breathing issues is endless. Still, the policy from the Federal VA Director’s office, supposedly, does not come with a line, “except for those with approved medical conditions.”  I claim allegedly, as I have yet to receive a copy of this mask mandate policy or find a copy anywhere online.  I have even gone so far as to use an FOIA request for the policy and never have received a response.

I asked a supervisor about the policy at the VAMC and was pointed to a marketing sign.  I asked a hospital director, in fact, the patient advocate director, and was told there is no official policy.  Because that would require writing things down, and the VA refuses to document anything for fear of reprisal and recrimination.  Also, a topic I have covered ad nauseam and ad infinitum in these articles to no avail, as an excuse for designed incompetence.

Never Give Up!Ask yourself this question, “Who is the primary person responsible for my health, myself, the media, the insurance companies, or the government?”  For how you answer that question will determine how you approach situations where your health is jeopardized.  We have programmable vaccines being passed off as a cure-all for a virus that makes up the common cold, yet people are still catching the common cold and testing negative for COVID.  We have had flu vaccines around since the 1930s, with mass vaccination campaigns since 1945; yet until COVID came along, we still had people dying from the flu every year!  By the way, an interesting fact, no one has caught the flu since February 2020; do you believe the COVID testing works?

America has witnessed years when the flu guessers guessed the wrong flu variant strain, and the flu vaccine people got was 100% ineffective.  Yet magically, this COVID vaccine comes along to end all those problems without long-term testing and in-depth research, and how many are lining up to get their COVID shot?  After getting the COVID jab, how many still are forced to live under COVID mandates?  See, the problem is not COVID; the problem is who controls your health decisions, the government, the media, the insurance companies, or you?

Non Sequitur - DecisionsThe discrimination we have been told all through school is “bad,” but the VAMC can mask discriminate against the population they are duty-bound to serve, and there are no legal consequences; where are the lawyers?  We have people who have been and are suffering from COVID-related vaccine sicknesses who lost their legal rights to sue the pharmacological manufacturer; where are the lawyers?  I would think the ACLU would be head over heels angry at this blatant abuse of people’s rights, except they are silent on these issues.  We have hundreds of thousands of veterans who cannot access their medical center, their doctors, and so forth due to a policy that isn’t a policy and are dying; where are the lawyers?

Dont Tread On MeWho controls your healthcare choices, you or the government?  I know my answer!

Reference

Sturrock, B. R., & Chevassut, T. J. (2020). Chloroquine and COVID-19–a potential game-changer? Clinical Medicine, 20(3), 278.

Todaro, J. M., and Rigano Esq, G. J. An Effective Treatment for Coronavirus (COVID-19). In consultation with Stanford University School of Medicine, UAB School of Medicine, and National Academy of Sciences researchers. Retrieved from: https://docs.google.com/document/d/e/2PACX-1vR1adodKPhWalV9djnerI2x_v1LGgGyhZZxpl0O5r-ZNyDdagqFq1rTCxXBqaeicfxgvypDOqKCZVyV/pub (Google is blocking access to this information)

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

NO MORE BS: Government Customer Service

Duty 3As a subject matter expert on customer service, as a professional customer service provider, and as a concerned American, I have to state for the record, the government’s abuse of the taxpaying customer is beyond atrocious, ridiculous, and craven!  I am sick to death of being treated like cat vomit; when I seek customer support from the government, I pay such incredible sums to fund.  Worse, I am fed up with the bureaucratic mindset that places the customer in the wrong, the customer as a pain, and the customer as a nuisance to be endured instead of assisted professionally.

ProblemsMy local Post Office here in Phoenix was visited yesterday (03 March 2021).  The Post Office does not deliver packages to the apartment complex we live in, so the standard procedure is for the USPS delivery person (mailman) to place a card notifying the customer of a package on a 10-day hold in the customer’s mailbox.  Since we moved in, we have not gotten these indicators, and Monday, my wife was notified a package she needs was returned by USPS.  It was delivered Monday to the Post Office and returned to sender as “customer refused delivery” the same day.

I went to the Post Office seeking answers.  The counter-working postal representative was the epitome of rude, obnoxious, and downright unfriendly.  It took more than an hour for a supervisor to arrive, and upon discussing the problem, I was told, “Lots of your neighbors have been complaining about this issue.”  Are you kidding me?!?!?!  You have two 500+ Apartment complexes across the street from each other, multiple people from both complexes are complaining about package delivery failures, and with a smile, you can tell me this is a known issue.

Theres moreAsk yourself the following question, if you had upwards of 100 customers complaining about your work, how long would you remain employed?  Frankly, I am still stunned 24+ hours after the interaction with this supervisor.  My visit was the sixth time I had been to the Post Office complaining about not getting package notifications and having trouble with packages sitting around the post office taking up space.  One of these visits included speaking to the Post Office’s head, general, whatever, the top person in charge of a local post office is titled.  Still, the employee has maintained their job, kept the same route, and the customers continue to be abused.

After I wrote a formal complaint, I was assured that action would be taken, and the employee talked to about this oversight in their duties.  Seriously, that was exactly what the supervisor said, “the employee will be talked to.”  I understand the human resources processes, understand and have designed human resource processes, and possess a Doctor of Psychology title specializing in industrial and organizational psychology.  But, I do not know how 100+ complaints can arrive at the post office weekly, and the same mailman is only on their verbal reprimand for failure to perform their duties.  We have been complaining about this issue for a year now, and in speaking with several neighbors, they have been complaining for longer than a year about this failure.  I have some doubts that this issue will be resolved, ever!

Detective 4But hey, the Post Office is only one of the government agencies exhibiting a race to the bottom where customer abuse and customer disservice are concerned.  The Department of Motor Vehicles (DMV), a state-run agency, is always in this race, and they take hostile customer service to new heights, or depths, depending upon how you look at their performance.  The last visit to the DMV ended with screaming for several minutes in my car before possessing the proper mindset to drive away safely.  The DMV is comparable to a dentist drilling before anesthesia starts and doing a poor job on an infected tooth; you just know you will have a bad day when a visit to the DMV is scheduled!

Yet, in discussing the race to the bottom, the Department of Veterans Affairs (VA) is also a constant competitor in asinine customer service practices, customer abuse, and inept inertia.  I do not think the VA could even get bureaucratic inertia correct if someone had not taught them how.  The Department of Veterans Affairs – Office of Inspector General (VA-OIG) investigated a surgical supply program for abuses and found:

VA controls were not sufficient to ensure VA medical facility staff accurately reviewed, verified, or certified distribution fee invoices for the program. VA also did not ensure staff at medical facilities accurately established and applied the on-site representative rates and paid fees based on annual facility purchases. The pricing schedule establishes fee rates for on-site representatives based on annual facility purchase amounts.”

The amount of money involved is staggering ($4.6 Billion). The fact that the VA cannot correctly oversee a supply program, check invoices, monitor stock levels, and pay invoices properly does not bode well for integrity in customer service.

LinkedIn VA ImageThe VA is to be congratulated, the colonoscope, which is used on multiple patients for a colonoscopy, is being cleaned properly and to standard, which means that infections from one patient are less likely to occur in another patient transferred from the colonoscope.  However, the training program, certification program, and training documentation remain under considerable scrutiny for continual failure, as discovered by a VA-OIG investigation of 10 different clinics!  Training, certification of training, and documenting and tracking training are internal customer service actions that the entire VA continues to fail.  Whoever is in charge of adult education and training at the VA is not performing their jobs, and this is witnessed every couple of weeks in the VA-OIG investigation results across the entire VA.  Designed incompetence leading to customer service failures, absolutely ridiculous!

I-CareThe VA-OIG conducted a lengthy investigation at the Veterans Benefits Administration (VBA) Chicago VA Regional Benefits office in Illinois.

The OIG found claims processors did not properly correct administrative errors in 88 percent of cases reviewed. Errors resulted in improper underpayments of about $59,100 to six veterans, improper overpayments of $18,900 to two veterans, and $5,900 in debts VA had inappropriately collected from eight veterans through January 2020.”

Revisiting the Post Office example above, if you had an 88% error rate in your job, how long would you expect to keep your job?  Training and certification of claims processing personnel remains a failure of internal customer service and is mentioned in every VBA investigation by the VA-OIG.  As a point of fact, the failures of training and training certification were recently cited as a significant deficiency, where in 2018, no certification and training occurred due to internal technical problems with the intranet.  Yet, even with all this evidence that training is failing, certification is not occurring, and claims processors continue to abuse veterans through clerical, system, procedural, and process errors on claims, they maintain their positions.  Cited in this latest VBA investigation was the claims processors’ continual failure to communicate with the veteran.

Boris & NatashaConsider the following analogy.  A 100% disabled veteran gets paid once a month and budgets those monies very carefully to last the entire month.  A claims decision is made, and without any communication for why, the amount the veteran is expecting to live is cut in half.  The veteran is then responsible for wading through the various call centers to find why, how the decisions were made, and what to do, which takes time, lots, and lots of time on the phone.  While bills go unpaid, food goes unpurchased, financial difficulties mount, and correcting the situation takes more time.  Sure, the VA will pay back pay, but that is never sufficient to cover all the accruing costs and losses experienced.

Hostile customer service by the government is the most inexcusable example of customer disservice imaginable.  Why; because there is no competitor to move your business.  There are no pathways for holding customer service representatives accountable when even talking to a supervisor is not worth the time and effort.  I spent four hours on the phone chasing a claims processing error; at one point, I finally got so mad I demanded a supervisor.  I waited on hold for just under 120-minutes for the supervisor, who said had I worked better with the agent, I would not have had to wait, and the problem could have been resolved, as their opening statement!

Survived the VABy this time, I had worked with four separate agents who were confused or refused the call by hanging up.  I had been sworn at, I had been told I was a liar, and I was told my office could not handle your request.  Each call required anywhere between 30 and 50 minutes of hold time waiting for an agent.  As the supervisor reviewed the problem, they discovered that their agents could not have handled the situation, and a specialist was required.  But, I never got an apology from the supervisor for the waste of my time, the issues experienced with previous agents, nor the loss of my time and resources it took to handle the problem.

Gadsden FlagGovernment employees beware; how you treat customers is a problem, and you need to be held to task for your insolence, depravity, ineptitude, inertia, and uncaring attitudes!  When discussing the BS of government, the customer service issue is the most egregious.  I will call you out publicly every time you abuse a customer.  I am done being abused!

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

VISN 22 – The Bureaucrats Operationally Living as Petty Tyrants

Survived the VA23 February 2021:  UPS delivered a letter package containing a single sheet of paper from Dr. Karen MacKichan MD, auto signed, and dated 09 February 2021.  Declaring that the Phoenix VA is absolutely correct in behaving as petty tyrants and denying me medical care, illegally sharing and knowing my HIPAA information with VA Police Officers, breaking EMTALA, and treating me to injuries, all because I cannot safely wear a mask.  My only infraction at the Phoenix VA is not to wear a mask.  Yet, this is considered a “behavioral problem,” and I am wrong for behaving in a manner that insists that my safety comes first!

From June 2020 to date, the charge has been, “Wear a mask or a face shield to receive service in the VA.”  Then, I got arrested while wearing a face shield and told my failure to wear a mask is “disruptive behavior.”  Seriously, not wearing a mask somehow disrupts the entire hospital and keeps it from running efficiently.  Refusing to believe the letter my VA provided Primary Care Provider wrote (August 2020) for my employer regarding my inability to breathe while wearing a mask.  The VA Police have continued to escalate situations to reflect “disruptive behavior patterns.”  Yet, I am the one punished, and I am the one injured; I am the one being denied care.

Literary FiendWhat are petty tyrants?

James Abyad quoted the Urban Dictionary for the definition of petty, which exactly expresses the sentiment of petty.  Urban Dictionary defines petty as “making things, events, or actions normal people dismiss as trivial or insignificant into excuses to be upset, uncooperative, childish, or stubborn.”  It further defines it as “a person who is purposefully childish with the intent of eliciting a reaction,” or “someone who does something in an attempt to hurt another person but makes themselves look stupid.”  Tyrant is a cruel and oppressive ruler, per Webster.  Hence, a Petty Tyrant is a childish, insignificant, oppressive ruler.

Well, Dr. MacKichan, Deputy Chief Medical Officer VISN 22, 300 Oceangate, Suite 700, Long Beach, California, 90802, you are incorrect!  I have followed all written VA directives. Do not assume that it is my fault the Phoenix VAMC leadership cannot write down a COVID Mask Directive and operational policy that supports all veteran health contingencies.  Then train the staff coherently upon written guidelines and directives, and engage in an honest and forthright manner with veterans seeking care.  Where are the written directives governing COVID Mask Wearing?  You claimed to have reviewed all the information; I have asked for these documents and been pointed to a sign.

VA SealOn the topic of written directives, written operational policies, written patient guidelines, and written job descriptions and duties, let’s talk about how the VA Police can injure people and not be held accountable!  The VA Police attacked me on 07 December 2020, violently pushed, then spun into a wall.  My C-and L-Spines did not move, and my T-Spine turned; I dropped like a rock sustaining spinal injuries, knee injuries, and got cut on my right hand and arm.  Worse, being handcuffed with my arms behind my back caused bruised wrists that were jerked by more VA Police officers on 10 December when I sought medical attention.  I am an 80% disabled person with mobility issues, yet your letter claims all the action of the Phoenix VAMC was in accordance with written policies, guidelines, and directives.  Well, I possess a Missouri mindset, “Show ME!”  Show me the written and published policies, guidelines, and procedures that allow VA Police Officers to physically assault patients!  Show me the written and published policies, guidelines, and procedures that allow me to be refused treatment.  Prove through written and accessible documents how the decision for this hodgepodge of ineptitude can label me a “behavioral issue” when my only discretion is not physically and safely wearing a mask!

The Duty of AmericansYou claim to have reviewed the actions of the police officers who routinely have medically protected HIPAA information about people being arrested, joke about this information, act in a manner that brings shame to all Federal Police Officers.  What happens to these unprofessional officers and their despicable commander?  When do my rights to have my HIPAA-protected information withheld from parties who do not need this information?  When do all the other veterans being served and not being served by the Phoenix VAMC become protected under HIPAA?  I am not the only veteran being refused service, denied care, and abused and injured by the VA Police for not wearing a mask, while also not being a “behavioral issue.”

Since your letter proclaims loudly that your review was thorough, independent, and comprehensive, and as the VISN 22 Chief Medical Officer, surely you cannot condone illegal activities being masked by calling a patient a “behavioral issue.”  The Emergency Medical Treatment and Labor Act (EMTALA; 1986), a federal law, requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay.  EMTALA was regularly abused at the Albuquerque VAMC, and I reported this issue multiple times. EMTALA’s abuse and illegal activity at the Phoenix, VA Medical Center are worse, and I have reported this issue multiple times.  Twice I have followed my primary care provider’s instructions to report to the VA ER for treatment, and twice I have been refused service.  Thus, what is to be done to correct this obvious deficiency in VISN 22 treatment of veterans, service members, and dependents by VISN 22 emergency medical care providers and the staff, including the VA Police, who should have no influence upon care being received or who should receive care?

Theres moreYour letter discusses “the most effective manner to have the behavioral flag lifted” as “checking-in with the VA Phoenix Police.”  Do you know what that entails?  Did your “thorough, comprehensive, and independent” investigation uncover what happens at this “check-in?”  I was told clearly what happens; I will be evaluated for wearing a mask, found not wearing a mask, arrested, cited, and denied service for not wearing a mask.  Then, I will have a black mark on my behavioral flag record for disorderly conduct!  I am not disorderly in my behavior because I cannot safely wear a mask!  What part of this do you, as a medical doctor, fail to comprehend?

I had my gallbladder removed in a Phoenix hospital (Sept 2020), never had a problem not wearing a mask.  I have had MRIs completed (Aug 2020), never had to wear a mask.  I have been seen three times in an emergency room and never had to wear a mask (Jun 2020, Sept 2020, Jan 2021).  The only medical service provider demanding through compulsion and fear that I wear a mask, which would place my health at risk, is the Phoenix VAMC.  Yet, you as a medical doctor cannot understand this issue, the problems with unwritten policies and directives, leadership failures to train staff properly, and you allow petty authoritarians wearing VA Police Badges to enforce a reign of terror at the VAMC in Phoenix.  Hence, you are part of the problem in failed leadership, poor management, and detestable petty authoritarianism!

InertiaI always interact with the staff at VAMC’s, even when they are wrong, in a respectful manner, knowing that the problems of dumb policies, time-wasting procedures, and bureaucratic inertia are the fault of the leaders hiding in their offices and cubicles.  I have been interacting with the VAMC’s across America, and the inept staff, since I left the service in 2004!  Never having a problem, never having an issue, and never getting injured by or even interacting with VA Police.  This all changed in June 2020.  The VAMC refused to write down a comprehensive directive for COVID Patient Mask Wearing.  I get blamed for following the unwritten policy and directives, then falsely accused of being “disorderly” in my behavior, then falsely accused, again, for being a “behavioral issue!”  I am not in the wrong here!  I am not a “behavior issue!”  I am not disrupting hospital operations, placing other patients at risk, or being violent!  Where are my rights in this farrago and railroading scheme?

Image - Eagle & FlagYour boilerplate response indicates this issue has reached the final point.  I beg to differ!  I will have my name cleared of these false charges.  I will not be blamed for the ineptitude of the leadership at the Phoenix VAMC and VISN 22!  I will not be silent and meek in the corner because you cannot tell the difference between standing for one’s rights against tyranny and compulsion and oppression through bureaucratic fiat!  I have done nothing worthy of these fallacious claims, false accusations, and the Phoenix VAMC and VISN 22 will admit this publicly when I am done cleaning my name of the scum you have thrown upon it!  Make no mistake; I am not angry, but I will have my rights restored, my name clear, and satisfaction from the injuries and treatment I have been made to suffer!

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

NO MORE BS: The Butterfly and the Little Boy

Monarch ButterflySeveral years ago, my granddaughter and her father came from Lansing, Michigan, to Phoenix, AZ, to visit grandpa and grandma.  We planned a series of events for their one full day of activity with us that included a visit to “Butterfly Wonderland.”  Butterfly Wonderland is incredible; you get to travel through a room with hundreds of incredibly beautiful monarch butterflies.  If you can make the trip, come and experience Butterfly Wonderland, I highly suggest the visit!

Yellow ButterflyWhen we visited, I gave my cell phone camera to my granddaughter, and she filled the phone with pictures of various butterflies.  One particular butterfly has remained with me, not for the butterfly’s beauty, which was gorgeous, but because of the dramatic story of a toddler 2-3 years old, a Koi Pond, and how the toddler rescued the butterfly.

Rescued Butterfly 2I have no idea how the butterfly got into the Koi Pond.  I entirely missed the beginning of this story.  I noticed the little boy because my danger button had been triggered with children and bodies of water.  Thus, I watched warily and enthralled as the drama unfolded.  The little boy was visibly upset; he wanted his mom to rescue the butterfly and actively worked to try and gain her attention, all to no avail.  The boy then tried to keep the Koi fish away from the butterfly.  He waved his arms; he moved his hands closer to the water to shoo the fish, he threw what he could wrap his hands around.  But that did not work too well, and the boy became more visibly upset at the peril of the butterfly.  Finally, the little boy settled onto a plan; you saw his plan take shape on his face, intention entered his eyes, and he designed a potential solution.  He stretched himself onto the low wall of the Koi Pond until his chest was squarely on the ledge of the wall; he extended his body and arm and fingers towards the butterfly, and at the absolute end of his stretch, he could just barely come within a distance of the stranded butterfly.

You saw the butterfly tentatively stretch towards the hand of the boy.  Unsure about the safety of accepting help but being stranded, the help offered became apparent to the butterfly and was accepted.  The butterfly extended a feeler or two, and the toddler could pluck the butterfly from the water.

Rescued Butterfly 3The butterfly, visibly exhausted from trying to free itself from the Koi Pond water, clung for dear life to this little boy’s middle finger.  The little boy, realizing he had the butterfly, gently pulled himself back, and gently placed the butterfly onto the edge of the wall, away from danger.  Still wanting to help, the little boy watched the butterfly.  He did not try to touch the butterfly’s wings, as I expected.  He continued to try and gain mom’s attention to “help the butterfly be better,” and he waited and attentively watched for the butterfly to gather strength.  You could see the hope for the butterfly written in the eyes and face of this toddler.  He cared and wanted the butterfly to be okay.

Pink Monarch ButterflyAll actions I never suspected a little toddler would do, this toddler did.  He was very patient with this resting butterfly, even shooing other butterflies away who might interrupt the rest of the recovering butterfly, including final shooing motions to the Koi fish who gathered at the base of the wall where the boy and the butterfly were.  After a period of minutes, the butterfly began flexing it’s now dry wings and shortly flew further into a nesting area to rest more and eat.  Mom collected the toddler, and they strolled through the rest of the exhibits.  The little boy never looked back after the butterfly flew away; he seemed to become interested in other things and talked happily with mom.  What he said was standard toddler, but I cannot help but wonder at the story he told.

Why do I remember this story and event so well?

Koi FishIn a recent post on virtues to live by, I encouraged you, the audience, to see people.  The story of the monarch butterfly and the toddler is one of my favorite stories of “seeing people.”  Watching the stories of life unfold around me.  Being present in the moment to record, understand, and then reflect upon what is witnessed, and hopefully, in the recollecting, help others to “see people.”

More, this story represents something to me, the power of desire to help and the boldness of action.  That little boy could have wound up in the water and in peril but didn’t.  That monarch butterfly could have been eaten by the Koi fish in the pond, long before this drama unfolded; but was not consumed by the multitude of fish that swam around the butterfly.  The mother could have been more attentive to her toddler and rescued the butterfly for him; but, luckily for us, she remained unresponsive.

To watch the ideas, thoughts, planning, etc., cross the face of this toddler as he tried to use his resources to rescue the butterfly was wonderful to behold.  I learned a lot about watching this toddler that I never expected to learn.  For example, toddlers can be interested in the world around them, to the point of spurning them to act.  I never witnessed a child this young perform a selfless act, intentionally, with planning and forethought.

Zebra ButterflyResearch would tell me these experiences cannot happen, or only happen rarely a statistical anomaly, and more.  Yet, I believe in the human spark, the human animal’s intelligence to think, reason, and act.  Best of all, in all my years of human observation, I know without a doubt, this was not a singular event.

The event was surprising. The event was singular to the toddler and this butterfly, but the pattern of intentional action, selfless action, interested planning, and forethought were not singular actions among children.  I have witnessed children as young as 4 observe another child crying and try to comfort that child.  But, never as young as 2-3.

Life ValuedOne particular incident involving young, toddler age children, 2-5 years old, occurred in a hospital emergency room situation.  The younger children cried along with the child who was injured.  The older children gathered around with looks of deep concern, thoughtfulness, and a desire to act.  Race did not matter; sex did not matter, boys and girls had their attentions set upon what was happening; a young child was in peril, and they wanted to help comfort the child.  Over the space of a few hours, while doctors and nurses rushed about, came in and out, and administered to the child’s injuries, little toys started showing up on the injured child’s bed.  A small dinosaur, a car, a book, a fluffy bunny, and other small items came out of pockets and parents’ bags and became gifts for the little injured child.  The mother of the wounded child witnessed this miracle, tried to return some items.  But eventually allowed the giving to continue unabated through the night.  Other children came and went, some offered help, others noticed and were enraptured by the drama for a spell, almost in the attitude of praying for the injured child.

The atmosphere was tangibly different when the children stood enthralled and watched caregivers working to help the injured child.  The best I can describe the feeling, stand in the middle of a church, be silent, watch and observe all around you, and slowly a sense comes over you that is difficult to explain but lifts you to a higher level of consciousness.  Multiply that feeling exponentially, and you have what was witnessed this night in the Emergency Room when children became aware of an injured child and stood enthralled and selflessly observant for a moment.

What has this story to do with NO MORE BS?

Spotted Monarch ButterflyIt is a pattern for us on multiple levels.  We can choose to see people, and in seeing people play that influential role of helper, friend, mentor, coach, caregiver, or simply listening ear and recognizing eye.  We can act locally for great good.  We can follow these children’s examples and chose to exercise that divine spark within us, reach out, and make a small difference somewhere.  We can encourage good!

As kids, we were told if you tried your absolute best, you are not a loser.  You tried, you strove, your acted, and all of these are worthwhile, even if you failed.  Yet, as adults, we seem to have forgotten this lesson, we have neglected to pass the lesson along, and in forgetting, we lose a part of ourselves that is precious and childlike.  We lose the ability of trust and confidence.  Trusting that our efforts can influence outcomes.  We lose the confidence of directed, planned, prepared action choosing to act selflessly to fulfill desires.

Eye-ButterflyThe toddler and the butterfly powerfully reflect the desire to help, coupled with a plan of action; after all other resources were exhausted, success was saving a life.  To that toddler, that butterfly’s life was precious, and help was needed urgently.  The New Testament, Luke 12:6-7, records:

“Are not five sparrows sold for two farthings, and not one of them is forgotten before God?  But even the very hairs of your head are all numbered. Fear not therefore: ye are of more value than many sparrows.”

To that toddler, that precious sparrow was a butterfly in need.  Replicating these verses of scripture on the value of helping others, seeing people, and being essential to a power greater than us all.

I want to affirm, in words of truth and soberness, that all effort is appreciated.  Every small act of learning, growing, helping, and being neighborly is critical and vital to improving our society.  That butterfly was vital to that toddler, those gifts from children had value beyond the price of the item given away, and we can replicate this pattern!  Some have asked what can I do, the enemy is too powerful; the answer is always the same, do something!  Improve your knowledge through reading, exploring writing, attending a school board meeting, raising your voice, voting in every election smarter and more empowered, standing when the flag passes and standing for the National anthem.  You know best what you can do, do that action, and you will make a difference!

Rescued Butterfly 3Remember the toddler and the butterfly, like the butterfly, we often need the toddler, and frequently, we can be the toddler to another butterfly!  The pictures featured come from my Granddaughter or myself at Butterfly Wonderland.

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds copyright to the butterfly photos displayed.

 

NO MORE BS – Local Elections: The Key

DutySeveral years back, on a conservative social media site, I discussed the importance of elections with a person.  Their position was that the only elections that mattered were Federal elections, as these are the only elections that the liberal leftists have the power to steal freedoms.  I begged to differ then, and I continue to maintain that local elections are more critical, and the most important elections are mayoral and school board elections.  All I ask here is to explain; if you disagree, please let’s discuss your thoughts openly; just hear me out, please.

When it comes to taxes, the most noticeable are those experienced locally, Gas Tax, Property Tax, Sales Tax, etc. The local additions to taxes make the national taxes so onerous to pay, but these taxes are all decided by your neighbors and local elections.  For example, Phoenix, Arizona, has an 8.6% sales tax, of which 5.6% belongs to the state, and 0.7% belongs to Maricopa County, leaving 2.3% of every penny of purchased goods taxed by local officials.  This is just the sales tax, not including all the other government fees, which are taxes, but the government couches these as fees, that oddly enough, sales tax is charged.

Theres moreWhen measuring elections, and based solely upon taxes, the more critical election is the local election for city and county offices.  I spent four years studying the Albuquerque Public Schools (APS) while residing in Albuquerque, NM.  What I found shocked, amazed, frightened, and blew my mind.  I do not know your school districts; however, I would presume many of the same problems found in APS are alive and well in your school district.  Hence, APS is used here as a warning and a proof of concept that local elections have more dramatic consequences than Federal Elections.

The residential property tax rate in Albuquerque, NM., is 1.05%. With a total grant budget of $1.6 Billion, no numbers have been found for the amount of tax revenue APS is handed; the school district is undoubtedly well funded.  From the 2018-2019 school survey on APS performance, we find a common theme from the citizens to the APS school district, reduce administration costs.  The answer from APS school administrators was to “Increase Counselors, Social Workers, Security, and other staff to support our student’s mental and physical health … Increase Custodians across the schools [sic].”  The Albuquerque Journal reports that APS is the lead agency for taking tax dollar revenues.  With Bernalillo County and the City of Albuquerque, plus property taxes, all collected at ridiculous rates, APS must be getting a significant chunk of revenue. Still, APS demands more money, “For the children.”

ProblemsAn Educational Assistant (EA; Teacher’s Aide) was called upon to be a substitute teacher in Seventh Grade math; because APS is bereft of substitute teachers and is experiencing a teacher drought.  The EA is not a licensed substitute teacher; thus, when asked how this is legal to have an EA substituting outside her legally licensed work and expertise, she said she “didn’t know” and then acknowledged this is standard practice.  The EA further elaborated that when she asked for a substitute teacher because her teacher was out or off, she had a very low probability of ever getting a licensed substitute teacher and generally had to teach the class, with no extra money for doing extra work.  The EA has worked in four other states in the US as an Educational Assistant/Teacher’s Aide and has never been licensed to be a substitute teacher; yet, somehow, in APS, she can be regularly called upon to substitute teach.

Scared Eyes!In discussing teacher performance, another classic APS child abuse issue was concerned, all while a good teacher is being forced out of her position.  Because of the teacher drought, APS is experiencing, and due to reduced registrations in a bilingual education school, an illiterate teacher in both Spanish and English, who had to pass a state-mandated test to get the license to teach bilingual students, is going to keep her job for another year.  This intellectually challenged teacher has been reported to APS more than a dozen times for swearing, insulting, and not being able to teach. Still, this teacher was just offered a full-time position to teach bilingual students when she cannot speak/read/write in either English or Spanish at an academically acceptable level.  Due to falling registrations, a Kindergarten teacher, who was the last one hired at this school, is being terminated.  The teacher being released is a stellar teacher, works hard, is well-liked by staff, parents, and students.  Since joining APS, this phenomenal teacher has been assigned to “catch” those students from the most impoverished homes and get them up to speed academically.  As reported by all who know this teacher, she is exemplary in her assigned duties, fully 180-degrees separate from the illiterate teacher who landed her job under shady circumstances or nepotism.  Yet the bad teacher is being kept and the good discharged.

The EA discussed above was called to substitute teach, spent 90-minutes after work writing notes to the regular teacher, and will not be reimbursed for her extra time.  Please note, this is 90-minutes on top of her regularly scheduled, non-paid, mandatory overtime.  Thus, every day this EA loses 90-minutes of pay at the end of the day and between 60 and 90 minutes at the start of the day, with no reimbursement to cover this employer-mandated time.  With a regular school year average of 38-weeks, 5-days per week average worked, and roughly 150-minutes per day unpaid, an average EA salary of $15,116.50 ($9.95 per hour), this EA is losing approximately $2,836.70 each school year

Wasting TimeDuring the summer of 2019, for the first time in 15-years, APS full-time licensed teachers received a pay raise.  Not for the first time in 15-years, the teachers saw a slew of additional requirements, mandates, and reductions in alternative licensure to “pay” for the teacher pay raise.  All while the school board received yet another pay increase.  The voters have already told APS NO on a slew of tax increases and bond sale schemes, yet, in November 2019, APS was trying again to raise taxes, raise money, and raise administrator salaries.

Detective 4Understanding checkpoint, we have more than one instance of a teacher unable to perform their duties and verbally abusing students.  We have a functionally illiterate teacher who landed her position based on either shady circumstances or through nepotism. We have a recorded phenomenal teacher being summarily discharged during a teacher drought.  We have citizens, parents, and a concerned community begging for reduced administration, where APS then responds they are increasing administration.  Then we have non-licensed staff forced to work outside their licensure because the administration cannot obtain substitute teachers. Plus, the teaching staff is forced to work extra hours without proper compensation.

Where are the more essential elections to focus upon, Federal or City/County/State?  The local elections strip more money and freedoms from a person than the federal elections.  The local elections represent a template of how national elections are stolen.  The provincial election process is where direct and visible harm comes to the citizen.  Yet, some people will only vote in federal elections.

If the BS government throws at the people is ever to be culled, we the citizens need first to get control and a positive handle upon the local elections.  Make the school board election process more transparent and more responsible to the community they serve.  These are your neighbors causing you pain, cheating (abusing) your children of their educational opportunities, and costing you thousands of dollars in tax revenues.  The local teacher you meet to discuss your child is stuck in a proverbial maelstrom. The administrators are dictating, the student doesn’t understand, the teacher does not have time to explain, and your child is left behind and abused, all because of how the school board operates!

Blue Money BurningAPS holds two titles for performance, APS is the largest school district in New Mexico, and APS has the worst-performing students academically.  Why?  Not because there are insufficient funds to operate, but because of the elected leaders and the labor unions interfering with how teachers teach!  Annually, America spends, per education data.org, on K-12 schools $612.7 billion, or $12,612 per pupil. Federal, state, and local governments spend $720.9 billion, or $14,840 per pupil, to fund K-12 public education.  Where does the money spent per student go; the United States spends a higher percentage on non-teaching educational staff, including school administrators.

Based solely upon the school board performance, what elections are more critical federal or local?  It would be best if you decided this for yourself.  As for me, I am going to continue paying more attention to the local elections, spending time getting to know candidates running for local offices, judgeships, school boards, mayor, county board, sheriff, and dog catcher, because at the end of the day these are my neighbors. They need to be called out for government malfeasance, theft, and child abuse!  I believe that local elections can win or lose the country long before a president takes office.

Per a collection of articles published by Forbes.com, California is the US State with the most out of control debt at $248.67 Billion in liabilities, with $53.05 Billion in assets, or five times more debt than it can pay off if forced into receivership.  Who holds that debt remains a murky question due to how each state calculates their debt, who they sell bonds to, and other debt financing options?  What is clear is that too often, the states with the highest debt have the most out of control spenders in elected offices.  Want an eye-opening experience?  Look up your city/town/county debt as a portion of the state debt, and ask the elected officials who hold those debt markers?  If that politician can even give you a straight and intelligible answer, you are doing better than every other city/town/county in America.

Boris & NatashaPlease, pay closer attention to who is running for public office at all levels of government.  But, when faced with critical resource shortages, pay more immediate attention to local elections.  By careful design, many local elections have been purposefully made to appear inconsequential, not worth investing your time, and of such extreme unimportance that voting is considered a waste of time.  But, from studying history, I know these are the elections where the most attention needs to be paid, and time invested in preventing government overreach, tax burden increases, and loss of rights and liberties.

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

Realities and Uncertainties – The Paradigm at the VA

I-CareThe Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports they are returning to a more regular schedule of release for the inspection reports with the Department of Veterans Affairs (VA) recovering from COVID-19.  Congratulations are in order, to the VA, as they begin returning to normal operations and procedures.  The reality is that standard operating procedures (SOP) are regularly missing at the VA, this absence causes uncertainty, and forms the crux of this report. A question for the VA-OIG, “How can you assess employee competency without SOPs?”  To the VA VISN leaders, “How can your directors and supervisors, conduct employee evaluations without written SOPs?”  The short answer is you cannot!

Congratulations are in order, for the Marion VA Medical Center (VAMC) in Illinois.  The Marion VAMC experienced a “comprehensive healthcare inspection” and were generally praised for the excellent work being conducted, the happiness of the patients, and the overall condition of the facilities.  While there were recommendations made by the VA-OIG (29 in 8 different areas), the overall report was satisfactory, and this is mentionable.  Hence, my heartfelt congratulations for your success in this inspection.

VA SealThe Marion VAMC VA-OIG report raises a common theme, and this is a reality the VA appears to be incapable of addressing training and two-directional communication.  From the hospital director to the patient-facing staff, training always appears as a significant issue in VA operations.  Having experienced the training provided by the VA for employees, and as an adult educator, I know the uselessness of the training program and have several suggestions.  Perhaps the problem would be best addressed if more evidence was provided of a systemic failure in training employees at the VA.

In 2017 Congress mandated a change in research operations for the VA, specifically where canine research was concerned.

The OIG found VHA conducted eight studies without the former or current Secretary’s direct approval, resulting in the unauthorized use of $393,606 in appropriated funds.VA continued research using canines after the passage of the funding restrictions, in part, because VHA executives perceived that then VA Secretary David Shulkin had approved the continuation of the studies before his departure.”

The cause of the problem, the VA-OIG discovered was, “Unclear communication, inadequate recordkeeping, and failure to ensure approval decisions were accurately recorded and verified all contributing to VHA’s noncompliance.”  The researchers and executives relied upon two leading causes for not following regulations, designed incompetence, and a lack of training through clear and concise communications.

Congress mandated the documentation to assure approval was obtained before research commenced; yet, the researchers and administrative staff collectively failed to do their jobs and were able to hide behind the bureaucracy they established to excuse their poor behavior.  Loopholes for designed incompetence and lack of training need closed; but, two incidents do not clearly illustrate the reality of the problem.

ProblemsThe VA Southern Nevada Healthcare System in North Las Vegas, in response to a referral from the U.S. Office of Special Counsel (OSC), was investigated by the VA-OIG after a community healthcare worker was attacked.  The VA-OIG findings are appalling, but the reasons for the problem are worse.

The OIG determined that facility managers failed to timely respond after the social worker reported an assault during a home visit and did not address the social worker’s health needs after the assault. The social worker’s supervisor failed to immediately report the incident to the community and VA police. The facility’s policies lacked specific guidance regarding employee emotional and mental health injuries. Further, the OIG substantiated that the social worker was not informed by a supervisor of a homicidal threat, occurring subsequent to the assault, until two weeks after facility leaders became aware of the threat.”

The facility leaders knew there was a problem, yet did nothing before or after the event, that could have cost this healthcare worker their life!  VA-OIG recommendations boil down to a need for clear communication and staff training.  The recommendations highlighted another issue entirely that forms the reality and creates uncertainty at the VA, communication is not a two-directional opportunity to share information.  Single directional communication is useless, and those leaders supporting the bureaucracy to only allow communication to flow in, need immediate removal from the VA.  During my time at the VA as an employee on the front-lines, facing patients, I regularly experienced the lack of communication, and this issue is systemic to the entire VA as witnessed and observed at VA Medical Centers across the United States.

The Nevada incident is deplorable, reprehensible, and the potential for loss of life cannot be overlooked by VA leadership in Washington, at the VISN, or at the Medical Center any longer!  The problems of communication cannot explain this incident, and failure for training cannot excuse this behavior!  Since the OSC initiated the complaint, I am left to wonder, did the employee reporting this incident get fired and needed to appeal to the OSC for remediation?  I ask because the knee-jerk reaction to problems at the VA is to fire the person reporting the issue, as previously observed and personally experienced, and as described to Congressional representatives during televised hearings.  A more thorough investigation into causation needs to be concluded and reported to Congress for this incident reeks of politics and CYA.

Leadership CartoonThe Harry S. Truman Memorial Veterans’ Hospital in Columbia, Missouri, and multiple outpatient clinics was recently provided a comprehensive healthcare inspection, and the leadership team provided 14 recommendations in 7 different areas for improvement.  While congratulations are in order, for the patient scores, the employee scores, and the overall conditions discovered.  Yet, again staff competency, e.g., training and communication, remain critical articles requiring targeted improvement.  Is the pattern emerging discernable; in Nevada, an employee is assaulted and training and communication are blamed, comprehensive healthcare inspections are conducted in three different geographic areas and the same causation factors discovered; training and communication are systemically failing at the VA.  But, the evidence continues.

The John J. Pershing VA Medical Center in Poplar Bluff, Missouri, recently underwent a comprehensive healthcare inspection.  The VA-OIG issued 17 recommendations in 6 fundamental areas, including staff competency assessments, e.g., training and communication, as well as the inadequate written standard operating procedures.  When discussing designed incompetence, the first step to correcting this problem is writing down the standards, operating methods, and procedures.  Then the medical center leaders can begin training to those standards.  Barring written instructions and published standards, employees are left to ask, “What is my job? and “How do I perform my job to a standard?”

The Oscar G. Johnson VA medical center, and multiple outpatient clinics in Michigan and Wisconsin recently underwent a comprehensive healthcare inspection, 11 recommendations in 3 critical areas.  As did the Tomah VA Medical Center and multiple outpatient clinics in Wisconsin, 4 recommendations in 3 crucial areas.  Both facilities are to be congratulated for their continual improvement and their success during the inspections.  In case you were wondering, staff competency assessments, e.g. training and communication, are vital findings and variables in improving further for both facilities.

The VA has what it calls “S.A.I.L” metrics that form the core standard for performance.  S.A.I.L. stands for Strategic Analytic (sic) for Improvement and Learning.  Learning is a critical component in how the facility is measured and yet remains a constant theme in the struggles for improvement.  Thus, not only is two-directional communication a systemic failure, but so is the poor training results found on all the comprehensive healthcare inspections performed by the VA-OIG.  Poor communication almost cost a healthcare worker their life, and staff training was a key component for recovering from this incident in Nevada.  How can the VA consistently fail at two-directional communication and training, designed incompetence?  Those in charge require an excuse for not doing their jobs, and the most common excuse provided is a lack of training and poor communication.

I-CareIt is time for these petulant and puerile excuses to be banished and extinguished.  The following are suggestions to beginning to address the problems.

  1. Easy listening is a musical style, not an action in communication.  By this, it is meant that the VA needs to stop faking active listening and engage reflective listening.  Reflective listening requires reaching a mutual understanding and is critical to two-directional communications.  In the world of technology, not responding to email, not responding to text messages, and untimely responses to staff communication are inexcusable on the part of the leaders.
  2. Staff training remains a core concept, but before staff can be properly and adequately trained, standards for performance, operational guidelines, and procedural actions must be clearly written down. The first question I asked upon hire was, “Where are the SOPs for this position?”  I was told, “Do not mention SOPs as the director hates them and prefers to work without them.”  Do you know why that director preferred to work at the VA without SOPs because she used it as an excuse to get out of trouble, to fire those she deemed trouble makers, and to escape with her pension and cushy job to another VA medical center?  A repeatable pattern for poor leaders to spread their infamy.  Shame on the VA Leaders for promoting this director to a level beyond her incompetence.  Worse, shame on you for creating an environment where many like her have excelled and done damage to the VA reputation, mission, and patients, including killing them while they awaited care.
  3. From the VA Secretary to the front-line patient-facing employee, cease accepting excuses. The private sector cannot hide behind immunity from litigation and act in a more responsible manner.  Thus, the VA needs to benchmark what private hospitals do where staff training and SOP’s are concerned.  Benchmark from the best and the worst hospitals for an average, then implement that average as the standard.  One thing discovered in writing SOPs for the NMVAMC, the committee for approving SOPs, and the process for writing SOPs were so convoluted and time-intensive that the SOP was outdated by the time it could be implemented.  Shame on you VA leadership for creating this environment!
  4. Training should be an extension of an organizational effort and university. The VA is not properly training the next generation of leaders; thus, the problems multiply and exponentially grow from generation to generation.  Launch the VA Learning University concept, staff that university with adult educators, and allow lessons learned from the university to trickle into operational excellence.
  5. Form an independent tiger team in the VA Secretary’s Office who has the authority to travel anywhere in the VA System to conduct investigations with the ability to enact change and demand obeisance. The Nevada incident was a failure of leadership and needs a thorough reporting and cleansing of the bad actors who allowed that situation to occur.  Worse, in my travels, I have heard many similar stories.  I heard of a patient getting their ear chopped off when a veteran assaulted another veteran after becoming irate at waiting times in the VA ER.  I have heard and witnessed multiple incidents of furniture being thrown, employees being assaulted, employees harassing and assaulting patients, staff property trashed, and so much more.  These incidents need direct intervention and investigation by a party not affiliated with that affected VAMC and the leadership’s political policies.

Carl T. Hayden04 October 2016, the VA-OIG released a report on dead veterans after the comprehensive investigation into the Carl T. Hayden VAMC in Phoenix, Arizona.  The same event occurred in 2014, at the same hospital, with the same causes and the same conclusions.  The core causes for the dead veterans, no written procedures, poor to no training, and reprehensible communication practices.  The Phoenix VAMC went out of their way to fire all the employees who reported problems at the Phoenix VAMC before the veterans began dying in 2014, I can only speculate that the same occurred in 2016.  Staff was frightened in 2014; they are demoralized in 2020.  Nothing has changed at the Carl T. Hayden VAMC in Phoenix, Arizona, after two successive hospital directors, if anything the problems have worsened.  The problems worsened because leadership failed to act, failed to write down SOPs, failed to communicate, and failed to train.  The hospital directors since 2014 have been appointed from the same pool of candidates who created dead veterans in the first place, and that is a central failure of the VA Secretary and Congressionally elected representatives’ failure to act!

How many more veterans or staff must die before the VA is willing to act?

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Let’s Talk About the VA – The Insanity Must Cease!

I-CareWhen the Department of Veterans Affairs (VA) does something good, I praise them.  The VA recently had a good report come from the Department of Veterans Affairs – Office of Inspector General (VA-OIG), apparently there was progress made in improving performance once policies were written down, training of employees occurred, and over time there has been an improvement, however small and seemingly insignificant.  I offer my sincerest congratulations on making progress and change on this issue.

Carl T. HaydenHowever, I will castigate and deride all abuses of veterans, myself included.  At the Phoenix VA Medical Center, the Carl T. Hayden VA Hospital remains a hotbed of bureaucrats on a power trip weekend from Dante’s first ring.  The abuses at this hospital continue and the leadership needs to be corrected!

For those who do not remember, the Carl T. Hayden VA Hospital in Phoenix, AZ used to be an award-winning hospital, a pillar of good performance, and an example of how VA Hospitals could be run.  Then, the director was changed, the hospital staff changed, awards stopped coming, and veterans started dying.  Leading to the fiasco of dead veterans on paper waiting lists, during Pres. Obama’s reign.  CNN reported on April 30, 2014, that at least 40 United States Armed Forces veterans died while waiting for care at the Phoenix, Arizona, Veterans Health Administration facilities.

On 29 June 2020, I reported to the VA ER sick and in desperate need of assistance.  The assistance was refused because I cannot physically wear a mask.  In my medical records, it is noted that I suffer from shortness of breath and any mask exasperates this problem.  In direct violation of Federal Law that commands all emergency rooms to see whoever walks in, the ER staff refused me service due to the “Mask Policy” as part of their “Covid-19 response.”  No options, no exceptions, no excuses, I as the patient could either endanger my health or find a different hospital ER.

The Emergency Medical Treatment and Labor Act (EMTALA; 1986) is a federal law that requires anyone coming to an emergency department to be stabilized and treated, regardless of their insurance status or ability to pay.  EMATALA also dictates that no person can be refused treatment in any Emergency Room.  The EMTALA is not new and is part of the training from day one for all staff at the VA.  For ER staff, this is the golden ticket and special care is taken to ensure this law is followed to the letter; rather, this law is supposed to be the premier standard from which good health care policy is built for emergency rooms.  Except, the Carl T. Hayden VA Hospital in Phoenix, AZ., and the Raymond G. Murphy VA Hospital in Albuquerque, NM., both appear to be the exception to EMTALA, by order of the staff bureaucrats, who are supported in their illegal and nefarious behavior by the hospital administration collectively, and the hospital leadership specifically.

Raymmond G. MurphyI have written previously of the patient abuse I witnessed, and reported, at the Raymond G. Murphy VA Hospital, in Albuquerque, NM.  I have written about the patients turned away by nurses and other staff because these staff members refused to follow the law.  I reported the risks and problems being run by refusing patients in the ER, and this all fell on deaf ears.  Well, I will not stop raising this illegal practice as a major concern for the hospital leadership all the way to Secretary Wilkie and the elected officials in Congress who refuse to act to improve the toxic culture found in the VA.

You, the bureaucrats in the VA cannot break the law with impunity and your actions are leading to major patient safety concerns, increased hospital operating costs, and putting real people in real harm!  I spent more than an hour in the VA Parking lot trying to calm my breathing down to safely operate a motor vehicle, so as to drive to a different hospital emergency room, where I was treated without ever having to deal with the mask issue.  While in the VA Parking lot, I was attended to by three Federal Police Officers who were willing to try and get me seen at the ER but were stuck trying to force the “Mask Policy,” regardless of my physical inability to wear a mask without causing additional harm and injury.  The Federal Officers were called because the ER staff reported a violent and non-responsive patient had just left the building.  I was both responsive and never violent in the ER.  Regardless of the fact that I was extremely short of breath, unable to walk, and unable to be seen at the VA.  When the officers found me in the parking lot, I could barely breathe and was so weak from lack of oxygen that I was graying out in vision and other major issues; thus, how the ER staff can say I was violent and non-responsive is beyond my comprehension.

The behavior of the ER Staff at the Carl T. Hayden VA Hospital in Phoenix is beyond the pale and bordering on obscene, as well as illegal!  Where is the accountability?  Where is the patient advocate?  Where is the Administrator on Duty who has the power to demand corrective action?  Where is the rightful opposition; well, I know where the rightful opposition is, it is buried with the dead veterans, who died awaiting care at the hands of the VA!

VA SealWhere is the patient advocate in this problem; well, that night after being refused care I reported the problem to the patient advocates office via secure message, and the following morning, the patient advocate replies that “It is VA policy to mandate all people wear masks if they desire treatment.”  Not caring about the federal laws governing ER visits, not even bothering to mention that the treatment by the staff as reported was ludicrous and vile, and not even to bother to ask if I was seen elsewhere.  Just a brief, less than 100-word, statement telling me my concerns for my safety and health are not important and policy must come first.  The perfect bureaucrat, with the most detestable response it has been my displeasure to experience since the last time I visited the DMV.

I am sorry but everyone is required to wear a mask at the VA Facility. I understand you may have shortness of breath but you can wear a mask and undo one side every couple of minutes. This is for your safety and the others around you.

T. C. M. [Name Shortened for Privacy]
Patient Advocate

Will someone please explain how this can occur?  Will an elected official please demand a behavior change at the VA, and remain interested long enough to facilitate the solutions Sec. Wilkie needs to effect change?  How many veterans will have to die needlessly at the hands of the VA before the elected officials decide that veterans’ lives matter and the VA is taking our lives?

I get it, there are a lot of problems in America, and more in the world.  But, the US House of Representatives, instead of passing a budget, which they are statutorily mandated to do, is writing letters, and meddling in Israel’s business.  If the US House has the time to meddle and jump down every rabbit hole on the political landscape, they must have time to assist the veterans and improve the VA.  If the US Senate has the time to meddle, postulate, and pander, then they have the time to review the plethora of VA-OIG reports and begin assisting the VA Secretary in correcting the problems in the VA.

The saga continued this over the first two days of July and forms the bitter cherry on top of the crap sundae the VA is trying to serve the veterans.  I received a call from my primary care provider’s nurse who has the attitude of supreme petty authoritarian to a lesser subject, reminding me several times that the mask policy was political, trying to blame all hospitals in the region of implementing a similar policy (which is fake), and then trying to excuse himself by claiming he was just a messenger and not involved in the policy implementation.  Concluding the call, with the temerity to tell me that I was in the wrong to not follow VA policy.  The patient advocate had the effrontery of sending a message to me stating that I should have asked for a full-face shield instead of a mask.  Seeing as no face shields were offered as a workaround, seeing as the policy enforcers demanding only a mask as the single viable and allowed option, and seeing as I spent more than an hour while in extreme pain trying to be seen to no avail, none of that mattered, the patient was at fault, per the patient advocate.

LinkedIn VA ImageMy cherub-like demeanor has taken a bloody beating over this incident.  Worse, my health has suffered tremendously and I have had to question myself and my advocacy of the VA.  The behavior of the bureaucrats and petty authoritarians of the VA at the Carl T. Hayden VA Hospital in Phoenix, AZ is detestable, and I can only conclude and wonder if I am having these problems, what are less outspoken and less knowledgeable veterans suffering?  I will not be the quiet little mouse in the corner where my safety and the safety of other veterans are being endangered by the politics and illegal actions of Federal Employees.  The policy is wrong and needs immediate revision before more veterans die at the hands of the VA!I-Care

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/

Structured Incompetence – The Department of Veterans Affairs and Congress

I-CareThe Department of Veterans Affairs (VA) is allowed the ability to govern themselves, provided they meet specific guidelines and legislated goals and directions.  The Department of Veterans Affairs – Office of Inspector General (VA-OIG) was established to provide legislators and the VA with tools and processes to improve, as well as to investigate root causes, and make recommendations for improvement.  But, here is the rub, the VA-OIG has no teeth to help their recommendations hold the attention of those in charge to make changes.

In December 2014, the Federal Information Technology Acquisition Reform Act (FITARA), passed Congress and was signed into law by the president; FITARA is a historic law that represents the first major overhaul of Federal information technology (IT) in almost 20 years. Since FITARA’s enactment, OMB published guidance to agencies to ensure that this law is applied consistently governmentwide in a way that is both workable and effective.  2014 saw the VA slow the loss of private data from the VA, the Office of Personnel Management (OPM) Data Breach is gaining momentum and will crest in 2015, and in case memory has failed 2014 saw an explosion in VA malfeasance get uncovered starting with the Carl T. Hayden VA Hospital in Phoenix, AZ.

December 2020 will mark the sixth anniversary of FITARA, and President Trump signed a five-year FITARA bill in May 2018.  The VA-OIG in reporting progress on FITARA at the VA has this to report,

“… The audit team evaluated two groups of requirements involving the role of the VA chief information officer during [the] fiscal year 2018. They related to the CIO (1) reviewing and approving all information technology (IT) asset and service acquisitions across the VA enterprise and (2) planning, programming, budgeting, and executing the functions for IT, including governance, oversight, and reporting. The audit team found that [the] VA did not meet FITARA requirements and identified several causes.”

The number one reason for non-compliance after almost six-years was, “VA policies and processes that limited the chief information officer’s (sic) review of IT investments and the oversight of IT resources.”  Not mentioned in the VA-OIG report is how many of these processes and policies had been enacted since 2014.  The VA’s own processes and policies reflect structured incompetence, making a ready excuse to be out of legal compliance with legislated obligations.  If this was a private business, and the legislated obligations were not being followed exactly, no excuse could keep the leadership team out of jail and the business in operation.  Hence, Congress why do you allow this egregious behavior by public servants?

On the topic of structured incompetence, foot-dragging, and legislated obedience, the VA-OIG issued a glowing report of compliance because the VA was found to be in compliance with three of the five recommendations from a VA-OIG inspection on the Mission Act from June 2019.  The progress made was on all aspects of the Mission Act except mandatory disclosure.  Why does this not surprise me; of course, the VA has had, and continues to suffer from, a horrible case of refusing to report, disclose, and communicate without severe prodding and legislated mandates.  Thus, I congratulate the VA on being in compliance with the Mission Act for the last three consecutive quarters on a total of three recommendations from the VA-OIG; this is a good beginning, when can we expect improvement on mandatory disclosure?  Structured incompetence relies upon disclosure malfeasance, collective misfeasance, and leadership shenanigans.

On the topic of structured incompetence, the VA-OIG reported that the Northport VA Medical Center in Northport, New York, prior medical center leaders did not plan effectively to address deficiencies in aging infrastructure.  Which is the polite way of saying, the buildings are old and maintenance has been creatively haphazard, so when steam erupts from fittings and contaminates patient treatment rooms with asbestos, lead paint, live steam, and other construction debris, a small problem becomes a multi-month catastrophe.  Thankfully, the VA-OIG reported no harm to the patients or patient care restrictions from this episode.  Unfortunately, the VA-OIG cannot hold the managers and directors of engineering services responsible.  Having worked in several capacities in engineering I am astounded at the following recommendation from the VA-OIG, and covered under creatively structured incompetence:

“… The OIG recommended that the medical center director develop processes and procedures for submitting work orders—including for notifications when work orders are assigned and reviewed for accuracy and consistency—to help the center’s engineering service prioritize work and manage [the] resource.”

Will the VA-OIG please answer the following questions, “Why is this the hospital directors’ job?”  You have an entire engineering plant, with a supposedly competent director to oversee engineering operations, why and how should the hospital director be focusing such extensive amounts of time on the job that rightly belongs to the engineering plant director?  There are several technology-based programs and options that can perform this work, and form reports automatically based upon performance by engineering staff in completing work orders.  Why is the VA-OIG recommendation not including an automated process to improve performance?  The lack of oversight in the engineering department is both creatively and structured incompetence, because the VA-OIG report recommended following the master plan, reporting progress to the master plan, and suggested that the director of the engineering plant needs to be doing the job they are collecting a wage to perform.

Behavior-ChangeOn the topic of creatively structured incompetence, we find the following from the Department of Veterans Affairs – Veterans Benefits Administration (VBA).  A veteran patient that spends more than 21-days in hospital for treatment is supposed to be placed on 100% disability, and be paid at the higher disability amount.  Those veterans with mental health concerns are supposed to have additional support to aid them in managing their benefits from the VA.

The VA-OIG estimated VA Regional Office employees did not adjust or incorrectly adjusted disability compensation benefits in about 2,500 of the estimated 5,800 cases eligible for adjustments, creating an estimated $8 million in improper payments in the calendar year 2018. The OIG estimated 1,900 cases did not have competency determinations documented for service-connected mental health conditions.”

Why is this another case of creatively structured incompetence, because every time the VBA gets caught not doing their job, the reason is training, reports not properly filed, and lack of managerial oversight.  I could have predicted these reasons for structured incompetence before the investigation began.  That managerial oversight, employees not filing proper and timely reports, and training not occurring for employees has been an ongoing and repeated theme in VBA incompetence since early 2000 when magically the VBA was behind in processing veterans’ claims for disability.  This theme stretches to the VBA inappropriately deciding claims for spine issues.  The same theme was reported in the VBA improperly paying benefits.  The list of offenses by the VBA is long, and the excuse is tiresome.  The VA-OIG reported:

Employees who processed benefit adjustments also lacked proficiency. They lacked sufficient ongoing experience and training to maintain requisite knowledge. This is also why employees were unclear on the requirement to document the relevant competency of veterans admitted for service-connected mental health conditions.”

ProblemsHow ironic that the root causes of a VA-OIG inspection would find people being paid to perform a job, but are not actually doing the job because they lack proficiency, training, managerial oversight, and are unclear on what they are expected to do in their jobs.

To the elected officials of the US House of Representatives and the Senate, the following are posed:

  1. If you hired a carpenter to enter your home, perform work, and you discover that the carpenter does not know the job they were hired and contracted to perform, what would be your response?  If your answer is to keep that non-working carpenter in that position, in your home, I must wonder about your intellect.
  2. How can you allow this structured incompetence to live from one VA-OIG report to the next? How can you justify this behavior at the VA?  How many other offices of inspectors general reports are reporting the same structured incompetence in Federal Employment and you are not taking immediate action to correct these deficiencies?
  3. Why should anyone re-elect you; when we the taxpayers endure this incompetence, paying you and them to abuse us. You were elected to oversee and manage that which we cannot; yet, you continually strive to perform everything but this essential role.  Why should we re-elect you to public office?

GearsThe following suggestions are offered as starting points to curb structured incompetence, improve performance, and effect positive change at the Department of Veterans Affairs, which includes the Veterans Health Administration (VHA), the Veterans Benefits Administration (VBA), and the National Cemeteries.

  1. Implement ISO as a quality control system where processes, procedures, and policies are written down. The lack of written policies and procedures feeds structured incompetence and allows for creativity in being out of compliance with legislated mandates.
  2. Eliminate labor union protection. Government employees have negotiated plentiful benefits, working conditions, and pay without union representation, and the ability for the union to get criminal complaints dropped and worthless people their jobs back is an ultimate disgrace upon the Magna Charta of this The United States of America generally, and upon the seal of the Department of Veterans Affairs specifically.
  3. Give the VA-OIG power to enact change when cause and effect analysis shows a person is the problem specifically. Right now, the office of inspector general has the power to make recommendations, that are generally, sometimes, potentially, considered, and possible remediations adopted, maybe at some future point in time, provided a different course of action is not discovered and acted upon, or a new VA-OIG investigation commenced.  This insipid flim-flam charade must end.  People need to be held liable and accountable for how they perform their duties!
  4. Launch a VA University for employees and prospective employees to attend to gain the skills, education, and practical experience needed to be effective in their role. I know from sad experience just how worthless the training provided to new hire employees is and this is a critical issue.  You cannot hold front-line employees liable until it can be proven they know their job.  Employee training cannot occur and be effective without leadership dedicated to learning the job the right way and then performing that job in absolute compliance with the laws, policies, and procedures governing that role.  Training is a leadership function; how can supervisors be promoted and not know the role they are overseeing; a process which is too frequent in government employment.

I-CareI – Care about the VA!

When will the elected officials show you care and begin to assist in improving the plight of veterans, their dependents, and their families?

 

© Copyright 2020 – M. Dave Salisbury

The author holds no claims for the art used herein, the pictures were obtained in the public domain, and the intellectual property belongs to those who created the pictures.

All rights reserved.  For copies, reprints, or sharing, please contact through LinkedIn:

https://www.linkedin.com/in/davesalisbury/