“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.

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  • 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.

Desperate Changes Needed at the VA – A Letter to the President

President of the United States
Attn: The Honorable Donald Trump
1600 Pennsylvania Ave NW
Washington, DC 20500

10 May 2020

Dave Salisbury
1947 Edith Blvd SE
Albuquerque, NM 87102

Subject: The Department of Veterans Affairs

Dear Mr. President,

Please forgive my presumptuousness in writing to you directly.  I have made several attempts at raising the issues contained herein at lower levels, to no avail.  As the Chief Executive Officer of the United States of America, I come to you as the person of last resort.  The Department of Veterans Affairs (VA), especially Healthcare and Benefits departments are sick, and in desperate need of urgent corrective action.

  1. The VA-OIG has documented multiple times when claims have been improperly been decided, where training was lacking, leadership failed, and the veteran suffered.  Yet, never in the VA-OIG report is a discussion on correcting the past decisions.  The process for a veteran to have a previous decision, more often than not improperly decided by the VA, is to produce new material evidence, and wait interminably for the VA to decide they need to act.  This single issue is a leadership failure of enormous proportions, that Congress refuses to act upon; thus, the leadership failure begins and ends with the House of Representatives and the Senate refusing to do the jobs they were elected to complete.
  2. While the following is specific to the New Mexico VA Healthcare System (NMVAHCS), the problem is rampant throughout the entire VA healthcare system. I witnessed, 11 December 2019, a VA employee tell a veteran that they would not submit paperwork for the veteran, to the doctor, in the clinic unless the paperwork was “processed correctly.”  Meaning that the veteran took an envelope, placed the VA forms inside the envelope, and then mailed that paperwork to the VA Hospital.  The veteran lives a significant distance to the hospital and was trying to do in person what had failed through the USPS, this was made clear to the VA Employee.  The employee went as far as to claim, “If that form is placed on my desk, I will throw it away because it is not being presented to the doctor in a manner acceptable to the employee.”  Never have I witnessed such blatantly disrespectful behavior by a bureaucrat.  In true bureaucrat fashion, he created rules to thwart, obfuscate, and dodge work; unfortunately, this is standard practice with the majority of employees in customer-facing positions in the VA.  The leadership failure, the protected status of termed (beyond first-year) employees at the VA, and the dearth of customer service skills are all aspects to the core problem the VA is terminally suffering from, bureaucratism.
  3. From June 2018 to June 2019 (5-days short of completing my first year) I was an employee of the NMVAHCS, working in the Emergency Room as a Medical Support Assistant (MSA). I was discharged through lies, deceit, and under the auspices of Quid Pro Quo, where my termination was required for two others to be promoted.  While employed, I regularly reported to the leadership team my supervisor, the HAS director, the hospital director, the VISN 21 director, and the VA-OIG problems like HIPAA violations, a physical attack by a senior MSA on my person, fraud, waste, and abuse, as well as potential solutions to improve the ER operations.  All to silence and platitudes from the leadership team.  Did you know there is a loophole in the whistleblower protections if you are under term employment, (1, 2, or 3 years term) you have no whistle-blower protections, and if your job is lost, you have no whistle-blower protections?  The abusers have worked out many angles to protect the dregs of society while allowing malfeasance and misfeasance to proliferate in government employment.  Please allow me to elaborate upon the specific issues witnessed:
  • A 14-year old is being treated in the ER. A 16-year old is turned away.  The difference, the triage nurse who decided who gets seen and who gets bumped because the NMVAHCS cannot treat children.  When asked what age is considered a “child” under the hospital policy, no answer in 12-months of regularly asking.  I saw several times when this repeated, the most egregious was a new military spouse, 17 years old, denied treatment at the ER that services the Air Force Base next door due to being “too young” per the triage nurse.  By the way, under Federal Law, this is illegal for an ER to do; yet, this was regular practice while employed.
  • A health technician supporting ER patient care comes out of the ER and begins to harangue a patient currently being seen, expressing comments that made clear the health technician knew intimate details of that patients’ chart, past care received at the NMVAHCS and other VA Hospitals across the southwester US, and treatment received. Under HIPAA this behavior is illegal, as well as being immoral, unethical, and plain wrong.  Yet, HIPAA is regularly broken by MSA’s, Health Technicians, and other care providers in this VA Hospital.  Every time these HIPAA violations were brought to the attention of the HAS Director, excuses, platitudes, and professional brush-off occurred, including the deletion of emails reporting these problems.  On more than one occasion, the HIPAA violator was promoted to “treat” the problem.  When these issues were brought to the attention of the VISN 21 Director, the problem was pushed back onto the assistant hospital director in NM for further consideration.  When complained of to Congressional Representatives, lame excuses were generated by the Assistant Hospital Director and the HAS Director and accepted by the Congressional Representatives staff.  HIPAA Abuse continues unabated!
  • Homeless veterans regularly received substandard treatment when compared to other veterans. I saw nurses bad-mouth, scream, and yell at homeless patients.  I saw a homeless patient with a broken leg, get delayed treatment for more than four hours because the duty nurse was tired of treating this particular patient and didn’t believe the veteran had broken his leg after a fall.  I saw nurses put patients into treatment rooms and left for anywhere between 45-120 minutes because the shift was changing and the nursing staff did not want to treat another patient before their shifts ended.  The nurses stood outside the patient’s door, joking, carrying on, and gossiping while the patient listened and waited to be seen.  Every time these issues were raised the lamest excuses came from leadership, platitudes, and pie-crust promises were delivered.  I reported these issues and more via both verbal and email, to no avail; yet, when a member of Congress’ staff contacted the hospital, there is no email proof that the leadership was ever made aware of these problems.  If these are examples of “World-Class Care” being delivered to veterans, I shudder to consider what poor service would include.
  • The NMVAHCS has a reputation for killing the employment of term employees all the way up to their last day under the term. For example, a house-cleaner employee, a good worker, well-liked by the staff where she cleaned, got into a disagreement with her supervisor and was terminated at lunch on her 364th day of employment in a 365-day probationary term.  Her supervisor did not need a reason to discharge her and used their disagreement to end her employment.  By the way, the employee was in the right, and the supervisor made the needed changes after discharging the employee.  An MSA male employee, hard worker, came in on his 361st day of term and was terminated, no reason, no excuse, no justification, simply told to scrape his employment parking sticker and leave.  This pattern has repeated so often, that the veteran employment counselor at workforce connections warned me to not accept employment with the VA due to the NMVAHCS’ reputation for ruining people.

The NMVAHCS is one dead veteran from becoming the next Phoenix VA Hospital incident.  I am not without hope, but it will take the House and the Senate to enact the type of change needed in the VA to truly see significant and lasting change.  Towards this end, I suggest the following:

  1. Draft legislation, one a single sheet of paper canceling the collective bargaining agreement (CBA) of all Federal Government Labor Unions immediately, and forever sundering the death grip the labor unions have on policies and procedures that protect the criminal and steal valuable resources from government coffers through direct and indirect means and methods. The cost of labor unions in government is astronomical and removing this single cost will open funds in Federal Budgets that are desperately needed.  I know this is a political hot potato, and I know the impeachment farce continues to be a mental and physical drain.  But, as the German Philosopher has said, “The hard is good.”
  2. Draft on a separate sheet of paper, new legislation giving the Secretary of the VA plenipotentiary power, the likes enjoyed by every CEO in the private sector, to enact change. You have a good VA Secretary, but the staff is a hodgepodge of weak-kneed political cronies that should have been retired years ago!  This legislation also would allow for a cleaning of house at the VA, realigning the entire organization, placing the power to positively affect veteran lives into the hands of the PACT team and out of the hands of the bureaucrats.
  3. Place power into the hands of a roving IG team to have benefit claims immediately reviewed after a lapse in the procedure is discovered. Meaning that the veteran’s claim affected by bad decision-making by the VA is immediately checked by the VA-OIG instead of waiting around in record purgatory for new and material evidence.  Another VA-OIG team should be put to work reviewing past claims where the VA was caught, and getting this backlog cleared out.  The appeals process for benefits claims needs a complete overhaul.  While this legislation and action might require more than a single sheet of paper to enact, it is the right thing to do.
  4. The Mission Act was a good first step, but the entrenched bureaucrats are hindering and hampering the roll-out for personal gain, e.g. retirement. Encourage Congress to take up the legislation proposed, insisting that nothing else is added to these bills to protect the veracity and simplify the approval process.

I appreciate the work you do.  I especially appreciate your classy wife, your well-behaved and intelligent children, and the gains made in “Making America Great Again.”  I know the proposals are difficult; but I also know if we do not attempt the impossible, we can never know the realization of the legacy left to each American by those who have sacrificed before and leave a legacy of hope for our children’s children.  Thank you for your sacrifice and service.

Sincerely,

M. Dave Salisbury

© 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:

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