“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.

VA 3

  • 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?

VA 3

    • 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?

VA 3

    • 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.

I Hate Being Lied To – Follow-Up on Diabetes and Dieting

Angry Grizzly BearEarlier this week, I went to a doctor’s appointment that included diabetes boot camp and was instructed by Dr. T., a clinical pharmacist for the El Paso VAMC.  At the time, I thought the only liars were the Food and Drug Administration and the food pyramid I have been living for 40+ years.  After some additional research, I have to add Dr. T. to the list of liars using peer-reviewed sources.  Well, at least he is in good company.  The list of liars includes a neurologist who claimed all calories are the same and reducing caloric intake and caloric burn will help a person lose weight.  The advice I have been following for the better part of six years to no avail.

Cave Man Foods

The “Cave Man Foods” pitched by Dr. T. were sourced from Keto-Diets, not “14-years of research at the VA.”  The problem with the Keto-Diets is Ketosis, and if you have a liver problem, which I do, you can do serious damage to the liver by eating eggs.  Eggs are a staple of the Keto-Diets; do you see the problem here?Gravy Train 2

I have a friend, and he and his spouse went Keto about 16 months ago.  Earlier this year, his wife had liver failure, and the Keto-diet helped create a liver problem for someone who has never had liver problems in their life.  The correlational relationship between consuming eggs and non-alcoholic fatty liver disease (NFLD) is pretty solid based on my research.  However, as I am not a dietician, a medical doctor, or a food researcher, I can only rely upon medical advice and encourage you to seek medical opinions (plural) before starting any diet regimen!

Calories are not the same!

Let us establish a base of information.  A calorie is a unit of energy defined as the amount of heat needed to raise the temperature of a quantity of water by one degree.  In Junior High School, we used peanuts, sugar cubes, and other home ingredients to explore calories in chemistry class.  I still remember setting foods on fire and measuring water temperature correctly to get the caloric burns right.  However, dieticians never discussed then and not discussed now that one calorie is not the same as another calorie.  Just like rocks are not all the same size, have the same value, or can be used in the same manner.

RocksFor example, calories from sugar are not the same calories from kidney beans, even though both are units of energy, and 2000 calories of chocolate are not the same as 2000 calories of carrots.  If we are clear on this, let’s discuss why this is important.  2015, a neurologist told me all my problems with my nerves lay in how much fat I was carrying around.  He claimed that if I reduced the amount of calories I consumed and increased the number of calories burned, I would quickly lose weight.  Losing weight never happened, nor could I keep any weight lost off for any length of time.

Three years after this meeting, I was told I had developed diabetes and a non-alcoholic fatty liver, as well as gallstones, and my GERD was out of control.  This was when I was first introduced to the notion that not all calories are equal, even though all calories are units of energy.  I did not understand this discussion totally then; after Dr. T.’s discussion, I still do not fully understand the entire argument.

Lemmings 3I am sure that energy sources are not equal, even though calories are simple units of energy, per the laws and rules of physics.  However, I am not a chemist, a physicist, nor exceptionally well versed in diet and health.  I am not a dietician and am left to try and figure out the best advice and live that advice.  As a foodie, I have yet to find any diet, as the first part of a diet is “die” dying of hunger!  Before you ask, yes, Garfield is a hero of mine and has been my whole life.

Complications to Weight Loss

2017 thru 2019, I had been more active and had lost a little weight.  July through December 2020 come along, and all the weight lost is back in spades; why, the injuries sustained at the hands of the VA Police in arresting me for not wearing a mask at the VA Hospital in Phoenix, AZ.  According to research conducted on people with spinal cord injuries, the following are key variables in weight loss:

      • Age
      • Race
      • Marital Status
      • Employment Status
      • Family history of overweight/obesity
      • Level and duration of injury
      • Cholesterol level at baseline.

Thus, it is only logical that since my fallacious arrests and injuries at the hands of the VA Police at the Carl T. Hayden VAMC in Phoenix, AZ., exercise and weight loss would be impeded, acting as complicating factors in improving my health.  Why is this important; because, my new primary care provider does not think I have any problems and refuses to renew medication until other specialists claim the medicines are needed.  I find it interesting that the doctors would vary so significantly between VISN 17 and VISN 22.Lemmings 4

Mask Policies

While the following is not a variable in weight loss, it is part and parcel of the lies and problems I have experienced since Feb 2020.  The Las Cruces, NM., VA Community Based Outpatient Clinic (CBOC) had no problems accepting my doctor’s note regarding my inability to wear a mask.  When I arrived at the El Paso VAMC, the VA Police had no problem with my doctor’s letter regarding my inability to wear a mask, handed me a face shield, and then provided protection for me with other bureaucrats who took umbrage that I was not wearing a mask.

cropped-bird-of-prey.jpgMeaning that what I have been declaring about the mask policy, the mask mandates, and the hypocrisy of zealot VA Police Officers at the Carl T. Hayden VAMC is 100% true, and my treatment was not in accordance with the mask policy (emailed directive) from Washington DC.  I hate being lied to, detest being arrested and injured when I am right and refuse to be silent about how poorly the VA is treating veterans!  Does anyone know a lawyer who is willing and hungry enough to take on the VA?

References

Chen, Y., Henson, S., Jackson, A. et al. Obesity intervention in persons with spinal cord injury. Spinal Cord 44, 82–91 (2006). https://doi.org/10.1038/sj.sc.3101818

Gundry, S. R. (2017). The plant paradox: The hidden dangers in “Healthy” Foods that cause disease and weight gain. HarperCollins.

Joshi, S., Ostfeld, R. J., & McMacken, M. (2019). The ketogenic diet for obesity and diabetes—enthusiasm outpaces evidence. JAMA internal medicine, 179(9), 1163-1164.

Mokhtari, Z., Poustchi, H., Eslamparast, T., & Hekmatdoost, A. (2017). Egg consumption and risk of non-alcoholic fatty liver disease. World journal of hepatology, 9(10), 503.

Taubes, G. (2008). Good calories, bad calories: Fats, carbs, and the controversial science of diet and health. Anchor.

Taubes, G. (2011). Why we get fat and what to do about it. Anchor.

© 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.

Abominable Enabling – More VA Chronicles of Shame!

Knowledge Check!Before I begin, please allow me to emphasize a key idea, “This is your government!”  Your tax dollars are paying for these shenanigans, and the bureaucrats do not fear you.  I have written some odious critiques in my time about the VA and other government agencies.  My cataloging these incidents does no good unless everyone in America becomes full of righteous indignation and DEMANDS Action through their elected officials!

The Department of Veterans Affairs – Office of Inspector General (VA-OIG) has been super busy this week, and my email box has been chock full of reports.  The VA-OIG reports begin in New Mexico, Albuquerque, where finally the VA-OIG has investigated some of the many complaints and is finally stating what the veterans and active-duty military have been saying for a long time, the NMVAMC leadership stinks!Raymmond G. Murphy

As a patient in Albuquerque VAMC, during the June 2018 window of investigation, I can affirm the integrity of the problem but seriously doubt the VA-OIG conclusions.  I was an employee of the Albuquerque VAMC in June 2018, so I know the leadership involved personally, and I guarantee the problem goes deeper than a lack of training.  The Albuquerque VAMC is fraught with leadership dysfunction, misfeasance, malfeasance, and intentional systemic problems.  Yes, the VISN 22 leaders were advised, and no, the VISN 22 leaders did nothing! There’s no surprise there; VISN 22 is one dead veteran from a major scandal that will make the death list scandals look like a minor nuisance.

From the VA-OIG report, we find the following:

The VA Office of Inspector General (VA-OIG) conducted a healthcare inspection to evaluate allegations that Community Care consults were completed in June 2018 without scanning and attaching available clinical results to patients’ Veterans Health Administration (VHA) electronic health records (EHR).”  “The VA-OIG substantiated that in June 2018, Community Care nurses were completing consults without scanning and attaching clinical documentation to patients’ EHRs.”  “The VA-OIG determined that Community Care nurses lacked a comprehensive orientation and training program. The Chief of Community Care did not verify adherence to consult-related VHA requirements or conduct regular reviews and improvements for departmental performance deficiencies. Additionally, Community Care performance monitoring addressed consult processes before patients receiving care but did not address the consult completion process or identify non-compliance with VHA policy before 2019.”VA 3

Let me break this down; primary care providers sent orders for community care, community care would be delayed, then to clear the backlog, the nurses doing the ordering would pencil-whip the documents claiming that care had been received, canceling the orders of the primary care provider.  Then the patient and the primary care provider would have to start the process for community care all over again.  Wasting time, money, and other resources, the facility leaders and VISN leaders refused to address the deficiencies and correct the problem.  The problems with community care existed before I arrived in Albuquerque in 2016 and continue without stop after this VA-OIG inspection.  I met with providers who had not been paid for years because the community care program was poorly managed and led.  Thus, the leadership enables people to break the trust, break the law, commit fraud, waste, and abuse, then collectively blame the problem on a lack of training, which is designed into the processes as incompetence.

QuestionI keep asking for the politicians and Washington VA Leaders to rip the scab off VISN 22, expose the wound to sunshine disinfectant, and drain the pus for the good of the VA body.  Yet, nothing ever happens, and the leadership continues to get away with abusing veterans, killing veterans, and destroying veterans.  Shame on you, political and administrative leaders!

Speaking of wounds needing sunshine disinfectant, the VA-OIG reports that “Mende Leone, 37, pleaded guilty to misappropriation of a federal benefit by a fiduciary.  As her uncle’s appointed fiduciary, Leone stole at least $151,000 of VA benefits intended for him.”  Continuing to prove that after the VA, families are the second most dangerous entity to the health and support of veterans.  Despicable crime indeed!Plato 2

Unfortunately, the third most dangerous entity to a veteran is the state government where they reside.  California moved very quickly to scoop up money after a veteran died.  At the same time, the Department of Veterans Affairs – Veterans Benefits Administration (VBA) was foot-dragging on deciding on awarding fiduciary control for the veteran in a long-term care facility.  Proving once again, if you want to see government in action, waive money in their faces, and watch them kill each other to obtain someone else’s funds.

The clowns at any circus in the world would make better administrators of the VA than those currently in power positions!  For the second time in as many months, the VA-OIG reports that unreliable information (the politically correct way to say they lied) was blamed for billions in cost overruns on IT infrastructure costs to the VA.  “… the Office of Electronic Health Record Modernization (OEHRM) estimated information technology (IT) infrastructure upgrade costs [but was not] in accordance with established VA standards and Government Accountability Office guidance.  The two $4.3 billion infrastructure upgrade estimates reported to Congress were not reliable and, because of incomplete documentation, determining the accuracy of the estimates was not possible. The VA-OIG also found VA did not report to Congress other IT upgrade costs of about $2.5 billion because OEHRM did not include costs other VA agencies would bear. OEHRM also did not update the cost estimates it provided to Congress.”VA 3

Yet, the US President continues to push to throw more trillions of dollars at the VA when they cannot correctly handle the billions already appropriated to upgrade their IT infrastructure.  The VA-OIG report, just for this farrago, is estimated at $11.1 Billion.  Einstein is famous for claiming that doing something over and over again and expecting different results is the epitome of insanity.  Maybe, it might be time to scrutinize the VA, fire some people, and get actual private-sector employees to fix the bureaucracy and obscene malfeasance in government!Apathy

The following investigation remains ongoing, and those indicted remain innocent until proven guilty in a court of law by a jury of their peers.  However, the investigation needs to be reported for the criminal activity and the lack of leadership that enabled the crimes accused.

Lisa M. Hoffman, 48, of Orange, New Jersey, is charged by indictment with one count each of conspiracy, theft of government property, and theft of medical products.

According to documents filed in this case and statements made in court:

From October 2015 through November 2019, Hoffman was a procurement officer at the VAMC. She used her authority to order large quantities of HIV prescription medications to steal the excess. After the medications arrived, Hoffman waited until co-workers were out of sight and removed them from the VAMC.

Once Hoffman stole the medications, she met her associate, Wagner Checonolasco, aka “Wanny,” generally at Hoffman’s residence so that Hoffman could provide the stolen HIV medications to Checonolasco in exchange for cash. Hoffman and Checonolasco used an encrypted messaging application to plan and execute their thefts and sales of the stolen HIV medications, including arranging for the medications-for-cash exchanges. After obtaining the stolen HIV medications from Hoffman, Checonolasco sold them. During the conspiracy, Hoffman and Checonolasco stole approximately $10 million worth of HIV medications belonging to the VAMC” [emphasis mine].

Where were the other employees and the hospital leadership during this crime?  When I received US Government property, I had to account for every penny, show the receipts, and held to general inspections verifying my veracity.  The supply officer lost $20.00, claimed I had spent the money, and I had to prove my innocence using documentation and a full property audit before I was cleared of the missing money.  You cannot tell me that the leadership and other employees magically are not culpable for their complicity and failure to perform their jobs.VA 3

For example, upon receipt of property, there is an inspection to verify everything purchased arrived.  Then when delivered to different stations, another audit is conducted to ensure nothing disappeared enroute.  If something comes up missing, there is another audit and inspection, as well as a host of paperwork involved in correcting deficiencies and proving where the property went.  Prescription drugs are held to a higher standard with greater penalties for those involved in missing drugs.  Thus, I ask again, where was the leadership who enabled this criminal behavior?  Where were the nurses who noticed missing drugs on inventory lists?  Where were the fellow employees in this scheme?

Multiple reports are circulating that the head of the viral, fungal meningitis outbreak from 2012, Barry Cadden, is being resentenced with stiffer penalties.  As a reminder, “In 2012, 753 patients in 20 states were diagnosed with a fungal infection after receiving injections of MPA manufactured by NECC, and more than 100 patients died as a result.”  Cadden was resentenced to 174 months in prison, forfeiture of $1.4 million, and restitution of $82 million.  Frankly, I still think the sentence is too light; but nobody asked my opinion on sentencing!Gavel

Finally, in our discussion on obscene enabling by VA Leadership, the following VA-OIG reports on COVID preparedness, lessons learned, and the preparation for a pandemic.  Under the heading, “Identified Trends Among VISN 19 Respondents’ Comments on Facility Readiness and Response,” we find “All need to practice infection control protocols (wearing masks and washing hands).”  Are you kidding me?!?!  You are a hospital; hand washing should be second nature and the first line of defense, not the patient wearing a mask.  The VA-OIG gathered this data from VISN 19, which includes the following VAMC’s:

        • Aurora, CO
        • Cheyenne, WY
        • Fort Harrison, MT
        • Grand Junction, CO
        • Muskogee, OK
        • Oklahoma City, OK
        • Salt Lake City, UT
        • Sheridan WY

Having been a patient in three of these VAMC’s I find it highly distressing that hand washing and wearing masks in a hospital setting is a “trend” of “readiness and response to a pandemic.”  How were you delivering care previously?  Why is handwashing suddenly a new activity?  How many patients were endangered by a lack of handwashing?VA 3

I have been a patient in two different VA Hospitals where the nurse routinely pulled off the finger of their glove or did not glove at all, to remove blood, use sharps to give shots, and a host of other activities.  I reported these behaviors as “concerns for patient safety,” and my concerns fell on deaf ears of the leadership.  Now, I see a VA-OIG inspection relating that hand washing is suddenly vital to delivering care, and I have to ask these questions.  Of the eight collated responses from local hospitals, proper hygiene protocols are mentioned in 6.  So, how were you delivering care before the pandemic?

Pigeon RevengeStill, the VA-OIG refuses to investigate the lack of written operational procedures, policies, and mandates for enforced mask-wearing, especially when the mask prohibits or makes unsafe the patient’s breathing.  Why was there no acceptable workaround to see patients with shortness of breath without a forced mask?  Why were patients refused care under EMTALA?  Why are VA Police Officers allowed access to private patient HIPAA-protected information? Fundamental questions about the rights and protections of patients who continue to be violated by the VA Leaders enabling harassment and harming patients, and the VA-OIG remains MIA.  I find this very glaring!

© 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.

Sometimes, You Have to – More Repugnant VA Chronicles

Angry Wet ChickenIn looking back, it has been a long time since I wrote two scathing chronicles about the Department of Veterans Affairs (VA) in a single week.  But, I could not allow these Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports to age any longer in my inbox.  With the Fourth of July fast approaching, as you celebrate, please keep in mind what the VA is purposefully doing to the Veterans, Dependents, and Spouses under their care.  America would not be here without her military, and military service produces veterans.  But, the VA is producing bodies and bureaucracy instead of helping veterans as they are paid and legally charged to do!

When I first left the US Army, I found myself employed in a telemarketing call center and was never paid the correct amount.  18-months later, I was employed with an Internet Service Provider, who bounced multiple paychecks before going bankrupt underneath the employees.  When the VA-OIG reports part-time physicians not being appropriately paid, I can understand the issues this causes.

I-CareThe VA-OIG randomly selected 134 salary agreements for part-time physicians on adjustable work schedules and found 44% of the physicians were either over or underpaid.  One might ask how and why these pay errors occurred.  The answer is extreme designed incompetence, not that the physicians will feel any better that they were either overpaid and owe back monies or underpaid and are now owed a considerable check.

From the VA-OIG report, we find the following as causes for the discrepancies:

This occurred because key management controls were missing or not working. Officials did not make certain that medical facilities complied with policies and procedures. Consequently, the OIG estimated VHA medical facilities had about $8.3 million in questioned costs that year (2019) and an additional $8.3 million in 2020. VHA medical facilities also may have violated the prohibition against voluntary services, and potentially the Antideficiency Act, by not correcting underpayments or by having physicians working above the 1,820-hour cap because their agreements were not properly reconciled” [emphasis mine].VA 3

The government officials’ neglect, malfeasance, and misfeasance might be illegal, as they failed to do their jobs properly.  Yet, the VA-OIG only issued recommendations.  There is potentially $16.6 Million in over or underpayments at stake, plus illegal actions, and people have not been fired or perp-walked into custody.  How can government employees get away with behavior that would have seen class-action lawsuits, criminal investigations, media reporting feeding frenzies if similar had occurred anywhere in the private sector?

IronyYet, the marketing materials produced by the Department of Veterans Affairs – Veterans Health Administration, a division of the VA, claims this is “Defining Excellence in Healthcare in the 21st Century.”  If you believe that, then you must believe that buffalo wings come from flying buffaloes.  Unfortunately, the problems only continue to worsen.

The VA-OIG reports that a doctor had accumulated more than 4000 alerts from the electronic health record (EHR) system.  This means that the computer system notified the doctor that patients needed care, appointments, were seen in the ER, required treatment, pharmacy prescription renewals, and much more.  The alerts, called views, are a built-in measure to help patients not get lost or have “adverse clinical outcomes” while receiving care at the VHA.  The VA-OIG found that the entire medical facility at the Charlie Norwood VAMC in Agusta, Georgia had similar issues.  The doctors were not viewing the patient EHR views as indicated.VA 3

What’s worse, the VA-OIG could not tell if “adverse clinical outcomes” had occurred because once the EHR views are settled, there is no record of the patient or why the view was required.  Talk about accountability, responsibility, and transparency in the patient-aligned care team (PACT).  In reading this VA-OIG report, it looks like when the facility leadership was alerted the VA-OIG was coming, the leadership team did a massive clean-up of the records, knowing they would never get caught and held responsible for any “adverse clinical outcomes.”  As a side note, the VA-OIG report claims the doctor with 4000 views is no longer providing care at this VA facility.  Heaven help his patients wherever this doctor is now!PACT 1

So far in 2020, I have had two different primary care providers assigned, and since moving out of Arizona, I will shortly have a third assigned to me.  My first primary care provider retired, but before doing so, he set up many EHR problems for his replacement to handle.  Including refusing to renew prescriptions, some of which were mine, which caused weeks of not receiving the proper medications.  Upon learning of my impending move, my second primary care provider essentially wiped her hands of my care, leaving me without medications and a clinic to contact for help.  Great job if you can get it; get hired to treat patients, and then not treat patients.  Before you ask, no, knowing I am not alone in this ordeal does not help!

PACT 3Finally, the VA-OIG has completed a full VISN wide comprehensive healthcare inspection (CHIp) for VISN 10.  VISN 10 covering Ohio, Indiana, Michigan and is located in Cincinnati, Ohio.  For all intents and purposes, the CHIp went well; the leaders are competent and knowledgeable.  Thus, I issue my sincerest congratulations to VISN 10 for their success.  The VA-OIG inspected the VISN’s ability to respond to the COVID pandemic appropriately, and the VISN performed well.

VA 3Except, this opens a few questions needing address.  At two VISN 22 and two VISN 17 facilities, I have experienced four utterly different responses to the COVID policy and masking mandates.  None of the facilities have written guidelines that are geographically specific to the patients and weather patterns in those areas.  None of the facilities have documented processes for veterans who cannot wear masks, with an approved policy supported, written statement for accommodating these veterans.  One facility insists that the veterans who cannot wear masks be arrested, cited, and fined.  One facility insists that if you have a letter from your doctor, you are okay.  One facility vacillates wildly from day-to-day and person-to-person, and the fourth facility doesn’t have a clue but is still very helpful, with supervisor approval.Question

Yet, somehow, VISN 10 has all their VAMC’s and VAHCS’ operating to the same sheet of music and behaving similarly.  How is this possible VA-OIG?  Better still, how does this spread out to other VISN’s and facilities?  May I hazard a guess, based solely upon the perceptions of veterans in VISN 10, the masking policy from COVID remains haphazard and improperly applied because Washington, DC, never issued proper guidance in the first place, the VISN leaders never issued written guidance.  The policy process on the local level is a quagmire of egos, bureaucracy, unions, all set into a cesspit of inaction and designed incompetence!  If COVID has taught any lessons, the number one lesson has to be that the leadership at the VISN and local levels remains inadequate to the task they were hired to perform!

© 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 – An Open Letter to the People of Arizona

To The Citizens of Arizona:

ArizonaIt has been my pleasure to have lived in Arizona four separate times since 1996.  Employment and pleasure have brought me relocation opportunities, and I have enjoyed my time in Arizona. However, since my return in 2005 to the present, I have feared for the soul of Arizona.  I have watched as despicable and detestable politicians have won political races that never should have been won.  I have witnessed governors act in cowardly and craven methods to thwart the people’s will.  I have witnessed those elected to Federal Offices from Arizona stop being held accountable to the electorate until the politicians have set up a hegemony and no longer fear the ballot box.  Most egregious of all, I have witnessed the veteran community become increasingly abused as every day ticks past.Patriotism

In April 2021, I wrote about my interactions with Rep. Greg Stanton (D) and his staff, where the VA is concerned.  For almost an entire year, I have been injured, cited, and arrested, denied care, had untold HIPAA violations, and other disgraceful conduct taken against me by the administration and leadership of the Carl T. Hayden VAMC.  In December 2020, I reached out again to the federally elected representatives, asking for help to clear my name and remove the atrocious behavior of the VA, all to no avail.The Duty of Americans

All four Senators rejected my pleas and never bothered to respond.  All of the members of the House of Representatives from Arizona refused to reply, save the staff of Rep. Greg Stanton (D).  Except, Rep. Greg Stanton (D) and his staff, did nothing!  Had no priority, refused to communicate, could not maintain pressure, and bought the lies and excuses of the Carl T. Hayden VAMC administrators.  These are the same administrators who create a crisis for veterans through inaction, duplicitous action, poor behavior, and refusal to perform the jobs they were hired to perform.  I have made it clear that the Administrators of the Carl T. Hayden VAMC and VISN 22 are but one dead veteran from another scandal to dwarf the death list scandal that originated with the VA administrators in 2012 and repeated in 2016.

VA 3No VA Administrator has addressed the root causes of those scandals, and without proper persuasion from Washington, D.C., they never will!  Worse, without continuous scrutinization, the bureaucrats will continue to exemplify the duplicity and failures, hiding behind designed incompetence and tissue paper-thin excuses for poor behavior.  Yet, what do we find from those enjoying elected office?  Zero interest, half-truths, straight lies, misinformation, smoke and mirrors, and plain laziness!  We, the electorate, find the politicians sitting on their hands, engaging in hopeless and stupid legislation that will go nowhere, and we find lackadaisical meandering in the House and Senate leadership.  I have witnessed amoebic life with more robust spines than the current political leadership in Arizona!Image - Quote Poltics is Dirty

It is true, Arizona is not the only state suffering from political abuse of the basest sort and blackest hue, but Arizona is where I have personally seen the destruction hit the hardest.  During Senator McCain’s tenure, my requests for help were rebuffed, but I could still obtain assistance from the House of Representatives members.  Now, the political party doesn’t matter, the politicians have plastic ears, and plastic lips, and their hearts are full of desire for political gain and not the electorate’s support.  Who loses, the electorate!  Who wins, nobody!

America, I ask you, in the year and change between today and the next election cycle, what will you do to change America’s government?  Arizona, you have been duped, lied to, and dishonored by those elected to power.  What will you do to reclaim the honor, integrity, and political government you deserve and pay so much for?Apathy

Personally, I have been betrayed, and I am sick to death of pleading for reprieve only to have lackluster performance, at best, provided so I would just go away.  I know of no honorable politician representing Arizona, and their respective staff is worse than the politician!  From the Mayor of Phoenix to the Governor, including the school boards, judges, and so many others, the fear of the ballot box is shrinking, and the bureaucrat is winning.   In contrast, the scrutinization of bureaucrats and other duties are dodged to win another term, always with a complicit media running interference.LinkedIn Image

I did not elect the media to their position, and since the media is not elected, they can be removed. However, while the politicians are elected, the fear of the ballot box needs to be retaught to the politicians.  How does a citizen get a politician to fear the ballot box; you first buck the trends and stand like a rock in a stream. Then, as additional rocks begin to stand, a dam is built, forcing change to that stream.Plato 3

If we are to change the government and retain our freedoms and liberties under the Rule of Law, we, the electorate, must first get the politicians to fear the ballot box!  We, the electorate, need to also teach accountability and responsibility to those who claim power but who only obtain power from those choosing to be governed!  We, the electorate, hold power over these politicians and the bureaucrats spawned in the legislative branch of government. So claim the power that is yours, and join your friends, neighbors, and communities in demanding better from those elected.

Knowledge Check!I heard the mayor’s office in Phoenix complain that they have no power over the Federal Government.  To think this is treason of the vilest kind.  Let me reiterate something discussed in several previous articles.  The local government stands as a bulwark against the county government overstepping its legal boundaries.  The city and county stand against the state encroaching against the freedoms and liberties of the state government.  The state government defends its citizens from the Federal Government’s encroachment, and the individual citizen is the most potent force in our Republican form of government.

Plato 2Cease the sophistry of plastic language and do your job!  End the tyranny of plastic words and work to aid the citizen in protecting their rights and freedoms from the ever-encroaching thieves of government and the bureaucrats spawned in the darkest pits of legislative fiat! So stand, every American citizen needs to stand and refuse to be governed until those elected are replaced with people willing to take action and honor the Rule of Law, holding previous politicians accountable and responsible for the mess America is currently suffering under.  Enough is enough, and I have reached the end of my tolerance, and my cherubic demeanor has been replaced with a hunger for justice!

© 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.

How Do I Know? – An Update on the VA Mandatory Mask Policies and VA Leadership Failures

Question24 May 2021 – 1200-1500 I visited the Las Cruces Community Based Outpatient Clinic (CBOC) in Las Cruces, New Mexico.  Upon entry, I was asked to wear a mask.  I described I could not wear a mask, and the employee said I might be required to wear one but left the decision to those working more closely with me.  I waited in line and was called to the Team 2 window, where a gentleman was more than happy to assist me in getting the paperwork started to change VA hospitals after relocating.  About 45-minutes into my time in this CBOC, the gentleman asked me to wear a mask.  I told him I could not and had brought my VA Doctor’s note as proof.  The gentleman read the letter, confirmed I was good to receive care without the mask, and provided exceptional customer support.

After the past year at the Phoenix VAMC, where my every movement on the property was shadowed by VA Police officers looking for a reason to injure, arrest, cite, and force me from the property, the employees here in Las Cruces was a breath of fresh air.  However, the experiences in Las Cruces provide further evidence of the following facts:

      1. The Hospital Director has statutory authority for adapting and creating policies and procedures that benefit the safety of the employees and the patients. A point I stressed to the leaders of VISN 22 and the Phoenix VAMC to no avail.
      2. The Federal Mask Mandates can be situationally applied for the circumstances of the individual. Yet, another point I have repeatedly stressed since July 2020, and the first time I was injured, arrested, cited, and forced from Federal Property. At the same time, I was being denied emergency care under EMTALA and having my HIPAA information repeatedly violated by the VA Police Officers.
      3. The bombastic and unprofessional behavior of the Federal Police employed at the Carl T. Hayden VAMC is a problem of the leadership, and the failures of leadership to instill professionalism, proper attitudes and behaviors, training, and tactics in approaching and handling situations in the Phoenix VAHCS. At the behavior of the Federal Police Officers in the Phoenix VAHCS, Che Guevara, Mao, Stalin, and Fidel Castro would be proud!VA 3

How can a person be sure the problems caused are a direct result of leadership failures?

ApathyBy tracing behaviors, attitudes, and influence to their source, the police chief acts as he considers appropriate, but the underofficers generationally multiply and mirror his behaviors.  The same is true for the chief who takes his example from the assistant director, director, and hospital leadership.  Chains of command always have this consequence; the example of those above are mirrored, replicated, and multiplied to impress the higher officers to gain attention and promotion opportunities.  Want to take a measure of a leader; look to the most junior person in the chain of command and watch them for behaviors, attitudes, and actions that originate in the leadership.

GavelCase in point, long have I detailed and described the failures of leadership at the VA.  The latest is a wire fraud scheme in Jackson, Mississippi.  From the Department of Veterans Affairs – Office of Inspector General (VA-OIG), we find the following:

Anthony Kelley, the owner of Trendsetters Barber College in Jackson, Mississippi, pleaded guilty to two counts of wire fraud in a scheme to steal federal funds. From October 2016 through March 2019, the college offered a master barber course that was not accredited by the state’s board of barber examiners. Kelley fraudulently represented that this course was approved and, as a result, was allowed to collect GI Bill money from veterans enrolled in the program.”VA 3

As the lowest person in the chain of command, Mr. Kelly was allowed to attempt to commit fraud by the VA.  Never in these reports is the VA employee, their supervisor, and their manager, who were complicit in allowing fraud to occur, mentioned and held accountable.  Somehow, we, the taxpayer, must presume that those committing frauds could hoodwink the Department of Veterans Affairs without any inside help.  Help coming directly or indirectly from government employees charged with investigating, ensuring, and following proper protocols and procedures to protect against theft and fraud.

Angry Grizzly BearLet the US Attorney and VA-OIG special investigators crow about catching the person perpetrating fraud.  Before they break open the champagne, they need to be looking into the leadership that either overtly or covertly allowed this fraud to occur.  The elected officials need to be demanding why fraud opportunities are so rampant at the Department of Veterans Affairs that criminal proceedings are being reported almost every week and asking about the culture of corruption and leadership failures allowing these behaviors to thrive.

Is it a “Culture of Corruption?”

Absolutely; the VA is sick with a culture of corruption!  It is my sad duty to report on another employee who was able to steal from the VA, stealing hydrocodone and oxycodone prescriptions from the VAMC mailroom and mailboxes at some 40 locations in Kerrville, Ingram, and Center Point.

Scott M. Brown, a pharmacy technician at the Kerrville VA Medical Center in Texas, was charged with one count of theft of US mail for stealing hydrocodone and oxycodone prescriptions from the medical center’s mailroom as well as from residential mailboxes between March and April 2021.”VA 3

Currently, Mr. Brown is being held in custody and remains innocent until proven guilty in a court of law by a jury of his peers.  However, the fact that Mr. Brown has been charged and is in custody speaks volumes to the lax leadership that allowed these prescription thefts to occur.  Where is the VA-OIG in asking how the robbery was possible?  Where are the special investigators demanding answers from the leadership on policies and procedures that an employee could easily violate to obtain these drugs?  Who else was involved, or had to know, what was happening and said nothing?Plato 3

The Department of Veterans Affairs has been overtaken by those without skill, knowledge, and ability to understand cause and effect and properly interrupt the cycles of corruption.  Worse, these same people will bleat about how they need more money for technology solutions when their personal example, leadership failures, and human-to-human relationships are the actual problems.  The leaders will bleat like sheep in a corral about engagement, customer service, and industry buzzwords because they have no substance and even less desire to see things change.Plato 2

Recently I detailed the failures at the Department of Veterans Affairs on information technology.  The fallout from the deplorable designed incompetence in the IT/IS infrastructure at the VHA continues to represent just how incompetent the current leaders genuinely are.

To promote compatibility with the Department of Defense’s electronic health record system, VA is replacing its aging record system. This requires VA medical facilities to upgrade their physical infrastructure, including electrical and cabling. The OIG determined from its audit that the Veterans Health Administration’s (VHA) cost estimates for these upgrades were not reliable. VHA’s estimates did not fully meet VA standards for being comprehensive, well-documented, accurate, and credible. The audit team projected that VHA’s June and November 2019 cost estimates were potentially underestimated by as much as $1 billion and $2.6 billion, respectively. This was due in part to facility needs not being well-defined early on. The estimates also omitted escalation and cabling upgrade costs and were based on low estimates at the initial operating sites. Because cost estimates support funding requests, there is a risk that funds intended for other medical facility improvements would need to be diverted to cover program shortfalls. The Office of Electronic Health Record Modernization (OEHRM) also did not meet its obligation to report all program costs to Congress in accordance with statutory requirements. Specifically, OEHRM did not include cost estimates for upgrading physical infrastructure in the program’s life cycle cost estimates in congressionally mandated reports. Although VHA provided OEHRM with an approximately $2.7 billion estimate for physical infrastructure upgrade costs in June 2019, OEHRM did not, in turn, include them in life cycle cost estimate reports to Congress as of January 2021. OEHRM stated it did not disclose these estimates because the upgrades were outside OEHRM’s funding responsibility and that they represented costs assumed by VHA facilities for maintenance—including long-standing needs” [emphasis mine].VA 3

Angry Wet Chicken 2Did you catch that; the office specifically tasked with handling estimates intentionally low-balled estimates, did not include all necessary contractual requirements, and then lied to Congress to cover their hides, and fell back upon designed incompetence to skirt blame, responsibility, and accountability when the VA-OIG came investigating.  Lying to Congress is a CRIME!  Yet, these federal employees can break the law with impunity, and all the VA-OIG can do is make recommendations for improvement!  If you want to read the full report of shame, you can find it here.

Leadership is change; management is stagnation and corruption.  When will the VA start hiring leaders to enforce, demand, and execute change to benefit the taxpayer and the veteran community?  Where are the elected officials willing to work with newly hired VA leadership in establishing legal frameworks for evicting employees who refuse to change from the federal workforce?  When can the veteran community and the taxpayer expect to see real and tangible change at the VA?

Knowledge Check!I am not asking these questions and not expecting an answer!  I am asking these questions looking for and expecting real results to begin immediately, if not sooner!  This is a national embarrassment with a global impact, and it is time for the United States to lead in correcting their detestable government workforce!

© 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: Calling Out Politicians – The Rep. Greg Stanton (D) AZ09 Edition

Foghorn Leghorn - MedicationWhile Rep. Greg Stanton (D)’s staff did respond, and this is a good thing, neither senator from Arizona Sen. Kyrsten Sinema (D) or Sen. Mark Kelly (D) cared enough about my concerns to respond.  Frankly, this speaks volumes about how little the senators representing Arizona care about their constituents or veterans.  Hence when re-election arrives, remember well the treatment and vote for anyone else!

Now, getting back to Rep. Greg Stanton (D).  I contacted his office initially in December 2020; by early January 2021, I received a response from the director of constituent services and was told to allow the VA 45-days to respond to my complaint.  Remember, this is my seventh attempt at contacting any of the federal elected representatives to no avail.  I was 6-months into being discriminated against by the Carl T. Hayden VAMC for my medically approved breathing problems that preclude wearing a mask.  I have sent letters to the hospital director, the VISN Director, and Secretary Wilkie to no avail.  I have sent emails to the patient advocate and gotten misleading information, at best.  My Primary Care Provider (PCP), at the Carl T. Hayden VAMC, refuses to diagnose over the phone or through distant means and has invited me to find another PCP.  I have been arrested, injured, and cited three times by VA Police, who have no say in writing policy.  The policy they are enforcing is causing me both injuries at their hands and refusal of emergency care illegal under EMTALA.  Not to mention the continuous HIPAA violations as they joke about my medications, mental diagnoses, and physical diagnoses.

PatriotismI explain this by phone at least three times to the director of constituent services for Rep. Greg Stanton (D), who called me multiple times while responding to my numerous requests for assistance since the election occurred in Nov 2020.  Not having heard anything from Jan 2021 to 25 April 2021, I sent the following message via email to the director of constituent services:

“Good Morning XXXX,

Has it been sufficient time for the VA to address my concerns and return a response to your office? The governor of AZ has made mask mandates unenforceable since 25 March, and the VA continues to push masks as mandatory and deny me access.  This includes refusing to schedule blood work through the community while insisting that I needed blood work to be conducted before I could get a prescription refilled.  I went more than 2-weeks without diabetes medication because my primary care provider refused to alert me in early February that a refill of Metformin would need blood work.  I did not discover the need for blood work was required to refill until after I had been without Metformin for a week!

Mask discrimination at the VA is real and dangerous to veterans’ health and safety, and I, for one, am sick and tired of the BS the VA keeps serving as excuses to deny service.  I am not a behavioral problem, as the Carl T. Hayden VAMC continues to claim.  I do stand up for my rights against all enemies, foreign and domestic!  I have paid my fines.  If the US Marshals at the Federal Courthouse can have situational empowerment to not press the mask issue for those of us with qualifying medical conditions, the same should occur inside the VA with the VA Police.

The mask mandate is a policy issue threatening my health, safety, and well-being, as well as thousands of other veterans with breathing problems.  Just what, if anything, has been done since January on this issue?

Sincerely,
Dave Salisbury”

I realize that the AZ State Governor does not have anything to do with the Federal Policies; I mentioned the governor’s action solely as an indicator that change in the state of AZ has come (finally), where mask mandates are concerned!  The VA claims their mask policy is “constantly changing,” but the only changes I have witnessed are moving from draconian to oppressive, then to ruthless and punitive!  The mask policy is wrong, has never been printed as a work standard, and has never been published for veterans to abide by.  The best a person has is a sign claiming masks are mandatory and a bunch of emotionally charged employees acting like snowflake Nazi Storm Troopers on a 6-day pass from hell!

The Duty of AmericansToday, 28 April 2021, I reached out to the director of constituent services as I had not received any additional information.  Sending the following email:

“I blog, I have a pretty good following, here is my latest: https://dnc-consulting.com/2021/04/28/no-more-bs-speaking-of-administration-bureaucrats-in-government/

Please note, I have not mentioned Rep. Stanton (D) by name, yet, as a politician, I am begging to perform his job of scrutinizing the government, but the temptation is real!  I have to be able to access the VA Healthcare system ASAP safely!  Where is this issue in being resolved?  Feel free to explore the other VA Articles I write on my blog.  You will find every single one of the letters to the VA, you will find other veterans having similar problems, and you will find I do not hesitate to name names and point fingers.

I am still waiting patiently, but patience does wear thin when information is lacking!

Sincerely,
Dave Salisbury”

Anton EgoWithin 3 hours of this email, I received the following:

“Dr. Salisbury,

Thanks so much for sharing! Apologies for the delayed response. I am following up with the Phoenix VA Medical Center and determine the status of the inquiry.”

Why am I writing this article?

Angry Grizzly BearFrankly, I am through!  I am done with the foot-dragging administration at the Carl T. Hayden VAMC, and Alyshia Smith, the director who has dodged, balked, and refused to engage.  I am through with the VISN 22 Director Michael Fisher being able to remain silent and unresponsive in this farrago.  I am sick to death of being ignored by the VA Secretary, Secretary’s Wilkie and McDonough and their respective staff, while many other veterans across this country and I are physically harmed by a mask policy that doesn’t have enough sense to include “except for medically acceptable conditions,” and was never a policy, just some bloody marketing signs.  I am beyond insane about having to go to court for being arrested at the VA three times, kicked off property two additional times, and harassed more than 15 times, for being short of breath, denied emergency care, and then had jokes made by the VA Police about my HIPAA controlled data!

The US Marshals have situational authority to assess and bend the mask policy; why does the VA Police not have this ability?  Simple, easy, direct policy question that everyone in the VA refuses to address as having received, let alone answer.  Why are the elected officials SILENT about this problem that is harming the safety and well-being of their constituents?  Why can a congressional inquiry not DEMAND a prompt and timely response from bureaucrats hiding from the public in their offices?

DutyRep. Greg Stanton (D), why are you not more involved personally in DEMANDING the VA to correct their errors?  Do you not realize how many veterans are in your district?  Do you think you can abuse us and through us our families and hope to be re-elected?  You, sir, are in desperate need of correcting your attitude and behavior before your re-election chances are forever harmed.  I promise this article will survive to your utter shame if a prompt and immediate response is not taken!

Dont Tread On MeI have reached the point where I no longer possess anything “cherubic” in my demeanor on this issue!  You cost me time, money, and physical health.  You cost other veterans in the AZ09 Congressional  District the same.  I will find more veterans suffering as I have, as the US Marshals reported that they had seen a massive uptick in veterans being arrested and cited for mask policy violations at the Carl T. Hayden VAMC.  The VAMC, coincidentally located in your Congressional District, is harming veterans. You cannot appear to care, let alone act in a manner befitting your office as a Congressional Representative!  Immediately come out in support and show yourself a true representative worthy of the title of your office, or leave office immediately, there is no third option!

Your need to change; its mandatory!

© 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.

More VA Insanity – COVID Mask Policy – Denial of Service

I-Care02 March 2021 – Today, I got a secure message from the pulmonologist at the VAMC in Phoenix; he needs me to go to the hospital for a series of tests to understand why I cannot breathe.  Except, when he tried to get me into the hospital, he was told the VA Mask Policy would not be allowed to be “adjusted,” and the administration is the problem.  Worse, the local administration refuses to engage in discussion, refuses to write a cohesive and legal policy, and absolutely continues to deny service to veterans illegally.

I desperately need answers as to why the VA Hospital is allowed to act in this manner.  The denials of service are more than just a mask policy issue where COVID is concerned.  The actions of the Phoenix VAMC since June 2020 extend beyond simple bureaucratese where COVID masking is concerned.  Where are the elected representatives in scrutinizing the Phoenix VAMC?  Where is the media in demanding answers to the abuses being witnessed?  Where are the police in protecting the innocent?

InertiaTo actively work to refuse service, shut down dissenters, and muzzle those who honestly want to help and change the Phoenix VAMC into something worthy of respect and improve the care of the patients who try and obtain healthcare at the facility is atrocious behavior worthy of the harshest condemnation.  My medical chart clearly states I cannot wear a mask, the pulmonologist needing me to receive tests to understand why, is unable to obtain community care due to administrative fiat, and unable to get the VA to stop needlessly harassing, injuring, and arresting me because I cannot safely wear a mask.  All because the administrators would prefer to refuse service, deny care, and then complain that nobody is making their appointments.

2004, I started this journey with the Department of Veterans Affairs (VA); I had spinal problems, I was short of breath, I had neurological issues, and a host of other issues.  Yet, for more than 10-years, the VA refused care after I left the service with injuries because of the Veterans Benefits Administration (VBA) treatment.  As soon as I finally get the VBA to act, the Veterans Health Administration (VHA) begins to act like I am scum that was drug in off the streets.

LookWhat drives me crazy, I have been across the United States and seen the inhumanity of the VA Administration up close and personal too many times to think the problems are limited to only one VISN or another.  I have witnessed veteran patients and dependents worthy of the highest care denied service and then further abused by the VAMC refusing these people’s future care.  I have witnessed VA employees create rules to inconvenience a veteran patient, slow care, and deny service to a patient who had to travel 4-6 hours to the VA.  The VA-Office of Inspector General (VA-OIG) relates more and more abuses by VBA and VHA staff monthly, where accountability is lost, responsibility rarely accepted, and the cycles of abuse continue because nobody in VA leadership will act!

Does anyone understand what this entails?  A patient, not me, with chronic pain and incredible service-connected injuries, is denied the ability to drop off a letter for his primary care provider, and the VA employee who would handle the letter anyway refused to accept the letter unless the letter was mailed.  The veteran drives four-hours to the VA Hospital every time he needs care and he works to maximize his time while at the VA taking care of as much business as possible.  The employee claimed that if the patient left the letter on that employee’s desk, the employee would throw it away.  The VA employee refusing to help a veteran was shortly promoted, moved to a less visible clinic, and the veteran who needed the help still has not received the support he needs.  Even after writing to the hospital administrator, the VISN administrator, and his congressional representative.  Why do I know so much about this case, I witnessed the scene and have been kept abreast of the trouble this veteran is having.

Survived the VAI met a veteran on social media who is in my same boat and cannot physically and safely wear a mask.  He has been actively denied service, even while bleeding, at the ER.  If President Trump had not signed the Community Care Act, which forces the VA to allow patients the VA refuses to see to access community-provided care, both of us would have been much worse than we are today.  Monday (01 March 2021), a nurse from my primary care provider called to relay information. The nurse refused to provide service, refused to answer questions, and then chose to become offended and disconnected the call.  Worse, I still have no idea why the nurse called, the purpose for the call, or what outcome will be derived from the call.  Why; because you cannot directly call your clinic and receive answers.  The phone chain games mean I call the clinic and get routed to a call center, they leave a message for the provider, and possibly within a week, I might obtain an answer from the provider.

Want to reach your clinic directly; send a secure message through the MyHealtheVet portal.  Then wait for an answer that can take as little as 24-hours, or as long as 3-months, if you get a response at all.  I have asked simple questions through both phone and secure messages and received atrocious answers, answers not fit to print, and answers that are a logical pretzel-making no sense but are regarded as “the policy of this hospital.”  A non-veteran I was casually talking to asked, “Why do you use the VA at all?”  The short answer is because if you do not use the VA, the billing nightmare to get the VA to pay for healthcare from military-connected injuries is a bloody nightmare!

VA SealCase in point, 30 June 2020, I checked into an ER for care.  January 2021, I receive a collections notice for the visit.  I called and asked why; apparently, the hospital submitted the statement to TriCare instead of TriWest, causing confusion and denial of service.  But, the VA “due to HIPAA” policies could not speak directly to the hospital, only to me.  I had to call the hospital and inform them of what the VA said.  The hospital’s billing department, the collections agency, and I are stuck between two bureaucracies at the VA, and I have an active collections problem hammering my credit.  These shenanigans are, but a small part of the regular issues all veterans are handed because the VA refuses to do their jobs creates rules and policies at whim to inconvenience, and flat out refuses to do their jobs!

Patients seeking care at the majority of VA Hospitals face no customer care, worse customer service, refusal to honor the job, disrespect of the patients, dependents, and veterans, and worse service for active personnel.  I have seen the VA’s actions, and I refuse to stay quiet about the illegal behavior, unethical actions, and the immoral treatment of veterans, active service members, and the qualified dependents seeking care and finding crass bureaucratic red tape.  There is no reason for this abuse of the patient, except as previously mentioned, the VA Hospitals can “get away” with bad behavior where non-government hospitals cannot.

Where do we go from here?

DetectiveWith the government being less than enthused with ending the COVID-Farce, with the media refusing to recognize a problem and assist in advocating for a reprieve, and with the elected officials failing to scrutinize the workings of the executive branch’s operations properly, I am not sure of the proper answer to this question.  Insanity, according to Einstein, is doing the same things over and over, expecting different results.  The paradigm of government-provided healthcare is a pernicious fraud and desperately needs to be corrected.  But the answer is more than simple bureaucratic inertia found in many other government agencies.  The VA has built a special case for itself, and the solution will necessarily require new approaches and new thinking.

The belief that government is good for anything but injuring others remains an idea that needs to spread far and wide in an effort to reduce the harm caused by the government.  The American people require a higher return on their investment in the government through forced taxation.  Yet, the administers of government and the elected representatives hired to scrutinize the government fail to act, believe the bureaucrats over the citizen, and are part of the problem.

Fishbone DiagramRoot cause analysis points to inertia as being a prime candidate in the failures experienced and witnessed.  Inertia is a comfortable blanket to wrap yourself in when change is supposed to occur, but change scares you.  The hospital administrators refused to act because that would require a spine and written records scare the hospital administrators; especially those in Phoenix after two dead veterans’ scandals where responsibility pointed to people who possessed written records.  Hence, besides inertia is the fear of being held accountable because the written records exist.  Yet, because policies, directives, and processes are not being written down, behavior can worsen where the veteran patient is abused, and there is nothing that can be pointed to claiming the actions taken were inappropriate.

Detective 3Logic claims that if the VA denies service to a class of veteran patients, then another option for receiving care should automatically open.  However, the lack of written policies and the inertia of the employees causes the veteran patient a nightmarish cycle of needing care but not being able to access care.  Because the employees are following spineless leaders and inertia is better than sticking one’s neck out and acting differently from the pack.  Thus, plotting a path forward requires leadership and a willingness to document, change, and adapt, all of which appear anathema to the VA generally and the Phoenix VAMC particularly.

The VA-OIG just recently finished an audit of community care claims being handled by 3rd party contractors.  The results are fairly typical of the VHA and VBA using designed incompetence.

The OIG audit found that inadequate contract terms and VA’s lack of effective oversight contributed to claims processing inconsistencies and errors. The VA’s contract did not include standardized criteria for contractor employees to use when distributing and processing claims. Furthermore, the contract did not require contractor employees to follow VA’s Office of Community Care (OCC) claims-processing guidance. Although the contractor cannot be faulted for acting inconsistently with OCC guidance not required in its contract, the resulting inconsistencies mean VA lacks assurances that proper processes were used. VA also did not have an official quality reporting mechanism in place before February 2019.”

The VA-OIG report quoted above discussed how 13% of the claims were handled inappropriately, causing veterans’ problems and delays in processing for providers.  In Albuquerque, NM., I saw this firsthand.  The VA sent me to a community provider; the community provider filed all the proper paperwork and kept gathering more paperwork for the next three years.  Finally, when all the red tape was satisfied, ¾’s of the bills were too old to receive payment.  That provider went bankrupt trying to provide services to veterans because he could not get paid in a timely manner.  I was there for the full and abysmal treatment of this provider by the VA.

Detective 4The designed incompetence is galling and getting worse.  The VBA is the portion of the VA that makes claims decisions.  Recently the VA-OIG investigated the VBA specifically to check consistency to comply with skills certification for compensation and pension claims processors.  The results are a horror story of designed incompetence, failure to do the job, and trainers’ failure to train properly.  Of the 10,800 claims processors required to certify their jobs, 4700 were never tested from 2016-2019.  Of the 2,500 who failed the certification test, 1,900 did not have any repercussions, training plans, identified corrective action, or employer counseling.  Worse, the VBA failed to take any personnel actions on 98% of the population surveyed (10,800).  2018, as in the entire fiscal year of 2018, the certification tests were unavailable due to technical issues on the VBA’s intranet.  Meaning that effectiveness in 2019 to measure and certify was virtually useless!  Does anyone wonder why veterans are refusing to trust the VBA and the VHA?  Is the problem clearer that congressionally elected officials’ failures to scrutinize the government influence the employees’ behaviors for the worst?  How many claims have been improperly decided, wasting taxpayer time and money and the veteran’s time and money since 2016 by failing to certify to fill the roles and duties the American Taxpayer is paying them to fulfill?

Wasting TimeIt is imperative for profound and fundamental organizational change at the Department of Veterans Affairs to begin as soon as practical.  Worse, scratch the surface of any other government agency on the Federal or State level, and the same problems arise.  The same abuse of taxpayers, the same refusal to do the jobs hired to perform, and extensive cultures of inert slugs just punching time and wasting money until they can retire!

© 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.