Palin to run VA?

[imprimis]

She is under consideration. I'd much rather see her face next to Trump's on the wall at the entrance to the VA Medical Center than what I've had to look at the last 8 years. She'd be well received by vets.

http://thehill.com/homenews/adminis...consideration-to-head-veterans-affairs-report

 

[HighStickHarry]

No way she is an idealist by definition. She can be in charge of va marketing.

The va needs a private sector ceo that is a veteran and has been in the system and has friends that have been in the system.

 

[windriverrange]

If I'm catching on correctly this seems like bait for the nearly discover "Largemouth Liberfish." They will go into satanic induced convulsions knowing Palin could be head of the VA, let alone head of it. Almost seems like Trump et al is really wanting the little liberal socialist to cry wolf so much & so often that anyone with an IQ above 10 says these guys suck, I'm done watching these idiots...and anyone on the fence will become revulsed by the constant whining by all the liberal sissies.

 

[HighStickHarry]

It's bait for sure but she can't do it.

 

[windriverrange]

Harry, I agree...really need someone with a huge capacity of organizational skills and name recognition. This is a place I think Romney would excel.

 

[HighStickHarry]

The minimum that veterans deserve is so far above what they get now. I'm not a veteran but it's from what I hear and what I read

 

[JimmyBob]

She is under consideration. I'd much rather see her face next to Trump's on the wall at the entrance to the VA Medical Center than what I've had to look at the last 8 years. She'd be well received by vets.

http://thehill.com/homenews/adminis...consideration-to-head-veterans-affairs-report

I'd much rather see her face buried in Earthquake Park trying to suck back the geological drop from the 9.2 Anchorage earthquake in '64.

 

[ThorOdinson13]

The minimum that veterans deserve is so far above what they get now. I'm not a veteran but it's from what I hear and what I read

I am of the opinion that it's not nearly as bad as some Veterans make it out to be. Some of the guys I served with are constantly upset because they think they should get more for disability or automatic hiring if they apply for a job. Hell, some even think that a combat Vet should get a "living wage" for the rest of their lives, usually north of $30k. Any examples of actual issues you can discuss?

 

[HighStickHarry]

I am of the opinion that it's not nearly as bad as some Veterans make it out to be. Some of the guys I served with are constantly upset because they think they should get more for disability or automatic hiring if they apply for a job. Hell, some even think that a combat Vet should get a "living wage" for the rest of their lives, usually north of $30k. Any examples of actual issues you can discuss?

I heard some stories of misdiagnosis and holding back on treatments from my wife's step grandpa and just that it was a hassle to deal with from a vet from the first gulf war I worked with at the welding Shop. Of course there are the stories of the waste and waiting lists highlighted by drudge the last few years. I think their medical care should be as good as anybody gets. As far as a living wage I feel the same way I do about athletic scholarships. A college education is a great leg up but after that you are back in the rate race as far as a career goes. I also thonknvets should get college credit for in service training, especially in the medical and teaching fields.

 

[ThorOdinson13]

Vets can get credit for training depending on the college.

Misdiagnosis happens even in the best hospitals. In fact, I think there were some studies done showing that on average VA has less sentinel events than the private sector. That was several years ago so no idea now. TJC (J-CO) reports would be the place to check if you're curious.

I agree in regards to the leg up education provides (if you select a quality degree) and getting into the rat race.

The waitlisting scandal is completely unacceptable. I can go into a little more background on this if you like.

Holding back on treatments. This happens for sure. The VA rations care and many times your diagnosis has to be at a certain point before specialized care can be arranged. Knew a guy with a spot on his brain. VA told him he couldn't be referred for specialized care until it got to a certain size. They scheduled him to come back in like three weeks to check it again.

 

[imprimis]

I'd much rather see her face buried in Earthquake Park trying to suck back the geological drop from the 9.2 Anchorage earthquake in '64.

I take that as a no. LOL

 

[HighStickHarry]

Vets can get credit for training depending on the college.

Misdiagnosis happens even in the best hospitals. In fact, I think there were some studies done showing that on average VA has less sentinel events than the private sector. That was several years ago so no idea now. TJC (J-CO) reports would be the place to check if you're curious.

I agree in regards to the leg up education provides (if you select a quality degree) and getting into the rat race.

The waitlisting scandal is completely unacceptable. I can go into a little more background on this if you like.

Holding back on treatments. This happens for sure. The VA rations care and many times your diagnosis has to be at a certain point before specialized care can be arranged. Knew a guy with a spot on his brain. VA told him he couldn't be referred for specialized care until it got to a certain size. They scheduled him to come back in like three weeks to check it again.

Would love to be informed on the waiting scandal. Was it just certain big city va's?

 

[ThorOdinson13]

Would love to be informed on the waiting scandal. Was it just certain big city va's?

I'll come back and discuss tomorrow but it wasn't just big city VA's and the fallout and negative impact isn't over.

 

[ThorOdinson13]

Please keep in mind a lot of this is from my perspective at a VA and being in leadership at that time.

A big cause of the scheduling fiasco was the release of the VHA Directive 2010-027 in 2010. Within the directive they put requirements that were unattainable for many VA's from the get go. Some examples are mental health having to establish an initial evaluation within 24 hours for any Vet requesting or being referred to mental health, getting all patients seen with 14 days of their "desired date" (this was a major part of gaming the system), and finally all Veterans beyond 30 days being put on the Extended Wait List (EWL). When this came out we had leadership meetings at the VA where I worked and everyone immediately knew this was setting many clinics up for failure as many did not have the resources required to meet these demands. This of course was also tied to performance measures going all the way up to each Director. From my perspective I cannot see that any of these measures were actually formulated based off of actual performance but I could be wrong.

The Associate Director (AD) at Phoenix was our AD prior to taking that position so his implication by OIG was shocking to us as he never presented us with doing anything unethical. In fact, in 2011 during a site visit we found a clerk at one of our Community Based Outpatient Clinics (CBOC) keeping a list to prevent patients from showing up on the 14 day report and EWL so that her performance measures were not negatively impacted. We immediately moved for suspension and removal, she retired four weeks later and he backed the whole entire thing.

The Chief of HAS there wasn't really a surprise. I was a Subject Matter Expert (SME) for one of our business lines and we used to hold VISN wide conference for updates, changes, best practices, etc. regarding those business lines within HAS. He was also an SME and he gave some recommendations that we refused to implement because it was technically gaming the system.

Do you remember when they were discussing the ACA (ObamaCare) and they were using the VA as an example of having shorter wait times, better access, etc? It was all crap due to gaming. An example is "desired date." The desired date was the date that the Veteran requested they be seen. So the scheduling script required the clerk to ask "when would you like to be seen" or "what date would you like to be scheduled." This was supposed to be put into appointment management menu within VistA then the clerk offers the dates closest to then and tries to stay within 14 days. Many times there was no availability so the clerk would tell them they could be seen on this day at this time which was also more than 14 days out. The Veteran would accept that date and the clerk would back out of the menu then move the desired date to the day they actually scheduled them making it look like the VA had stellar access to care. So there were clinics that literally looked like they were getting Veterans in at any time the Veteran wanted when metrics were pulled which also gave the appearance of surpassing performance measures.

Another example was rampant in Mental Health across the country and it had to do with limiting "no-shows" to appointments. Basically, the clerk would write down the date the Veteran was coming in for their appointment without actually scheduling it in the system. Then when the Veteran arrived for the appointment they would schedule it at the window on that day within zero days of the desired date and it went toward workload. However, if the Veteran was a no show it came up as an unused slot or walk in which further gave the appearance of VA having amazing access to care, scheduling procedures, and again surpassing of performance measures all the way up to the Director.

The EWL was just putting it on paper or on a spreadsheet then not listing it in the system which contributed to the falsity of VA having amazing access

Hopefully with those examples you can see that the narrative that poor little clerks were just following orders from leadership isn't the full picture. I saw during the scandal where physicians were trying to completely wash their hands of it and say it was all admin, then clerks saying it was all leadership, and admin leadership saying clerks acted independently. The fact of the matter was that it was actually all three. It just depended upon each situation at each facility. The clerk, the doc, and the admin all had to gain and in some instances it was docs putting a lot of pressure on clerks, sometimes the leadership, and sometimes clerks all on their own acting independently.

Personally, I had several instances of docs showing up in my office yelling at me or my administrator about me not letting clerks engage in this. You can google the OIG reports to read and learn more and at one point I think there was a report out there that showed how many VA's were implicated. The problem is that most of it was technically improvable and became a he said she said situation because leadership and docs that did force clerks to game never put it in writing or official guidance and I can guarantee none of them had the practice written into SOP. I think this has a lot to do with why there really hasn't been but a couple of firings. The more telling stat is the resignations and immediate retirements.

One area this is still being felt is in the VA actually having the capacity to serve Veterans. How can the central office move to increase employees, docs, equipment, work space, clinic space, etc. when it has a false sense of meeting demand? The answer at least in the short term was the choice program and I have a feeling you will see that program get extended and expanded upon instead of the funding being put toward additional space, equipment, staff, etc. VA had a massive shortage in funding to handle choice and VA paid community care (this one was huge) after this happened because it wasn't able to fully grasp the extent of the problem which is why you saw VA needing more money after congress passed choice. After the scandal broke you saw VA's start utilizing VA paid community care like crazy and it led to many operating in the red for several months until funding could be granted. They even started letting those that are paid out of that pot of money (MS) that furlough could happen.

One clarification to add. VA choice money was there and still is but money for VA paid community care was running in the red. This is why they asked congress to convert money from Choice over to community care to be used.

 

[ThorOdinson13]

Oh, and I think Palin would be an awful choice and result in business as usual for the VA.

 

[aix_xpert]

If you were Trump, would you consider floating McCain's name for head of VA. He'd have to give up his Senate seat, but he'd get killed if he turned it down (given his past statements). He's been a vocal (but not effective) advocate of the issues at the VA. This would give him a chance to "put his money where his mouth is." It would also neuter one of Trump's biggest Republican-side opponents while also insulating Trump from any failures within the VA. The only concern would be if the Dems might pick up that Senate seat as AZ has moved more left (but is still a bit right of center).

 

[JimmyBob]

I take that as a no. LOL

A little late, but I did want to acknowledge your "overpowering sense of the obvious".

 

[imprimis]

A little late, but I did want to acknowledge your "overpowering sense of the obvious".

At my age, it's one of the few senses still intact.

 

[ThorOdinson13]

If you were Trump, would you consider floating McCain's name for head of VA. He'd have to give up his Senate seat, but he'd get killed if he turned it down (given his past statements). He's been a vocal (but not effective) advocate of the issues at the VA. This would give him a chance to "put his money where his mouth is." It would also neuter one of Trump's biggest Republican-side opponents while also insulating Trump from any failures within the VA. The only concern would be if the Dems might pick up that Senate seat as AZ has moved more left (but is still a bit right of center).

No, I'd look elsewhere. This needs a forward thinking individual who's well aware of the many challenges facing VA. Honestly, it doesn't need to be an SES employee either.

 

[osu_orangestreak]

Better be the best they can find.

http://www.foxnews.com/us/2016/12/04/4-quit-after-oklahoma-veteran-with-maggots-in-wound-dies.html

 

[Ostatedchi]

Better be the best they can find.

http://www.foxnews.com/us/2016/12/04/4-quit-after-oklahoma-veteran-with-maggots-in-wound-dies.html

GD it. I'm over Rustled right now. People should go to jail for this. If I'm the Lefore county DA, I'm filing charges against the facility director.

Hell, illegals in this country get better care. Total BS.

 

[ThorOdinson13]

Better be the best they can find.

http://www.foxnews.com/us/2016/12/04/4-quit-after-oklahoma-veteran-with-maggots-in-wound-dies.html

This is the state run facility. Not the Department of VA.

But I agree that they need to make a damned good hire

 

[hollywood]

Better be the best they can find.

http://www.foxnews.com/us/2016/12/04/4-quit-after-oklahoma-veteran-with-maggots-in-wound-dies.html

Just so everyone can be clear on this one. This is NOT the Fed VA, this is 100% on the State of Oklahoma. The Fed Govt has no authority or management of these facilities. The statutes enacted establish control over these facilities by the Oklahoma Dept of Veterans Affairs. (The only Fed involvement is that the Fed provides funding directly to the State of Oklahoma to cover about 60% of their expense.)

They are not actually hospitals or treatment centers, they are nursing homes and there are Seven in the state. This is not the first time that this issue has been raised. In 2012, the state commissioned an investigative report and a financial audit on the management of the facilities. The reports showed abuse, neglect, needless deaths and there was some hanky-panky going on with some funds.

Fallin promised at the time to "fix" the problem. In her words: “This isn’t something we can tolerate, this is something that has to be fixed.” It's been 4 yrs and a lot still seems to be broken.

http://journalrecord.com/2012/05/03...evalent-at-many-state-veterans-homes-capitol/

Reading the comments on that article is enlightening, seems to be a pattern of "say something about conditions and you risk getting fired" going on at some of the facilities. Comparing patient families and workers notes, they seem to mesh, so I don't think you can disregard them as simply "bad apples."

 

[ThorOdinson13]

To further clarify the fed funds wood mentions above; they come from the VA State Home per diem program. Which is under a lot of scrutiny within VA due to the way the money is being handled. I think it's been labeled as a high Risk program under IPERIA. None of this is surprising considering how much of a PIA it is to track and audit.

The concerning thing here is that VA hasn't caught it when conducting audits and site visits. So either they clean up and get straight before visits, which are scheduled, or VA employees that handle the program in OKC either don't give a shit to do their job right or are complicit.

 

[Ostatedchi]

Regardless, this is unacceptable. People should be in jail.

 

[imprimis]

Regardless, this is unacceptable. People should be in jail.

One of my hopes from Trump. The VA isn't the only agency in government which has serious problems. Clean them all up.

 

[hollywood]

Regardless, this is unacceptable. People should be in jail.

Absolutely, but let's take our grievances to the top Oklahoma Law Enforcement Officials.... people should be on the phone and email to the GOV's office and the State's AG's office demanding this happen.

Not going to do a damned bit of good complaining about the Fed VA, when this is ALL under the Jurisdiction of the State of Oklahoma.

BTW, seeing reports that one of those who resigned, has already been employed at one of the other seven nursing homes in the system.

I would also note on facebook, the following story. (I have no reason to believe that this woman is lying, as it meshes with the news stories back in 2012 about the deaths at the Claremore facility.)

" Glenna Hiseley None of this is going to change. My Dad, Louis Arterberry, was in the Claremore Veterans Center in 2012 when he had a stroke. Kenneth Adams, the physician's assistant, on duty that night completely ignored my Dad and gave him no treatment. During that time, Adams was looking for a "sexual liasion".

Finally, the next morning my Dad was sent to Tulsa and died a week later. Adams was initially charged with first degree murder and elder abuse for my Dad's death and the death of Jay Minter who was scalded to death in a whirlpool bath the next month. As far as employees being arrested, we went through three years of hearings with Adams and he finally was charged with neglect and abuse and was sentenced to 90 F------ DAYS in the Rogers County jail.

That's the justice for the deaths of Veterans. Those employees resigned so they wouldn't lose their licenses and/or retirement. Kenneth Adams wife, Cindy, was the administrator of the Claremore Center but when all this blew up, she took her "toys" and ran. She should have been put on trial, also, with a lot of others. She kept her benefits and is working at another facility for the elderly. What kind of justice was this ???"

http://www.newson6.com/story/317294...sentenced-to-90-days-for-deaths-of-2-veterans

 

[ThorOdinson13]

What in the holy Fvck!!!!!!!