Another MISSION Act Fail: Poor Staffing Behind Scheduling Delays

IG found veterans seeking MISSION Act non-VA care at VISN 8 experienced unnecessary wait times due to understaffing by the agency in 2018.

An audit by the Inspector General found VA medical center understaffing and procedural bungling unnecessarily delayed veterans’ access to community care. The audit team found five of seven facilities were short-staffed as of October 2018. Additional burdens from Health Net losing its community care contract exacerbated the situation.

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For years, VA has improperly staffed its VA medical centers. This became a front and center problem known to the public in 2014 when the veterans were documented dying while waiting for access to VA health care services.

AFGE has long alleged the refusal to staff properly has its root in senior leadership gutting Veterans Health Administration to harm its ability to provide timely access to care while hastening the move toward privatization.

If true, this newest IG report should be seen as a sign the alleged scheme, if true, is biting the agency on the backside by harming its performance under the MISSION Act of 2018. What seems more likely than AFGE’s theory, though, is the agency’s bureaucrats refuse to properly implement MISSION Act to support keeping veterans in the system.

Regardless of the motive behind the understaffing, not only is VA understaffed in providing care, but its staffing levels were too low to ensure proper scheduling when VA outsources the care. This understaffing is harming veterans. Yet, VA has the largest budget in history, so what else can be done to increase staffing to speed up approval of non-VA care requests?

Is the MISSION Act money well spent? Or, will veterans continue to fight for timely access to care regardless of who is providing the care?

A November 2019 IG audit revealed the agency was sitting on troves of appeals for non-VA care claims that went unprocessed for nearly two years. Those appeals were simply storied in filed cabinets, boxes, and bins without any tracking.

Veterans waiting for resolutions to those appeals were likely forced to pay for their own health care or went without access to care at all thinking VA was timely processing the appeals.

Either way, veterans’ health, and finances were placed at risk because the agency poorly staffed its appeals process for non-VA care.

So, is VA intentionally spiking the ball on the MISSION Act and non-VA care?

Does anyone else think it seems odd that such failing would be allowed for so long into the Trump Administration given the MISSION Act is one of the supposed successes on which President Donald Trump will likely declare victory?

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  1. I don’t think it’s “poor staffing”! I believe it comes down to “incompetent staffing”!
    Think about it. Who are these reprobates the VA hires to take care of its veterans? Especially when it comes to dispersing the monies the VA is responsible for!
    You’d be surprised at the number of “excuses” VA employees use to keep from paying their bills. Or, you wouldn’t!
    We’ve already been made aware of the VAOIG report released in 2018. Where VA employees, in the “billing sections”, were NOT paying emergency room and hospital stays they were responsible for! We’ve been made aware these illegal acts may have caused veterans to commit suicide!

    How many more egregious acts do veterans have to be dealt before the lid bursts from the pot? When will these incompetent assholes be held accountable?

    Rant over! For now!

  2. were they short staffed or just did not give a damn. I sat and waited for a blood test and watched many of the VA staff just walk around reading their cell phone and it was not lunch time

    1. @Peter Kreutzfeldt,
      I’ve actually watched VA employees play video games and watch porn on the VA computers!
      This is normal during business hours. Because the unions and upper management won’t shut it down!
      All they care about is getting a paycheck and nothing more!

  3. Social security Administration found guilty of firing a disabled veteran for being disabled. Post office found guilty of terminating veteran while serving and sending emails to get rid of disabled which most are veterans. US attorney office has committed crimes threw out the US from theft drugs to hiding and destroying evidence on death penalty cases. This Government hates the American People!

    1. Oh I agree. Most of DC does not care for anyone but themselves. They sit in their bubble. They are at a total disconnect. They sit and enact laws without knowing the details and really why they are putting them into law. This has been going on forever begin. The President has been trying to change some of this but it is a war between him and the establishment. So we will see. They just sit behind the scenes and write laws. These are mostly the unelected government officials in the agencies who are a thorn in Trump’s backside. Bad as Speaker Pelosi and Schiff. Honestly, the Democrats are a soap opera. One drama after another. They are really boring and shallow to me. ? ????
      Would be nice if the Democrats would actually one day do something productive to help someone instead of always trying to destroy all. However, this concept is not who they are. All she wrote.

  4. Its the entire government that has failed America even the DOJ was selling whistle blower complaints. I would suggest every American read licensed to lie. Iran kills with bullets while the US government kills with denials and pills. The president is on infowars and I believe listens to it. Even if you are a democrat brother or sister veteran issues are a bi partisan issue. Call Infowars tell them your issues with the VA because they take live calls and its pretty easy to get threw unlike many other networks. VA has been sitting on hospital bills for years so piss on the Mission act nothing more but failures!

  5. Fixing the VA? Wishful thinking. Remember too, US ranks somewhere in the 27th-30th ranking in Healthcare.

    Hopeful? No! That is until someone with the Authority to make changes, announces an outline of VA’s major issues, and how these issues are going to be reviewed and then approached for solvency, and what happens to any VA staph that hinders or misleads the process of change, I’ll not put ANY hope into this decades long VA problem that puts the health and lives of my Brothers & Sisters in jeopardy.

    VA’s lack of consistent precision care should’ve been dealt with properly and swiftly long ago.

    Until someone of authority.puts their job and name on the line, and forcefully speaks out against VA corruption, negligence, and malpractice, hopefulness in VA change is like a dissipating nose hair burning fart. IMO.

  6. Here’s another take on this issue:

    I live in Florida. I didn’t wait at all to use the “Mission Act” in the private sector!
    Read WHY this is occurring nationwide!

    1. Crazy Elf,
      they spoke about VISN 8 only in this article. Why is this? I do not believe it is accurate. This is political in my opinion. To sabotage the president. Also, I believe they reported this off old information. My question is where are the current numbers VA OIG? They are trying to deliver a trend to the public that is not current. Old information with believing people would not notice the dates. All matter of opinion and subjective Crazy Elf.

  7. If the top Scumbag wanted to fix the
    problem he would. The President does
    not care about Veterans. He thinks things
    are fine.

    1. @Do Mar,
      I answered you! I’d like to see the VA’s healthcare side go belly up!
      Let vets use private healthcare on our own terms!
      One way would be to use “Champva”!

      1. Good idea, Elf, for all those whose spouses qualify for ChampVA. Would be a quick simple fix for a lot of Vets who don’t trust the VA Health Care. Could also easily be expanded to everyone with a combined rating of over 50% which qualifies them for total health care. It is a single payer system like a lot of liberals are pushing for similar to Medicare but better because of co-pays and deductibles. Includes better pharmacy than Medicare.

    1. @Do Mar,
      I’m for the healthcare side of VA to be shut down!

      Can you imagine hundreds or thousands of incompetent individuals trying to get hired out in the civilian world.

      Are you aware over 50% of ALL vets in the country are NOT even registered with the VA. Are you aware that a large portion of vets, who are registered, want private healthcare! Are you aware Sec. of VA Wilkie is no better than any of the previous secretaries. He “spins” the truth like those at CNN and the rest of our main stream medias!
      These are just a few of the FACTS being presented to vets and taxpayers!

  8. I am so disappointed with the care I receive at the VA. Waiting months for a heart procedure is just wrong. I have had numerous spine and hip surgeries and other joints. The take each joint separately and deny you benefits, while in fact and I have told them since day 1 it is a system problem I inherited. On my mothers side of the family everyone had had problems due to a inherited form of arthritis that softens the cartiledge. I understand Trump had good intentions with the RAMP program, get you to a judge faster once one is assigned. Now the just sit on them and do not assign judges. I was one of the first in this program and 18 months later still have not been assigned a judge. My lawyer figures 12 – 18 months then a judge will probably remand it. Because of all my surgeries I had to fight just to be allowed to go to a local clinic to have me toenails cut. They were making me drive 220 miles round trip. Finally they did when I pointed out that they are paying me around 85 bucks for travel while locally they do it for 29.50. After a few months however the company they hired to manage this was busted for double billing. The VA wonders why they have such a suicide problem but I truly believe they caused it. I consider it all the time. So tired of pain and being sick life has no meaning.

  9. Angela – earlier you said the President does not know so you cannot blame him…..nonsense, bullshit, what else?
    T is the President. He knows everything OR he is responsible for the dopes giving him bad dope (information).

    1. All are too blame. Congress, VA, the AFGE Union, the legsl system, the DOD. In the way that the President will not know the actual truth, zero government official is on the receiving end. He can only implement whatever according to what is communicated to him. There is no way he can know the truth until he experiences it. This is why the only way to solve the healthcare debacle is for all of the Congress and the Senate to be positioned to receive care under the government healthcare status that of which is overregulated with zero accountability. Points of private sector involvement is it opens up flexibility and it opens up the accountability process under the civil legal system. It also increases competition which can lower costs if transparency is required by the law. Capitalism 100% will solve many problems; but, the law has got to be honored and applied.

    2. @Do Mar,
      Are you aware many high echelon VA scumbags have been caught stating the following, after they’re caught committing egregious acts against vets AND taxpayers –

      Quote: “The president serves 4 to 8 years! We’ll be here after he leaves!” Unquote!

      Taking that statement literally means vets are screwed!

  10. Ben,

    This is good.

    The IG rates a wow!

    Seems like VA is moving to privatization. The Misson Act is just a blowjob like the Act before which was a failure. All they do is change the names, put out a million dollar + advertising campaign, the dollars of which they could be spending on doctors for veterans. They need to remember what President Lincoln said. Ya think?

    Maybe VoRehab will make me a brain surgeon.

    Ben, I want to write for you. You advertised for a writer. Let me finish up my personal cases then we will talk about what you need.

  11. Congress and the current administration got what they needed in PR optics with the Mission Act. If the details of implementation wasn’t clearly defined in the Act itself and is not monitored – not their problem. Mission Act Accomplished.

  12. Yeah, I hear you but they won;t get get you involved because that’s the game they play. You have my sympathy.
    I’ve complained to the Whithouse, the OIG and the FBI- does anyone give a damn anymore? NAH, they think we should just die.
    Maybe if we were willing to sell our vital organs to them they would “keep us Comfortable” like the Governor of Virginia.
    Big Government People are all SCUMBAGS and the VA is BIG GOVERNMENT.

  13. Understaffing is not the problem and hiring more employees only exacerbates the problem. Until they set up a referral/payment center contracted through those that have quality experience at this, the problem will continue. As stated in previous documentation, if the agency expects the VA to outsource its product (Veterans) they need to rethink the process. These people are totally corrupt and they will circumvent the process to hold on to their cushy little positions while continuing to charge the taxpayers for their bankroll of bonuses while operating at status quo and below. The problem with the culture created has blown to unimaginable proportions and the only answer is oversight through reconstructive measures that incorporates the private sector into their affairs. If you look at it closely, the VA is already privatized. The only thing that’s missing is the reconstruction of executive staff through higher quality individuals by offering competitive salaries at that level, and aligning the government employees benefits package with its alliances (the private sector.) This would definitely solve the problems at the VA and I venture to say that the numbers have already been crunched. They are just waiting for the most feasible plan to swing into action. Being totally Veteran centric does have its benefits. Mainly, Veterans and their families. It’s time!

    1. John, I agree with you.
      The VA has been being outsourced for a long time. However, the care totally controlled by the private sector does not solve the problem either. Look at Medicare Advantage. Millions of dollars of fraud by the private sector companies managing it. Alot more than the traditional Medicare. In my opinion, it is not necessarily about who is managing the care as in agency or the private sector; but, it is about deregulating the agency so the civil legal system can be applied. In my opinion, the AFGE union perpetuates unaccountability.

      1. Very true, but if the VA can restructure the pay scale, the benefits package, and operate closer to the scale of accountability measures through the private sectors module with a board in place, we will see an immediate change. True business modules find ways of operating at a higher level because they can’t justify hiring aunt Sue in a position that she is highly under qualified for. A board oversees the cash as well as unruly employees and corruption. Believe me, the structure built upon accountability comes with those that can expand through profit. There is a way to ensure bonuses on a very higher level through utilization of a (HRO).

      2. Benjamin, why would the federal government want to hire me? Please can you help me understand. With the way I beat them up. Please. The VA does not even know me at this point at all. I am serious. Scholarship deadline coming up soon. I plan to apply. It is with the Society of Women Engineers. They have and have had non traditional scholarships for re-entry. I do not care about working for the VA or the SS people now at all. I grew up on a farm and I have a foundation. I know about agriculture. I know about the Agricultural Research Services. I know about them using the multi Gene research being done to grow more environmentally resistant crops that uses less pesticides and fungacides. Jobs for testing the residue left on the crops from the presticides. Soy Bean crops etc. Bayer… BASF… Agricultural and Biological Systems engineering…. Work for the Department of Agriculture or ARS or a Ag company or a Chemical company. I desire employment with some movement to it that of which I enjoy and that of which I am somewhat informed about. Biotechnology..Organic Farming… Entomology… Like I say the VA has no idea who I am. I know how to drive tractors, turn and harrow land, power wash buildings, know about growing crops somewhat.. I have met personally with the research scientists who work with the Agricultural Research Services inside the experiment stations… This happened about a year ago…. All of this has been in the making but this other stuff had to be straightened out so I could be present to pursue. I know you and all are tired of my comments. I am too. Ready for action taken. Best.

  14. Does not surprise me in the least. FYI another Trump idea is the so called COVER COMM. It was suppose to look for Alternative Treatments for PTSD at the VA. I attempted time and time again to get my 29 page report into the hands of the COMM, made up of 10 individuals and headed by hand picked Jake Linencugal (SP) Finally my wis senator office told me they hand delivered in Vegas gathering of VA upper management I have worked for vets throughout this country on their PTSD claims. for 35 yrs, privately. Well no response at from this COMM and have check few days ago and can’t find anything more recent the late 2018. Another fine mess You got me in Olle. Oh well the beat goes. Oh I also sent copies to bout 15 senators to little or avail. This country/plus VA does not want to solve the PTSD treatment for vets. Finally realized, slow learner, that the system and culture (VA) and the powers to be that send the young off to war do not give one shit about them, me included. Cannon Fauder is what we are.

    1. I feel your pain! As stated, they are not worried about the Veterans that experiences problems, they are worried about keeping that cash allocated for Veterans under their umbrella. I’ve never seen a management staff anywhere other than at the VA, that totally expects bonuses for doing absolutely nothing. They schedule meetings and talk about the problems all day and then go home. This has been going on for years. When people create and present numbers from conversation rather than the actual affects that hampers operations at the expense of Veterans and their families, we’ve got a problem. Meeting after meeting produces nothing. It’s almost as if they have created a social club. These people must be held accountable.

  15. I finally complained to the right person. I called the Cheyenne VAMC ‘Chief of Police’ and told him I was being harassed by the patient advocate and he gave me a phone number to the ‘Mission Act Information Line’ (1 844 698-2311) so I called them and when they heard that I was being harassed and the fact that the male P.A. (both of them really) was delaying and interfering with my care preventing me from getting the care I needed causing me significant harm the young lady patched me through to the ‘White House Hotline’ (1 855 948-2311) and the person there said they were going to open a major investigation into the situation.

    I recommended that the investigators get me involved so I can ‘point out’ the perps and what they have done to me.

    I hope they haul the ‘son-of-a-bitch’s off in handcuffs.

    Interfering in a patient’s care causing delay and/or harm is a felony.

    1. “Interfering in a patient’s care causing delay and/or harm is a felony.” I’m sorry, but if you deal with the VA it’s not only not a felony, it’s a fact of life. The VA would be shut down if they arrested everyone for malpractice. No one cares but the veterans. I have an open and shut case and the attorneys won’t touch it because the VA said “no proof” and even though it’s all there in the VA’s writing and well documented, it will cost them $50-75 grand to take it to court so it’s not worth it. Even though it would likely save hundreds of other veterans lives. Oh well, I tried. I wish you the best, you’ll need it.

    2. Yeah, I hear you but they won;t get get you involved because that’s the game they play. You have my sympathy.
      I’ve complained to the Whithouse, the OIG and the FBI- does anyone give a damn anymore? NAH, they think we should just die.
      Maybe if we were willing to sell our vital organs to them they would “keep us Comfortable” like the Governor of Virginia.
      Big Government People are all SCUMBAGS and the VA is BIG GOVERNMENT.

  16. VA continues to operate in a shady way, making sure veterans are not the priority. Notice how some politicians run to the microphone and boast about their veterans support, yet show no proof of actually fighting for vet-friendly bills? Still think politicians are on our side? If you look at the bills just under the Committee on Veterans’ Affairs and compare the 115th with the 116th, its a 1000% increase. There are numerous ‘duplicate’ bills and there are many politicians who are flooding the committee with BS bills, knowing that most of the bills will be left to die off. Now why would that be? Probably the same reason politicians are not asking the VA Secretary why the ‘Candy Man’ of the Tomah VA hospital is still employed….still treating veterans, despite having credentials revoked twice.

    My main point is: as veterans who have suffered at the hands of the VA, we need to be better organized because the execs at the VA do not care and know that they are made of Teflon, the Secretary will continue to ignore any/all messages from veterans and the VSOs sitting in DC, who plead that they are always for the veterans, earn 6 figures as well while ‘fighting’ for veterans? Odd how so many veterans still suffer while our VSO reps are ‘fighting’ so hard… It has been about the money off of the blood of veterans, yet the VA still boasts that out of the 20+ per day dying from suicide, only 6 actually seek VA care. Why do you think they are hanging their hats on that one? Because they refuse to admit that the rest of those veterans refuse to get put through the same horror stories of their veteran-brethren? I know many veterans who deliberately avoid VA care, especially after reading almost-weekly headlines.

    If we do not become better organized, we will continue to suffer at the hands of abuse and greed.

    1. It takes Veterans, their families, Veterans organizations, Congress, and the senate, to combat this conglomerate of a MESS! I’m with you one hundred percent!

  17. Privatizing VA health care only makes some HMO Corporations wealthier. You are not going to get Mayo Clinic or Cedars Saini care that is held for the richest of the rich and special studies patients.

    You’ll get the worst of the worst of private care that money grubbing CEOs can dish out. If it goes to private insurance it will be like Health Net and Tri Care. The health care operators will have trouble getting paid. Yes Health Net got so bad paying they lost their contract. But they should neve have been anywhere close to veteran health care. They bribed their way in for a quick hit of $$$,$$$,$$$,$$$.

    1. Not with correctly constructed contracts. I believe that there are just as many cooperations out there that want to help Veterans as those that are dedicated to fixing the problems. I also believe that they will not have to build buildings to do so, we already have them.

      1. You are right, John. But it doesn’t only take correctly structured contracts, they must be enforced. The big missing link in all VA contracts. From scanning that 5.15 mile high stack of documents to just simply archiving old hard copies and maintaining backups of data copies. To actually ensuring CBOC contractors are doing their jobs according to contract obligations.

    2. In my opinion, the whole healthcare industry has lost it’s purpose. Their purpose is the dollar bill. The care is delivered from the perspective of the people in positions of authority. Even the medical schools curriculum is taught different from what should be. Not one aspect of the healthcare industry or of the medical training in my opinion comes from the perspectives of the patients themselves. The whole healthcare industry has become top down. Healthcare not medical care. Will return.

  18. It’s all Higher Management. Look at the Whistleblower Program that Donald Trump, Hired Peter O’toole to Run the Office.

    He was sending all of the Whistleblower Complaints right back to the people involved in the Whistleblower Complaints.

    They Finely Fired Him. Now a new person is trying to fix the problem. The IG made 22 recommendations, found 6 major deficits.

    Out of 72 Whistleblower retaliation only 1 released from duty.

  19. Why was there an understaffing and a lack of knowledge on how to get a person an appointment with a community care facility. Does not mean the MISSION ACT is a failure. It means there is a failure of leadership and willingness of people to do the job they were hired for.

  20. Tried to get help via the Mission Act, Called for the authorization to proceed but was told I do not qualify. I and a %100 disabled vet but because I was TDIU they do not consider me at my %100 rating. Another VA (non-vet) offense.

    1. @Paul,
      If your 50% or higher with disabilities caused by your time in service, you qualify for the “Mission Act”! And are enrolled in priority 1 group, your eligible!

      1. P.S.
        Look up the regulations concerning the Mission Act.
        There’s enough information there to let you know IF your eligible.
        Some of the main eligibilities are distance, travel time and IF your clinic doesn’t provide the specialty healthcare.
        There’s a few more. Only if you qualify. Fight for it!

      2. Being they are looking for chopping blocks, how about the Congress and the Senate join in on the chopping block? How about reducing their salaries being most of them wallow in non work? How about reducing the cost of living? Instead of continuing to raise salaries to meet the costs of services, goods, and products. How about it? Look at how they squander money on slush funds for sexual misconduct to pay people off. I would like for the government leaders to switch roles with the American people. How about the government officials who spend all of their time trying to destroy people become the American people to assume the role of being on the receiving end of all their laws, regulations, and crap that they dish out? Ben, this could be the best solution for all right here. Let them experience their own crap.

    2. The President is not being told the truth. They do not desire to deliver to life. Sabotaging the President is not the answer. Fully privatizating the VA is not the answer. The VA as it stands needs continued reform in it’s laws, reducement of regulations, reform of medication formulary, eliminate the compartmentalization surrounding the VA employees that of which stands in the way of teamwork and that of which obscures transparency that is necessary for the VA healthcare process and for VA claims process due to too involving too many hands. The VA employees do not know what the other employee is doing. They are only allowed to function in their designated job description that is restricted by the AFGE Union. They may claim VA employee shortages. True to a point but the compartmentalization thwarts all VA proceses. Will return.

    3. Being this article is about VISN 8, the consult process has and has had problems with the consult process of care heading out of the VA; and, even with the care inside of the VA. Hell, this did not even involve the VA having to pay non VA physicians at all. This is was with them. Primary Care physician in VA submitted a consult to the next door VA to one of its clinics because the wait was too long with the VA of where I and the primary physician were located. Anyway, after the primary care physician submitted it to the next door VA, the clinic which received it decided to cancel it. Yes, the VA physician of the next door VA cancelled it. Like I have said I was tired of fighting with them. So this is another issue that contributed to me leaving. I helped the issue myself. Even the damn private sector wanted to do injections and surgery. I said to hell with this. So I resolved it 80 % myself. I also researched and found a physician who specialized in what I already knew would help the issue. He resolved it the other 20%. See even if a person receives care in the private sector, the care of these physicians has to be researched. I already have a foundation due to having an Exercise Physiology degree and due to having been a competitive athlete most of my early life. Having the life experience that I have had is what afforded me the foundation to have assisted both my mother and my sister. Though, the VA employees have mocked me about the undergraduate degree that I earned prior to the Navy. Exercise Physiology is a foundational degree to all of the healthcare professions. Unfortunately, at that time I did not have the resources to proceed. I tried to enter the Navy as a hospital corpsman to attend their physical therapy training to work as a PT tech in the Navy but the wait was long. I mean long – 2 years… probably… So I entered the Navy to the needs of the Navy. Though, the Physical Therapy today has become politicized. I do not like how they deliver the home Care at all. An hour appointment with the patient and 50 minutes of it is spent on a damn IPAD documenting all for the over-regulated government and the insurance companies. Put it like this being their focus is technology and not the patient, why don’t they send an IT technician with the Physical Therapist when they deliver Home Health Care. I bet they have not even thought about this. But what one expect? The federal government is not known for innovation and new ideas. The innovation and new ideas belong to the private sector companies without government strangling. The PT can deliver therapy and the IT data entry person can document. No I am not saying send a physical therapy assistant because PTAs deliver care too. Thus getting back to the consult, this happening was a good thing. This event set the stage for my leaving out of the VA. I was tired of them deciding when their decisions were not in my best interest. The VA demeans or it did in the past. I do not care to work in healthcare today because of what I have been witnessing and have witnessed mostly Obama administration forward. As for healthcare, the only two areas that I would like to work are the Athletic Training profession and as a medical researcher. To work in these professions, one needs advanced education and training. This costs money. Plus the VA has stood in the way of progression forward. Because what they believe that I should do does not come close to what I might could do. This is what I mean. They predetermine before knowing the truth. Along the way the engage in self fulfilling prophecies whether they realize it or not. The VA is not a system that is set up for positive change to happen in a veteran’s life. The modality is sustain. Example, when vets are injured or actually anyone for that matter, people are written off when it comes to the federal government. Once identified in a such state, the laws and regulations prevent real recovery. Example, a physician prescribes med for patient for mental health condition. Well all good and fine. Yes med helps. However patient is not supposed to stay on med for lifetime. Here is where mental health care falls short. Prescribing the med is just a temporary solution. How about the vets life? The environment surrounding him or her. Housing, food, a job, school, church, relationships, opportunities, principles, and the list goes on. Now does a medication solve this? No and hell no. Mental health should be treated as one with the rest of the body. Also, in order for the mental health care to deliver effectiveness, all issues surrounding the person have to be improved. This does not mean leaving veterans packed away in assisted living facilities to eternity with continuing to increase of meds to control them. Or even leaving them homeless. Many people can move forward if the hand up shows up. But getting back to the issue for why the consult was written, I cleared up the issue by the application of castor oil. Plus, stretching and exercise. And some of the physicians spoke about injections and surgery. I say give me a break. As for an other issue that has never been resolved and is service connected but is not documented as being service connected, still remains unresolved. Yes, in the Navy record and years past the VA failed in the care. The VA care surrounding this issue was a failure. I do not qualify for any of the new healthcare legislation due to mileage. So I was hoping to be hired into decent employment so I can take care of it myself. However, companies desire an updated skill set. Do I have an updated skill set one that is documented? No and hell no. This is why I say the VA can go to hell.

    4. Benjamin, it is not just about consults. The whole healthcare industry has become a sham. High costs and poor quality. Many of the more brilliant doctors left the industry due to the massive government. Research it and you will see my point. This topic has been discussed by the professionals themselves. It has been true in many situations the VA providers at the bottom of the chain have had their hands tied due to the massive bureaucracy. They were in gridlock due to the massive regulations and laws. For example before the Obama administration, there were a few VA providers who were making an attempt to assist me in my pursuits. Whether their attempts were genuine or not, I will never know. At least they were trying. More than I can say for the VA employees in recent years. During this time, it was the system, VA leadership, and the Congress and the Senate who had roadblocked my path. My recovery forward mostly arrived from guidance and assistance from people in the community who were in established positions. Also arrived from my efforts, and from my parents efforts. As for the consults for outside care, some of the consults needed may not have been needed if the care had been delivered appropriately to begin with. For example, the veterans in the nursing homes. Ben, I cannot hardly even discuss this. This makes me almost sick to my stomach. Going back years with watching my mom’s brother decline in health due to the poor quality delivered. Many veterans wind up in the nursing homes well before their time due to poor care. The over-prescribing of medications adds to even more health issues of the person. I am not saying that he did not have issues but the treatment by the VA from what I had observed just made me sick. Few years before he passed away, I tried to assist my mother in helping him in relation to making the efforts to communicate with the VA in regards to his transportation and care. However, I was shutdown totally by the VA care providers. Not only was I fighting with VHA in regards to my care but his care too. Ben, the VA never wanted to let the family know anything about anything not even for the purpose of preparing for a funeral. He was just a few years older than me. I had met him at medical center in which he was transported to. Ben, the medical records contained little of the correct history. I had to clean it up. This is the medical center in the private sector funded by the VA. Plus, the nursing home care in this country is a damn disgrace particularly if it is funded by the government. Ben, the nursing homes get funded no matter what if it is a private sector / government business relationship. Mr. Shulkin speaks to this type care being needed to improve the system. I disagree. I believe 3/4 of the healthcare should be shifted by to the private sector with limiting medicaid and medicare for those who have worked to pay into it over the years. As for Tricare, it’s costs are a lot for such little service. Their dental plans are pathetic. I cannot afford them so I have not enrolled. I will just save for it myself because the deductibles are too high. Anyway, getting back to the VA nursing home care and this is the VA nursing home private contracted care, what a disgrace. The nursing home care in the actual VA from what I witnessed years ago and this was before the Obama administration was actually decent care from the appearance. Yes this was the case. I recognized it because I was volunteering. Ben, even back then I had inquired about volunteering enough in the VA to become eventually hired by them. Yes and yes. The VA said no and hell no. This is their laws. Now do you see this? I had a friend in the past who was homeless with having been a prior teacher volunteered in a health care system in transport for over 3 years. He eventually become employed in this job with this healthcare system. Getting back to the VA contracted nursing home, they left him to lie in feces and urine. Ben, they did not even crush up the medications. I am not saying these medications were in his best interest to begin with. They would leave the medications in a cup sitting beside his bed on the nightstand. The government assisted his death. I watched it. In regards to the medical supplies, oh my gosh. If people in the positions of the need to know want to know where the supplies have gone. Take a look where the VA is sending them. The VA sends out too much. Plus, when the care providers go into the veterans homes, they take even more with them. I bet you I hauled 3 car trunk loads of medical supply waste to the police station incinerator. Yes, I did. The rest was picked up by a local thrift store. All inspected by healthcare professionals prior to giving or selling to others. Cleaning out this home in November 2018 was something else. We did not believe we would ever get it completed. As for the Director of this VA or any VA for that matter, Ben, they rarely know the details of their facility under them. This is why. The source is the communication process. This is true in many cases and you already know this.
      When an event happens with one person by the time the content about the event in the conversation travels where it is supposed to go, the content is twisted 10 million ways. This is what happens when there are too many hands involved. This is why I say the President does not know the truth. He knows about what I would say is 75% of the truth. However, his leadership is the best of what I have witnessed during my time.
      The truth lies with the people who have experienced whatever. What helps the president is he is able to connect to the people. This is how he knows without actually having been present in the moment of the happenings. See most of Washington DC lives in a bubble of their own. They sit up there and write laws without knowing the details behind the purpose for which they are writing them. For example, the implementation of a fitness program. One would think they would communicate to the consumers about their needs like age, fitness levels, muscular indexes, male or female, or just characteristics about the group of consumers. This was not happening. Washington DC has been delivering all with how, when, where, and what without the connection to the consumers. This is difference in the president and the rest of DC. Many Republicans are onboard with the president’s leadership. However, there are some who are not and this is because they are not connected with the truth. They do not choose to be. All can figure out the rest. As for me and zero updated documented skills. I am enrolled in some Mathematics such as a Stats class aligned with the data analysis add on option in Excel. I figured this could be an immediate skill that might could assist me in being hired into a job. Kind of hard to accomplish new degree, certifications, and even get hired if one has been spending lots of one’s time straightening out what was supposed to having been already taken care of or being taken care of by those who are already employed. Best.

    5. Benjamin, let me say this I would already be interviewing for employment if the current university of which I am enrolled with had not changed their Mathematics Statistics from 16 weeks to 8 weeks. This university I almost believe has the VA as their sugar daddy due to the GI Bill. I have been in class with other active duty as well. Some in my Calculus class worked for Lockeed Martin, Energy companies, etc. A couple were past Cryptologists in my old Navy rating. But the point I am getting to here is I would not put it past the VA to have paid this president of this university to shorten the Statistics class to 8 weeks from 16 weeks in an effort to sabotage me. The VA has not liked moving forward out from under them at all. As a matter of fact when I was having to assist my sister in Atlanta, I caught flack from the VA. They did not like it at all. Ben, she is my family and she needed me. I know that I am of little importance to the VA period. I would not put it past them though. This VISN has been a double dagger in my back for the last 10 years. This VISN has been the most sabotaging. I originated out of the Northeast out of Newport, Rhode Island from the Navy base there. Here is what I needed to say. President Trump is speaking about cutting government assistance. Put it like this and in my case, I do not object. Though, from the way this country has become with being so focused on status, it is harder for some older to build back up particularly if they have been slammed to hell and back. Others see the money but they do not take into account what has happened at all. Once they become aware of the happenings of what the person has been through and the past history diagnosis then they decide the money is not so great. Most people who are not wise always believe the grass is greener on the other side of the fence and they desire what someone else has. I do not care who reads this. Have at it.
      How many people would like to have a past history of psychosis with having been diagnosed with Schizophrenia as the Service Connected disability when being retired from the Navy? Zero Ben. See my point. This past history was a screenshot of time during my life. Yes and only a screenshot. They speak about red flag laws for people of whom they consider risks. Most of the time this applies to anyone who has or has had a past history related to this. I do not believe they should make decisions in relation to this perspective alone. Here is why. People who have experienced these types of conditions and who have had some treatment to assist them by ones own efforts, community efforts, and medical community efforts should not be labeled as a risk. Ben, if the correct medications and the therapy have helped the individuals, then they are more better off than if they were never diagnosed and if they never received treatment. People who have had some sort of recovery develop an appreciation for life and goodwill for all. They develop an awareness that many others may not have. They develop interpersonal skills. They know how to connect and engage. This is how I understand the president. I am not saying the president has a past related to having a mental health diagnosis either. However, the way that I am today I have almost always been this way as in principles. I grew up in a good family. However, the derailing of my life had all to do with the abuse of power. Yes and yes. The end result was how my psyche reacted to the situations. Getting back to this VISN, there have been helpful VA employees. The ones who were most helpful to me in the past either retired from this VA or left the VA. Though, none of them have ever been willing to tell me the truth and none them have ever been willing to allow me to advance my agenda for my own life. How can they determine? They cannot because the system is not set up to do so. If the president wants to take the step with what he calls entitlements, I do not believe Social Security retirement is an entitlement because people have worked and paid into the system. But you see it has been the idiotic past administrations who have taken the money out and have never put it back. They took some out to fund shit Obamacare. I am not on Social Security retirement. I am just commenting. However, I believe this is one entity that has stood in the way of the VA retraining me. It is all about money. The government has zero path to transition. They say one cannot have it both ways. Ben, it has never been about having it both ways. They so shallow and stupid. Yes I will say it because they are. Once one lands on their dime they want to be the ones to decide about everything. I object. This is why. When I have developed to the point that I am straightening up after them, I do not see how their decisions are beneficial at all. Ben, they cannot even stand it for one to apply for scholarships to pay for retraining. I have never in my life witnessed such jealous people. They try to block that too Ben. Ben, this is what I desire for the president to do. To hell with these government agencies, I desire for him to deregulate the laws that which prevent the transition. Though, the companies do not care to hire older folks even if many of the millennials are jumping ship to the vacationing. Companies are trying to accommodate to keep them. I rarely see a physician. I rarely see a physician even with being own govt compensation. I cannot afford it. So the healthcare is not medical care and I manage myself almost. As in my case, I do not give a shit what he does with the government assistance. Only my compensation is of any value. Money so I can pay rent and food. That is about it. I have been trying to reenter the workforce for ten years now. Only way to have transitioned into employment that has healthcare -medical care benefits is to have a skill set that a company desires. This is what the VA and the SS people have been blocking. So Ben I say to the president as in my case, enact employment training and strip the hell out of it. Ben, I did not land in the VA on my own accord. With what happened in the Navy, they are responsible due to the negligence that contributed to my situation. ZILCH of the government care is serving me in my best interest. It is serving itself. So I do not give a shit what the president does. I had rather be earning my own money while holding a decent job. My compensation is truly earned from the shit that I have experienced. With employment that is of substance, I may can pay for my own damn medical care. People in government concerned what if one develops a life threatening illness. Well if that happens so be it. I personally do not see what the difference is with being under government healthcare or not being under government healthcare. Being under government healthcare most certainly many times does not save one’s life. In many cases in the recent years, the government being involved adds to the problems. I am not directing this statement at Social Security Retirees who have worked for 50 years +. There is a difference. I cannot receive decent medical care now so what is the difference. Look at the oldest living lady engineer who is still working at the age of 87 as a project manager for the DOT in the state of Missouri. In my remote circle, I had someone share about someone who became a physician at the age of 87. Yes and she graduated from Harvard Medical School. Ben, the Trump administration can reform what they call entitlements but they need to make sure they do not remove from those who only have SSDI and medicare and who do not a way to return to work at the present time. As for student loans, people who are older do not have a lifetime to pay it back. See my point here too. And a company will not retrain someone who is older. So as in my case, I have no idea how I can arrive to be hired into something decent. Now all jobs are have value and have to be done. What I am saying is with being older adds to the discrimination in upward mobility in a company. With zero skill updated skill set, the person may be hired to scrub floors and they will be left there to eternity. Even if the older person maybe higher performing compared to someone who is younger. Only way an older person can advance themselves in improving their skill set via education and training is to see about themselves. So Trump administration if you can fix this crap, please do.
      VISN 8, if you can fix your facilities, please do.

    6. My comments about this VISN include 2016 and back. I have been gone since the late summer of August of 2016. This is the summer when I arrived back from assisting my sister. So my comments Ben are based on what was. The conditions of which I was not able to receive care for included an eye infection, incorrect eye glass prescription, kidney infection of which they had did a CT scan on and did not treat, 7 travel doctors of whom contributed to little continuity, canceled consult, neuroma on ball of foot causing pain, thyroid antibodies well above 900 beyond the established range, denied chapter 31 in late summer of 2015, in accounting class summer of 2016 with appointment with provider and provider was too busy taking a break with union tasks…checked in early with nurse around 11:00 and provider was supposed to meet with appt at 12pm…nurse mentioned she was on break and she would see me at appt time but they never called me. I had to go to the desk to inquire…they said she had a patient…but the nurse said she was on break so which was it?…Well, Ben, I had an Accounting class at 2pm. Now do you see this conflict? Do you see how they were conflicting with whatever the vets tasks were involved in?…Now if this were employment in the private sector what do you think would happen? The world did not wait on the VA. She finally got me in around 1pm. Ben this was after a small confrontation. As for the eye infection, I could not get an appt until the next spring because I had an appt in late spring of 2016 after returning from Atlanta of when they messed up the eye prescription and missed the eye infection. So I proceeded to move care out. Maybe they will improve….Who knows? This is up to the VA leadership. But, I cannot take them at all. I have had enough of them. They probably had enough of me too. So that makes us even. I will march on to a job hopefully.

    7. The 2019 IG Audit noting all the stored appeals in filing cabinets, etc. This is intentional sabotage because they know they can get away with it. Ben, honestly if they wanted to hire more personnel, they would. They choose not to because this can be their excuse as to why the work was not done. Ben, when HR in the VA receives employment applications, they sit on them forever. If an i is not dotted correctly, they will throw the application out. Ben this is what they used to do. I witnessed it with others. I even applied for employment with them back before my car accident in 2012 which was before I took the GRE exam in 2013 and before I applied to the Social security administration for employment in 2014 and before I applied for Chapter 31 Vocational rehabilitation in late 2014 and before my GRE scores became dated in 2018 due to having to correct and clean up after them. My care, my moving, cleaning up after their mess with my mom’s brother. See this timeline Ben.

    8. Benjamin, the service organizations get on the president’s ass about his statement on claiming no serious injuries with the attack recently. I agree to a point. The President should have waited to fully respond on this particular issue. He should have checked the details a little closer before issuing his full statement. However, why can’t these same service organizations issue statements regarding the VA issues when the VA harms veterans and denies care? And when the VA does not follow through with the veterans claims for non VA care. See this Ben. If they can publicly get on the president’s ass, why can’t they get on the VA leaderships’ asses? And the AFGE Union’s asses? They are not consistent. I do not care for the service organizations because they have become too politicized as compared to years in the past. When a veteran has a local DAV veterans service officer take a marker and mark thru the dates of the veteran’s award letter, what is wrong with this picture Ben? Corrupt Ben. You should hear this shit they are teaching these kids in school. Nothing about the Holocaust…they are teaching about China…they are not teaching any American history….2/3 of the millennials do not know anything about the Holocaust. If I can I am going to discontinue SS. Yes employment soon.

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