Saturday, December 17, 2016

VAMC Northport voted best in Country......NOT!

Saturday, December 17, 2016
VAMC Northport has a 90% satisfaction rating!
And, a 5.5 day wait time for appointments!!
In a perverse sort of way, it’s heartening to see that this type of arrogance and disrespect happen across the Country at all our VA Facilities. For a while, I thought it was unique to the VA Medical Center in Northport, NY. What is happening at the VAMC, Northport, is far worse than the isolated accounts that appear in my email every day.
I am taking the liberty of “marking” this article up so that I can reference certain aspects of it. I admit to reading this, and all other similar accounts, with a jaundice eye. Time after time, our wonderful Department of Veterans Affairs makes a statement in one paragraph, only to contradict itself in the next paragraph. I have come to realize that the VA really does think we are all idiots, and will drink their Kool- aide whenever served.
Health Care at St. Louis VA
This May 28, 2014, file photo shows the St. Louis VA Medical Center in St. Louis. (AP Photo/Jim Salter)
Associated Press | Dec 15, 2016 | by Jim Salter
¶1   St. Louis Veterans Administration health care officials insufficiently investigated the death of a mental health patient who killed himself, according to a report from the VA Office of Inspector General.
¶2   The OIG launched an investigation in 2014 after concerns were raised by Dr. Jose Mathews, the St. Louis VA's former chief of psychiatry. Mathews alleged in a federal whistleblower complaint that veterans often waited a month or more for mental health treatment because psychiatrists and other staff members were so lax in their work.
¶3   The investigation report released Tuesday found that new patients wait about 17 days for appointments -- only about three days above the national average for all VA centers. Investigators also denied Mathews' claims that staff psychiatrists were unproductive; in fact, the report said the St. Louis       psychiatrists ranked high in productivity.
¶4   VA St. Louis spokeswoman Marcena Gunter said Wednesday that several recommendations suggested by the report have been implemented, and others are in the works. She said the St. Louis facility is now in the top 20 percent of all VA medical centers in providing access to mental health services.
¶5   Perhaps the most alarming finding concerned the VA's response to the suicide of a 69-year-old schizophrenic.
¶6   The report said the veteran had tried to kill himself at least once before when, in 2014, he told VA medical staff he heard voices urging him to shoot himself.The man even asked for information about a suicide prevention hotline.
¶7   Nearly three months after the initial visit, unable to reach the veteran by phone, VA officials sent a letter advising him that medical tests showed his kidney function was deteriorating and a prostate test result was "abnormal," especially alarming since the man had prostate cancer.
¶8   The man fatally shot himself two weeks after receiving the letter.
Soon after the death, a leadership team review member at the VA requested an internal management review, calling the case "a pretty serious miss."
¶9   But the OIG report said that among other errors, a formal review of the psychiatrist or nurse was not requested until OIG investigators were on site nearly four months later. Corrective action didn't occur until eight months after the man's death, the report said.
¶10 The report also found "no evidence of any administrative follow-up" of another death, a mental health patient in his mid-20s who died in a car wreck three days after hospitalization amid suicide concerns. The death was ruled accidental but the report said suicide could not be ruled out. The investigation also found that the VA failed to provide timely treatment for a woman who complained of being sexually assaulted in the military, and for a patient       suffering from post-traumatic stress disorder.
¶11 The St. Louis VA has had other problems in recent years. In 2010, faulty sterilization in the dental clinic could have exposed 1,812 veterans to hepatitis and HIV. Testing eventually found no link to either disease in any of the patients.
¶12 In 2011, operating rooms at the medical center were shut down after rust stains were found on surgical equipment. Surgeries resumed months    later after the faulty equipment was cleaned or replaced. The VA opened a new $7 million sterile processing lab in May 2012.
So, paragraphs #3 & #4 claim that there is “no problem, here”! Really??
Take a close look at paragraphs #9 - #11. Do you see any slight little contradiction; perhaps a 180 degree flip-flop on the “no problem” statement?
The Hen House has been guarded by the Fox for way too long. It’s time for the Fox to go. It’s time to have a “top-to-bottom” outside, independent audit of this Department. If we have to throw the baby out with the bath water; so be it!
There is a way to re-construct, re-structure this Government Agency. Almost all the necessary parts exist in the current configuration; no need to reinvent the wheel. We do not need any more “blue-ribbon” panels; no more investigative outings by Congress. We have been throwing good money after bad, and it’s high time to just “QUIT IT OUT”!
Come up with a plan. Send everybody home for a month. Institute the plan. Call everyone back to work. Tell everyone exactly what his or her job function is. Tell everyone exactly how they are expected to behave towards the Nations’ Veterans. And, get the show on the road.

To all you “nay-sayers”, who throw up their arms and say this can’t possibly be done, I say “SIT DOWN AND SHUT UP!” Get out of our way, because, if you don’t want to be part of the solution, you are doomed to be part of the problem. And, we don’t need any more problems.


Tuesday, December 13, 2016

It’s a wonderful day in the VA Northport neighborhood...

“It’s a wonderful day in the VA Northport neighborhood...won’t you be my neighbor?”

It seems like my “second home” is going up for sale; literally and figuratively.
I am, of course, referring to the Veterans Affairs Medical Center (VAMC) in Northport, NY. The writing has been on the bathroom walls for some time, but I just didn’t want to believe it; yes, denial is the correct word, here. I remember about five years ago hearing that the VAMC Northport was in closed-door discussion with the North Shore/LIJ Health Network, and the takeover (privatization) of the VA Hospital was one of the topics on the agenda. There was ultimately a collaboration effected at the VA’s Bay Shore Clinic. And, I must admit that this affiliation/collaboration has worked pretty well. It seems be all accounts that a Veteran can get an appointment in the Bay Shore Clinic much sooner than he/she can at the VAMC Northport Hospital (go figure?). I have a very close friend who frequents the satellite Clinic in Riverhead, NY, and he has had a fairly decent experience there with appointment wait times and the little amount of treatment he asks of them.
Now, when it comes to wait times for appointments and satisfactory treatment at the main VAMC Hospital in Northport, the management seems to love quoting those Veterans who do not demand very much in the way of services. This set of Veterans tends to give the entire Hospital carte-blanche, positive feedback regarding their treatment at the VAMC Northport; even though they have not yet used, or consumed, but a small fraction of the VAMC’s product line. This “positive” feedback is being crammed down the throats of our elected Officials in Washington DC. The infamous Koch brothers are lobbying hard and heavy to hand the entire VA System over to private industry for the profit motive.
Ah, but wait, there’s more to this than meets the eye.
If you continue to ask questions of this set of Veterans, and start to dig a little deeper with more precise questions, you find out that, indeed, they have had problems in the past getting timely appointments, receiving proper treatment from the Medical Staff, and being treated with respect when dealing with the “system”. So, in fact, the glowing numbers the VAMC Hospital management produces and publishes are not a reality for 99% of the Veterans on Long Island who consume VA Medical and Mental Health products.
[note: Only about 28k of the roughly 140k Veterans on Long Island are registered users of the VA Health Care System in Nassau and Suffolk Counties; 20%. Where’s the other 80%?]
So much for the Veteran consumers at the VAMC Northport. Let’s talk a little about those folks who are under the employ of the Federal Government and hold jobs at the VAMC Northport. Being a part of the largest health care system in the World, there are, obviously, many levels of employment at play here. Employment ranges from the Veteran who mop the floors for $2.50/hour to the Doctors and Administrators earning from $100k to $300k per year. The low-end employees are doing the best with the cards that have been dealt them, and they are our Brothers and Sisters just trying to get by. The middle of the pack are the folks who have signed on and are trying to do the best they can under a corrupt, arrogant, and intimidating Administration. And, people being people, some react differently than others, but, by and large, there is a solid, dedicated “middle class” of Nurses, Social Workers, Doctors, lower administrators and assistants, etc.
Then, there’s the old 1% at the top!
This is where the “system” totally breaks down! This is where the culture of corruption, arrogance, intimidation, etc. starts and ends. The buck cannot be passed up or down the line from here. Luckily, for us Veterans and our Health Care, 2016 has been good to us in one respect. Some much-needed light has been shone on the disaster that is our VA Hospital and its upper management. September saw an unprecedented Congressional Hearing held on the Hospital grounds. A Hearing that saw the Hospital Director and the VISN 2 Director give (and, I’ll be kind, here) misleading information to a Congressional Investigative Panel while under oath. The funny thing was that the Congressional Panel members knew the answers to their questions before they asked them (Oh, that’s such an old “lawyer” trick. How could anyone with half a brain get tripped up on that?). And, it turns out that while everything seems to have gone a little quiet since then, in actuality the Investigators are still in the process of constructing a case strong enough to produce criminal indictments of these bad players. The word on the street has them very close to handing their findings over to the Justice Department for formal indictments. I find it interesting that some of “lesser” players in this game don’t have a clue that they, too, are open for indictment, as well as their buddies at the top.


Monday, December 12, 2016

New Regulation Decreases Cost of Outpatient Medication Copay for Most Veterans

Veterans AFFAIRS

VA News Release

12/12/2016 11:12 AM EST
New Regulation Decreases Cost of Outpatient Medication

Copay for Most Veterans

Washington – The Department of Veterans Affairs (VA) is amending its regulation on copayments for Veterans’ outpatient medications for non-service connected conditions. VA currently charges non-exempt Veterans either $8 or $9 for each 30-day or less supply of outpatient medication, and under current regulations, a calculation based on the medication of the Medical Consumer Price Index (CPI-P) would be used to determine the copayment amount in future years. 
“Switching to a tiered system continues to keep outpatient medication costs low for Veterans,” said VA Under Secretary for Health Dr. David J. Shulkin. “Reducing their out-of-pocket costs encourages greater adherence to prescribed outpatient medications and reduces the risk of fragmented care that results when multiple pharmacies are used; another way that VA is providing better service to Veterans.”   
This new regulation eliminates the formula used to calculate future rate increases and establishes three classes of outpatient medications identified as Tier 1, Preferred Generics; Tier 2, Non-Preferred Generics including over-the-counter medications; and Tier 3, Brand Name. Copayment amounts for each tier would be fixed and vary depending upon the class of outpatient medication in the tier. 
These copayment amounts will be effective February 27, 2017: 
$5 for a 30-day or less supply - Tier 1 outpatient medication
$8 for a 30-day or less supply - Tier 2 outpatient medication
$11 for a 30-day or less supply - Tier 3 outpatient medication 
These changes apply to Veterans without a service-connected condition, or Veterans with a disability rated less than 50 percent who are receiving outpatient treatment for a non-service connected condition, and whose annual income exceeds the limit set by law. Medication copayments do not apply to former Prisoners of War, catastrophically disabled Veterans, or those covered by other exceptions as set by law.
Copayments stop each calendar year for Veterans in Priority Groups 2-8 once a $700 cap is reached.
More information on the new tiered medication copayment can be found here.

How's this for a novel idea? If you are a United States Military Veteran, you can get any/all medications for free! That's friggin' copays, no tier systems, no more playing favorites. If you need 'em, you get 'em. That's it; no if's, and's, or but's about it.

PBS Story Shows Longer VA Wait Times After 2 Years

PBS Story Shows Longer VA Wait Times After 2 Years

May 20, 2016
After $10 billion and two years, VA wait times are causing veterans to wait even longer for health care appointments despite claims from AFGE that VA is fixed.
In their report, PBS found that wait times are worse than this time last year. Presently, there are 70,000 more appointments taking at least one week.
VA claims the increased delays in health care administration are due to greater usage of VA resources, but data analyzed in the report contradict the claim. Instead, PBS says, “the problem has more to do with the way Veterans Choice was set up.”
It is as if the entire Veterans Choice program was set up to fail, no?
VA has failed to administer the program within modern standards. Non-VA doctors are not being paid in a timely manner. As a result, many of those doctors originally willing to work with the new program have stopped since VA cannot honor its agreements.
That seems to be the most convenient foible of the Veterans Choice debacle. Now, the entire country knows how dysfunctional and incompetent VA is at administering new bureaucratic programs.
PBS did a great job highlighting some very human examples of how the program is still not working. They even covered problems with the lead contractor responsible for administering the program, Health Net.
According to PBS:
In Gastonia, N.C., Kelly Coward, a surgery scheduler at Carolina Orthopaedic & Sports Medicine, dials yet another veteran with bad news.
“I’m just calling to let you know that I still have not received your authorization for Health Net federal. As soon as I get it, I will give you a call and let you know that we have it and we can go over some surgery dates,” she tells a veteran.
The practice sees about 200 veterans. Dealing with Health Net has become a time-consuming part of her job.
“I have to fax and re-fax, and call and re-call. And they tell us that they don’t receive the notes. And that’s just every day. And I’m not the only one here that deals with it,” she says.
Carolina Orthopaedic’s business operations manager, Toscha Willis, is used to administrative headaches. They’re part of the deal with health care, she says, but she’s never seen something like this.
It takes “multiple phone calls, multiple re-faxing of documentation, being on hold one to two hours at a time to be told, ‘We don’t have anything on file,’ ” she says. “But the last time we called about it, they had it, but it was in review. You know, that’s the frustration.”
It can take three to four months just to line up an office visit.
Sounds like a big problem with the Veterans Choice system lies within the government contractor VA hired to administer the program. What if we eliminated the Veterans Choice program, per se, and just allowed veterans to use
What if we eliminated the Veterans Choice program, per se, and just allowed veterans to use their VA ID Card to get normal health care like elderly Americans on Medicare? Wouldn’t that eliminate the middle man, so to speak?
If we are going to allow veterans to use non-VA health care, perhaps the agency should take some tips from our nation’s elder care system since that one at least seems to work.
When you are old, you get health care.
Why can it not be that simple for veterans?
No doubt, Veterans Choice has many problems, and if VA was truly committed to getting it done right the first time, they would have done so. But like many other programs administered by VA, getting it right the first time, or the second time or even the third time never seems to be a realistic expectation.
As for the union, if you asked AFGE president J. David Cox, we should scrap the program and force veterans back into VA.
And like Pandora’s Box, let’s hope that now that the horses are out of the barn, they cannot be put back in.

"..and, its one, two, three....what are we fightin' for?...

More US Troops in Syria Under Risk of Attack from Turkey

In this Oct. 5, 2015 photo released by the Rased News Network, a Facebook account affiliated with Islamic State militants, authenticated based on contents and AP reporting, people gather at the site of an airstrike in Al-Bab. (Rased News Network via AP) | Dec 10, 2016 | by Richard Sisk

The 200 additional U.S. troops heading into Syria will support a drive on the self-proclaimed ISIS capital of Raqqa led by Syrian Kurds who are under risk of attack from NATO-ally Turkey, according to a senior U.S. military official.
"They're the horse we're riding to Raqqa," the senior official said of the Syrian Kurdish fighters known as the YPG, or People's Protection Units.
Turkish forces invaded Syria in August to clear border areas under the control of militants affiliated with the Islamic State of Iraq and Syria, or ISIS, and also to attack the YPG, which Turkish President Recep Tayyip Erdogan has labeled a terrorist organization bent on carving out an autonomous Kurdish region.
"Their biggest concern is the Turks behind them" and not the ISIS fighters arrayed against them in Raqqa, the senior official said of the YPG fighters who have been trained and equipped by the U.S. and are widely considered the best rebel fighting force in northeastern Syria.
The Turks "hate who we're working with," the senior official said. The U.S. has cut off air support for the Turkish forces inside Syria out of concern over their intentions.
The senior military official, who spoke on grounds of anonymity last Friday, described an increasingly complex battlefield in Syria in which the U.S. worried about potential clashes between the Turkish forces inside Syria and those of the Syrian regime of President Bashar al-Assad pressing north with backing from Russia.
The U.S. military was also operating in a policy vacuum as the Obama administration leaves and President-elect Donald Trump takes over as the new commander-in-chief, the senior official said. He asked, "Is it still a policy objective to remove Assad?"
In a major address on Mideast policy at a security conference with Arab leaders in Bahrain, Defense Secretary Ashton Carter said, "the United States will deploy approximately 200 additional U.S. forces to Syria, including Special Operations forces, trainers, advisors, and explosive ordnance disposal teams."
"These uniquely skilled operators will join the 300 U.S. special operations forces already in Syria, to continue organizing, training, equipping, and otherwise enabling capable, motivated, local forces to take the fight to ISIL, and also bringing down to bear the full weight of U.S. forces around the theater of operations like the funnel of a giant tornado," Carter said, using another acronym for ISIS.
The speech was expected to be Carter's last on Mideast policy. Trump has announced that he will nominate retired Marine Gen. James Mattis to replace Carter as Defense Secretary in the new administration.
In a video briefing from Baghdad to the Pentagon last Friday, Air Force Col. John Dorrian, a spokesman for Combined Joint Task Force-Operation Inherent Resolve, said that U.S. and coalition warplanes had carried out nearly 300 airstrikes over the last month to support the advance on Raqqa of the mixed force of Kurdish and Arab fighters led by the YPG and known collectively as the Syrian Democratic Forces.
"These strikes have destroyed about 90 fortifications and over 50 vehicles," and were continuing to disrupt supply routes of the Islamic State of Iraq and Syria, Dorrian said.
"The SDF, with its Arab elements, has enabled the establishment of a governance structure representative of the local population" in areas liberated from ISIS, including the flashpoint town of Manbij, Dorrian said.
"They've begun providing services to the people of Manbij, including having opened more than 240 schools since its liberation. A similar model with local governance is in the works for Raqqa once it is liberated," Dorrian said.
Dorrian also noted the threat to the advance on Raqqa from Turkey. He said that the U.S. was "facilitating joint discussions with Turkey, the SDF and other coalition partners to promote de-escalation in the area. These meetings are starting points in addressing a challenging situation."
Dorrian acknowledged that "There have been instances where -- previous instances where there has been an exchange of fire between the SDF and the Turks -- the Turkish military. That has already occurred at different times during the campaign. So what we're trying to do is make sure that we keep all these operations de-conflicted."
The Turkish General Staff claimed Saturday that more than 70 PKK (Kurdish Workers Party) and ISIS terrorists had been killed by recent Turkish airstrikes in northern Syria and in Kurdish areas of southeastern Turkey, Turkey's Andalou news agency reported.
Turkey has charged that the YPG is an offshoot of the PKK, which has been labeled a terrorist organization by Turkey, the U.S. and the European Union.
In a statement, the Turkish General Staff said that local forces backed by Turkey called the Free Syrian Army were also closing in on the ISIS-held town of al-Bab in northeastern Syria with the support of Turkish tanks, artillery and airstrikes, Turkey's Hurriyet newspaper reported.
The senior U.S. official who spoke on background last week said the U.S. also had concerns about a potential all-out fight he called a "meeting engagement" around al-Bab that would involve the Turks and the Syrian opposition, and the Assad regime forces backed by the Russians moving from the south. "This is a very tenuous situation," the senior official said.
-- Richard Sisk can be reached at