Showing posts with label VA. Show all posts
Showing posts with label VA. Show all posts

Saturday, June 12, 2021

SECOND LARGEST BUDGET...WORST PERFORMANCE

 NOT ALL THE BAD GUYS ARE IN JAIL

STEEPED IN CORRUPTION FROM THE START

A Veterans Administration Medical Center – Northport, NY


the land purchase & occupation:

1925

Construction1926-1927

First occupants

1928

@@@

The Observer
The Northport VA Medical Center

May 29, 2020

Teresa Reid is curator for the Northport Historical

Society, author of the book Northport, and a

columnist for The Observer.

Northport VA Medical Center

Shortly after WWI, it became apparent to Congress that the returning veterans were not able to obtain the proper medical and psychological treatment they needed and deserved. To rectify this situation, President Harding established the US Veterans Bureau in 1921, which assigned Public Health Service hospitals to the new agency’s control. 

Under the supervision of Brigadier General Frank T. Hines, a committee was formed to choose a site in the New York area for a new modern and specialized health care facility. In 1925, the committee, after scouting hundreds of locations in the tri-state area chose the small, picturesque village of Northport. 

Residents, having learned plan to purchase 522 acres of farmland in the Middleville area, rallied together in protest. Public hearings were held where citizens voiced their concerns about another such hospital, like the one in King’s Park and Islip, coming to Suffolk County. The people in attendance thought land values would decrease, businesses would suffer, and traffic would stress the small unpaved roads. A resolution was drawn up and sent to the NY Representatives. Two weeks later, a delegation from Northport led by Mr. R. B. Jones, went to Washington DC and appeared before the Federal Board of Hospitalization. Among the list of disputes: the land was too expensive. Why had the Federal Government paid $350 an acre, double the going rate? 

The property once owned by Rinaldo Sammis (hence Rinaldo Road), was then owned by Mrs. Inez Todd Hodges. Just before the land purchase though, the land became the property of rich and powerful copper industrialist Ryan [1], who had made a fortune during the war. It seems that, for reasons unknown, Mrs. Hodges was in debt to Mr. Ryan for over $100,000. They struck a deal. He would sell the land for her to pay off her debt and anything over the debt amount, would be extended to her. Ryan sold the property to the government at the inflated price, perhaps because of powerful friends doing a favor, Mrs. Hodges never saw a dime, and Northport resident’s concerns fell on deaf ears.

Construction began in August of 1926. The plan of the Medical Center is based on the standard set plan developed by the Veterans Bureau in Washington DC for all such facilities in the U.S. Between 1920 and 1946, the Bureau built 50 Veterans’ hospitals across the country, constituting the most ambitious and most advanced health care delivery system in the world at the time.

The original Medical Center in Northport was built for $3,386,518. The 956-bed facility offered a campus-like setting with beautiful landscaping, out-door recreational facilities and paved roadways. The exterior design was approved at the highest level of the VA in Washington but reflected the historical nature of Northport Village. Thus, the style selected, Georgian Colonial home, is unique among the VA system. 

The first patients were admitted on April 16, 1928 with Doctor George F. Brewster as the Medical Officer in Charge and the Center soon became a source of pride for Northport.

Patients received the most current treatments and therapies of the time, there were no bars on the windows, there was a swimming pool, large porches, and community dining rooms. All the cooking was done with electricity in the large kitchen. A large recreation room seated 1,000 patients, contained a stage, scenery, and dressing rooms. The Center was equipped with x-ray machines, a research lab, and an operating room. Dental care was also offered. It became its own little community, with farms, a fire department, general store, mechanic shop and its own baseball team, the “Wildcats.”

Patients were kept busy with occupational and agricultural therapeutic programs, such as carpentry, textile making, painting and farming. They ate the fresh vegetables they grew, including potatoes. They also had “chores” taking care of gardens or working in the stables. Chickens, pigs and sheep were raised for research purposes. Many of these programs lasted until the 1960s.

During WWII, many activities were curtailed due to fuel shortages, however the hospital maintained a “Victory Garden.” Many employees joined the armed services and as a result military personnel were assigned to fill the vacancies. One of the enlisted men assigned to the hospital was actor Sidney Poitier. After the war the hospital’s ecumenical chapel was built as a gift from the readers of the New York Journal American.

In the 1950s, Northport’s hospital was one of the first psychiatric hospitals to treat patients with newly discovered drugs and was pioneering programs like group therapy and community out-placement, earning them an award for its accomplishments. After the Korean and Vietnam Wars the increasing number of veterans forced the Medical Center to expand, providing general medical and surgical care. Many new buildings were constructed, and the farm-setting community atmosphere changed dramatically, however, patient care was always their number one goal. 

In the decades that followed, the Northport Veterans Medical Center has had to continually adapt to change as it finds itself doing once again during the Covid-19 Pandemic. On March 27th the VA released its Covid-19 response plan and announced its “Fourth Mission”, a plan to help the U.S. combat the virus. 

Reference(s):

[1] - John Dennis Ryan (October 10, 1864 – February 11, 1933) was an  

         American industrialist and copper mining magnate. He served as

         President of the Anaconda Copper Mining Company and was a founder

         of the Montana Power Company.

LINK:   https://teresareid.com/f/the-northport-va-medical-center

United States Third Generation Veterans Hospitals, 1946-1958

Investigation into Veterans Administration Practices, 1945 The condition of these Veterans Administration facilities led to a public demand that returning veterans deserved only the best, modern facilities, and not the old-fashioned hospitals of the past. In early 1945, Albert Deutsch, a journalist with a particular interest in the care of the mentally ill, published a series of articles in the New York City newspaper PM that criticized the medical care provided by the Veterans Administration. Deutsch conducted a survey of multiple VA facilities and interviewed VA staff including General Hines, lower-level employees, doctors, and members of veterans’ groups. Deutsch identified multiple problems within the Veterans Administration, including a “medieval attitude towards medicine” that discouraged young doctors from joining the VA, limited medical research, a massive bureaucratic system that restricted the time doctors spent with patients, and “undue kowtowing” to political pressures. 60 While Deutsch acknowledged that the Veterans Administration likely did not suffer from the same corruption that had triggered the scandal that led to the Hines appointment in 1923, he condemned the administrator’s ability to provide the necessary medical care for the veteran population. At one point, Deutsch suggested Hines must adhere to the tenets of Christian Science, a faith reliant on prayer over medicine for healing, as it could be the “only logical explanation for his otherwise incomprehensible antagonism to medicine.” Hines responded he was Episcopalian.61 Deutsch identified multiple ways to fix these problems. Suggestions included creating a VA medical corps independent within the Veterans Administration, constructing new hospitals in urban areas near medical schools, forging connections with medical schools to ensure the Veterans Administration’s doctors were aware of the latest research and medical innovations, allowing young doctors to intern at Veterans Administration hospitals, convincing the American Medical Association to permit the VA’s doctors to join, hiring African-American doctors and nurses, and “break[ing] down the isolationist tradition in the VA system.”62 These charges and calls for an investigation were echoed in other publications, including the Journal of the American Medical Association, Cosmopolitan magazine, and the New York Times, which claimed “more attention has been devoted to the construction of monumental hospital buildings than to the standards of care within them.”63 The New York Times summarized the complaints alleged “brutal treatment, unwarranted overcrowding, neglect, improper care, poor food, bad sanitation, and inferior medical care.”64 The Veterans Administration responded with denials, but acknowledged there may be isolated incidents that were the result of issues with under staffing rather than a systemic problem.

References:

60 Alfred Deutsch, “Vets’ Setup Needs Revamping Now to Avert Scandal,” PM, January 7, 1945, 6.

61 Alfred Deutsch, “Program for Vets: Remove Hines,” PM, March 14, 1945, 8.

62 Deutsch, “Vets Setup,” 6; Alfred Deutsch, “Hospitals Should be Freed from Medical Isolationism,” PM, March 15, 1945, 5; Alfred Deutsch, “’Paper Work Doctors’ in Vet Hospitals Should be Freed to Relieve Shortage,” PM, March 16, 1945, 9.

63 Leo Egan, “Veteran Hospitals Widely Criticized,” New York Times, May 16, 1945.

64 Leo Egan, “Veterans Critical of their Hospitals,” New York Times, May 17, 1945.

reference:   United States Third Generation Veterans Hospitals, 1946-1958 (penndot.gov)


AND, ON, AND ON, AND ON………...”AD INFINITUM”.

Considering what has happened over the past twenty years, It appears absolutely nothing has changed: not the direction of the Hospital; not the upkeep of the buildings & grounds; not the treatment of employees; not the management of outside contractors; not the treatment of medical students and interns; and above all, not the treatment of Veterans.

1] May, 2016

Northport VA Hospital Forced to Shut Down Operating Rooms

Kristina Rebelo

{!! Guess what? It did happen, again. Luckily their portable A/C units, which had been rented (about $30,000 per month). This was a much shorter outage due to their previous experiences.}

2] September/2016

Deaths, Fraud Allegations and an Inquiry into the Long Island Veterans Hospital 

3] April, 2018

Schumer: Northport VA needs $15M in emergency repairs

By Sara-Megan Walsh

“Standing in front of Northport Veterans Medical Center’s shuttered homeless shelter on Monday morning, U.S. Sen. Charles Schumer (D-NY) said the center requires $15 million in emergency repairs to its heating and air-conditioning systems. Or, it faces the possibility of closing more buildings and its operating rooms again this summer.  

4] June, 2019

Head of Long Island VA hospital quits after year on the job

The VA hospital has been without a full director since Scott Guermonprez left abruptly…”           

The list of all things anti-Veteran and anti-employee is enormous. Even a long time researcher would be overwhelmed by uncovering the scabs at the Northport VAMC over the 100 years of its existence.

 

 

Monday, April 19, 2021

Commission Defends Integrating VA Care and Outside Doctors

POSTED BY: TOM PHILPOTT, SEPTEMBER 8, 2016

PREDICTION:

By the second quarter of 2017, The VA Health Administration (VHA) will be well on its way toward “privatization". The Commission on Care was chartered by Congress. Most of our elected Officials and many prominent private citizens are fully behind this movement. They have very quietly made extraordinary progress toward their goal of enriching the private health systems with the money they will receive from the Federal Government for enrolling Veterans. I had to read this twice to make sure I wasn't missing something extremely important to Veterans; Mental Health Care. The 'Commission on Care' report to Congress does not address this at all. There is a way to remedy the problems inside the Department of Veterans Affairs. It seems that no one involved in this has any desire to do the right thing for Veterans. It's going to be a dark day for our Nation's Veteran population when this report morphs into Law and practice.

Military Update: Commission on Care leaders defended their tough diagnosis and 18-point treatment plan for what ails the VA Healthcare system, including their controversial push to let veterans begin to choose their own primary care doctors from new, integrated networks of VA and private-sector physicians.

Answering critics who say they went too far or not far enough in proposing to transform the Veterans Health Administration (VHA) over the next 20 years, Commission Chair Nancy Schlichting, Chief

                                                                              

Executive Officer of the Henry Ford Health System in Detroit, and Vice Chair Dr. Delos “Toby” Cosgrove, CEO of worldwide Cleveland Clinic hospitals, warned the House Veterans Affairs Committee on Wednesday that VHA is rife with weaknesses. TheThe many “glaring problems,” said Schlichting, include under staffing,aging facilities, obsolete information technology, flawed operating processes, supply chain weaknesses and health outcomes that vary across VHA, all of which “threaten the long-term viability of the system.” Yet VHA’s ability to transform is most hampered by “lack of leadership continuity and strategic focus,” and “a culture of fear and risk aversion,” she said.

By having only two of 15 Commissioners from the Congressionally chartered panel testify allowed committee members to focus on what a majority of industry health experts recommend, rather than complaints of Veterans’ service groups defending the status quo or the unpopular notion of dismantling the VHA system as backed by the billionaire Koch brothers.


But Rep. Jeff Miller (R-Fla.), the Committee Chair who will retire in January, added his own list of VHA weaknesses that have been the focus of House Committee hearings and press releases: “persistent access failures, noncompliance with federal prompt pay laws, lack of accountability, a bloated and self-preserving bureaucracy, and billions of taxpayer dollars lost to financial mismanagement of construction projects, IT programs, bonuses for poor performing employees.” The list, Miller said, is “legion and growing.”

But, Miller on one issue joined with the Obama administration and most Veteran service organizations. He opposes the Commission’s call to establish a new layer of VHA oversight — a Board of Directors comprised of health industry experts who would have authority to direct VHA transformation, set long-term health care strategy and ensure both are carried out by a VA Under Secretary of Health who would be appointed for five-year fixed terms.

“Outsourcing the crucial role of a Cabinet Secretary to an independent board…neither elected nor accountable to the American people would be irresponsible and inappropriate, not to mention unconstitutional,” Miller said.

 Miller and Rep. Mark Takano (Calif.), the Committee’s ranking Democrat, agreed with many Commission recommendations and noted that VA Secretary, Robert McDonald, said many already were being implemented as part of his ambitious MyVA reforms announced last year.

But, Takano, on behalf Veterans’ groups, criticized the Commission’s call to integrate VA medical staff with networks of screened private care physicians, to allow enrolled Veterans to choose their own primary care doctors, and to allow their providers in turn to manage all care including referrals to specialists on VA staffs or approved outside networks.

The worry, Takano said, is that too many Veterans will choose private sector care, driving up VA costs and jeopardizing “the viability of unique VA health services” to treat spinal cord injuries, polytrauma cases, amputee care, blindness or traumatic brain injuries. Why didn’t the Commission recommend that its expanded “choice” model be tested initially to determine the impact on VA budgets and programs, he asked.

Commissioners did discuss a phased approach to include testing, Schlichting said, and that is reasonable considering the complexity of implementing these reforms.

“It’s important to balance this question of choice — making sure access is really available within every market across the country — with the issue of how we’re trying to also control those networks to better serve Veterans,” the commission chair said. “Finding that balance is really important.”

Schlichting recalled heated commission debates over how and why to expand patient choice using the private sector. In the end a consensus of commissioners believe they have hit a “sweet spot” for expanding choice by preserving VA system strengths while also allowing access to outside providers carefully screened to provide quality and Veteran-centric care.

The commission would allow VA-enrolled Veterans to pick a private care provider even when a doctor was available inside VA. What data did the commission rely on to decide that would be okay, Takano wanted to know.

“If you begin to the think of the VHA care system in the way we did,” Schlichting said, then “it’s not a question of VA versus provider-in-the-community. It’s one system that should be operating in a much more integrated way. And every provider within that VHA care system then would be able to provide access for Veterans. It’s a different mindset than today.”

She bristled at a charge from Rep. Doug Lamborn (R-Colo.) that the commission missed a chance to truly transform Veterans’ health care by rejecting the vision of two dissenting commissioners who wanted VA care more fully privatized and the VHA bureaucracy largely dismantled.

Neither of those commissioners, Schlichting said, “has ever implemented a major change in a health system as Dr. Cosgrove and I have. I think we recognize the transformative aspects of what we’re proposing.”

If Congress embraces recommendations from a majority of commissioners, she said, it would begin a “process that will take many, many years to complete, recognizing the complexities of both facilities and staffing issues and leadership [and] IT interoperability…And to say that what we’re proposing is not transformative I think is just untrue.”

Cosgrove, a former Air Force surgeon, emphasized that a first step toward transforming VA health care must be replacing a woefully outdated electronic health records system with an off-the-shelf commercial system that allow providers and patients to schedule their own appointments.

He and Schlichting also stressed that VHA can’t be transformed without an Undersecretary for Health who sticks around, and the backing of some sort of oversight team of experts to demand adherence to sustained progress. Congressional oversight, they argued, just isn’t enough.

THE MILITARY.COM GUIDE TO MILITARY AND VETERANS’ BENEFITS

CTRL & CLICK ON LINK:

https://www.military.com/benefits


Sunday, April 11, 2021

A VA VIDEO CONNECT APPOINTMENT GONE UPSIDE DOWN: WTF, AGAIN!

THIS IS THE “QUALITY” OF CARE

WE GET AT THE NORTHPORT, NY VAMC

[ This is the actual report in PT. file ]


This is DUBOSQUE, HUTCHINSON JR, a 71 gentleman with a past medical history of former smoker quiet smoking in 2004 with PMH HTN, HLD, hypothyroidism, PTSD, depression, spinal stenosis s/p fusion (9/15), essential tremor, PUD, COPD on home O2, OSA not complaint with nasal CPAP and chronic respiratory failure who was called via VVC for discussion regarding his lung transplant evaluation.

Participants of the VVC meeting included myself and pulmonary attending, Dr. Chernyavskiy.

Pt comment: I just love me some I---. These notes from our little video chat point out that I--- just doesn’t give a flying fuck about Veterans.

Patient reports that he has undergone extensive evaluation with John Hopkins' lung transplant team over the past year and has recently been listed on the lung transplant list on January 7, 2021. We explained to him that the VA would not pay for his lung transplant at Johns-Hopkins' as the VA lung transplant protocol is to go through VA eligible lung transplant centers, i.e., at Wisconsin.

We explained to patient repeatedly that the lung transplant process at the VA hospital goes through either the University of Wisconsin or Seattle VA.

Pt comment: Right up front, they state that they will deny me access to Johns-Hopkins for lung transplantation through the Mission Act. Further down, they start back-peddling like the little weasels they are. If I get just a whiff of COVID, I’m dead, and I---knows that.

Patient would forward all the information and investigations performed at Johns-Hopkins to Northport VA and we will forward this information to the University of Wisconsin. Patient and his wife agreed to the above and would be sending us a package of his results and hospital records from Johns-Hopkins.

Pt comment: No way in Hell this is ever going to happen!

 Nature of patient call is to request VA to pay for pulmonary transplantation at Johns-Hopkins Medical Center, where patient went more than 1 year ago and underwent extensive evaluation, testing, and as I understood he is placed on the transplant waiting list over there. Pt went to Johns-Hopkins on his own; he stated that he doesn't trust care at the VA and he didn't want to wait until he dies at the VA.


Pt comment: I had to do my own research on this, as VA and I--- conveniently never mentioned anything about a lung transplant…ever! Not in these notes is I---’s statement that he knows nothing about Johns- Hopkins. It is only #3 in the Country for transplants, including lungs.

 

Patient has advanced COPD/emphysema from smoking complicated with significant fibrotic changes. At some point I spoke to the patient regarding his request to have in the bronchial lung volume reduction procedure. I strongly advised him again this procedure as it appears that he can be harmed rather than helped from this procedure; pt was advised that VA will cover this expense if he finds someone to offer this procedure and he would accept the risk. Patient on triple therapy and Daliresp and he is on oxygen replacement therapy.

Pt comment: I initiated the discussion on Bronchial Bypass, after doing my own research. VA and I--- never mentioned any options at all…ever.

But, stated right here, is an admission that VA will pay for a procedure that would kill you!

 

Patient can be considered potential candidate for lung transplant given that his cardiac pathology and other comorbidities will not interfere with success of intervention. Patient stated that he wasn't at VA for more than 1 year because he is afraid of catching COVID 19 infection.

Pt comment: Based on historical experience with this VAMC, there is no way I’m stepping foot in the place.

 

I explained to the patient that pulmonary transplantation can be offered at the VA medical system and for the EAST Coast the hub is Univ of Wisconsin. Should the patient express interest, we can initiate that process; in layman terms I explained that this is a standard process applicable to all veterans who are receiving medical care at Veteran’s Affairs Medical Center.

Pt comment: No way in Hell am I traveling to Wisconsin with my condition and COVID raging in the midwest. No way in Hell am I moving to Wisconsin for three months to complete the process. After that, there are periodic visits involved which VA would task I--- with in Northport, NY.

 

Patient became extremely angry and started using nonstandard expressions in the conversation; I strongly advised him to calm himself and use an appropriate language in order to continue our dialog. I reiterated to the patient and his wife that no one can deny and assessment/evaluation for pulmonary transplant for the patient of his type.

Pt comment: You bet I became enraged and nasty. And, yes, he and VA are realistically denying my request to use the Mission Act before anyone has even looked at my files!

 

I do not understand why they will undergo impression that VA in pulmonary section deny this assessment. Patient and his wife that told by Johns Hopkins Hospital that transferred is a local geographically procedure, but it is their opinion and the it is not standard practice for any kind of transplants which can perform at VA, kidney, lung, liver, etc. even though patient was adamantly not interested to go to Wisconsin for the evaluation.

Pt comment: It was not recorded that I--- did deny access to the Mission Act.

 

The following is never going to happen: even though we agreed to do it.

He and his wife agree for us to start formal process. They will send all available information obtained from Johns-Hopkins Hospital, which will be included in the package to be sent to Wisconsin. Patient medications were renewed. Patient didn't have any other questions. 25-30 minutes total encounter.

Contacted Senator Chuck Schumer’s office re. denial for Mission Act.

 

/Es/ I-- -----------y  Pulmonary Attending--

Date/Time:   14 Jan 2021 @ 1340

Signed: 01/15/2021 16:15 

 

Johns-Hopkins, 2/24/2021 – The aftermath. A new, 20 y/o lung