Whistleblowers and the Department of Veterans Affairs

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On April 27th, President Trump signed an Executive Order to create the Office of Accountability and Whistleblower Protection within the Department of Veterans Affairs (“the VA”).

According to the AP, VA Secretary David Shulkin said the office will help identify “barriers” that make it difficult for the department to fire or reassign bad employees. Another function of the office will be to help shield whistleblowers from retaliation.

To many, it may seem surprising that a new office within the VA is required to protect “whistleblowers,” since private and public whistleblowers have long been afforded protection under the Whistleblower Protection Act of 1989.

Clearly, additional protection is needed if doctors like Dr. Dale Klein can be relegated to an empty room for bringing VA abuse to the attention of the Inspector General.  Found below is a report for Fox News:

Dr. Dale Klein may be the highest-paid U.S. government employee who literally does nothing while he’s on the clock. A highly rated pain management specialist at the Southeast Missouri John J. Pershing V.A., Klein is paid $250,000 a year to work with veterans, but instead of helping those who served their country, he sits in a small office and does nothing. All day. Every day.

“I sit in a chair and I look at the walls,” the doctor said of his typical workday. “It feels like solitary confinement.”

A double board certified physician and Yale University fellow, Klein said the Department of Veterans Affairs (V.A.) took away his patients and privileges almost a year ago after, he alleges, he blew the whistle on secret wait-lists and wait-time manipulation at the V.A. in Poplar Bluff, Mo., as well as his suspicion that some veterans were reselling their prescriptions on the black market.

While one would like to be optimistic that the new “Whistleblower Office” within the VA would help improved efficiency within the VA, I suspect that there are far too many institutional barriers to be overcome in this mammoth organization.

Department of Veterans Affairs

Size Matters at the Department of Veterans Affairs

The VA’s simple mission laid down by President Abraham Lincoln is “to care for him who shall have borne the battle, and for his widow, and his orphan.”

Needless to say, each person has his or her interpretation of what that VA mission entails, but over time the VA has laid on layers of responsibility to fulfill that mission.   In the military, we often refer to that as “mission creep.”

In effect, the VA – whether pressured by Congress, the President or their own Administration – have taken on responsibilities that may or may not be what was originally intended under President Lincoln’s promise.

More importantly, the VA has centralized most functions under its umbrella to administer to the needs of Veterans.

Employing some 350,000 people and many outside consultants, the VA administers health and benefit programs to millions of Veterans.  In economic terms, one might characterize the VA as a monopoly.

While many of the services provided by the VA are excellent, it would be unrealistic to expect that ALL services are effective.

In fact, the IG, internal VA audits and the IG have reported many irregularities at the VA.  Unmanned Crisis Call Centers, unacceptable patient “wait times” and the heavy reliance on prescription drugs all contribute to public wariness and distrust of the VA.   More importantly, many Veterans reject the services provided by the VA.

SFTT has long argued that the VA is far too large to succeed on every front without compromising their main mission.  Shortly after Dr. David Shulkin was appointed Secretary of the VA, we wrote:

NO AMOUNT OF MONEY or CHANGE IN LEADERSHIP or ENACTMENT OF NEW LEGISLATION will bring about A MORE RESPONSIVE VA.

The VA has become a bureaucracy that answers only to itself and is not responsive to the needs of Veterans.  Frankly, the VA has lost its way and very little will change unless the VA is broken down into far smaller manageable components.

While smaller components of the VA will invariably fail, A SMALLER AND LESS CENTRALIZED VA WON’T COMPROMISE THE FULL MISSION.  

VA Whistleblowers and David Cox

Dr. Shulkin and others clearly realize that there are serious problems of accountability within the VA.  The April 27, 2017 Executive Order is designed to help “weed out” waste and inefficiencies within the VA.

J. David Cox

J. David Cox

Despite much needed reform within the largely ungovernable VA, I suspect that  J. David Cox, President of the American Federation of Government Employees, will continue to run a destabilizing campaign to block any meaningful reform.

We admire the courage of “whistleblowers,” but Veterans shouldn’t expect great changes considering the entrenched positions of David Cox and his henchmen.

It is reassuring to see Dr. Shulkin take action to confront the serious problems within the VA.  We wish him success in his endeavors and hope that he receives much needed support from our elected leaders to bring radical reform to the VA.

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Does Federal Hiring Freeze Threaten VA Staffing?

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President Trump’s executive order calling for a freeze on hirings by the Federal government (military, security and public safety are exempt), has created serious concerns among Veterans seeking positions with the Department of Veterans Affairs (“the VA”).

Donald Trump Veterans

Furthermore, Trump plans to “dismantle Obamacare” could cause many privately-insured Veterans to seek relief from an already stressed VA.  Quil Lawrence of National Public Radio (“NPR”) comments as follows:

As promised, President Trump has moved to dismantle the Affordable Care Act. It’s a concern for those who might be left without health insurance — and especially for the Department of Veterans Affairs, which may have to pick up some of the slack.

Carrie Farmer, a health policy researcher at the Rand Corp., says 3 million vets who are enrolled in the VA usually get their health care elsewhere — from their employer, or maybe from Obamacare exchanges. If those options go away, she has no idea just how many of those 3 million veterans will move over to the VA.

“I would expect that the number of veterans using VA health care will increase, which will only provide a further challenge for VA to provide timely and accessible care,” Farmer says.

Needless to say, it is next to impossible to predict the dynamics or fallout of somewhat conflicting policies as they pertain to Veterans seeking affordable and reliable healthcare.

Adding to the complication is that Veterans account for roughly  “30 percent of the more than 2.8 million employees in the federal workforce,” according to the White House Office of Personnel Management.

In effect, potential changes in healthcare regulations will cause Veterans to place great demand on the VA and the freeze on Federal hiring will most certainly curtail a critical source of employment for Veterans.

It is also important to note that the Federal hiring freeze applies to the VA.  Press Secretary, Sean Spicer confirmed that:

. . . the hiring freeze would apply to the VA, which had been seeking to bring on 2,000 new employees to help clear up appointment backlogs and improve care.

Spicer justified the VA hiring freeze by saying that it would be fiscally irresponsible at this time to add workers to a dysfunctional system at the VA. “Right now, the system’s broken,” Spicer said. “When you have a system that’s not working, and then going out and hiring additional people doesn’t seem to be the most efficient way of solving the problem.”

While I have no doubt that this situation will sort itself out over the near term, it is hard to argue with Mr. Spicer’s assessment that the VA is “broken” and “hiring additional people” doesn’t seem the appropriate way to fix the problem.

Indeed, a comprehensive independent reform plan already exists to overhaul the VA.   The June 30th (2016) “Commission on Care” reports list 18 specific recommendations to improve overall care for Veterans.  Simply implementing these suggestions would provide Veterans with much needed care and support.

J. David Cox

J. David Cox

While there appears a clear path to reform the VA, J. David Cox, the President of the American Federation of Government Employees, is not convinced.  In fact, Mr. Cox previously threatened the former VA Secretary with “physical violence” if he carried out the suggested Commission on Care reforms.

Frankly, it is hard for me to accept the fact that a political hack like J. David Cox could block clearly needed reforms within the VA.   Specifically, Mr. Cox seems to argue that job security of AFL-CIO government employees is far more important than the well-being of military Veterans.  Shame!

Stand for the Troops has a defined goal of supporting our brave Veterans and the men and women who serve our country bravely.  People in leadership like David Cox should recognize the failings of the VA and become a beacon of constructive change rather than destructive rhetoric.

Frankly, the interests of the AFL-CIO and the Veterans who have served our country so heroically would be far better served.

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Veterans Affairs: Hope on the Way for Those Suffering from PTSD and TBI?

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With the expected change in the administration of the Department of Veterans Affairs (“the VA”), hope could well be on its way to provide more effective and timely treatment for the tens of thousands of Veterans suffering from PTSD and TBI.

Regardless of one’s political affiliation, the VA doesn’t seem to have a handle on treating Veterans with serious brain injury.  One hopes that the “new” VA will be more open to alternative therapy provided in the private sector, rather than current dogmatic approaches that have produced few – if any – positive approaches to treating PTSD and TBI. Maj. Ben Richards explains in far more detail below:

I just finished watching an exceptional documentary on PBS by Bob Woodruff entitled Medical Medicine Beyond the Battlefield.   The video, which may be watched below if you can spare 58 minutes – details some incredible medical breakthroughs in helping Veterans recover their lives after they have lost limbs in combat.  Truly miraculous!

Approximately 36 minutes into the video, Mr. Woodruff focuses on how the VA is dealing with brain injury.  Shortly thereafter, he chronicles the issues faced by Elana Duffy, an intelligence Sgt. First Class who suffered traumatic brain injury while serving in Iraq (39 minutes).

It is evident that the VA is not making as much progress in treating neurological disorders as they are on other medical rehabilitation fronts.

While concerted efforts are being made to understand and treat PTSD traumatic brain injury, it appears that “progress” within the VA has been impeded by dogmatic positions maintained by Dr. David Cifu and others. In effect, Veterans suffering from PTSD and TBI are given few treatment alternatives outside the narrowly defined treatment programs so vigorously defended by VA administrators.

SFTT has long held the view – based on feedback from many Veterans – that the VA is not in a position to provide the necessary care and treatment to truly help Veterans suffering from PTSD and TBI.   This is a huge problem for Veterans and their families and one needs to “think outside the box” or the confines of VA orthodoxy to embrace new treatment alternatives.

It is terribly sad that the VA has become a political ping pong ball to the chagrin of many Veterans. The release of the Commission on Care report recommending 18 major reforms within the VA triggered an immediate backlash from employees and lobbyists who felt threatened  by the findings.

J. David Cox

J. David Cox

Like others, “I was appalled by the outburst of J. David Cox, the President of the American Federation of Government Employees, who threatened VA Secretary with ‘physical violence.’Cox was ‘prepared to whoop Bob McDonald’s a – -,’ he said. ‘He’s going to start treating us as the labor partner … or we will whoop his a – -, I promise you.'”

Against this particularly toxic background, it is difficult to know whether a new VA Secretary will be able to implement the reforms outlined in the Commission on Care report.

Former U.S. Senator Scott Brown to Head Department of Veterans Affairs?

According to recent information, former U.S. Senator Scott Brown of Massachusetts is apparently a front-runner for the post of Secretary of Department of Veterans Affairs in the new Trump administration.

As reported in the Boston Herald and several other respected media sources, Scott Brown is

 . . . under consideration for the Cabinet post of Veterans Affairs secretary — said he would create a 24-7 manned hotline for suicidal soldiers, take back bonuses and raises awarded to incompetent VA staffers and outsource PTSD and other serious mental health cases to private professionals.

“People are hurting and they need some real help,” Brown said last night, hours after he spoke with President-elect Donald Trump. “There are some great angels working in the VA right now and they need a morale boost.”

If true, this could very well accelerate outsourcing the treatment of Veterans suffering from PTSD and TBI to private healthcare providers.   Sen. Brown is quoted as saying, “The VA’s trying to do it all — they can’t. We need to outsource that and get those people help right away.”

There is no way of knowing whether Sen. Brown will be offered the job of VA Secretary or will be confirmed to this “cabinet-level” position, but implementing the steps recommended by the Commission on Care would be a major step forward in getting Veterans the help they deserve.

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Dysfunctional VA or a Paradise for Veterans?: Pause for Reflection

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Stand for The Troops (“SFTT”) has long been critical of the manner in which the Department of Veterans Affairs (the “VA”) treats Veterans with PTSD and TBI.  Other critics have singled out long wait times for Veterans seeking treatment and other issues that have prompted Congressional inquiries.

Sadly, one can no longer discuss this issue dispassionately considering that many stakeholders and political candidates seem to be positioning themselves on one side of the debate or the other.  With a $170 billion budget and over 200,000 employees, a decision to make the VA more responsive to the needs of Veterans is never a black or white decision.

J. David Cox

J. David Cox

Like many others, I was appalled by the outburst of J. David Cox, the President of the American Federation of Government Employees, who threatened VA Secretary with “physical violence”

Cox was “prepared to whoop Bob McDonald’s a – -,” he said. “He’s going to start treating us as the labor partner … or we will whoop his a – -, I promise you,”

According to U.S. Rep. Jeff Miller, a Republican from Chumuckla, Florida, and the chairman of the House Committee on Veterans’ Affairs as reported in Military.com

The exchange perfectly encapsulates the corrosive influence government union bosses are having on efforts to reform a broken VA. It’s a never-ending cycle in which pliant politicians and federal agency leaders bow to the boss’s demands to preserve the dysfunctional status quo of our federal personnel system, which almost guarantees employment for government bureaucrats no matter how egregious their behavior.

The problem with union bosses like Cox is that they are more interested in protecting misbehaving VA employees than the veterans the department was created to serve.

The problem with VA leaders like McDonald is that, in their perpetual quest to placate big labor’s powers that be, the taxpayers and veterans they are charged with serving are paying the price.

Frankly, it is tough to find fault with Representative Miller’s assessment of the situation.  If we want meaningful reform within the VA to provide Veterans with the support they deserve, then we need to confront entitled thugs like David Cox and others that block long overdue change.

It will not be easy, but we must admit that the VA is fragile – if not broken – and we need to fix it to provide Veterans with the level of care they deserve.

Veterans with PTSD and the VA

As regular readers of Stand For the Troops newsletter are aware, we are keenly focused on the level of care and treatment provided to Veterans suffering from Post Traumatic Stress.

Based on our research, we have found that the care and treatment provided by the VA leads to no lasting benefit to the thousands of Veterans affected by PTSD and TBI.  We reported on this earlier, but it is worthwhile watching a video of Maj. Ben Richard’s explain the failure of the VA to provide meaningful solutions:

This sobering assessment by Maj. Richards was featured a couple of months ago in our article entitled “The VA Can’t Handle the Truth, So Why Bother.” SFTT’s goal is not to throw rocks at the VA, but to insure that Veterans get the needed treatment they deserve.

It is hardly reassuring that some Veterans find it necessary to swim with sharks as an alternative therapy for PTSD, but it is evident that the lack of responsiveness and credibility of the VA has driven Veterans to embrace other solutions.

The Big Questions for Taxpayers and Government Leaders

Will the much needed reform within the VA be held hostage by self-serving labor leaders like J. David Cox and disingenuous medical practitioners like Dr. David Cifu?

Do we have the courage to change the VA system for the benefit of our brave heroes?

Can we agree to promote VA programs that work, improve those programs that are not effective and reform or radically change existing programs and protocols that simply do not work?

For all Americans, it is time to reflect on the kind of support we truly want to provide to Veterans.

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