VA official to clinics: Stop gaming the system. Thank you Larry Scott

VA official to clinics: Stop gaming the system

By Kelly Kennedy - Staff writer
Posted : Monday Jul 12, 2010 13:38:45 EDT

After years of complaints from veterans who say they aren’t getting VA medical appointments within 30 days even if Veterans Affairs Department records show they are, a top VA official sent out a memo asking employees to quit “gaming” the system.

“It has come to my attention that, in order to improve scores on assorted access measures, certain facilities have adopted use of inappropriate scheduling practices sometimes referred to as ‘gaming strategies,’ ” wrote William Schoenhard, VA’s deputy undersecretary for health for operations and management, in the April 26 memo.

The “gaming” came after VA required its employees to ensure patients were given initial appointments within 30 days of entering the VA system. Instead, several clinics came up with ways to make it look as if the veterans had canceled their appointments or hadn’t asked for one until within 30 days of when the appointment was made.

“As we strive to improve access to our veterans, we must ensure in fact that improvement does not focus or rely on workarounds,” Schoenhard wrote. “Workarounds may mask the symptoms of poor access and, although they may aid in meeting performance measures, they do not serve our veterans.”

The memo, first reported by Larry Scott of VAWatchdog.org, comes in the wake of exceptional gains in reducing appointment waiting times announced by VA officials.
read more here
VA official to clinics: Stop gaming the system

Shocking New VA Scandal Uncovered by VAWatchDog

Like most Vietnam vets, after years of no help at all, they have to go to see their VA doctors on a regular basis to stay stabilized yet when they need to be sure they have a stable support force behind them, they are told their appointments need to be cut back. Just too many new veterans flooding the system to have time for all of them. So they are given medication enough to last about three months until they can find the time to see them again. It's not the doctors fault they don't have enough of them to fill the needs but it is however the fault of the people in charge to properly plan and staff based on the needs of the future.

It is not just mental health that is an issue for disabled veterans. They get sent to another part of their state or to a different state to receive the medical care they need. Appointments are canceled or changed without notice and for those seen on a regular basis, they are spread out too far in between.

The VA has to meet "standards" of care and apparently thanks to Jim Strickland reporting, we now know they found a way to make it look as if they have met the standard by hiding the facts. What they cannot hide is the damage they are doing to the veterans feeling betrayed yet again. For Vietnam veterans with PTSD, they overcame the stigma and lost years but can they overcome this?

VCS Salutes VA Watch Dog;
VCS Urges Congress to Fix VA

Shocking New VA Scandal Uncovered by VAWatchDog - -

VA Staff Manipulate Appointment System, Delay Care

This week, the web site VAWatchDog.org posted an internal VA memo where a top VA leader confirmed the existence of 24 ways to "game" VA's appointment computer system. VA's staff manipulate the computer system to conceal delays in setting medical appointments. Veterans are justifiably outraged.

Deputy Under Secretary for Health William Schoenhard's memo confirms a key point VCS and VA's Inspector General have made for years: VA intentionally misleads veterans and Congress about how VA routinely delays and denies medical care for our veterans. VA leaders now know VA's medical appointment system is broken. We are pleased VA's Schoenhard said the improper practices will not be tolerated.

Schoenhard's memo forces a key leadership test upon VA Secretary Eric Shinseki. Will VA reveal how many veterans over the years were harmed by VA's improper practices? What other ways are used to hide VA's problems scheduling appointments? Will VA re-train staff on the proper use of the appointment system? Will VA leaders hold accountable those VA employees and leaders who delay and deny medical care? We want more facts, more training, and more accountability.

VA DOCUMENT REVEALS HOW THE AGENCY IS "GAMING" VETERANS' MEDICAL APPOINTMENTS
Lists 24 ways that VA employees are "gaming" the dates on medical appointments to make themselves look more efficient while veterans wait for health care.



NOTE from Larry Scott, VA Watchdog dot Org ... I have been writing about the waiting list issue since 2004, and VA employees have only gotten better at "gaming" the figures to make it look like they are meeting appointment schedules ... when in reality, veterans are waiting for health care.

I detailed the use of log books for waiting lists before veterans could get on the electronic waiting list. That way, the original date requesting an appointment was not entered into the system. VA employees would wait until an appointment opened up (within 30 days) and then take the vet out of the log book and put them into the system, using that date as the date of request. This made it look like the VA had fulfilled their 30-day appointment commitment to the veteran.





The Games People Play
by Jim Strickland
Has it ever happened to you? Have you shown up for an appointment at your VA Clinic or Medical Center only to be told that you don't have an appointment? Tried to make a convenient appointment 2 months away and were told that the rules don't allow that? Is your appointment scheduled in an old fashioned log book rather than the computerized system VA uses? These are the games that are played with your appointment schedule.

The VA says that it takes pride in your care. The truth be known, VA takes even more pride in keeping score so that everyone looks good on paper. Thus, the system that keeps track of the performance of clinics and hospitals is "gamed" in ways that seem to annoy Mr. Schoenhard. "These (gaming) practices will not be tolerated." he tells his troops, "This is not patient centered care."

read the rest here
http://www.vawatchdog.org/10/nf10/nfjun10/nf062310-1-1.htm

RIECKHOFF'S NON-APOLOGY TO VIETNAM VETERANS

This is from Larry Scott and pretty much sums up how I feel as well.

Mr. Rieckhoff, your non-apology is not accepted.

And, to the staff at IAVA: Keep Paul Rieckhoff away from all computers. He's the only person I know who can dig a hole with a keyboard.

Rieckhoff can claim what he wants in order to defend what he said, but the truth is, all you have to do is listen to him talk when he pops up on cable stations and know, he really isn't interested in Vietnam veterans or other veterans at all. It really is a shame because he can't understand he ended up insulting every other generation of veterans in the process. I wonder how many of those "other" veterans supported the IAVA and ended up shocked by what he said?

This is really beyond just slamming Vietnam veterans. The media has not been interested in them at all but they have been suffering from lack of care longer than the newer veterans. Not only are they still trapped in the monstrous backlog of claims, they are being treated to appointments cut back to make room for the newer veterans. Does Rieckhoff ever think of this? Does he use the media spotlight to bring this appalling treatment into the public's mind? No. Does he bring it to the public's mind that had it not been for the Vietnam veteran he just slammed, none of the understanding, as pathetic as it is, would have been available for "his kind of veterans" had they not fought for it and demanded it over 30 years ago and never gave up fighting for it for their generation as well as all other veterans? Does he acknowledge at all that because of the way Vietnam veterans were treated when they came home "his kind of veterans" have been treated with respect and appreciation by the public and people around the country are fighting like hell to make sure they are taken care of including the Vietnam veterans and their families?

Rieckhoff has had no use for me or this blog. After all, I can't gain him any attention. If he had been interested at all he'd see how hard this Vietnam veteran's wife is fighting for "his kind" of veteran as well as all veterans. We have one Department of Defense and we have one Veterans Administration supposedly taking care of all generations and if there is a problem with "his kind" of veterans then he needs to fully acknowledge there is a problem with ALL generations of veterans. I am so tied of the spotlight focused on just the newer veterans because people like Rieckhoff get their attention but people like Larry Scott don't. He's focused on what the VA does and does not do for ALL veterans! You'd think the media would get the message that as they focus on the newer veterans suffering we still have Vietnam veterans suffering after all these years and yes, they watch TV too! Plus they don't consider how many more Vietnam veterans there are than the newer veterans. Wonder what their ratings would be if they ever paid attention to them?

RIECKHOFF'S NON-APOLOGY TO VIETNAM VETERANS
IAVA chief claims remark was about who fragged the most and not meant as disrespect.

by Larry Scott, VA Watchdog dot Org



Sometimes I wish people would just do the simple and correct thing when they open their mouth to change feet: Apologize for an un-smart comment and move on.

But, no ...

Sometimes I wish people would just do the simple and correct thing when they open their mouth to change feet: Apologize for an un-smart comment and move on.

But, no ...

Most people have to explain and explain ... and explain some more in an attempt to make it appear that what they said really was correct and really wasn't meant to be offensive ... thus trying to put the onus back on the person(s) they offended.

Such is the case of Paul Rieckhoff, Executive Director of Iraq and Afghanistan Veterans of America (IAVA).

Yesterday we reported that Rieckhoff, in response to a soldier killing five fellow troops in Iraq, said, in part:

"Unlike during the Vietnam War, today's military is a professional, all-volunteer force."

This remark greatly offended me ... as it did Veterans' Advocate Jim Strickland ... and, we let our feelings be known. It also offended many other veterans as noted by the angry comments at the bottom of the article.

Instead of just saying, "I'm sorry. It was an insensitive remark and doesn't reflect my true feelings. I apologize," Rieckhoff tried to explain his way out of it.
go here for more
http://www.vawatchdog.org/09/nf09/nfmay09/nf051309-1.htm

DoD NOT COMPLYING WITH REQUIREMENTS FOR PERSONALITY DISORDER DISCHARGES

GAO REPORT: DoD NOT COMPLYING WITH REQUIREMENTS FOR PERSONALITY DISORDER DISCHARGES
(11-01-08)Military officials responsible for reviewing servicemembers' records could not explain why many PD separations were approved.
GAO's review of enlisted servicemembers' records found that the selected military installations GAO visited varied in their documented compliance with DOD's requirements for personality disorder separations. DOD has requirements for separations because of a personality disorder, which is defined as an enduring pattern of behavior that deviates markedly from expected behavior and has an onset in adolescence or early adulthood. The three key requirements established by DOD are that enlisted servicemembers

(1) must be notified of their impending separation because of a personality disorder,
(2) must be diagnosed with a personality disorder by a psychiatrist or psychologist who determines that servicemembers' personality disorder interferes with their ability to function in the military, and
(3) must receive formal counseling about their problem with functioning in the military.

go here for more

http://www.vawatchdog.org/08/nf08/nfnov08/nf110108-4.htm

Florida VETS BLAST VA FOR EMPLOYING FULL-TIME INTERIOR DECORATORS

VETS BLAST VA FOR EMPLOYING FULL-TIME INTERIOR

DECORATORS -- In the Tampa area, VA has eight

interior decorators with total salaries of $660,000

a year. (with must-watch video)

This goes on all over the country!

My VA hospital has a half-time interior decorator.

What does she do? ..... "Let's see...should I paint this hall institutional gray, institutional brown or institutional green?"

You ABSOLUTELY must watch the video at the link below to see the reaction from a veteran.
click here for more
http://www.vawatchdog.org/08/nf08/nfJUN08/nf062108-4.htm

Absolutely, positively, sickening! In Florida we have some hospitals that look like resorts but they don't hire full time decorators. When you listen to this report, they asked other hospitals nearby James A. Haley VA about this and they laughed! Who had this bright idea at the same time we have psychologist, psychiatrists and mental health workers donating their time free of charge because the VA doesn't have enough of them to go around?

U.S. SUPREME COURT AGREES TO HEAR VETERAN'S CASE

U.S. SUPREME COURT AGREES TO HEAR VETERAN'S CASE --
The Court will consider the extent to which the VA is liable
if it fails to adequately inform a veteran of the information
needed to process a benefits claim.


The notice of the veteran's case is in the second part of the story below.
The full petition can be downloaded or opened for reading here... http://www.usdoj.gov/osg/briefs/2007/2pet/7pet/2007-1209.pet.aa.pdf
For more on this case, plug this into Google "Peake v. Sanders" using the quotes.
go here for more

http://www.vawatchdog.org/08/nf08/nfJUN08/nf061708-1.htm

VA NOW ACCEPTING CLAIMS FOR HYPERTENSION

VA begins taking claims related to Agent Orange exposure

By Chris Roberts
El Paso Times



Veterans Affairs has started taking claims for hypertension related to Agent Orange exposure, but it will determine at a later date whether the claims will be honored as being military "service-related," according to service organizations who received notices from VA.

A letter from the Texas Veterans Commission to its county service officers indicates that the claims are expected to be approved.

The claims won't be actively "worked" until the VA makes its decision.

Requests for comment made to local VA agencies were referred to Washington, D.C.

However, after two days, the public affairs office in Washington, D.C., still had no comment.


If the claims are approved, it could mean as much as $300 a month for Bob Snow, a retired soldier who worked as a forward observer directing artillery fire in the Vietnamese jungles.

Snow - who worked with special forces soldiers and Montagnards, a French name for the indigenous people of Vietnam's central highlands - operated in areas sprayed with Agent Orange, a defoliant that knocked down vegetation used as cover by the enemy.
go here for more
http://www.vawatchdog.org/08/nf08/nfMAY08/nf051008-3.htm

Older veterans pushed aside for new veterans

Old and in the Way

As the “new vets” from Iraq and Afghanistan, just 2% of the veteran population, are given priority at the VA, the other 98% find themselves pushed to the rear of the line, now the forgotten of previous conflicts.

by Larry Scott



Bosnia, Somalia, the Gulf, Grenada, Vietnam, Korea, World War II, plus all the Cold War and peacetime veterans in between. Add them all up and you have about 23.5 million veterans, 98% of the U.S. veteran population. Add them all up and you have the veterans that are being pushed to the rear of the line by the Department of Veterans’ Affairs (VA).

On April 24, 2008, the VA made a stunning announcement. They are going to set up a special call center to notify all 570,000 “new vets,” veterans of the conflicts in Iraq and Afghanistan, of all available VA benefits. On the surface this appears to be a noble gesture. But, in the past, the VA has vigorously fought legislation that would have required them to notify ALL veterans of these benefits. Why? Too expensive, they claimed.

So, why the change and why now? And, why does this just apply to the “new vets,” those who make up just 2% of the veteran population? The VA has a history of denying that problems exist, then using quick-fix Band-Aids to make it appear that the problem has been solved. We find the VA short-staffed, especially in the area of mental health workers. So, they hire a few mental health specialists, many of them short-term contract workers, and consider the problem fixed. There is a backlog of 600,000 disability claims, so the VA hires a few more claims raters, and considers the problem fixed. Neither of the afore-mentioned Band-Aids addresses the long-term problems of mental health care or the claims backlog because not enough workers were hired to adequately solve either problem.
go here for more
http://www.vawatchdog.org/08/nf08/nfAPR08/nf042808-1.htm

He's right. It happened to my husband until on of his doctors said that he couldn't wait to see him for three months in between appointments. He's not the only one this is happening to.

To Deny Purple Heart For PTSD Is Wrong

Well I guess we can't agree on everything all the time. I adore Larry and I know how hard he works for the veterans. He always gives them 100%. The only other time I remember disagreeing with him was on the veterans not using the DAV to help them with their claims. I guess this makes the second time. He does not believe they should get a Purple Heart. I knew this would be coming and that's why I suggested to reinstate the Wound Chevron they used to give out instead of the Purple Heart. The truth is, I just changed my mind now that I read what Larry had on his post against it.

Asked to respond to Fortunato’s comments, the Army provided a copy of Army Regulation 600-8-22 on military awards, which lays out the criteria for the Purple Heart.

The regulation defines a wound as “an injury to any part of the body from an outside force or agent,” such as bullets, explosives and shrapnel.

Post-traumatic stress disorders are among the injuries that do not merit the Purple Heart, along with heatstroke, frostbite, trench foot and self-inflicted wounds.

http://www.vawatchdog.org/08/nf08/nfMAY08/nf050508-1.htm

click above for the rest.

The answer is right there in the quoted part. PTSD comes from an outside force. It comes from trauma. It does not come from the inside but it does cause the inside to change and become wounded. It's not a certain part of the body that is wounded. It is all of it, mind, body and soul. TBI is a wound. It also comes from an outside force. It's time we recognized both of these wounds for what they are and stop treating them in a sub-class of honor. The only thing I changed my mind about is that it shouldn't have a sub-class of award instead of the Purple Heart.

When we think of wounds, we think of burns, bullet wounds and amputations. We forget that most of the men and women suffering from the obvious wounds are also suffering from TBI and PTSD. We know where PTSD comes from and we know where TBI comes from. It's time to acknowledge these two wounds fully and faithfully. If we are ever to remove the stigma of PTSD, it is now.

Larry, forgive me on this if you ever read my blog, but in this case, you are wrong.

VA staff charged $2.6 billion to their government credit cards

Investigators Review VA Credit Charges

By HOPE YEN



WASHINGTON (AP) — Veterans Affairs employees last year racked up hundreds of thousands of dollars in government credit-card bills at casino and luxury hotels, movie theaters and high-end retailers such as Sharper Image and Franklin Covey — and government auditors are investigating, citing past spending abuses.

All told, VA staff charged $2.6 billion to their government credit cards.

The Associated Press, through a Freedom of Information request, obtained the VA list of 3.1 million purchases made in the 2007 budget year. The list offers a detailed look into the everyday spending at the government's second largest department.
go here for more
http://www.vawatchdog.org/08/nf08/nfAPR08/nf040708-1.htm

Don't even get me started on this!

A new band of brothers

A new band of brothers

By JON ERICSON
Courier Staff Writer



WATERLOO — Iraq war veterans Joe Nolte and Ron Devoll find it hard to fit in with existing veterans organizations. Members are too old and the causes aren’t tailored to the experiences of Iraq War vets, they say.

So the men want to launch their own veterans organization.

Devoll is a lifetime member of the Veterans of Foreign Wars, while Nolte belongs to none of the existing groups.

They haven’t defined exactly what their new organization will be, but they want it to accomplish at least two things — be a place a veteran can go for help and provide a forum for veterans to talk about issues.

"We don’t want it to be a typical organization, not a club, not a political organization," Nolte said. "We want a place where a vet can call when they need help."


The working name for the potential organization is Veterans with a Voice. They are looking into registration as a nonprofit 501(c)3 entity exempt from some taxes.

For now, they want to see what interest is out there for such an organization.

"We wanted to get it out there to see if there are other people out there with concerns that may want to help them get off the ground," Nolte said.

Both men have had their own problems since returning from Iraq.

Nolte is a Mason City native now living in Waterloo and going to school at the University of Northern Iowa. The Marine suffered injuries when his vehicle drove over a roadside bomb in Iraq. When he returned, Nolte struggled to get the Veterans Affairs hospital to cover the cost of his injuries.

Devoll of Cedar Falls is an army veteran and has struggled with post-traumatic stress disorder since his return.
go here for the rest
http://www.vawatchdog.org/08/nf08/nfMAR08/nf033108-4.htm


Women are doing the same. Will the DAV, VFW, American Legion and the rest get the point before it's too late?

Dr. Karen Seal taking PTSD in new direction

Karen Seal and her colleagues worked to get a new clinic in San Francisco for Iraq war vets. (Chronicle photo by Michael Macor)

Waiting room fills with young vets

Meredith May
Chronicle Staff Writer



Four years after the start of the war in Iraq, Dr. Karen Seal took a job at the San Francisco VA Medical Center to work in the liver clinic, treating patients with hepatitis C.

She noticed the veterans in the waiting room. Most of them were from the Vietnam era, in their 60s and older.

But over the months, the faces began to get younger. The waiting room was starting to fill with young men in their late teens and 20s, the first trickle of Bay Area soldiers emotionally and physically injured by the war.


Seal, a primary care physician, began working with them, taking their medical histories and directing them to the right care.

"At the time, I had never heard of PTSD," Seal said.

Now she knows how post-traumatic stress disorder contributes to the alcohol addiction and depression she sees in many of her patients.

She made referral after referral to the mental health wing of the VA hospital, but heard from colleagues that those initial patients never made it. It was too much of a stigma - especially in military culture - to walk across the campus to the mental health ward.

So Seal and colleagues got an idea. What if there were a special clinic just for Iraq war veterans that combined primary care and mental health checkups in a nonjudgmental setting?
go here for the rest
http://www.vawatchdog.org/08/nf08/nfMAR08/nf031708-3.htm

Larry Scott, VAWatchdog, clears up PTSD new rule

Leave it to Larry Scott of VAWatchdog to get to the bottom of this.

UPDATE: VA'S NEW PTSD POLICY APPLIES ONLY TO THOSE

DIAGNOSED WHILE ON ACTIVE DUTY -- VA agrees that

veterans who are diagnosed with PTSD while on active duty

should be recognized as having PTSD for VA purposes.

by Larry Scott

Yesterday it was reported that the VA had a new policy regarding proof of trauma in PTSD claims. That story here...
http://www.vawatchdog.org/08/nf08/nfFEB08/nf021908-8.htm


Unfortunately, a confusing story published by the Military Times Group did not mention that the new policy applies only to those diagnosed with PTSD while on active duty.

We now have a clarification from Sen. Daniel Akaka (D-HI), Chairman of the Senate Committee on Veterans' Affairs.

Akaka's press release on this matter is here...
http://www.vawatchdog.org/08/scva08/scva021508-1.htm

As posted earlier, it sounded too good to be true. It's a step in the right direction but leaves too many holes to be plugged up.

Personality Disorder discharges, all over 20,000 of them, along with the misdiagnosed are left with what under these new rules?

PTSD being diagnosed while active, in other words by the DOD, have not protected any of them so far. Remember the redeployed under medication for PTSD? Where does this leave them?

What about the discharged who were diagnosed with PTSD but at such low levels they are receiving zero compensation or ridiculously low compensation?

This will do nothing to reduce the backlog of claims in the VA especially if they were diagnosed after they were discharged. Then we also have to figure in those who have not been diagnosed yet but are trapped in the waiting line. How do they turn around and prove the traumatic event happened? Are they supposed to end up like the Vietnam veterans still trying to find people who will offer support for a claim?

Like I said, it's a step in the right direction but why does it have to be such a tiny baby step?

VA Watchdog: VA strikes back at CBS for doing their job

The VA is striking back at CBS News for their reporting on veterans and suicide.
The first CBS report is here...
http://www.vawatchdog.org/07/nf07/nfNOV07/nf111407-10.htm
The second is here...
http://www.vawatchdog.org/07/nf07/nfNOV07/nf111507-10.htm
But, the VA's arguments, against CBS and for their own advocacy, do NOT hold water.
VA's self-congratulatory press release (below) speaks of all they have done in the area of suicide prevention. Truth be told, VA has virtually ignored the problem of veterans and suicide until this year.
In the wake of the Walter Reed scandal and the ensuing stories about problems in VA healthcare, the VA added more suicide counselors.
Their suicide hotline did not get started until late July of this year.
go here for the rest
http://www.vawatchdog.org/07/nf07/nfNOV07/nf111607-1.htm

It took CBS months of hard work but the VA has had years. No excuse will work now.