Friday, May 30, 2014

Head injury could explain a lot

BULLY BOY PRESS &   CEDRIC'S BIG MIX -- THE KOOL-AID TABLE

FADED CELEBRITY IN CHIEF BARRY O TRIED TO TAKE BACK CENTER STAGE YESTERDAY WHEN HE WENT OFF BOOK TO ANNOUNCE HE HAD PLAYED FOOTBALL (STOP LAUGHING) AT A YOUNG AGE (3?) AND HAD A CONCUSSION.

MOST AMERICANS HAD NO IDEA THAT THE WORLD OF POWDER PUFF FOOTBALL WAS SO ROUGH AND TUMBLE.

WHEN THESE REPORTERS ATTEMPTED TO QUESTION HIM ABOUT THIS ALLEGED CONCUSSION AND ALLEGED FOOTBALL EXPERIENCE, JAY CARNEY SAID IT WASN'T POSSIBLE.

THE WHITE HOUSE'S PLUS-SIZE SPOKESMODEL INSISTED "THE O" WAS TOO BUSY BECAUSE HE WAS ABOUT TO SPEAK TO A GROUP OF FORMER SOLDIERS WITH T.B.I. AND WOULD BE EXPLAINING THAT HE THOUGHT HE HAD T.B.I. AS WELL BECAUSE HE USED TO PLAY SOLDIERS IN A SANDBOX WHEN HE WAS SIX AND WATCHED THE G.I. JOE CARTOON WHILE STONED THROUGHOUT COLLEGE.

FROM THE TCI WIRE:

Last night, there was no accountability from the VA for their actions. There was even an attempt by the VA to insist that the Phoenix secret list was not, in fact, secret from the VA.

Dr. Thomas Lynch: Congressman, I don't think these lists were secret --

US House Rep Tim Huelskamp:  How did you not find them, Dr. Lynch?  You were there.

Dr. Thomas Lynch: I did find them, Congressman!

US House Rep Tim Huelskamp:  How many were on the list?

Dr. Thomas Lynch: Pardon?

US House Rep Tim Huelskamp:  You told me you didn't even look at this list.

Dr. Thomas Lynch:  I told you we didn't document the numbers.  I told you we were aware --

US House Rep Tim Huelskamp:  You saw the list?

Dr. Thomas Lynch: We were aware of the problem.

US House Rep Tim Huelskamp:  Why didn't you report to the press and to Mr. Shinseki and to the President of the United States that there were 1100 veterans waiting for care on that list?  Did you tell anybody about this?  You waited 35 days.  35 days.  You said that you care about veterans, you care about them, they waited on a list, languishing!

Dr. Thomas Lynch: Congressman, I was focused on trying to improve the process --

US House Rep tim Huelskamp:  What about the 1100 veterans?  So you knew about these veterans that were waiting for care --

Dr. Thomas Lynch:  Congressman, I wish I had identified the number of veterans and we could have moved forward more quickly.

US House Rep Tim Huelskamp:  Did you try to do anything to get care for these veterans, 1100 veterans, waiting?  Some of them might have been on the list that died.

Dr. Thomas Lynch:  Congressman, we identified the processes and we put people on the ground --

US House Rep Tim Huelskamp:  Yes or no?  Did you do anything for those 1100 veterans?

Dr. Thomas Lynch:  Congressman, I put in place an understanding of the process which allowed us --

US House Rep Tim Huelskamp:  They are still waiting for treatment. Sir, I think that is your answer.  I yield back to the Chairman.


Again, that's from Wednesday night's House Veterans Affairs Committee hearing on the VA's inability to provide the Committee with information in a timely and accurate manner.  US House Rep Jeff Miller is the Committee Chair, US House Rep Mike Michaud is the Ranking Member.

The Committee held from one panel which was comprised of VA's Assistant Deputy Under Secretary for Health for Clinical Operations Dr. Thomas Lynch; the VA's Assistant Secretary for Congressional and Legislative Affairs Joan Mooney; and the VA's Congressional Relations Officer Michael Huff.


Inability to provide information?

Since March 14, 2013, US House Rep Tim Huelskamp has been asking for a list of "those who had been punished."  He still hasn't gotten the list.

"Meanwhile, the bonuses continue,"  Huelskamp noted.  "You realize, the information that we have, this is from a website source, we can't get it from your agency, but at Phoenix an $843,000 worth of bonuses. So it wasn't just the director.  It was over a two year period.  My question, what we haven't received yet is the listing of those who lost their bonuses for failures in the system?  Who are we going to hold accountable?"

Inability to provide information?

As Ruth reported on the hearing the VA has also been denying Congress access to VA employees.  Ranking Member Mike Michaud explained to Joan Mooney that when the Committee requested testimony from subject matter experts, these experts aren't allowed to testify.

Ranking Member Mike Michaud:  Okay, we have an e-mail and we'll be glad to share it with you, Ms. Mooney, from a subject matter expert saying that that is the policy of the VA.  Now we can address that, I brought it to Sloan Gibson's attention, I've talked to the Secretary [of Veterans Affairs Eric Shinseki] a number of times about the fact that the relationship between the Department [of Veterans Affairs] and this Committee is getting extremely strained because we are not able to get the information that we need to.  We tried to, at the beginning of my term as Ranking Member, we tried to smooth out some of the requests as far as going directly to the subject matter expert.  That has not worked.  And so hopefully, we'll be able to get that working the way it should be working, rebuild our trust and open line of communication.


At this point, there is no trust or open line of communication.  This morning, I noted US House Rep Beto O'Rourke

US House Rep Beto O'Rourke:  I hope you will do that.  Another thing that struck me, you were talking about a failure within the VA that resulted from elevating a performance measure into a goal which could possibly have led to the scandal in Phoenix and other -- perhaps other-other parts of the VA.  If the current performance measures are not working what are some recommendations that you have for how we measure performance at our VHA system?

Dr. Thomas Lynch: I-I -- Don't get me wrong, I think that we need to have performance measures.  I think that they need to be tools that help us understand our system.  And I think we need to focus on our primary goal which is: are we seeing veterans, is our system growing, are we providing quality care?  When those become the goals of the system, then you cannot game performance measures.  Performance measures become a tool.  If you ignore them, then you're actually hurting yourself because you're not growing your system like you're supposed to and as a director or an administrator you will fail.


So, according to Lynch's testimony, the goals of the VA were not "seeing veterans" or the growing system or "providing quality care."  If those had "become the goals of the system, then you cannot game performance measures." Performance measures were gamed via secret lists. That happened.

Lynch also told O'Roarke about one of VA's potential "plans."

Dr. Thomas Lynch: Congressman, one of the options we have been discussing internally is whether or not we could partner with the Veterans Service  Organizations and use their membership and use their members as, uh, an opportunity to identify the kind of service we're providing and where they're experiencing delays.  I think there is an opportunity there that clearly needs to be explored further.

The VA gets billions of dollars.  It's proven currently to be inept and criminal.  The answer VA floats is to utilize the labor of the VSOs and the veterans?  With all that money, VA can't provide its own oversight?  It's going to need to tax the VSOs?

And am I the only one who remembers that it was just months ago when the VA was slamming the figures of the American Legion?  But now it wants to use these VSOs to do the job that the VA should be doing on its own?


US House Rep David Jolly noted the "frustration" on the part of the Committee "because we do have an Article I authority to ask the questions but our frustration is rooted in the fact that while we conduct the necessary oversight as part of our Article I responsibility, we continue to hear of a wait list and know that there are wait lists.  And we are held accountable for that, from our constituents.  It's kind of a remarkable process that our constituents hold us responsible for a wait list created by the administration.  And that's probably fair because we have to execute our responsibility."

And if you're not grasping why the Committee is frustrated, let's note this very basic request made in last night's hearing and the VA response to it.



US House Rep Julia Brownley: My constituents and my veterans in my community are also saying there not so concerned about how we got there right now at this moment, but they want to resolve this issue in terms of getting a timely response and making sure that their health care needs -- both physical and mental -- are taken care of.  We've got to figure out the longterm problems, without question.  I think the one question that I wanted to conclude on is that I'm happy that we're going to do sort of a national audit.  I want to understand what that includes.  Does it include the Oxnard CBOC [Community Based Outpatient Clinic] in my district?  Does it go down to that level?  And I want to know 

Dr. Thomas Lynch:  It is my understanding that the audit has now been extended to all VA health care facilities. 

US House Rep Julia Brownley:  Very good.  Very good.  And then, if the VA could provide us with a timeline of every single facility and when this audit is going to take place  and when it will be completed and what are the results of that so that we have a timeline that we can report back to our districts on but so that we can also monitor and watch to make sure that we're covering every single facility across the country. Phoenix has brought a lot to our attention but I'm concerned about so many other facilites across the country.  And if I could get your commitment today that you will provide us with that information, I would be very appreciative.

Dr. Thomas Lynch:  I will do my best to get you that information.  I think it is available --

We're going to stop him right there.  "My best"?

The hearing took place because the Committee is having to subpoena the VA for basic information that the VA is required to supply Congress with.  Brownley's request is a basic one and it's nothing more than compiling a list and schedule.  If the VA hasn't already generated that internally, they should get on that.  But there should be "my best" to provide that basic information to Congress.  It should be, "Yes, we will provide that information."


On the audit . . .

US House Rep Mark Takano:  You state, Ms. Mooney, that the -- that you think the audit might be complete within a week -- a week or two?

Joan Mooney:  Yes.

US House Rep Mark Takano:  My question to you may seem a little perverse but how can you get the audit done so quickly given the scale of the department?  And is that a realistic, uhm, turnaround time for you?

Dr. Thomas Lynch:  Congressman, maybe I'll try to answer that based upon what I know about the audits.  Uh, VA has mobilized resources from across our system.  We have asked each of the networks and facilities to provide volunteers to do these audits, to go out and evaluate hospitals so that we can get this audit completed in a timely fashion.

US House Rep Mark Takano:  Now, again, I go back to this issue of-of how good this information is that you're getting from people.  I mean, public officials have called for criminal investigations or turn this over to the Justice Dept.  Are people going to lawyer up, clam up?  I mean is that going to slow down the ability to get information out of people?

Dr. Thomas Lynch:  I am sure that there are people who are concerned.  I think that the IG is also our partner in this.  They have also been evaluating facilities -- particularly those with concerns.  They have authorities that we don't have to obtain the information that we need.  

Stop.  The Inspector General's office is not VA's "partner."  The IG exists to investigate VA.  The VA IG is already tasked with investigating over 40 VA medical centers currently.  They released an interim report on Phoenix this week.  They will not be able to release a report on the other medical centers for awhile.  So to claim that the two are working together is false in so many ways.

The IG is independent.  It can't coordinate with VA leadership in an investigation and be independent.  If Lynch understands what's going on an expressed it accurately to the Committee, the Committee needs to immediately take testimony from the IG's office because Lynch's remarks, if accurate, would indicate several walls in place to protect the independence of the IG office have now collapsed.



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