EL PASO TIMES - ' BITCH OFF,' 4 - 20 - 2015, PISSED OFF - BUT ALL GOOD NOW

EL PASO TIMES

FUNNY THING ABOUT THE STORY ABOUT THE ' RUMOR ' OF TERRORISTS IN JUAREZ, MEXICO IS THAT I WAS TOLD THE SAME THING AT THE MISSOURI ST. RESIDENCE BY A ' CLIENT ' OF THE BUSINESS. YOU WILL HAVE TO ASK THIRD PARTY VA REP. JULIO GUTIERREZ, FOR HE REPRESENTS THAT INDIVIDUAL. " ALWAYS HAVE THEM LOOKING THE OTHER WAY." STUPID GRINGOS," HA!?

I ASKED BOARDER PATROL AND THE PRETTY BOYS ON THE BIKES LAUGHED, AS IF, ARE ' THEY TAKING MY PICTURE TOO? '

IMAGINE THAT, ' A FUCK'IN MEXICAN ! NOT A DRUG DEALER, OR TIMOTHY MC VEIGH, BUT A FUCK'IN MEXICAN! A TERRORIST, ' WHERE YOU COMING FROM MAN ? ' " ARE YOU FUCKING WITH MY HEAD UMBRA ? "

IF THERE WERE NO TERRORISTS IN JUAREZ, THEN WHAT WAS ALL THAT SHIT GOING ON IN MEXICO A COUPLE OF YEARS AGO? GUESS IT WAS JUST ' WAG THE DOG,' GOOD MOVIE TOO. TO BAD FOR THE DIRECTOR ( CHARACTER IN MOVIE ), GUESS THAT'S HOW COPS AND DRUGGIES GOES. OH, AND I GUESS THE DEATHS AND DUI'S AND SUICIDES AND OD'S AND KIDS SELLING ILLEGAL DRUGS AND ALL THE TRANSPORTATION METHODS USED BY THE, SHIT, NOT CALLED ' TERRORISTS, WELL, LETS SEE, UHMMM, I KNOW ' RETAILERS OF VIRTUAL ENHANCED REALITIES,' YA! FUCK! LOOK DOWN! IT REALLY WORKS !

IT GOT BIIIGGGGERRRRRR !

IT'S JUST AIN'T'S WHAT IT IS, THAT IT REALLY IS ! YEP !

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LOOKED UP SOME FRIENDS IN ALBUQUERQUE, NM. THEN MY OWN ON THE JOURNAL'S SITE. HAD A LAUGH. REVISED A POST OF MINE.

I TESTED THIS BLOBS COMMENTS BOARD AT BOTTOM. I'M ' DUMB ARTIST,' FIGURED IT OUT THE SECOND TIME. IT WORKS NOW IF YOU PASS ROBOT TEST. I DID AFTER SECOND TEST. ' BAD ROBOT, ' BAD ! BAD ! SORRY CRUSE ( YOU'RE CATRON'S FAVORITE, BUT I'M BETTER LOOKING ! ).

AM LOOKING FOR PICTURE OF ' END DAY'S ' SCULPTURE, I HAVE PICS OF MY PIECE OF ART AND WILL TRY TO TAKE PIC OF DEMON IN MOVIE TO MAKE ' OTHER ' POINTS AS TO ' TERRORISM.' THE ' CREATION OF GENERATION ' FOR THE PLEASURES OF THE WEALTHY AND CREATION OF ' TERRORISTS ' WEALTH IN THIS COUNTRY. BE CAREFUL WHO YOU SELL YOUR ART TO.

I PREFER COMMENTS AND I WILL ' POST ' THEM. BE CAREFUL. I HAVE TAKEN ALOT OF HEAT AND SHOT AT FROM PEOPLE. SOME ' ACCIDENTS ' MIGHT NOT BE. SAY WHAT YOU MEAN, BUT ASK YOURSELF " WILL I SEE THIS OPINION THE SAME TOMORROW AS TODAY? "

I AM CLOSING IN ON THE ' END ' OF ONE LEVEL, ONE DIMENSION, OF WHAT I SAW. I DO NOT KNOW IF I WILL SURVIVE TO THE NEXT. WHO DOES?

I HAVE SEEN THE ' TRIAL.' BUT ' EVERYTHING ' SOMETIMES CHANGES BECAUSE OF ACTIONS THAT ' WE ' HAVE TAKEN.

ARTICLE 77

I MUST POINT OUT THAT ALOT OF POSTS OF NEWS FROM OTHER SOURCES HAVE NOTHING TO DO WITH THIS BLOG AND ARE NOT ALWAYS IN RELATION WITH MY OPINIONS AS I AM REASONABLY SURE THAT MY BLOGS EXPRESSIONS DO NOT REPRESENT ' THEIR ' OPINIONS. I TRY ALWAYS TO GIVE REFERENCE AND CREDIT.

I DO ' READ ' THE NET SOME TIMES WITHOUT MACHINES, AND AM AWARE OF MOST INFO SENT MY WAY, AND AM VERY AWARE OF WHAT THE BAD GUYS ARE DOING AND HOW THEY PLAN TO MAKE MONEY OFF ME, EVEN ON THINGS I HAVE NOT BEEN AWARE OF. I KNOW THIS.

I SUFFERED A BRAIN INJURY BACK IN 2006, AND SEVERAL OTHER ' ACCIDENTS ' THAT MOST ARE CONNECTED TO THE MILITARY. I KNOW THIS TOO. HOWEVER, IF WE CAN'T DEPEND ON THE GOOD PEOPLE IN OUR MILITARY, THAN ALL IS COMPLETELY LOST FOREVER.

EVERY MAJOR COUNTRY KNOWS THIS. MOST ESPECIALLY THE SMALLER ONES.

THERE ARE BAD ' VETS.' MAYBE IF THEY HAD BETTER CARE? RESPECT? WHY DO YOU PUT VETERANS IN THE COMPANY OF CRIMINALS ?

MORE IDEAS.........

WHY DID THIS FAIL ? ? ? ? ? ? ?
BELOW:

Summary: S.2300 — 113th Congress (2013-2014)

All Bill Information (Except Text)

There is one summary for this bill. Bill summaries are authored by CRS.

Shown Here:
Introduced in Senate (05/07/2014)

Jacob Sexton Military Suicide Prevention Act of 2014 - Directs the Secretary of Defense (DOD), at least once each year, to: (1) provide a person-to-person mental health assessment for each member of the Armed Forces on active duty and for each member of the Ready Reserve of an Armed Force for the purpose of identifying mental health conditions to determine which members are in need of additional care, treatment, or other services; and (2) submit to the House and Senate Armed Services Committees a report on such assessments, including on the number of members referred for care and services based on mental health conditions detected.

Requires the Secretary to: (1) convene an interagency working group to review and recommend collaborative approaches to improving the provision of mental health services to members of the National Guard and the Reserves; (2) report the findings and recommendations of the working group to specified congressional committees; and (3) report to the Armed Services Committees on an evaluation of specific tools, processes, and best practices to improve the identification of, and treatment by the Armed Forces of, mental health conditions and traumatic brain injury among members of the Armed Forces.

CONCERNED VETERANS FOR AMERICA

BELOW:

YOUR IDEAS: FIXING VETERANS’ HEALTH CARE

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By Caroline Phelps
On November 6, 2014

Note: The opinions below were submitted via an online portal and do not necessarily represent the views of Concerned Veterans for America or the Fixing Veterans Health Care Taskforce.

Since the launch of the Fixing Veterans Health Care Taskforce, nearly 1200 people have submitted their ideas on how to fix veterans’ health care through our submission portal. Below are some of the responses we’ve received so far:

“The VA should make customer service and the user experience a priority. Many times this is where the VA fails is in its interactions with the veterans it serves. Get rid of the automation, robot responses. Train the 1st contact employees to focus on customer satisfaction providing answers in a timely manner and being available to talk with veterans. Something as simple as a response from a human being when asking questions will go a long way. Confusion, lack of answers or updates on claims, appointments, resources causes hate and discontent among the veteran/customers. Focus on taking a hard look at the “user experience” with the 1-800#s, the appointment process, the walk-in process at Vet Centers and other VA offices.   That’s the point of contention for many veterans that can be fixed.”

-Veteran in Virginia

“I am a Marine/Viet Nam veteran with a 30% disability. I live in central Pennsylvania and it is 70 miles to the nearest V.A. Hospital. I currently am scheduled with 6 month appointments that are scheduled one or two weeks after my local 6 month doctor’s checkup which provides the V.A. with current blood lab work as well as a copy of my local doctor’s notes.  After driving 2 hours to my V.A. appointment I spend approximately 10 minutes with a physician’s assistant while he reviews my local doctor’s notes and lab notes, and then I am done with my V.A. appointment.  Why can’t I just have my local doctor email or fax the info to the V.A. and save me the 70 mile drive? If there is something that changes with my health then the V.A. could schedule an appointment.”

-James, USMC Veteran in Pennsylvania

“I am the wife of a retired Army Special Forces Warrant Officer who served 35 years for this country. I am a registered nurse and work in a level 1 Trauma Center. I see homeless, alcoholics, drug addict get better treatment than our solders do. First we have been fighting for compensation since 1996. They lose your records, they don’t file your records, they don’t look at your records, they falsify your records. There needs to be a better way to get claims processed… Continuity of care would be better for patient. That way you don’t get lost in the system. The wait time is long. We filed an appeal and were told it would take 3 years. The other appeals were just lost.”

-Ramona, Military Family Member in Arkansas

“Put ever veteran on CHAMPVA at the same rates of coverage as the spouse of a veteran allowed CHAMPVA health coverage. That would allow veterans to seek personal health care with local doctors, with less dependence on the VA Health clinics, and Hospitals. Perhaps making adjustments to the amount of paid medical, 80% to 100%, due to the severity of the individual veteran’s disability compensation rate, or pension status. Such an idea would put the veteran’s health care back into the community in which the veteran lives. As you are aware, the thirty mile rule allows veterans to seek emergency care locally, with the VA picking up a portion, or all of the cost. Travel payments to the veteran would be reduced. I have Tricare for life, but the example of Tricare Standard, but under the name of CHAMPVA, and administration, would save both money and improve medical care for our veterans. This is only an idea, but one that should be implemented now. The physical expansion of VA Hospitals could be restricted, which would allow for some serious savings. As with Tricare, VA Hospitals would serve the same purpose as Uniformed Military Hospitals to reduce costs, to be used by those veterans living nearby for daily use.”

-Paul, Veteran in Oklahoma

“Veterans are our greatest natural resource.  To waste their collective talent by providing the worst possible health care is tragic.  There should be a group health care system for ALL veterans to voluntarily participate in that acts essentially the way any other group health insurance plans acts.  It’s requirement, e.g., providing health, dental, vision and prescription drug coverage could be let out contractually to be bid on by available health care insurance companies just as private companies select group coverage.  Most health care providers would not have to undergo the burdensome governmental requirements that cause so many to deny VA coverage, and participants could go to the doctor of their choice within the plan.”

-Brad, Veteran in Virginia

“I am a wife, daughter, sister-in-law, daughter-in-law, grand-daughter, niece, and cousin to combat, non-combat, service connected and non-service connected veterans. I also provide discharge planning for veterans who receive services in the community hospital. Veterans have very specialized needs that are related to their service, and many are more comfortable and receptive to care among other veterans. The VAMC meets these needs admirably, but sometimes services must be provided in a community facility. A smoother transition through the continuum of care is needed to provide a safe and effect discharge plan for these Veterans.

Problems:

*Homeless Veterans are sent for elective procedures in the community (ie: ortho surgery) without a plan for them in advance, and they cannot return to the domiciliary until they can ambulate across campus for meals, etc. Typically, they are not appropriate for an inpatient rehabilitation admission.

*Home oxygen cannot be assessed until the final 24-36 hours of an acute admission. The VAMC does not accept outside hospital testing. It requires an arterial blood gas which is painful, invasive, risks nerve damage, and is expensive. Please note that Medicare/Medicaid accept simple pulse oximetry which is obtained by placing a monitoring device on the outside of a finger for less than a minute. The Veteran being discharged from a community hospital has to wait until the home oxygen evaluation appointment is scheduled at the VA, and then transfer to the VA as an acute inpatient. I am told that the home oxygen is not available that same day because the VA does not have contracts with local providers. Instead, it has 1 national contract. The local VA does not provide hemodialysis for their acute inpatient Veterans, so these Veterans cannot transfer back for evaluation. Also, the Veteran discharging on Fri.-Mon. cannot get appointment until mid week. So, either the Veteran pays for 1 month of oxygen or the Veteran remains as an inpatient in the local facility waiting. Please note that the VA only accepts inpatient transfers through 1-2 pm Mon. – Thu.. The cut off is earlier on Fri.  No transfers are available on Sat. or Sun. I have had Veterans who are 100% service connected – and 1 with a Purple Heart – pay for home oxygen so they can discharge home without waiting in the community facility for days.  This and home medications are the only services that cannot be arranged from the community hospital.

*The Veteran discharging from a community hospital with new medications has to go from the hospital to the VA to sit and wait in the clinic to see a physician before those medications can be filled by the VA pharmacy.

*The VA will not cover Xarelto unless the Veteran has failed Coumadin treatment, but the VA will not give Coumadin or follow the labs that are required for monitoring until the Veteran has been enrolled in (seen by) the Coumadin clinic. The medical conditions that require services outside the VA often require anticoagulation at discharge.

*Home Health provides nursing, aides, therapies and social workers. If the physician orders home health aides with any of the other services, then the care is broken up between 2 companies. A VA nurse sets up the nursing and/or therapy with the home health agency. Then the VA social worker sets up the aides through a home care company. This is a duplication of services within the VA as well as in the community. It fragments care because the aide works under the supervision of the home health nurse and provides vital information to the nurse on days when the nurse is not in the home. This relationship cannot exist if the aide is from one company and the nurse is from another.

*Veterans who are brought from outlying areas by the VA transportation for appointments and then are admitted to the community hospital face an added obstacle of not having transportation back to their home which is sometimes 4 hours away. VA transportation to those outlying areas is only available at certain times and on certain days of the week, and many of these displaced Veterans do not have family who can provide transportation.

*The Veteran hospitalized for medical stabilization, who is an involuntary hold (1013 in the state of Georgia) for harm to self or others, and who has medical issues is also problematic because the VAMC does not accept anyone who is involuntary. Many Veterans have medical/physical needs that cannot be met by Mental Health facilities. The Veteran who has shot himself and needs wound care or has a colostomy is not going to be accepted to a mental health facility. Neither is the Veteran who is unable – or unwilling – to toilet himself. Yet they have mental health needs that are not being met.

Suggestions:

*Streamline processes to make care less fragmented and to avoid duplication of services. This may require modeling private sector processes.

*Contract with more than 1 company to assess for and provide home oxygen and accept testing from hospitals that is in line with Medicare/Medicaid requirements.

*Make a plan/policy for Veteran’s treated in community hospitals instead of trying to fit these Veterans into the policy that exists for those treated in the VAMC.

*Utilize more nurse navigators and nurse case managers. For certain populations, like those planning surgery, the CM could work more closely with the Veteran and the physician to ensure that he/she has a place to go after the procedure. It may be beneficial to model this after the workman’s comp process of sending a nurse with the patient to critical appointments. They could also work proactively to have a plan for transporting displaced Veterans back to their homes.

*Extend hours and days that care coordination is available to the community facilities which operate 24/7.

*Expand services to include care for involuntary mental health patients with medical needs that cannot be met in the community.

Thank you for your consideration, and also for your time and dedication to improve the care provided to our Veterans.”

-Valerie, Military Family Member in Georgia

19 Responses to “Your Ideas: Fixing Veterans’ Health Care”

1. ARNOLD CABRAL on November 7th, 2014 - 6:33pm Poster address: PRESCOTT VALLEY ARIZONA, 86314
   
   MORE VETERANS DOCTORS SHOULD BE HIRED BECAUSE I KNOW MY VETERAN DOCTOR HE HAS OVER 1000 PATIENTS HE DEAL WITH A MONTH PLUS HE TOLD ME SOME OF MEDICAL RECORDS IS NOTAT HIS DISPOSAL and he at times he forget that assist email me back to tell what you think of that PLEASE God bless stay healthy
   
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• David Steward on November 7th, 2014 - 8:33pm Poster address: GREENUP KENTUCKY, 41144
  
  thats not a fix the VA dont have real DR ASK ONE TO SEE HIS DEGREE and see what they say and law said they have to have it posted in there office at all time but you will never see one in any VA hospital in the country
  
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• Sarah Steinman on November 10th, 2014 - 3:18pm Poster address: fort worth TX, 76115
  
  Until the doctors are forced to adhere to the very oath they took “To do no harm”, hiring more doctors won’t help the problem.
  Only after the doctors, nurses, PAs are forced to treat our veterans with the respect they are due (given their sacrifice to this country), can we think about hiring more people.
  
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2. Marcus H. Cherry Jr. on November 7th, 2014 - 7:17pm Poster address: Magnolia Texas, 77354
   
   Yes, The VA wants us all to die. The latest started in February 2013 when I let the VA operate on me and put in two implants. I ended up in the hospital for 3 1/2 weeks in severe pain, passing blood, stopping up and almost died. They just wanted to keep me on drugs for the pain. The implants never worked right. I was always in pain and passing blood. In August 2013, it was getting worse and the Urology clinic would not see me again without another referral It took over 4 weeks to get the referral  from my doctor. I went back to the urology clinic, I was in pain, passing blood, and stopping up. They were trying to put me off until the 23 of December f 2013.  I ended up in the emergency room in severe pain and stopped up and the doctors at the urology clinic would not even come down. After another trip to the emergency room. The doctors in the emergency room at the VA, put a Foley cather in me and I had a sinker valve that was causing the problem and the foley cather caused more damage. I went to the Methodists hospital on 249, spent several days in the hospital, then was sent to St. Joseph to see an expert on the urology implant, he put me in the hospital right away, removed one of the implants, repaired the other and since then I’ve been recovering and healing. The VA had left a hole in my pee tube and it was infected  “bad” The two doctors that I saw out side of the VA, both called the main doctor in the Urology clinic, of course nothing happen.  I will never let the VA touch me again. They are a bunch of liars. Right now I cannot get far from the rest room, but almost healed, healing takes forever. When I’m healed the doctor will replace the implant.  This is not the first time the VA has treated me wrong, there are many more, but it is the first time they nearly killed me. I’m still under treatment by Dr Cornell and will be for several more months. His last statement to me was that the doctors and the people that put the cather in caused a lot of damage and now he has a lot to repair.
   
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• David Steward on November 7th, 2014 - 8:27pm Poster address: GREENUP KENTUCKY, 41144
  
  i know what you mean they killed all my friends over the years chop chop chop away at the 1 they blinded then chop chop chop he died last year the did give him 100% he got 6 months back pay after 43 years fighting to get it he got his back pay in 6 different check when he got a regular check they chopped 1 more time so he would die and he did 2 months later shame so dont let the VA do nothing bro ive spent millions to fix what they have messed up on me and i only get 7 bucks as a check they think there doing some thing ! holding my money sorry to here how they done you i like to sue them so you fine a lawyer let me know im on face book DAVID V STEWARD just send a message ill get back with you ,/ and any one that reads this like to sue dop me a line class actions get lots more money from the government we will fix this even make them pay for killing all the others out there that cant speak now gods speed brother of arms hang in there !
  
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• Debra Steinman on November 10th, 2014 - 3:14pm Poster address: Los Alamos NM, 87544
  
  I know precisely what you mean. As a soldier, I held any sickness or pain I felt. I saved up my money and always saw ‘civilian doctors’ whenever possible. When it wasn’t possible, they kept sending me back into the field even though I had bronchitis, high fevers etc.. then threatened to court martial me, when I passed out due to their ‘incompetent’ care.
  As a veteran (for the few years I qualified to go to VA Doctors), I only went to civilian doctors (even though at times that meant I had to choose between eating three meals a day, and getting the medical care I needed.
  Sadly our cases our only a harbinger of what is to come now that we are all being forced (against our will) onto Obamacare/ACA.
  
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3. Rachael Overweg on November 7th, 2014 - 7:33pm Poster address: Holland MI, 49423
   
   Hire more veterans to work in all areas.
   
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• David Steward on November 7th, 2014 - 8:29pm Poster address: GREENUP KENTUCKY, 41144
  
  thats not a fix list still be there and appointments be the same think what would fix it
  
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• Sarah Williams on November 9th, 2014 - 1:37pm Poster address: Lexington Park Maryland, 20653
  
  cut out the piles of paperwork, make it more like an assembly line with a diognistition at the end and someone with you to walk you through it each step of the way. utilize organizations across the country that are readily available. Dont leave the vet to navigate the maze by themselves give them a direct path. Paperwork is not the answer to covering their butts. Then yes bring in more vets to help other vets. Give them a new purpose. Helping others is the best medicine but we only can only help others if we can afford to take care of everything els in our lives as well. Also, taking a holistic approach meditation, yoga, EMDR. If the VA cant do it send them to people who can and there is a place in every town or city who can and guess what that stimulates the economy.
  
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4. David Steward on November 7th, 2014 - 8:12pm Poster address: GREENUP KENTUCKY, 41144
   
   I LIVE IN KY. BUT HAVE TO GO TO WVA HUNTINGTON WEST VA. HOSPITAL ive been going there 35 years now this is the first year i seen a DR. i was discharged with 30% service connect but i have never received pay for the 30% since my discharge why would the VA and THE VA HOSPITAL SAY they dont have my medical discharge papers this is bull and you know its bull ,i was hung up on the back of a truck and drugged for miles in traction for a long time ,my back had 4 damaged vertebrates my left hip was twisted out of scockit more than 1 time knocked out and my left knee was twisted 180 degree more than 1 time so the MARINES gave me 30% progressive that it will get worse over the years well it has and the spent my own money for treatment way over a million dollars the VA has not spent 5k on me even charged me for meds / now it you want to fix the VA hospitals close all of them down! we dont need them at all there no real DR. in them / give each vet a med card they can use any where and get there drugs to on same card /now for non service connect in less stsd give them a card at a discount like Medicaid is now from what state they live in same with there drugs . The Government will save billions of dollars VET get better health care no need for up keep of huge building no more paying people that dont do a dam thing at all less on workman come and insurance on each and every building this is how it should be if you need Vets to have a hospital for the ones that need therapy and limns and extra treatment just have a few hospital for those till the are able to go home to live /BUT FIRST FIRE THESE ONE THAT HAVE GOT MONEY TO DO NOTHING BUT KILL US ME IN CLOUTED MURDER IS MURDER BUT TO GET BONIEST MONEY THAT’S SAME AS PAYING TO KILL THEY NEED IN JAIL FOR LIFE
   
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5. Ricky R Green on November 7th, 2014 - 9:46pm Poster address: Frisco City Alabama, 36445
   
   Close down all VA Hospitals and allow Veterans to find the care they need and VA can be a new billing process center to cover the cost of treatment. The VA will never be fixed the VA can only be closed down. The VA healthcare has been screwed up for over 20 years now. No one at VA is willing to take responsibility for anything but if I seek out my own healthcare I can hold my own private free market healthcare provider Responsible by firing them myself and find another healthcare provider if healthcare is substandard. .
   
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6. Lyle Chambers on November 8th, 2014 - 3:58am Poster address: Fairborn Ohio, 45324
   
   When I see, or receive treatment from, a physician, I would like to see the same physician when I go back for followup or additional treatment. I cannot recall seeing the same physician more than once for anything. I could not tell you the name of my Cardiologist, Ophthalmologist or Podiatrist. At times, I am told different things from different physicians. Sometimes, my medications expire, and I have to notify someone to approve more refills. I stay confused over my current health conditions.
   
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7. georgia reilly on November 8th, 2014 - 4:06pm Poster address: Marion CT, 06444
   
   THERE SHOULD BE A COMMITTEE OF VETERANS WHO ARE NOT CONNECTED TO THE GOVERNMENT IN ANY CAPACITY TO INVESTIGATE WHERE ALL OF THE MONEY THE VA HAS BEEN GIVEN HAS GONE. ANY VA THAT HAS MISAPPROPRIATED FUNDS WILL HAVE THE ADMINISTRATION SUSPENDED WITH NO PAY UNTIL THEY CAN SHOW THERE WAS NO WRONGDOING IN THE HANDLING OF FUNDS AND THERE SHOULD BE RECORDS MADE PUBLIC ON HOW APPOINTMENTS WERE HANDLED FOR OUR VETS AND ANY DOCTOR OR SUPPORT STAFF WHO IS SHOWN TO HAVE TURNED VETS AWAY OR MADE TO WAIT AN EXTENDED PERIOD OF TIME TO HAVE ACUTE PROBLEMS RESOLVED SHOULD BE FIRED AND INVESTIGATED FOR CRIMINAL BEHAVIOR. THESE VETS WHO HAVE BEEN TREATED IMPROPERLY SHOULD BE SENT TO PRIVATE MDS AT THE EXPENSE OF THE VA HOSPITAL THAT DID NOT TAKE CARE OF THEM. ANY VET WHO WAS NOT SEEN FOR A LIFE THREATENING CONDITION BECAUSE OF THE DELAY OR OUTRIGHT RIGGING OF THE APPOINTMENT SCHEDULE SHOULD HAVE FAMILY COMPENSATED AND THE PERSON FOUND RESPONSIBLE FOR ORDERING THIS ACTION SHOULD BE PROSECUTED TO THE FULLEST EXTENT OF THE LAW.THIS IS JUST A START OF WHAT SHOULD HAPPEN TO SET THINGS RIGHT IN A BLOATED GOVERNMENT AGENCY THAT BELIEVES THEY DO NOT HAVE TO ANSWER TO THE CITIZENS OF THE US. WE AS A PEOPLE OWE THIS TO OUR SERVICE MEN AND WOMEN AND IT IS TIME THE GENERAL PUBLIC START SHOWING THEIR GRATITUDE TO THESE PEOPLE. IF THERE IS EVER A VOLUNTEER COMMITTEE FORMED FOR THE PURPOSE OF INVESTIGATING THIS ATROCITY CALLED THE VA SYSTEM I WOULD BE RIGHT THERE TO VOLUNTEER.
   
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8. Ramona Young on November 8th, 2014 - 8:11pm Poster address: Mountain Home AR, 72653
   
   First off the VA clinic my husband goes too he is seen by a PA. I highly doubt the physician who is suppose to over see this PA ever looks at the records. I have to say as a nurse I see a lot of neglect in the care of the pt. My husband has severe back pain and radiculopathy from a herniated disc and degenerative joint disease. This is service connected from all the airborne jumps, rucks with the 60 lbs., He has never seen a neurosurgeon, they just keep sending him to interventional radiology for injections. He has 3 TBIs which are service connected one from running into premature explosions to save 5 Jordanians, for which he received a Soldiers Medal. At the time he knew something was wrong had blood coming from his ears. But because he was the medic he flew with his patients to the hospital and was never treated by the military. He was in a parachute accident where the parachute caught a wind gust and sent him to the ground from about 60 feet up at about 45 miles per hour. He had a positive loss of consciousness. They never put him in a cervical or did a CT of his head, and all the time he was confused and dizzy. He hit on his right shoulder and the right side of his head. He had surgery on his shoulder and that was it. He has cervical stenosis with herniated disc , and cranial nerve damage which is directly related to parachute accident. But never has been addressed. Being a neuroscience nurse , I started noticing changes, Headaches, memory loss, personality changes, difficulty concentrating, depression. He was diagnosed finally at Poly trauma clinic with TBI with deficits. The doctor in Little Rock told him that was wrong and it just his PTSD. I have researched the education these physician should know to differentiate between TBI and PTSD. WE filed our claim and the C&P exam doctor falsified the whole thing. Then the whole claim was just lost. His claim for hearing loss was denied because the female said he did not have enough time in service, 35 years is that not enough. She never looked at his file. They have given him hearing aids for sensorineural loss. There are multiple other injuries but they continue to deny there service related. A soldier who has documentation of his service connected injuries should not have to prove anything to a bunch of bureaucrats who to them you are just a number. They are suppose to be working for the veteran, The system is broken. The veteran fought for this country, sacrificed his family life and now he has to fight for what is right fully his. Sitting in the DAV office there were two men sitting in there with us. The poor old elderly man said I am here because they cut my check to $1 a month, I have been trying all these years to get my hearing loss and can’t. I asked him what he did in the service . He said I was on the aircraft carriers. The other guy chimes in and says well I was in Nam , I was a truck driver and I got 100% for hearing. Now you tell me what is wrong with this system. Non service connected vets should have there own clinics so that the VA system for service connected is not so bogged down. By the way my husband served 37 years for this country. He went to Vietnam, OIF/ OEF. I believe the families and the vets need the opportunity to sit in front of our paid senators and congressmen and tell them what the issues are. We voted them in to stand up for we the people. The process for filing claims need to be made more vet friendly. They need a system to keep up with the vets records so they are not lost. Lets fix this broken system .
   
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9. Susan on November 9th, 2014 - 3:15am Poster address: Buckley Michigan, 49620
   
   people in the congress retire with a retirement. So should service people who have served at least 6 years. All service people should be given a medical card to go to any doctor of their choice and the government to pick up their tab. They should also have free dental and eye care. They laid down their lives for our country, our country should care for them after that service.
   
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10. Sarah Williams on November 9th, 2014 - 1:30pm Poster address: Lexington Park Maryland, 20653
    
    I have been to the DC VA once a week for the past 2 months or so. Let me tell you it has been one hell of a roller coaster ride. I am a US Army combat vet who deployed twice to Iraq. To get to the DC VA it is a 2-3 hour drive depending on traffic. I have a TBI PTSD and Meniere’s Disease. It is hard for me to dive that far as I get dizzy and tired and nauseous sometimes even throw up. The pressure in my head is consistant and I always feel lightheaded. Marylands commitment to vets has offered rides and i took them up on it more than once but the problem is they never call before hand to confirm someone will in fact be there or what time they will pick you up. So I drive instead. I also have twin 3 year old boys. I do not work because I cant and cannot afford childcare so often I have to rely on my husband or a friend making it very hard and very stressful to even figure out who will take care of the boys for these all day appointments I have to go to. At the VA in DC the staff is generally nice but I have run into a few Doctors who were not even close to nice or helpful. I used and OIF OEF rep and I had high hopes but all they did was make this appointment or that and start this process and that to fill out their check list and they didn’t follow up. The places they called either never called back or I did have the appointment and there was no one on the other end to receive the input. So here is what I have realized. First the pressure on the VA to changed has not made things better so far it has just made workers have to fill out more paperwork to make it seem like they were doing their jobs when in fact everyone’s job at the VA has become paperwork leaving less time for Veterans. Secondly they left had does not know what the right hand is doing. The staff is confused and every time I see another specialist or have another test they are like your PCP will go over it and figure out what to do next. Well my PCP is no longer working at the VA which i am glad for because she was horrible but, now no one is looking over these tests or on the other end for diagnostics. Also, the whole reason I went back to the VA was because I cannot work and need to get back on my feet again so I can go back to work. I want to work I miss having a purpose but at this point I always feel dizzy and my cognitive function is getting worse and worse. The OIF rep said he would start the care provider process he said he would help me fill out a claim and help me with the not being able to work status. I had 3 appointments with him and now he is through with me and all he did the whole time ask questions fill out paperwork and check off his list. I know this is not his fault but this has to change. The VA needs a full rehall. Start over again this time fill it from the top to the bottom with veterans, take away the red tape, and create an assembly line where someone is at the end to process all the data and make a diagnosis. Stop making us have to jump through all the hoops you will spend less money on each of us if it worked more smoothly and seamlessly. Also, the biggest thing that needs to be addressed is therapy. I have called the Crisis hotline more than once and each time I was sent to the clinic at charlotte hall, which is completely worthless which is why I bypass it and go to DC, they are always booked a moth out and when you get there you sit in front of a tv screen and skype with the doctor. I can see how this might be useful if you could A) do this out of your own home and B) are just speaking with a doctor who is changing meds or processing all the data from all the specialists and tests but in no means is this therapy. There are a lot of organizations out there including my own Operation Warrior Refuge who do offer therapy and it works! But Vets don’t know about them. If the VA provided vets with these resources and worked with these organizations they would actually get help. For me I was going to a civilian here locally and she was amazing she was giving me resources and using EMDR but sadly she didnt take my insurance and commitment to Maryland said they might be able to help then decided they couldn’t because in their mind the VA offers therapy. I have been in the system 8 years now and I can tell you not once have I seen a therapist they were always psychologists pushing meds. I was always looking and still am for the holistic approach you know use emdr to retain my brain teach me meditation teach me yoga. Help me to change my nutrition to make my life better but instead you get pushed from one place to another and put me on this med and that med. Hers an Idea why dont they put us in patient from the beginning for a short time long enough to push us through the assembly line and get our meds straight put in claims and all of that and then put us in the hands of a non profit organization or civilian healthcare or for that mater military healthcare. I live right next to a base yet I have to drive to DC to get care and I am just one of many. The Va keeps sending me to the Vet center to get therapy and they are in my area once a week but all they offer is talk therapy which has never been effective for me and without a plan of action its not helpful for anyone. If I could have just continued with the local civilian my life would be back on track instead due to not being able to afford it I am in the hands of the VA and not getting anywhere and my family is suffering because of it.
    
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11. Ricky R Green on November 9th, 2014 - 5:15pm Poster address: Frisco City Alabama, 36445
    
    Close down all VA Hospitals and allow Veterans to find the care they need and VA can be a new billing process center to cover the cost of treatment care. The VA will never be fixed the VA can only be closed down. The VA healthcare has been screwed up for over 20 years now. No one at VA is willing to take responsibility for anything but if I seek out my own healthcare I can hold my own private free market healthcare provider Responsible by firing them myself and find another healthcare provider if healthcare is substandard. Phase it in over a 3 to 5 year period so it will not be a shock to the VA system and allow the VA healthcare workers time to re-intergrate into the free market healthcare system where they will be held accountable.
    
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12. John Fender on November 14th, 2014 - 5:14pm Poster address: St. Louis Mo, 63105
    
    Contributing to an already problematic VA service model is the National Records Center in St. Louis, Mo., where the outstanding number of medical and service record requests has reached 120,000 outstanding. The wait has reached at least the 120 day level and growing. State of the art processing…….a brand new records center………..?
    
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13. Katherine Rogers on January 28th, 2015 - 9:29am Poster address: Warren Michigan, 48093
    
    IF the public may go with Obama care to their local community for care, why are veterans not allowed the same option? Why are veterans, once again, second class citizens? Allow veterans to go to primary care in their own communities. Note I said allow and not force. If veterans were allowed to vote with their feet, VA clinics which lack quality care would close and those which were of high quality would remain open.
    The VA primary care provider represents himself first and the VA second. I have repeatedly had to go to the community to pay out of pocket to have an outside physician write the VA and demand further testing for my symptoms. Once testing is done, the testing agrees with the diagnoses I put forward. The VA doctor serves to delay this new diagnosis and complicate charting. I don’t need the taxpayer to pay for a VA primary care physician to impede progress.
    I am applying to get conditions service connected. VA primary care charting is so poor that conditions treated at the VA don’t end up in the assessment of patient case notes. Comp and pen is under no obligation to review pharmacy records nor treatment plans. Comp and pen workers and primary care physicians still collect their pay checks no matter how poorly they behave. The upshot is that I am now treated for conditions with onset during military service or contributed to by military service …and that are not service connected. IF a VA physician simply refills medications and writes orders but does not go back and add these additional diagnoses to the assessment, comp and pen denies a claim for these additional conditions. IF the diagnosis is described but is not exactly the wording written in the schedule of disabilities, comp and pen is under no obligation to clarify this with the primary care physician. IF a physician improperly charts…no disciplinary action is taken and the veteran is to stand the loss. If comp and pen workers and VA physicians refuse to communicate with one another to clarify the charting problem, they receive no decrease in pay. Why would they bother to clarify an issue or do any extra work if …their salary is not effected?
    Primary care claims that its not policy for them to contact comp and pen if a chart is poorly written to the point of being misleading. The case has been forwarded to the congressional investigator, but with the VA so far not rendering a response. Veterans need a time frame in which the VA …MUST frame an answer or render a decision in favor of the veteran.
    Meanwhile, I …am to continue to use this same VA primary care team. I would like care from a community physician. Each state has a state university where there are physicians not in the pocket of the VA who would be willing to serve.
    I ask that the VA be required to respond specifically to veteran attempts to service connect conditions. Once it is proven that a veteran served, this…should be placed in a section of the VA chart related to Comp and Pen. Once the predeployment physical(s) are submitted, this should be attached to the patients VA chart in the Comp and Pen section. I am being asked each time I submit a new diagnosis and appeal to resubmit that additional documentation. Its may seem easy enough to simply resubmit that paperwork, but many veterans are homeless, and due to mental illness, injury or medication …are confused. Veterans should not have justice delayed or denied because they have not …reproven those same issues again. Comp and Pen should be required to state if the condition in question ever existed and to list date of onset and date the condition was declared resolved. This would assist veterans in knowing that they only must prove the condition existed back during military service. It would assist if the condition was viewed by comp and pen as resolved but this is incorrect. If the onset was after military service and the first year following service but was caused by or made worse by military service, comp and pen needs to state this if its indicated by the medical records. If the existence of the diagnosis is accepted by comp and pen and that its ongoing, this would leave the veteran free to gather evidence only to prove this later point and not …reinvent the wheel, as in reproving all the other necessary points. Reproving the same information wastes taxpayer funds re comp and pen workers saleries, and frustrates veterans. The edict to …submit more information…is vague to the point of being nonhelpful.
    I recommend that a copy of Current Diagnosis and Treatment 2015 be available in the medical library and an updated copy be placed there each year. In my case VA doctors apparently just could not see how certain things were true. The copy of Current Diagnosis and Treatment disagreed with VA doctors. Veterans should be able to look up to see if their doctor is following the current standards of care AND if the physicians advice to the patient matches what is being done with civilians. That this material is available should be posted on the walls of the VA hospital and sent as a notice to the veterans. A procedure should be set up for veterans to follow when their doctor is not meeting that standard of care.
    I also suggest that the VA choose each year text books that they consider standard re pharmacy. Some medications are used for no other diagnosis than the diagnosis the veteran is putting forward to comp and pen. For example, a veteran may be treated with insulin by the VA. This drug is used for no other purpose than a deficit of insulin ie diabetes mellitus. Veterans should be able to insist on comp and pen review of pharmacy notes and prove by means of accepted pharmacy texts that they do…in fact have the condition claimed…no matter how incompetent the VA physician is at charting diabetes mellitus in the assessment. (Disclaimer: I do not have diabetes mellitus so am not revealing medical information here. This disease is used as an example of how other evidence could reasonably be used to bypass poor VA primary care charting.)
    The list of medical diagnoses should be available on the veterans chart and be available for veteran review via my healthy vet. Next to each medication in the pharmacy list should be the medical diagnosis for that medication. Orders for treatments such as physical therapy or consults should be written with an attached DRG diagnosis. Working diagnoses such as abdominal pain not other wise specified, should be clarified as soon as possible. These medical diagnoses should match the diagnoses listed in the disability rating. There are many ways to describe a diagnosis. Physicians should be required to use the same description ie DRG as used by comp and pen. The workers in comp and pen do not translate an unfamiliar diagnosis nor require a physician to do so. The veterans claim is simply denied. Failure of VA physicians to comply should be grounds for termination. Comp and Pen workers should not be allowed to work off a separate list of diagnosis. If there is a possible additional diagnosis and VA physicians are uncooperative, it should be possible for patients to be sent to physicians outside the VA for clarification such as to the University health care system. Each state has a university teaching system. Some states have more than one university with a medical teaching program. If the university finds in favor of the veteran and deems that the diagnosis in question should be added, the ruling should go in favor of the veteran. Personally I have gone to VA specialty physicians AND to the university. Both of these physicians agreed with the diagnosis in question and yet, due to primary care charting…comp and pen denies the claim. Onset of the condition and resolution date of the condition should be listed in the diagnosis list at the VA. If the condition occurred during military service or the first year there after should be noted. If the condition could have been worsened by military service or other service connected conditions should be noted on the diagnosis list. Comp and pen workers who are not trained physicians and who do NOT examine the patient should not be allowed to overrule information on that diagnosis list that is in the patients favor.
    A clear mechanism MUST be in place to correct the chart if punitive charting has taken place. In my case VA physicians attempted to deny a diagnosis. Later they claimed that I have the condition but must be symptom free. I am being treated by the same VA for many of the individual symptoms. Conns Current Diagnosis and Treatment records that patients with normal lab values tracking the condition are still symptomatic. Its punitive charting for blowing a whistle about the charting issue at the VA and about that diagnosis specifically. There is no current penalty for punitive charting. VA physicians are free to state for the record that a patient does NOT have a condition or state that the patient is asymptomatic. Currently labs or other testing showing the diagnosis will not override this punitive charting. The physician(s) in question are not fired as would be appropriate. University physicians are not allowed to override the charting problem at the VA.
    On another note, the VA needs to stop labeling as abnormal patients who are homeless, or still in dispute with their VA and who are sad or angry. Get veterans in housing. Ensure they have food available through out the month. Get claims through the VA system and rule in a fair manner. Penalize physicians who engage in poor charting practices and punitive charting. Then and ONLY then determine if a veteran is abnormally sad or angry. Unless 1000 out of 1000 people would be happy in the same circumstances…its not an anomaly. Instead of more pills and more meetings in a circle to express feelings, give grants for food, housing, transportation, and make real attempts to be fair and timely re comp and pen. Being handed pills or being told to recognize feelings as feelings and send those feelings away states the feelings are somehow not a valid indicator that something MUST be corrected. Its yet another form of VA disrespect for veterans. Yet if staff are angry or disappointed, their VA staff peers take those feelings as valid and not to be wished or medicated away.
    Veterans that have conditions that make driving difficult need other options other than the Veterans choice 40 miles rule. Veterans who have psychiatric conditions, closed head trauma or who take medications that cause confusion such as opiates are not provided with veteran van service. Apparently for these veterans 40 miles is a hardship but 39.4 miles is always feasible. It seems that IF a vet would require van service, it would be yet another reason to allow veterans to opt for in community care where possible to save transport costs.
    Veterans need a mechanism to record intent to see a physician outside the VA system and the working diagnosis. IF a veteran is seeing an outside physician to prove a diagnosis denied by the VA and through testing, the veteran is proven correct, the VA should be required to reimburse these costs. If primary care denies the need for a consult, then preapproval is denied. Veterans need to have a way to reverse this when the primary care doctor or for that matter VA specialist …is incompetent. Veterans also need a way to get reimbursed if they must leave the VA and go immediately to an outside urgent are or ER for conditions caused by or ignored by the VA doctors if the veteran is proven correct. When the VA physician is shown to be wrong, disciplinary actions needs to take place from mandatory education regarding the condition in question, forwarding the case to a medical license board, to firing the physician. I have had this type of circumstance happen repeatedly over the years. Nothing is ever done with the VA physician re incompetence. Of note, a veteran is allowed to fill out a form and change from one primary care clinic to another if another is available. The newer clinic may likely be just as incompetent. Often if its a specialist physician who is incompetent or punitive, the VA offers no option.
    Note that not all VA physicians are incompetent. There should be a mechanism for patients to review their physicians and to tell why the physician received such a review. Lowballing a rating as a punitive action for not agreeing with a potential diagnosis for compensation should be disallowed. Refusing to clarify a diagnosis, explain a medication use, or treatment orders to comp and pen should be appropriate grounds for low rating. Punitive charting, and medical errors as pointed out by physicians within or outside the VA system should also be noted in the physician rating. There should be a minimum rating standard to retain VA physicians. A portion of salary should be paid for high veteran patient satisfaction with care. Physicians who are decent human beings and medically competent should not be paid the same as those that barely surpass minimum standards. To be fair, a negative review should contain specific recommendations to remediate the situation. Veterans should have a mechanism to submit new possible recommendations to the list.
    Veterans need recourse if their treatment plan is not meeting current standards of care. I have been treated for years for a condition. My lab values are NOT within the target range for treatment for this condition. This has been going on for years. I am still required to use these same VA physicians for care. There should be VA time limit standards for getting patients within the bounds of acceptable care. If this time limit passes, the VA should be REQUIRE to refer care outside the VA system for a second opinion such as to the University Hospital teaching system.
    IF a veteran is confused enough to be incapable of self care, no matter if from psychiatric difficulties, head trauma, or a medication issue, they should NOT be sent to drive home if VA beds are full. They must be referred for transport to another hospital at VA expense.
    Status of veterans re housing, food available until the next VA check, ability to perform activities of daily living such as carrying laundry and grocery shopping should be assessed at each visit. By housing I mean safe housing with no domestic violence, and with heat, lights, running water, and sanitation. Any deficits should be remediated. It is insane to be concerned with a cholesterol a bit over the norm when the veteran’s basic survival issues are not being met. Sending the veteran to social services or a homeless coordinator is not the answer unless primary care checks back with the veteran to see that something was actually done. A closed homeless office or information that all shelters are full should not be counted as actual assistance. Sitting in a circle in the psych expressing disappointment at being homeless should not be counted as solving the problem.
    Give identity cards to veterans identified to a homeless coordinator as homeless. Subtract the veterans disability rating from 100 percent to obtain an ability rating. Ask hotels to supply a percentage of their rooms to these veterans at cost reimbursed by the VA. The difference in fair market value minus cost times the ability rating should be the cost to the veteran. Restaurants could participate with meals using the same type of calculation. Incentives such as tax breaks to participating merchants could assist in gaining acceptance.
    Identify veterans that have difficulty with grocery shopping due to mobility issues, mental health issues, or issues with other health problems. A similar program such as that listed above with the hospital and restaurants could be applied to purchasing food items online for shipment to the home. Currently there is a deficit of the ability to ship fruits, vegetables, and meats to a home at low costs, even in the form of dried foods or MRE’s.
    
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