Wednesday, June 25, 2014

Happy Birthday

It's all of our birthdays this summer . . . All together now:

It's all of our birthdays this summer
One number older
Another year younger
I'll go to your party
You'll come to mine
We've given up cigarettes
We've given up wine

We've given up caffeine
And sworn off desserts
I don't try to seduce you
We don't even flirt
We're too good to be happy
Too straight to be sad
So just blow out the candles
Happy Birthday

Stay out of the ocean
Stay out of the sun
Stay in perfect shape
And be number one
We've got brilliant excuses
For having no fun
So just blow out the candles
Happy Birthday

That's Carly Simon's "Happy Birthday" which appears on her Have You Seen Me Lately? album.

What's June 25th?

Carly Simon's birthday.

So happy birthday to Carly.

Happy birthday to all of us.

Carly's one of our country's finest singer-songwriters.

She's shared her gifts with us and inspired so many.

Carly's hits include "You're So Vain," "Jesse," "Anticipation," "You Belong To Me," "The Right Thing To Do," "Coming Around Again," "Let The River Run," "That's The Way I've Always Heard It Should Be," "Vengeance," "Waterfall," "Mockingbird," "Devoted To You," "Gimmie All Night," "All I Want Is You," "Love of My Life," "Better Not Tell Her," "The Stuff That Dreams Are Made Of" and (a song she didn't write or co-write) "Nobody Does It Better."

Of all the singer-songwriters, male or female, Carly was really the only one who could have made it if she hadn't been able to write songs.

She's an amazing songwriter but she's also an amazing singer.

My top five favorite Carly albums?

1) The Bedroom Tapes
2) Anticipation
3) Playing Possum
4) This Kind Of Love
5) Have You Seen Me Lately?

I love all of the albums but those are my top five.

My top five non-single tracks written by Carly?

1) "We Just Got Here"
2) "You Don't Feel The Same"
3) "Scar"
4) "Hold Out Your Heart"
5) "How Can You Ever Forget?"

"Iraq snapshot" (The Common Ills):
Tuesday, June 24, 2014.  Chaos and violence continue, 3076 violent deaths so far, the UN plays a con game where they reduce Iraq to 4 provinces (it has 18), Cindy Sheehan and Dahlia Wasfi talk reality on Iraq, Congress looks at veterans issues, and much more.

On this week's Cindy Sheehan Soapbox, Cindy speaks with Iraqi-American peace activist Dr. Dahlia Wasfi.

Cindy Sheehan:  Well, obviously, we were talking before the interview, it's just disheartening because Obama has gotten away with so much since he's been president.  And I'm not saying, you know, that an active movement against what he's doing would have stopped anything --

Dr. Dahlia Wasfi:  Right.

Cindy Sheehan:  -- but at least we would have -- we would be out there showing our opposition.  Now I want to talk about an article you just posted on CounterPunch called "Keep Calm and Trust Iraqis with Iraq."  Now I have been getting some communications with people and they're telling me, "But, Cindy, this is different because I protested to oppose the 2003 invasion and occupation but I don't want to see Iraq fall to Islamic fundamentalists."  First of all, is that what is happening? And secondly, like you wrote in your article, keep calm and trust Iraqis with Iraq.  What business is it of ours?  And can you just talk a little bit about that?

Dr. Dahlia Wasfi:  Sure.  It's been actually -- It's eye opening and quite disappointing though I think understandable just the level of discomfort and suspicion around Muslims in general. 

Cindy Sheehan:  Mmm-hmm.

Dr. Dahlia Wasfi:  That people can be so easily -- Just the concept of Islamic fundamentalism -- the seeds were planted and the roots run deep in this country of this fear of The Other.  And it's still working to trigger fear here.  It's upsetting.  But actually, if they didn't want Islamic fundamentalism in Iraq, then we shouldn't have handed the keys over to Nouri al-Maliki.

Cindy Sheehan:  Right.

Dr. Dahlia Wasfi:  We essentially brought a very conservative -- I don't know whether to say "right wing."  In this country, I would say right wing.  But a very conservative fundamentalist party that Nouri al-Maliki belongs to called the Dawa Party.  And they found, the Dawa Party started in Iraq but found its base in Iran when they -- some of them -- were exiled, some of them fled on their own.  But the reason for that was Saddam Hussein was secular and parties like the Dawa Party -- they're not the only ones -- but the multiple parties that were seeking theocratic rule which is, of course, what has been in Iran since 1979.  And they got support for that in Iran so they grew very strong -- at least grew strong in Iran since their days of exile -- I think mostly in the 1980s.  And over that time parties like this built up religious militias.  Now what happens when the US invaded was the borders were left wide open and, of course, for many years the Shia majority in Iran wanted access to the holiest  cities like Karbala in Iraq and Saddam Hussein purposely shut down that route -- that travel route -- again, to limit the amount of theocracy that was in the country and also everything was about maintaining and protecting the regime.  So after 2003, a lot of the parties, a lot of the followers, a lot of the militias, they all crossed the border into Iraq and the southern part of Iraq was greatly influenced and controlled, dominated, by these militias.  When we brought Nouri al-Maliki to power and  just before him Ibraham al-Jafaari and the Constitution that we helped "independent Iraq" write, this opened the door for Sharia Law -- very conservative rule and it's very sectarian.  What happened as we helped the training and arming of the new Iraqi army and police was that these militias -- members of these militias -- became incorporated into the army and police and they have been acting as death squads in Iraq.  So the big fear should have been back in 2003 -- very religious influence.  What we're seeing now is the backlash of that.  There are extremist groups on the other side.  Because we brought one extremist group to power, just from cause and effect, you're going to find other extremist groups merging like ISIS.  They are one of multiple groups who have set their political differences aside for now and are working together for the common goal of removing the Shia sectarian regime in Baghdad. It's messy.  It's not fully neat and tidy but this is what I'm hearing from the people on the ground.

That's just the opening of the interview.  Time permitting, we'll note more of it this week. Dexter Filkins (New Yorker) observes:

As dramatic as the insurgents’ approach has been, it is not terribly surprising. They have fed on the deep discontent that prevails across the Sunni heartland, provoked and sustained by Maliki. Since the last American forces departed, he has embarked on a stridently sectarian project aimed at marginalizing the Sunni minority. He has presided over the arrest of his Sunni political opponents, jailed thousands of Sunni men, and excluded the Sunni population from any meaningful role in government. The Sunni Finance Minister, Rafe al-Essawi, fled the capital; the Sunni Vice-President, Tariq al-Hashemi, fled the country and faces a death sentence if he returns. When the Sunnis rose up in anger, as they did in Falluja and elsewhere, Maliki ordered the Army to shell civilian areas and detain more Sunni men. Ever since the fall of Saddam Hussein, Iraq’s Sunnis have been faced with the choice of pledging their allegiance to the Shiite-led government in Baghdad or to the armed groups within their own community.

Let's start with non-surprising news.  Jacob Siegel (Daily Beast) reports:

As Iraq devolves into a multi-party civil war, President Obama has moved one step closer to sending military forces back into the country. Yet the White House has not clearly explained what the proposed contingent of 300 special operations troops would actually do, other than some vague talk about advising their Iraqi counterparts. Veterans of the special operations community spoke with The Daily Beast about what the operation would likely entail and expressed their skepticism about how much it could accomplish.
Asked if he believed sending the small military force into Iraq was a good thing, a special operations veteran and former CIA officer said, “It’s not a good thing or a bad thing, it’s a no thing. These guys are being given an impossible mission. What are they going to do? Host a dinner party? It’s 300 guys to stop ISIS from taking over Baghdad.”
On Monday, as reports spread that ISIS had captured border crossing points along the length of Iraq’s western frontier, the Obama administration cleared the most significant obstacle to sending the U.S. military to Iraq. The White House announced a diplomatic agreement providing immunity for U.S. forces from prosecution under Iraqi law. It now seems like only a matter of time before the planned 300 special operations troops arrive in Iraq. But what they will do there is an open question.

Last Thursday, we noted the plan was murky at best

It's an important point.  I don't support Barack sending troops in, [Senator Saxby] Chambliss does. We can agree that the mission needs to be clearly defined.
What is success?
How it will it be measured?
What would warrant even more troops being sent in?  What would result in US troops leaving?
None of this is defined.
A speech consisting of 946 words and nothing is clearly defined.
Whether you support or oppose the move, whether you support or oppose Barack, it needs to be defined.  If it's not defined, and Barack is your favorite president of all time, there's a good chance this mission will do huge damage to his reputation and his legacy.  It is in everyone's interest -- including the Iraqi people -- for Barack to clearly define this mission, its goals and the measurements for success or failure.
Barack insisted in his speech that there would be no "mission creep" -- well he was insisting that in 2007 to the New York Times -- check the transcript.

National Iraqi News Agency reports a Syrian fighter jet bombed the city of Qaim in Anbar Province today resulting in 20 deaths and ninety-three people being injured.  And this is why Barack can't guarantee "mission creep."  Incidents like the bombing of Qaim -- which may or may not have happened -- can pull the US further into a country.

'Advisors' were in Vietnam and then came the Gulf of Tonkin incident involving the USS Maddox. William P. O'Connor (CounterPunch) noted in 2008:

According to President Johnson, the U.S.S. Maddox was fired upon by North Vietnamese forces. This so-called attack in international waters led to the direct and massive build up of American forces in the region. Many years after the Gulf of Tonkin resolution was passed, however, President Johnson said, “Hell, for all I know, we could have been shooting at a bunch of seals out there” (McNamara 141). The young soldiers in the field were not privy to such remarks.

In 2010, O'Connor noted:

After Kennedy’s assassination, his successor Lyndon Johnson never told the more than 150,000 U.S. casualties that his administration made up the “attack” on the U.S.S. Maddox in the Gulf of Tonkin, which expanded the war. Johnson later joked, “For all I know they could have been shooting at a bunch of seals out there.” Determined not to be the first American administration to lose a war, the Executive Branch beat its breasts, twisted arms and waved the flag until Congress approved the Gulf of Tonkin Resolution. Johnson laughed and later called the resolution “grandma’s nightgown.” because he said, “It covers everything.” 
Some have mistaken Rachel Maddow's column this week -- originally for the Washington Post -- as 'antiwar.'  How stupid are you?
Rachel wants legislative cover for Barack.
There are many in Congress who want Congress to pass a bill granting authorization.  They're not opposed to providing troops on the ground.  They want to define (help spread war) what responses can further war.  An attack from Syria, like the one NINA is describing, would likely be such a response.  This is how you get mission creep.
(Aided by creeps like Rachel.)
Barack can't convey to the American people what he wants out of his Iraq mission.
And it's not a plan worth having.  The US shouldn't be in Iraq. 

 Gary Langer (ABC News) reports on a new ABC News - Washington Post poll.  "Two-thirds oppose sending ground troops to fight the Sunni insurgents in Iraq" and 52% of those surveyed disapproved of Barack's methods of addressing the issue of Iraq (the poll has a 3.5% margin of error).  Sarah Dutton, Jennifer De Pinto, Anthony Salvanto and Fred Backus (CBS News) report on another poll, a CBS News - New York Times poll, which finds only 18% of those surveyed feel the Iraq War was 'woth it' (75% say it was not worth it) and:

When Americans are asked about a range of military options in Iraq, there is support for some actions, but not others. A slim majority of Americans (51 percent) favor sending military advisers into Iraq to train and advise the Iraqi military and collect intelligence, which President Obama has proposed. Forty-two percent oppose it. There is bipartisan support for this plan.

Barack's mission is both controversial and ambiguous.  He's failed to define the mission, define success or even the need for it.

He's floundering.

She's floundering
Good God, what she does in one day you wouldn't believe
She's into Christian Science
And voodoo
And laugh therapy
And bathtub therapy
One day she's a Jesus freak
Then she goes Orange with Rajneesh
Oh, God, she uses the mandela
Gone to Silva Mind Control
She's into homeography
And Sufism
-- "Floundering," written by Carly Simon, first appears on Carly's Hello Big Man

Sufism?  Sufyan bin Uzayr (Foreign Policy in Focus) explores that and more in an article which opens:

So Iraq is in turmoil, and a full-fledged sectarian conflict between Sunnis and Shiites looks imminent. Probably, USA will need to interfere yet again (there’s oil at stake, after all), and the inefficiency of Nouri al-Maliki’s rule has been exposed.
However, beyond all that, something else is worth discussing here. The message and motives of ISIS have clearly shown that they intend to restore the Caliphate, like it or not. This has sent the alarm bells ringing: Caliphate poses a threat to both Western hegemony in the region as well as the misrule of regional despots. Quite obviously, everyone is alarmed at the success of ISIS.

The fact that ISIS have shown a visible dislike for Shiite rule in Iraq further adds a new dimension to the age-old question: Sunni Caliphate or Shiite Imamate? Which one is better as a self-rule option for Muslims, and more importantly, for preserving the peace of the entire region?

US Secretary of State John Kerry visited the KRG today.  We'll note it in tomorrow's snapshot.

On some of today's reported violence, Alsumaria reports 2 corpses were discovered dumped in Muqdadiya, security forces bombed Baiji and state they killed 19 people, a Yathrib battle has left 13 rebels dead, and Nouri's ofice states it killed 24 suspects and left ten more injured in Anbar.  All Iraq News notes security forces say they killed 13 suspects in southern Tikrit with 40 more killed by aerial bombings.

Iraq.  The violence.

Today the press whores were out in full force insisting that 1,000 'civilians' had died in Iraq since the start of the month and that UNAMI said so.

Did UNAMI say that?

Here's what the UN said:

According to UNAMI, at least 757 civilians were killed and 599 injured in Nineveh, Diyala and Salah al-Din Provinces between 5 and 22 June. This figure – which should be viewed very much as a minimum – includes a number of verified summary executions and extra-judicial killings of civilians, police, and soldiers who were hors combat.
At least another 318 people were killed, and a further 590 injured during the same period in Baghdad and areas in the south, many of them as a result of at least 6 separate vehicle-borne bombs.

See the problem?  Nineveh, Diyala, Salah al-Din and Baghdad?  Provinces.  Four provinces.

Iraq has 18 provinces.

The ones with the largest death tolls for each month this year have been Baghdad and Anbar.

Not only does UNAMI ignore 14 provinces in the country -- one of the fourteen they ignore is Anbar.

3076.  That's the number of violent deaths for the month through yesterday as tabulated by Iraqi Body Count.

Last night, Anderson Cooper 360 broke a major story on veterans.  Scott Bronstein, Drew Griffin and Nelli Black (CNN) report:

Records of dead veterans were changed or physically altered, some even in recent weeks, to hide how many people died while waiting for care at the Phoenix VA hospital, a whistle-blower told CNN in stunning revelations that point to a new coverup in the ongoing VA scandal.
"Deceased" notes on files were removed to make statistics look better, so veterans would not be counted as having died while waiting for care, Pauline DeWenter said.

DeWenter should know. DeWenter is the actual scheduling clerk at the Phoenix VA who said for the better part of a year she was ordered by supervisors to manage and handle the so-called "secret waiting list," where veterans' names of those seeking medical care were often placed, sometimes left for months with no care at all.

Staying with the topic of veterans . . .

Chair Jeff Miller:  This morning, we're going to examine the outlandish bonus culture at the VA and the larger organizational crisis that seems to have developed from rewarding performance awards to senior executives despite the fact that their performance fails to deliver on our promise to our veterans. As the Committee's investigation into the Dept continues and new allegations and cover ups are exposed, it's important that we examine how the Dept has arrived at the point where it is today. Sadly, it's a point which has eroded veterans' trust and Americans' confidence in VA's execution of its mission. Part of the mistrust centers on a belief that VA employees are motivated by financial incentives alone, and I can see why.  It appears as if VA's performance review system is failing veterans.  Instead of using bonuses as an award for outstanding work on behalf of our veterans, cash awards are seen as an entitlement and have become irrelevant to quality work product.  I know we all agree that preventable patient deaths, delays in care, the continual backlog of disability claims, cost over-runs and construction delays for VA facilities, and deliberate behavior to falsify data are not behaviors that should be rewarded. Yet, despite startling issues that continue to come to light, as well as numerous past IG and GAO reports highlighting these same issues, a majority of VA's senior managers received a performance award for FY13. According to VA's own data, over $2.8 million was paid out in performance awards to senior executives for FY13. These performance awards went to at least 65% of the senior executive workforce at the Department.  In fact not a single senior manager at VA, out of 470 individuals, received a less than fully successful performance review for the last fiscal year. Based on this Committee's investigations, outside independent reports, and what we have learned in the last few months, I wholeheartedly disagree with VA's assessment of its senior staff.  It should not be the practice of any federal agency to issue taxpayers dollars in addition to paying six-figure salaries to failing senior managers just because a current OPM statute for members of the SES allows it. Bonuses are not an entitlement. They are a reward for exceptional work. VA's current practice only breeds a sense of entitlement and a lack of accountability, and is why we are where we are today.

We're dropping back to Friday to note a House Veterans Affairs Committee hearing.  US House Rep Jeff Miller is the Committee Chair and US House Rep Mike Michaud is the Ranking Member.  What was the focus of the hearing?

Chair Jeff Miller:  Today we will explore the circumstances surrounding the award and eventual rescission of a performance award provided to the former director of the VA Medical Center Director in Phoenix, AZ, Ms. Sharon Helman. In February 2014, Ms. Helman was given an $8,500 bonus for her performance during fiscal year 2013. Only after allegations against Ms. Helman came to light, as a result of this Committee's work, did a conscientious VA employee examine whether she received a bonus in fiscal year 2013. When we questioned the award, VA determined that she was given this bonus due to an "administrative error." However past documentation from VA has stated that all performance reviews and awards are ultimately reviewed and signed by the Secretary.  Furthermore, Ms. Helman's direct supervisor, former VISN 18 Network Director, Susan Bowers, stated in May that Sharon Helman received her bonus "for a highly successful rating, and for improving access concerns and wait lists." Perhaps we should also question Ms. Bower's qualifications? These stories do not match up, and I believe it further brings into question VA's transparency, as well as diligence when issuing thousands of dollars to individuals.  Although Acting Secretary Gibson has rightly put a freeze on all bonuses for Senior Executives at VHA for the time being, it is still this Committee's responsibility to understand the rationale for awarding five figure bonuses to individuals who have clearly fallen short of the Department's mission and their commitment to those who have served.

Due to time constraints (included floor votes), Ranking Member Michaud spoke briefly but had his full statement entered into the record.  We'll quote from a section he didn't read outloud:

I have sat here, hearing after hearing, as we have learned, over and over again, that VA senior executives received significant bonuses after the people and organizations under their responsibility have failed to deliver on reasonable expectations of performance, and, in some cases, have harmed the very people they are supposed to be serving.  How does this happen?  In its testimony, VA will lay out a very extensive and diligent process with all the seemingly right pieces, parts, checks and balances.  So, what has repeatedly gone wrong?  Where does the system break down?   I have asked numerous people -- in and out of the federal senior executive system - this question, and the most consistent answer is that the measures are wrong.  That the goals and objectives defined for some VA senior executives are not adequate or appropriate to elicit the actions and behaviors desired or required.  That the senior most leaders in VA are held accountable for managing the process that benefits VA, not delivering an outcome beneficial to veterans. This has got to change.  Making the current form electronic and fillable isn't the answer.  Transferring performance management data from a spreadsheet to a database isn't the answer.  Defining goals and objectives based on what needs to be done for veterans is the answer.   Rewarding senior executives only when they consistently do those things well is the answer.

Appearing before the Committee was one witness, the VA's Assistant Secretary for Human Resources and Administration Gina Farrisee.  We'll note this key exchange:

Chair Jeff Miller:  According to your testimony, from FY2010 to 2013, not a single member of the SES [Senior Executive Services]  -- a pool of 470 individuals -- received a less than fully satisfactory or successful rating.  Is that correct?

Assistant Secretary Gina Farrisee:  That is correct. 

Chair Jeff Miller:  Knowing what we know now about the fraudulent actions being taken in facilities all across this country that have harmed our veterans, do you think the assessment of 100% of senior managers at VA have been fully successful in the past four years is in line with reality? 

Assistant Secretary Gina Farrisee:  Mr. Chairman, if we knew what we know today at that time, it is unlikely that their performance would have reflected what it reflected at the time the [performance] reports were written.

Chair Jeff Miller:  Do you go back and change a performance review based on information that's gathered after the fact?

Assistant Secretary Gina Farrissee:  Mr. Chairman, you cannot go back and change a rating once it has been issued to an employee as the final rating.

Chair Jeff Miller:  Even if there's information that was hidden from the raters?

Assistant Secretary Gina Farrissee:  Even if there's information that was -- 

Chair Jeff Miller:  Is that a law or a rule?

Assistant Secretary Gina Farrissee:  It is a law.

Chair Jeff Miller:  It's a law that needs to be changed? 

Assistant Secretary Gina Farrissee: [Long pause]  There are other ways to discipline employees for misconduct.  If you find out -- 

Chair Jeff Miller:  Wait, wait, wait. You're telling me that if you find out somebody does something that specifically harms veterans, is potentially criminal, that the Dept's position is you would not go back and change somebody's rating if you had the ability to do that?

Assistant Secretary Gina Farrissee: If we had the authority, we would use all authorities provided to us.

Chair Jeff Miller:  And so my question to you is is that something that you would recommend that this Committee do?  To look into having the law changed so that you can go back and change performance reviews?

Assistant Secretary Gina Farrissee:  Mr. Chairman, if that was for across the federal government, I could agree with that.

Chair Jeff Miller:  Well, we're focused on the VA, okay?  And VA ain't been doing very well lately. And I would hope that the anger and the frustration that I hear in the Acting Secretary's voice [Sloan Gibson] would filter through every employee -- and especially in the central office.  Things have to change.  We can't keep doing it the way it's been done.

Assistant Secretary Gina Farrissee: I concur, Mr. Chairman.

On the above, if the Congress can pass a law on this, great, I support that.  I don't know that it's needed though. We'll get to the way around it in just a second.

But Sharon Helman's bonus was pulled and there have been press reports about how wonderful that was.  In the hearing, it was explained that was actually exceptional.

Helman hadn't officially been awarded the outcome of her performance review.  Because of questions about her work, her performance appraisal had been placed on a pending list.  As a result of her part in the VA scandal coming to light, and because she was on the pending list, her bonus was 'pulled.' It had never been delivered.

This won't be the case for many because most already received their bonuses.  Defrauding the government is a criminal activity. There should be an investigation by the Justice Dept to address the criminal activity.  That's the only way to deal with all the people who received bonuses that shouldn't have been awarded.  I'd be all for a sort of amnesty for any VA employee to return their bonus (and provide testimony about what happened) and they wouldn't be criminally investigated.  But a criminal investigation is the only way to deal with what happened.

For the future, a law is great if Congress can get it passed.  I'm not sure that they can.  Farrissee's reluctance to see a law like that only applied to VA may be because she fears VA is being singled out or it may be due to legal issues or whatever.  She didn't express her thoughts on that.

But what Sloan Gibson could do right now is have VA's legal staff redraft the performance appraisal to include one to three sentences at the bottom, above the signatures of the reviewer and the reviewed noting that the review is based on the best possible information available and should information later emerge of criminal or ethical misconduct, the bonus can be and will be rescinded.

A bonus is a reward for good work, it is not salary.  If your performance appraisal is false and evidence emerges to prove that, your bonus can be pulled.  A sentence or two or three should also tie in that the rating will be dropped as well.  And it should be dropped to the lowest rating possible and that should be in there so no one's getting favors from those reviewing them.  And VA might also address the ratings of the reviewers who repeatedly and consistently get it wrong when conducting performance reviews.

We should also note the I-quit-after-I've-already-put-in-my-retirement-notice con artist Dr. Robert Petzel was noted in the hearing.  He'd promised the Committee to look into a specific bonus and whether it could be rescinded.  And he told the Committee after 'looking into' it that it couldn't.  But Farrissee is whom he should have been speaking to and she testified that he never spoke to her about that individual.

And let me point out that the press loved Petzel.  They treated him like a god and did so for years.  But those of who were at the hearings?  We noted he lied repeatedly from one hearing to the next.  We called out Petzel for years.  We also called out Allison Hickey and you'll note she's under a rock these days thinking she can wait the scandal out.  She misled and lied to the Congress repeatedly.  As long as she remains at the VA, the Dept is never going to be fixed.  (In May, the American Legion called for her, Shinseki and Petzel to resign.)

US House Rep Phil Roe:  Look, and I think you hear this from both sides of the aisle, we want the VA to go from good to great.  And to be able to do that, though, we have to have information that's accurate and timely.  And I looked at the memo today that we were sent on the RVUs  [Relative Value Units] and I know this is not a big thing but I think it is a symptom of what goes on in the VA.  If you look at a law that was passed in 2002, it looks -- it appears to me when you look at the evaluation that the IG did with these five medical centers in Boston, Houston, Indianapolis, Philadelphia -- that it looked at the staffing levels we're talking about for specialty services, it's taken 12 years and we're still don't know what they are.  I mean, this law was passed in 2002 and it's 2014 and we're still talking about, 'Well we don't know what our staffing needs are.' 

That's Dr. Roe speaking at the House Veterans Affairs Committee hearing on Monday and that's where we start because I came into the hearing around that point.  We also start there because you can't attend hearings and pay attention and not grasp that the VA officials always promise they're changing and they're implementing and . . .  At the end of the day, the officials do damn little but offer excuses for why they still haven't done what they were supposed to have done years prior.

Ranking Member Mike Michaud:  Providing timely, quality, safe care to veterans is the primary mission of the Department of Veterans Affairs  Integral to accomplishing this mission is the ability to successfully measure the capacity and capabilities of the organization. Mr. Chairman, at this point in time, I do not have much confidence VA has been able to do that analysis. I firmly believe if you do not have good numbers on which to base calculations, then you cannot possibly begin to accurately measure capacity or demand.  Anticipating capacity and demand is central to good strategic planning.  Clearly VA is struggling to get a handle on how many veterans are undergoing or waiting for treatment.  It seems to me having a significant number of patients on waiting lists indicates a system that is overwhelmed and unprepared.  VHA simply cannot handle the increasing number of veterans to whom we have a moral obligation to provide sound treatment.  The VA OIG reported in testimony on March 2013, that VHA's Office of Productivity, Efficiency, and Staffing conducted studies in 2006 of 14 specialty care services.  The report had nine recommendations. One of the recommendations was to have VHA develop Relative Value Unit productivity standards and staffing guidance for the field. I recognize this is a complicated process and VA health care has continued to change over the years, but eight years to develop this system is too long. It's unacceptable.

That's from Ranking Member Mike Michaud's opening written remarks.  Appearing before the Committee were the VA's Dr. Thomas Lynch and Dr. Carolyn Clancy -- neither of whom can see patients, as US House Rep Tim Walz established -- because they haven't kept up their credentials and training.

"Get out of the administration office and go see patients," Walz said echoing the recommendation of Vietnam Veterans of America called on administrators who were medical doctors to start seeing patients four days a week to address the problems with lengthy wait time for medical appointments.  Walz felt the refusal of medical doctors in the VA's administration posts to see patients during this crisis went to the problem itself.  He declared, "This is cultural, it's leadership, it's structural and it runs deep."

Chair Miller wanted to know, "How many physicians are there in the system who don't see patients that are in administrative roles?"  Lynch replied, "I don't know, Mr. Chairman."  Asked to find that number and report it to the Committee, he responded, "Yes, sir."

We'll note this exchange.

US House Rep Ann Kirkpatrick: Dr. Lynch, I just have two questions.  Is there a complaint system within the VHA?  Something like a hotline a veteran can call and someone gets back to them about their complaint? 

Dr, Thomas Lynch:   Dr. Clancy, do you want to take that?

Dr. Carolyn Clancy:  Yes.  Every facility has the patient advocate and in fact they get complaints, they get all kinds of calls.  And that is actually tracked in terms of time to resolution and so forth.  That, uhm, that -- All of the patient advocates now come under an Office of Patient Centered Care and Cultural Transformation. So we have begun working with them a bit from the quality and safety side to figure out how could we learn more from what they're hearing because we're noticing that a number of private sector organizations are taking to heart just how important and useful it can be to learn from the patient themselves.  So --

US House Rep Ann Kirkpatrick:  So is that information looked at nationally?  Nation wide?  Not just -- It doesn't just stay at the local facility?

Dr. Carolyn Clancy:  Yes, there is a national data base. 

US House Rep Ann Kirkpatrick:  And then my second question is, are you consulting with the VSOs in how to engage innovation within the system when it comes to scheduling these appointments?

Dr. Thomas Lynch:  We have not been communicating directly with the VSOs.  I-I think we-we certainly have been looking at ways the VSOs can help us understand how the veterans are perceiving our care and the timeliness of that care.  I think there's a huge opportunity there.

US House Rep Ann Kirkpatrick:  I agree.  And you know, Chairman Miller, I think it might be good to have a hearing where we hear from the VSOs about their suggestions about how to fix this problem.  I yield back.

Chair Jeff Miller:  Thank you very much Ms. Kirkpatrick.  We do have one hearing that will be coming up in several weeks.  It will be specifically geared towards the VSOs.  And it's at that particular hearing that we will invite the [acting] Secretary to be here to hear their recommendations as well.

It's good that they're going to hear from the VSOs (Veterans Service Organizations) but did not one patient advocate hear about the problems with the wait lists?  Why didn't any patient advocate step forward?  Or did they?  The Committee should schedule a hearing where they hear from the patient advocates.  This hearing would allow the Committee to know what issues are being reported to the advocates as well as what happens with the advocates when they attempt to resolve problems or report them.  I'm sorry but Dr. Clancy did not seem very trustworthy in her remarks and we've seen this dance before, the Committee's told, 'Oh, yes, yes, this is handled by _____ and they're doing a great job with it.'  But then it turns out that _____ either isn't tasked with it or they're not being listened to in the chain of command.

Patient advocates are not a 1-800 complaint line and that was Clancy's first lie.  I'd be interested how much more she misrepresented in her remarks.

I wasn't at the full House VA Committee hearing last night.  I started out at the IRS hearing at the House Oversight Committee [and wrote about that last night at Kat's site with "'Officer, I didn't throw the gun into the river!' (IRS hearing)"].  Ruth covered it in "Gerald Connolly sobs and whimpers like the lead in a Harlequin Romance" and I was at that because Ruth got some nasty e-mails after her Congressional report on Friday  resulted in a number of e-mails insisting this wasn't a story.  I don't know what happened at this point and don't pretend but it is news and when Ruth mentioned the nasty e-mails, I told her I'd go to the hearing with her and write about it.  When the IRS hearing was over (it was in recess actually, but it was clear that it was over), I went over to the VA hearing and caught maybe 20 to 25 minutes of that.

And we'll close with this from Senator Patty Murray's office -- Murray serves on the Senate Veterans Affairs Committee and is the Chair of the Senate Budget Committee:

FOR IMMEDIATE RELEASE                                 CONTACT: Murray Press Office
Tuesday, June 24th, 2014                                               (202) 224-2834
VETERANS: Murray Delivers Remarks at Veterans’ Affairs Conference Committee Meeting
(Washington, D.C.) – Today, U.S. Senator Patty Murray (D-WA), a senior member of the Senate Veterans’ Affairs Committee, delivered remarks at the House and Senate Veterans' Affairs Conference Committee Meeting. In her opening statement, Murray called on the conference committee to continue to build on recent bipartisan momentum to address some of the immediate accountability and transparency concerns plaguing the VA, and fix its deep-seated structural and cultural challenges. 
Full text of Senator Murray’s remarks, as prepared for delivery:
“Thank you Mr. Chairman.
“I believe that when it comes to caring for our nation’s heroes, we cannot accept anything less than excellence.
“So while the Department generally offers very high quality health care and does many things as well as, or better than, the private sector—I am very frustrated to be here, once again, talking about these deeply disturbing issues and allegations.
“It’s extremely disappointing that the Department has repeatedly failed to address wait times for health care. 
“GAO and the Inspector General have reported on these problems many times over the years. 
“And last Congress we did a great deal of work around wait times, particularly for mental health care. 
“We learned then that VA has no reliable or accurate way of knowing if they are providing timely access to mental health care.
“I think VA is starting to see that business as usual is not acceptable.
“So I am very glad to be serving on this Conference Committee. 
“Calling for a formal conference is a very rare step in veterans issues, and I think that shows how severe the problems facing VA are, and how serious Members are about fixing them.
“There have been major bipartisan efforts in both the House and the Senate to move legislation addressing these problems. Many of the Members here have been part of those efforts and I commend them all for their commitment to bipartisanship and putting the needs of our veterans first.  
“I want to personally thank Chairman Sanders and Senator McCain for all the work they did over the last few weeks to get us here.
“I appreciated working with you over those weeks and look forward to seeing where we can make compromises in order to pass a bill and begin ensuring veterans get the care they need and deserve. 
“I also want to commend Chairman Sanders and Chairman Miller, for bringing this conference together as it shows how serious the two of you are about getting to the heart of this matter and addressing this critical issue. 
“Working with you two over the past few years, I know how dedicated you are when it comes to taking care of our veterans.
“Now it is vital that we continue to build on that bipartisan momentum to address some of the immediate accountability and transparency concerns plaguing the VA, and to fix its deep-seated structural and cultural challenges. 
“The bills before us have some important provisions that will help address these very complex problems.
“First and foremost, caring for our veterans is a commitment we make as a nation when we go to war.
“Our brave servicemembers have sacrificed so much and we need to make sure their country is there for them when they come home—no matter what it takes.
“I know Members here have a wide range of concerns.
“I hope to work with all of you to address these concerns responsibly and in a way that puts our veterans first and gives the VA the tools they need to address the challenges they face.
“That means building and strengthening the VA system so it delivers the best care over the long term.
So it is important for us to act quickly to start making these changes.
And as more problems are uncovered, and as the investigations proceed, we will need more action from VA, the Administration, and Congress.
Because the government made a promise to the men and women who answered the call of duty—and one of the most important ways we uphold that is by making sure our veterans can access the health care they need and deserve.
Kathryn Robertson
Deputy Press Secretary 
Office of U.S. Senator Patty Murray
154 Russell Senate Office Building
Washington D.C. 20510


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