I WILL FINISH TODAY THE TALK ON SAFETY NET ISSUES SURROUNDING DISABILITY AND EEOC====EQUAL OPPORTUNITY. NEXT WEEK I'LL TALK ABOUT HEAD START AND WIC PROGRAMS.
How do you kill employment for returning vets? You privatize and outsource the VA---the largest employer of vets.....you privatize and outsource the US Post Office---the source of many jobs for veterans.
While the SSDI is being imploded by subpriming the next largest Federal disability program is under attack by outsourcing. I showed yesterday how what used to be VA fund resources going to corporate private non-profits to tell vets to volunteer for their community as no jobs are available below you see why vets are being reduced to volunteering and not working-----all the job areas they have always known as a resource are being outsourced and much VA funding is now going to corporate executive pay and the typical corporate fraud and corruption.
As important is the outsourcing of the medical staff-----Walter Reid was the world's best military hospital and now it is being closed as doctors are sent to do global medical tourism and vets are left with the same Medicaid clinic care by staff with less training and experience.
THIS IS DELIBERATE BECAUSE WHAT USED TO BE THE BEST MEDICAL CARE IN THE US FOR VETERANS IS NOW BECOMING THE SAME MEDICAID FOR ALL LEVEL OF CLINIC CARE.
VA accused of excessive outsourcing of vets' jobs
The Veterans Affairs Department is being accused of undermining its own goal of hiring more veterans by expanding its outsourcing practices that eliminate many federal jobs currently, or historically, held by veterans, according to the union representing 205,000 employees at the VA.
In November, President Barack Obama signed into law the “VOW to Hire Heroes Act,” which included language to set up an expedited process for hiring returning solders for federal jobs.
But the VA’s own outsourcing, which began to grow under the Bush Administration and are continuing to expand, are abolishing many federal jobs currently held by veterans, the American Federation of Government Employees (AFGE), an AFL-CIO union, said in a Feb. 8 news release.
For example, the Veterans Benefits Administration recently entered into a $54 million three-year contract with ACS Government Systems to perform claims processing work.
That work currently is being performed by “large numbers of veterans,” the union said. “To add insult to injury, the VBA employees are being asked to volunteer to train the contractors to do their work.”
“Contract claims processors working for profit will now handle the most personal information of our veterans.” AFGE National President John Gage said in the release.
In several other outsourcing contracts in recent years, the VA also has gotten rid of many government jobs historically held by veterans, AFGE said.
Other jobs recently outsourced by VA medical centers and cemeteries, which historically had been held by veterans, included cemetery caretakers, laundry and food service workers, housekeepers, groundskeepers and transportation assistants.
The VA also has failed to comply with a 2009 law that requires the agency to do a cost-benefit analysis before each outsourcing contract is awarded, to determine whether the contract is cost-effective for taxpayers, the union said.
“The agency continues to violate federal law by contracting out work that has been traditionally performed by veterans,” the union said. “The outsourced jobs include many entry level jobs that disabled veterans rely on to get back on their feet after returning from the battlefield.”
The union also claimed the VA conducts “excessive contracting” of physician and nursing services rather than hiring clinicians from within the military.
“Contract physicians and nurses lack the specialized skills and best practices of clinicians who dedicate their lives to serving the veteran population as VA employees,” said AFGE National VA Council President Alma Lee.
VA officials did not immediately respond to requests for comment on Feb. 9.
Complaints about VA outsourcing have arisen on a regular basis in recent years. In 2009, the president reversed course on a proposed third-party billing initiative for veterans medical care following negative media attention about it.
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As someone with a family member who dead early because of mistakes at a VA hospital the number is growing as the quality of staff and doctors declines and as the time wait for care grows too long for a healthy outcome. Veterans are being forced from what was world-class care to what 80% of Americans are being forced to---Medicaid for All ----a clinic -level care with people having less training and low wages.
This is reflected even more so by veterans with disabilities who need more time and access and are getting less. The backlogs are just the tip of a dysfunctional system made so by outsourcing and downgrading of resources and funding.
Dec 23, 2014 at 11:26am ReplyQuote Post by MeMyselfandI on Dec 23, 2014 at 11:26am
More Than 500 Veterans Have Died Because Of Mistakes At VA Hospitals Since 2010
More than 500 military veterans died because of serious mistakes at Veterans Affairs hospitals across the country between 2010 and 2014, VA records show.
There were a total of 1,452 “institutional disclosures of adverse events” between fiscal years 2010 and 2014, 526 of which resulted in patient deaths, according to VA data obtained by the Washington Free Beacon through a Freedom of Information Act request.
According to the Veterans Health Administration, such disclosures are required when “an adverse event has occurred during the patient’s care that resulted in or is reasonably expected to result in death or serious injury.”
Specifically, adverse events are defined by the department as “untoward incidents, diagnostic or therapeutic misadventures, iatrogenic injuries, or other occurrences of harm or potential harm directly associated with care or services provided” by the VA.
The 1,452 disclosures represent a miniscule portion of the hundreds of thousands of patients who are treated annually at VA hospitals, but they reveal for the first time a fuller picture of errors and lapses in medical coverage that affect veterans across the country.
The disclosures include feeding tubes being placed in patients’ lungs, patients being sent home with undiagnosed rib and shoulder fractures, and in one case extracting the wrong tooth from a patient.
But buried among the more common mistakes that occur in even the best hospitals — incorrect dosages, surgical equipment accidentally left in patients’ bodies—are reports of the fatal delays in cancer diagnoses and follow-up treatments that would later lead to a national scandal and the resignation of the VA Secretary.
“Chest X-Ray for [patient] showed an ill-defined one centimeter nodule overlying the left anterior fourth rib,” a 2011 entry from a San Diego VA hospital reads. “Radiology recommended a CT scan of the chest for a more complete evaluation of possible left midlung nodule. Patient was not informed about abnormal imaging and no follow-up was arranged. Patient was seen in the ER six months later. Patient diagnosed with Stage IV small cell lung cancer and passed away two months later.”
“[Patient] had chest X-ray in 2010; no follow-up until patient presented for ER visit in 2010,” another entry from Erie, Pennsylvania reads. “Patient ultimately found to have lung cancer. He expired in 2011. A delay in work-up of approximately 6 months occurred.”
“Follow-up CT scan ordered at CBOC to be completed at parent facility. Order faxed to unmanned printer and it did not get scheduled. Delay of diagnosis of lung cancer of approximately 9 months.”
Scores of similar entries are scattered through the quarterly reports from every corner of the United States, from Puerto Rico to Fargo to Los Angeles.
In fiscal year 2012 alone, 74 patients with some form of cancer saw delays in their treatment or the initial findings were overlooked. Twelve of those veterans ultimately died from their illness.
Less frequent but equally troublesome are reports of VA staff not properly screening patients at risk for suicide.
“Missed Opportunities prior to Suicide Completion” is the entirety of one entry from 2011.
Medical privacy laws strictly bar from disclosure the names of patients and other details, making it difficult to document individual cases, but the data does show general trends. Reports of patient deaths and injuries rose steadily from 2010 to 2013, peaking with 126 reported deaths.
As US troop drawdowns in Iraq and Afghanistan accelerated over those years, VA hospitals struggled to handle the surge in patients and simultaneous shortage of doctors and staff. Some did the best they could under the circumstances, but other hospitals turned to dishonest means to hide the scope of the problem from VA headquarters in Washington.
VA Whistleblowers first began coming forward in late 2013 with allegations that schedulers at the Phoenix VA hospital used secret paper waiting lists to hide the long wait times faced by patients. Whistleblowers alleged that up to 40 veterans died while their requested appointments languished on unofficial paper lists.
The VA disclosed in April that, since 1999, 76 patients nationwide were seriously injured because of delayed gastro-intestinal cancer screenings, and 23 died.
A May audit of the Phoenix hospital found 1,700 patients were put on unofficial wait lists and subjected to treatment delays of up to 115 days.
VA Secretary Eric Shinseki resigned as a result of the scandal, and the department ordered a nationwide audit of its consulting practices.
That audit released in June, found that 57,436 newly enrolled veterans face a minimum 90-day wait for medical care, while 63,869 veterans who enrolled over the past decade requested an appointment that never happened.
According to the audit, 8 percent of scheduling staff nationwide used something other than the official electronic wait lists, and 13 percent of staff had been instructed by a supervisor to enter a date other than the veteran’s requested appointment into the “desired date” field, fudging the actual wait times.
Since then, the new VA Secretary has fired five senior administrators at problematic VA facilities, including the director of the Phoenix VA hospital.
The number of patient deaths due to errors dropped to 107 in fiscal year 2014, according to VA records.
However, the widespread use of secret waiting lists means that there are potentially many more cases of patients who died because of long-delayed appointments than appear in the reports that were filed to VA headquarters. For example, the Phoenix VA hospital appears relatively few times in the reports, and no significant delays were reported there in 2013.
Columbia, South Carolina
The Williams Jennings Bryan Dorn Veterans Medical Center in Columbia, South Carolina reported the highest number of delays in cancer care, of any facility, in 2012.
The cancer care of at least eight veterans was delayed significantly enough that officials said it may have impacted the rate of survival and the ability to later provide sufficient treatment.
Four disclosures note that a “delay in diagnosing impacted [the veteran’s] cancer staging and survival rate.” Four others use similar language, explaining that delays “in diagnosis impacted … cancer staging and treatment” of the patients.
The Dorn facility first came under scrutiny for delays in cancer care, specifically gastrointestinal (GI) care, following a CNN report in November of 2013.
The facilities’ own disclosures show that delays in gastrointestinal care have plagued the facility for a number of years.
In 2013, nine patients experienced delays between their initial consultation and necessary diagnostic procedures, such as endoscopies and colonoscopies.
The delays in GI care for two veterans, in 2012, meant they were required to undergo surgery to remove a mass in their colon, which “might have been removed endoscopically” instead of surgically if the procedure was completed earlier.
There have been six total deaths since 1999 due to delayed cancer screenings, according to the VA report.
A February report by the VA Inspector General found the Dorn hospital faced staffing and equipment shortages that led to delays. The report also noted that Dorn ranked 127th out of 128 VA facilities in health care-associated infections during 2013.
In response to the report, the Dorn VA hospital said it was immediately taking steps to fix the problems.
The Dorn VA hospital did not immediately return requests for comment.
Gainesville, Florida
The Malcom Randall VA Medical Center in Gainesville, Fla., reported 31 “adverse events” during fiscal year 2013, the most of any VA facility. Three of those incidents were delays in cancer diagnosis and treatment.
The VA also confirmed earlier this year that two patients died at North Florida/South Georgia system, where the Gainesville hospital is located, due to delayed cancer screenings.
Additionally, the hospital conducted an “incorrect autopsy,” according to a 2013 disclosure.
The system is the busiest in the country, serving roughly 125,000 VA patients per year. However, numerous congressional investigations and internal audits by the VA also describe a corrosive work environment, where leadership encouraged staff to cook the books to meet performance standards and where whistleblowers were harshly punished.
Three VA officials in Gainesville were placed on leave this year after an audit by the VA Inspector General found the hospital was using a secret paper list to keep track of appointments.
There were also allegations that surgeons were not allowed to perform certain operating room procedures to avoid increased mortality rates, and that patients with a high mortality risk were sent to a local hospital. However, the VA Inspector General said in a report it could not substantiate those claims.
Augusta, Georgia
The Charlie Norwood VA Medical Center in Augusta, Ga., reported 14 “adverse events” during fiscal year 2013, and three cancer patients died as a result of delayed screenings over the past two years.
In 2013 alone, there were ten reports of delayed colonoscopies, two of which resulted in patient deaths.
According to a 2012 report from the VA Inspector General’s Office, five patients died or sustained serious injury as a result of mismanagement between 2007 and 2010, and more than 4,500 gastrointestinal endoscopy consults went unresolved.
A VA audit this year reported that 26 new patients in Augusta had to wait at least 90 days for an appointment. Additionally, 133 veterans were not scheduled for an appointment despite requesting one in the past 10 years.
Since then, Augusta officials say they have reduced the number of veterans waiting at least 90 days for an appointment from 26 patients to two.
There were four open federal investigations into whistleblower retaliation at the hospital as of July.
‘Missed Opportunities'
Twenty-two veterans are said to commit suicide each day, and decreasing that number has become a key mission of the VA. However, some disclosures raise questions about the steps being taken inside the department’s facilities to ensure veterans receive appropriate attention for mental health issues.
“[Registered nurse] documented patient had frequent thoughts of suicide,” one 2011 entry reads. “RN did not perform a suicide risk assessment with the patient and the patient attempted suicide by overdose.”
“Providers did not listen to patient complaints that psychiatric meds not working,” a 2012 report from a Salt Lake VA hospital said. “Patient overdosed on acetaminophen.”
In one case, the family of a veteran reached out to staff at the facility in Albuquerque, New Mexico after they became concerned with the patient’s depressive behavior, but staffers failed to follow up on those concerns.
“Patient attempted suicide by stabbing with a knife to his neck requiring emergency surgical repair,” the report notes. “Family had contacted facility with concern of patient depression behavior on [redacted]; lack of appropriate follow-up and medication regime.”
In Saginaw, Michigan a veteran “on a day-pass from an inpatient PTSD treatment facility” died after ingesting medications prescribed by his primary care doctor without a “face to face assessment.”
He was found dead in a motel room, two days after receiving the prescription, from “an accidental or intentional overdose of medications.”
A Comparison To Civilian Care
There are several caveats to the VA data. In many cases, the “adverse events” occurred from one to several years prior to the year they were reported. Many patients were also injured in falls or other accidents that were not strictly the result of staff error.
In other cases, the VA was scrupulous in reporting events that could not be conclusively connected to the death of a patient, some of whom had other severe medical problems.
Sometimes the mistakes did not even result in an injury. For example, in fiscal year 2013, 67 patients suffered no injury despite an error requiring a disclosure. Even in cases where the VA reported a mistake, some patients were still grateful for the care they received, according to the reports.
Although it is difficult to make a direct comparison without more detailed information, VA hospitals are not alone in committing serious, sometimes fatal mistakes.
According to a 2010 Department of Health and Human Services Office of Inspector General report, “an estimated 1.5 percent of Medicare beneficiaries experienced an event that contributed to their deaths, which projects to 15,000 patients in a single month.”
In a groundbreaking 1999 study, the Institute of Medicine estimated that medical errors killed between 44,000 and 98,000 patients at hospitals nationwide every year. However the Journal of Patient Safety said in a report released last year that the numbers may be as high as between 210,000 and 440,000 patients each year.
Every year, an estimated 4,000 cases of “retained surgical items— in other words, things accidentally left inside patients’ bodies—reported in the United States.
The Department of Veterans Affairs did not immediately respond to a request for comment for this article.
See the documents here: Institutional Disclosure Data Summary; Institutional Disclosures in FY2011; Institutional Disclosures in FY2012; and Institutional Disclosures in FY2013.
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Below you see that the ADA is under attack as people with disabilities are being squeezed from the workplace at the same time worker's compensation and disability laws are being 'reformed' such that workers will find it near impossible to prove an injury or a disease vector originated on the job.
The EEOC like OSHA is a Federal agency with an appointed director and we know OSHA has not been functioning for a few decades in protecting workers and it looks as though the EEOC is now doing the same.
Workplace Disability Discrimination Claims Hit Record
By Shaun Heasley January 29, 2013
More complaints of disability-related job discrimination were filed last year than ever before, new statistics show.
The U.S. Equal Employment Opportunity Commission received 26,379 claims of job bias citing disability issues in fiscal year 2012. That’s up slightly from 25,742 filed the prior year.
Of the disability-related cases handled last year, the EEOC said they found that allegations in 5,907 had merit.
Aside from disability, the EEOC monitors employment discrimination complaints based on a variety of factors including race, sex, age, religion and national origin.
Overall, the number of job bias complaints filed with the EEOC was down somewhat in 2012, with a total of 99,412 charges filed by private sector workers. Disability claims, however, have increased every year since 2005.
The reason worker's compensation and workplace discrimination cases are soaring is that the American worker is being exploited and abused with long work hours----broken shifts that kill sleep patterns----long exposure to operational procedures like repetitive motion and staring at computer screens that break people's health. At the same time working conditions worsen and people's health compromised the agencies that should be supporting workers like OSHA and EEOC are being led by corporate directors that look out for a corporations profits over the well-being of workers.
People fired are of course-----the disabled, seniors, and people of color---all within the protective window of EEOC. This article makes it appear that people are using EEOC as an excuse for the layoff----
BUT I THINK WITH THE EMPLOYMENT STATS SHOWING RECORD NUMBERS OF THESE EMPLOYEE GROUPS ON THE DOLE----THERE ARE A RECORD NUMBER OF CASES OF DISCRIMINATION.
EEOC Discrimination Claims Soar in Early 2010
By Fox Rothschild LLP on September 24, 2010 Posted in General Employment Discrimination
The Wall Street Journal reported today that claims of employment discrimination filed with the EEOC from November 2009 through April 2010, increased 60% over the same period one year ago, with 70,000 claims filed. Attorneys quoted in the article cited layoffs attributed to the economy as a major factor in this increase. For example, with an increase in layoffs, more employees who are in a "protected category" are bound to be among those terminated, and they are more likely to file claims of discrimination if a new job is not found quickly. One such category of claims relates to age, since older workers are sometimes over-represented in layoffs, even if unintentionally.
Another factor in this increase is the 2008 change in the federal age discrimination law. The law broadened the definition of disability and therefore put more pressure on employers to accommodate these employees. In a down economy, more employers are claiming that it is "too burdensome" to make the necessary accommodations, and are taking their chances and terminating such employees.
We have found an uptick in meritless claims filed by laid-off employees who have no other means of support, and seek to extract a possible settlement from employers by filing a simple and free EEOC claim.
_____________________________________________
The Affordable Care Act has placed into the hands of corporate health institutions slated to profit from how health care access is managed the ability to define treatment and compensation charges and what constitutes on-the-job injury. What was once standards written from the public interest standpoint is now being re-written by corporations making sure these programs will be hard to access and wither on the vine.
Congress is writing law that makes defining on-the-job injury harder and the ability for disabled to receive long-time ADA workplace exemptions are disappearing. All of this is happening because Obama is a Clinton neo-liberal working for wealth and profit just as is the Republicans. If we elect REAL labor and justice candidates during primaries we can reverse this and bring back our public disability and workplace disability programs as before.
Remember, it is national labor unions and national justice organizations who support every election Clinton Wall Street neo-liberals doing all of this even as they protest against these actions.
SO, PLEASE MAKE SURE WE HAVE STRONG LEADERS IN LABOR AND JUSTICE AND POLS THAT ARE NOT WALL STREET AND CORPORATE!
States are eliminating their commitments to worker's comp and saying there is Federal agency coverage---but these Federal agencies are staffed by corporate directors that are outsourcing much of the work with the direction to slow the number of claims.
Workers Compensation Targeted By Business, Insurance Groups Across Country
Posted: 04/22/2011 9:08 am EDT Updated: 06/21/2011 5:12 am EDT Former cop Bill Fournier told the Maine state legislature last week about the time he responded to a crime scene and found a 4-year-old girl burned alive in an oven. The grisly 1984 murder sent his life off the rails, Fournier said, to the point where he once put a revolver in his mouth and cocked the hammer.
It isn’t something Fournier would like to revisit, but a subject dear to him was on the table: Reform of workers compensation laws.
Joined by other police officers, firefighters and paramedics, Fournier testified against a Maine bill that would diminish the role of psychiatric and emotional damage in determining a worker’s right to compensation after an injury. The hotly debated measure, sponsored by state Rep. Kerri Prescott (R), has drawn support from the Maine Chamber of Commerce and insurance interests and opposition from labor groups. Many workers, particularly first responders, have argued that mental and emotional injuries should carry no less weight than physical ones when it comes to compensation.
Kevin Gillis, the head of the Maine Workers’ Compensation Coordinating Council, an organization that represents businesses and insurers and backs the measure, says Fournier’s emotional testimony epitomizes a lot of the heated discussion surrounding workers comp in Maine and elsewhere right now.
“People can understand just enough to comment on it, but they still don’t fully understand it,” Gillis told HuffPost. “A lot of people don’t understand the significance or lack of significance of these [reforms]. You have to have a good grip on the whole statute.” Gillis insists the reforms are aimed at lawyers who manipulate the system, and he believes the proposed changes wouldn’t have affected Fournier’s case.
There’s a flurry of legislative activity around the country -- notably in Maine, North Carolina, Illinois, and Montana -- geared towards reining in the costs to employers of workers compensation claims. Maine Governor Paul LePage (R), who’s already sparked a high-profile battle with the state’s labor groups, went so far as to mention workers comp reform in his inaugural address. Illinois Governor Pat Quinn (D) recently told his state's enthusiastic Chamber of Commerce that workers comp reform will happen “this year.”
While some bipartisan efforts exist, Republicans generally push the reforms, which business groups and insurance trade associations support. And though many of these discussions have been brewing for years, the ongoing efforts seem to dovetail nicely with the anti-labor zeitgeist fostered in Wisconsin and Ohio, as stories of able-bodied workers gaming the system now abound in legislative halls.
A representative of the Workers Injury Law & Advocacy Group (WILG), which represents claimants’ attorneys, told HuffPost that “workers’ rights and benefits, nationwide, appear to be under greater attack this session.”
North Carolina serves as one of the prime battlegrounds, where a Republican-sponsored bill would cap the amount of time an injured worker can collect compensation at 500 weeks. Right now there is no time limit. The state's GOP has tried unsuccessfully to implement caps before, but now that the party controls both the House and the Senate for the first time in a century, the measure may have its best shot.
A study released by the Workers’ Compensation Research Institute last year deemed North Carolina’s workers comp costs among the highest of 15 states studied. Proponents of the reform argue higher taxes and insurance premiums for employers discourage businesses from settling or staying in the state, and the system is ripe for abuse without caps. Earlier this month, a scrum of injured workers and labor groups showed up at the state's assembly steps to protest the proposal.
“We believe there’s a number of provisions being proposed that would hurt workers,” said James Andrews, president of the AFL-CIO for North Carolina. He warns that the bill could make it harder for injured workers to change doctors and that it would redefine what “suitable” employment means. “It would require workers to take Walmart-type jobs in an effort to quickly return to work,” James said.
Sorting out the real costs and savings of reform hasn’t been easy. Ray Evans, the director of the North Carolina Rate Bureau, the state-chartered non-profit that determines insurance rates, said the impact of a cap isn’t clear and the discussion tends to veer off into emotionally charged territory.
“In this legislative environment, it’s difficult to separate the anecdotal evidence from what we consider more factual evidence,” said Evans, whose bureau doesn’t take a position on the possible reforms in North Carolina. “We hear all the time about people on disability out playing golf or basketball. We don’t know if that’s urban legend.”
In Illinois, members of both parties have vowed to tackle the workers comp issue. Quinn recently told the business community that reform could save local companies half a billion dollars. Calling for an overhaul of the state’s compensation commission, Quinn said, "Nobody's going to get scalped in the reform -- someone might get a hair cut -- but nobody's going to get scalped."
Although a few reforms would be possible in Illinois, one may fundamentally change the definition of a compensable injury, by requiring the worker to show that the accident was the "primary" factor in the resulting disability. The state head of the AFL-CIO has called this provision “deal-breaker” for labor. WILG argues that one Illinois bill would “effectively abolish" the Illinois Workers’ Compensation Act and put cases with the state’s circuit courts rather than with its compensation commission.
Last week, Montana Governor Brian Schweitzer (D) signed a bill pushed by the Republican-led legislature that will change the state's workers compensation system significantly, including limiting benefits to a five-year period (two-year extensions are possible) and making those injured during a break ineligible. Proponents said the measure will cut expenses by 25 percent in a state known to have both some of the highest workers comp costs in the country and some of the highest workplace injury rates.
The Montana reforms came after five years of negotiations, and it’s unlikely the bills in Maine and North Carolina will move swiftly given the resistance from labor groups. In the meantime, those following the developments expect more heated debate and hyperbolic talk in the statehouses.
Many people probably won’t understand their state's compensation systems -- or the implications of ongoing reforms -- until the time comes to file a claim. “For the most part, folks don’t have a good idea on the differences in workers compensation programs,” said Evans of the N.C. Rate Bureau. “You can ask a hundred different people on the street how it all works, and I’m not sure you’d get an informed answer.”
How do you kill employment for returning vets? You privatize and outsource the VA---the largest employer of vets.....you privatize and outsource the US Post Office---the source of many jobs for veterans.
While the SSDI is being imploded by subpriming the next largest Federal disability program is under attack by outsourcing. I showed yesterday how what used to be VA fund resources going to corporate private non-profits to tell vets to volunteer for their community as no jobs are available below you see why vets are being reduced to volunteering and not working-----all the job areas they have always known as a resource are being outsourced and much VA funding is now going to corporate executive pay and the typical corporate fraud and corruption.
As important is the outsourcing of the medical staff-----Walter Reid was the world's best military hospital and now it is being closed as doctors are sent to do global medical tourism and vets are left with the same Medicaid clinic care by staff with less training and experience.
THIS IS DELIBERATE BECAUSE WHAT USED TO BE THE BEST MEDICAL CARE IN THE US FOR VETERANS IS NOW BECOMING THE SAME MEDICAID FOR ALL LEVEL OF CLINIC CARE.
VA accused of excessive outsourcing of vets' jobs
- By Alice Lipowicz
- Feb 09, 2012
The Veterans Affairs Department is being accused of undermining its own goal of hiring more veterans by expanding its outsourcing practices that eliminate many federal jobs currently, or historically, held by veterans, according to the union representing 205,000 employees at the VA.
In November, President Barack Obama signed into law the “VOW to Hire Heroes Act,” which included language to set up an expedited process for hiring returning solders for federal jobs.
But the VA’s own outsourcing, which began to grow under the Bush Administration and are continuing to expand, are abolishing many federal jobs currently held by veterans, the American Federation of Government Employees (AFGE), an AFL-CIO union, said in a Feb. 8 news release.
For example, the Veterans Benefits Administration recently entered into a $54 million three-year contract with ACS Government Systems to perform claims processing work.
That work currently is being performed by “large numbers of veterans,” the union said. “To add insult to injury, the VBA employees are being asked to volunteer to train the contractors to do their work.”
“Contract claims processors working for profit will now handle the most personal information of our veterans.” AFGE National President John Gage said in the release.
In several other outsourcing contracts in recent years, the VA also has gotten rid of many government jobs historically held by veterans, AFGE said.
Other jobs recently outsourced by VA medical centers and cemeteries, which historically had been held by veterans, included cemetery caretakers, laundry and food service workers, housekeepers, groundskeepers and transportation assistants.
The VA also has failed to comply with a 2009 law that requires the agency to do a cost-benefit analysis before each outsourcing contract is awarded, to determine whether the contract is cost-effective for taxpayers, the union said.
“The agency continues to violate federal law by contracting out work that has been traditionally performed by veterans,” the union said. “The outsourced jobs include many entry level jobs that disabled veterans rely on to get back on their feet after returning from the battlefield.”
The union also claimed the VA conducts “excessive contracting” of physician and nursing services rather than hiring clinicians from within the military.
“Contract physicians and nurses lack the specialized skills and best practices of clinicians who dedicate their lives to serving the veteran population as VA employees,” said AFGE National VA Council President Alma Lee.
VA officials did not immediately respond to requests for comment on Feb. 9.
Complaints about VA outsourcing have arisen on a regular basis in recent years. In 2009, the president reversed course on a proposed third-party billing initiative for veterans medical care following negative media attention about it.
____________________________________________
As someone with a family member who dead early because of mistakes at a VA hospital the number is growing as the quality of staff and doctors declines and as the time wait for care grows too long for a healthy outcome. Veterans are being forced from what was world-class care to what 80% of Americans are being forced to---Medicaid for All ----a clinic -level care with people having less training and low wages.
This is reflected even more so by veterans with disabilities who need more time and access and are getting less. The backlogs are just the tip of a dysfunctional system made so by outsourcing and downgrading of resources and funding.
Dec 23, 2014 at 11:26am ReplyQuote Post by MeMyselfandI on Dec 23, 2014 at 11:26am
More Than 500 Veterans Have Died Because Of Mistakes At VA Hospitals Since 2010
More than 500 military veterans died because of serious mistakes at Veterans Affairs hospitals across the country between 2010 and 2014, VA records show.
There were a total of 1,452 “institutional disclosures of adverse events” between fiscal years 2010 and 2014, 526 of which resulted in patient deaths, according to VA data obtained by the Washington Free Beacon through a Freedom of Information Act request.
According to the Veterans Health Administration, such disclosures are required when “an adverse event has occurred during the patient’s care that resulted in or is reasonably expected to result in death or serious injury.”
Specifically, adverse events are defined by the department as “untoward incidents, diagnostic or therapeutic misadventures, iatrogenic injuries, or other occurrences of harm or potential harm directly associated with care or services provided” by the VA.
The 1,452 disclosures represent a miniscule portion of the hundreds of thousands of patients who are treated annually at VA hospitals, but they reveal for the first time a fuller picture of errors and lapses in medical coverage that affect veterans across the country.
The disclosures include feeding tubes being placed in patients’ lungs, patients being sent home with undiagnosed rib and shoulder fractures, and in one case extracting the wrong tooth from a patient.
But buried among the more common mistakes that occur in even the best hospitals — incorrect dosages, surgical equipment accidentally left in patients’ bodies—are reports of the fatal delays in cancer diagnoses and follow-up treatments that would later lead to a national scandal and the resignation of the VA Secretary.
“Chest X-Ray for [patient] showed an ill-defined one centimeter nodule overlying the left anterior fourth rib,” a 2011 entry from a San Diego VA hospital reads. “Radiology recommended a CT scan of the chest for a more complete evaluation of possible left midlung nodule. Patient was not informed about abnormal imaging and no follow-up was arranged. Patient was seen in the ER six months later. Patient diagnosed with Stage IV small cell lung cancer and passed away two months later.”
“[Patient] had chest X-ray in 2010; no follow-up until patient presented for ER visit in 2010,” another entry from Erie, Pennsylvania reads. “Patient ultimately found to have lung cancer. He expired in 2011. A delay in work-up of approximately 6 months occurred.”
“Follow-up CT scan ordered at CBOC to be completed at parent facility. Order faxed to unmanned printer and it did not get scheduled. Delay of diagnosis of lung cancer of approximately 9 months.”
Scores of similar entries are scattered through the quarterly reports from every corner of the United States, from Puerto Rico to Fargo to Los Angeles.
In fiscal year 2012 alone, 74 patients with some form of cancer saw delays in their treatment or the initial findings were overlooked. Twelve of those veterans ultimately died from their illness.
Less frequent but equally troublesome are reports of VA staff not properly screening patients at risk for suicide.
“Missed Opportunities prior to Suicide Completion” is the entirety of one entry from 2011.
Medical privacy laws strictly bar from disclosure the names of patients and other details, making it difficult to document individual cases, but the data does show general trends. Reports of patient deaths and injuries rose steadily from 2010 to 2013, peaking with 126 reported deaths.
As US troop drawdowns in Iraq and Afghanistan accelerated over those years, VA hospitals struggled to handle the surge in patients and simultaneous shortage of doctors and staff. Some did the best they could under the circumstances, but other hospitals turned to dishonest means to hide the scope of the problem from VA headquarters in Washington.
VA Whistleblowers first began coming forward in late 2013 with allegations that schedulers at the Phoenix VA hospital used secret paper waiting lists to hide the long wait times faced by patients. Whistleblowers alleged that up to 40 veterans died while their requested appointments languished on unofficial paper lists.
The VA disclosed in April that, since 1999, 76 patients nationwide were seriously injured because of delayed gastro-intestinal cancer screenings, and 23 died.
A May audit of the Phoenix hospital found 1,700 patients were put on unofficial wait lists and subjected to treatment delays of up to 115 days.
VA Secretary Eric Shinseki resigned as a result of the scandal, and the department ordered a nationwide audit of its consulting practices.
That audit released in June, found that 57,436 newly enrolled veterans face a minimum 90-day wait for medical care, while 63,869 veterans who enrolled over the past decade requested an appointment that never happened.
According to the audit, 8 percent of scheduling staff nationwide used something other than the official electronic wait lists, and 13 percent of staff had been instructed by a supervisor to enter a date other than the veteran’s requested appointment into the “desired date” field, fudging the actual wait times.
Since then, the new VA Secretary has fired five senior administrators at problematic VA facilities, including the director of the Phoenix VA hospital.
The number of patient deaths due to errors dropped to 107 in fiscal year 2014, according to VA records.
However, the widespread use of secret waiting lists means that there are potentially many more cases of patients who died because of long-delayed appointments than appear in the reports that were filed to VA headquarters. For example, the Phoenix VA hospital appears relatively few times in the reports, and no significant delays were reported there in 2013.
Columbia, South Carolina
The Williams Jennings Bryan Dorn Veterans Medical Center in Columbia, South Carolina reported the highest number of delays in cancer care, of any facility, in 2012.
The cancer care of at least eight veterans was delayed significantly enough that officials said it may have impacted the rate of survival and the ability to later provide sufficient treatment.
Four disclosures note that a “delay in diagnosing impacted [the veteran’s] cancer staging and survival rate.” Four others use similar language, explaining that delays “in diagnosis impacted … cancer staging and treatment” of the patients.
The Dorn facility first came under scrutiny for delays in cancer care, specifically gastrointestinal (GI) care, following a CNN report in November of 2013.
The facilities’ own disclosures show that delays in gastrointestinal care have plagued the facility for a number of years.
In 2013, nine patients experienced delays between their initial consultation and necessary diagnostic procedures, such as endoscopies and colonoscopies.
The delays in GI care for two veterans, in 2012, meant they were required to undergo surgery to remove a mass in their colon, which “might have been removed endoscopically” instead of surgically if the procedure was completed earlier.
There have been six total deaths since 1999 due to delayed cancer screenings, according to the VA report.
A February report by the VA Inspector General found the Dorn hospital faced staffing and equipment shortages that led to delays. The report also noted that Dorn ranked 127th out of 128 VA facilities in health care-associated infections during 2013.
In response to the report, the Dorn VA hospital said it was immediately taking steps to fix the problems.
The Dorn VA hospital did not immediately return requests for comment.
Gainesville, Florida
The Malcom Randall VA Medical Center in Gainesville, Fla., reported 31 “adverse events” during fiscal year 2013, the most of any VA facility. Three of those incidents were delays in cancer diagnosis and treatment.
The VA also confirmed earlier this year that two patients died at North Florida/South Georgia system, where the Gainesville hospital is located, due to delayed cancer screenings.
Additionally, the hospital conducted an “incorrect autopsy,” according to a 2013 disclosure.
The system is the busiest in the country, serving roughly 125,000 VA patients per year. However, numerous congressional investigations and internal audits by the VA also describe a corrosive work environment, where leadership encouraged staff to cook the books to meet performance standards and where whistleblowers were harshly punished.
Three VA officials in Gainesville were placed on leave this year after an audit by the VA Inspector General found the hospital was using a secret paper list to keep track of appointments.
There were also allegations that surgeons were not allowed to perform certain operating room procedures to avoid increased mortality rates, and that patients with a high mortality risk were sent to a local hospital. However, the VA Inspector General said in a report it could not substantiate those claims.
Augusta, Georgia
The Charlie Norwood VA Medical Center in Augusta, Ga., reported 14 “adverse events” during fiscal year 2013, and three cancer patients died as a result of delayed screenings over the past two years.
In 2013 alone, there were ten reports of delayed colonoscopies, two of which resulted in patient deaths.
According to a 2012 report from the VA Inspector General’s Office, five patients died or sustained serious injury as a result of mismanagement between 2007 and 2010, and more than 4,500 gastrointestinal endoscopy consults went unresolved.
A VA audit this year reported that 26 new patients in Augusta had to wait at least 90 days for an appointment. Additionally, 133 veterans were not scheduled for an appointment despite requesting one in the past 10 years.
Since then, Augusta officials say they have reduced the number of veterans waiting at least 90 days for an appointment from 26 patients to two.
There were four open federal investigations into whistleblower retaliation at the hospital as of July.
‘Missed Opportunities'
Twenty-two veterans are said to commit suicide each day, and decreasing that number has become a key mission of the VA. However, some disclosures raise questions about the steps being taken inside the department’s facilities to ensure veterans receive appropriate attention for mental health issues.
“[Registered nurse] documented patient had frequent thoughts of suicide,” one 2011 entry reads. “RN did not perform a suicide risk assessment with the patient and the patient attempted suicide by overdose.”
“Providers did not listen to patient complaints that psychiatric meds not working,” a 2012 report from a Salt Lake VA hospital said. “Patient overdosed on acetaminophen.”
In one case, the family of a veteran reached out to staff at the facility in Albuquerque, New Mexico after they became concerned with the patient’s depressive behavior, but staffers failed to follow up on those concerns.
“Patient attempted suicide by stabbing with a knife to his neck requiring emergency surgical repair,” the report notes. “Family had contacted facility with concern of patient depression behavior on [redacted]; lack of appropriate follow-up and medication regime.”
In Saginaw, Michigan a veteran “on a day-pass from an inpatient PTSD treatment facility” died after ingesting medications prescribed by his primary care doctor without a “face to face assessment.”
He was found dead in a motel room, two days after receiving the prescription, from “an accidental or intentional overdose of medications.”
A Comparison To Civilian Care
There are several caveats to the VA data. In many cases, the “adverse events” occurred from one to several years prior to the year they were reported. Many patients were also injured in falls or other accidents that were not strictly the result of staff error.
In other cases, the VA was scrupulous in reporting events that could not be conclusively connected to the death of a patient, some of whom had other severe medical problems.
Sometimes the mistakes did not even result in an injury. For example, in fiscal year 2013, 67 patients suffered no injury despite an error requiring a disclosure. Even in cases where the VA reported a mistake, some patients were still grateful for the care they received, according to the reports.
Although it is difficult to make a direct comparison without more detailed information, VA hospitals are not alone in committing serious, sometimes fatal mistakes.
According to a 2010 Department of Health and Human Services Office of Inspector General report, “an estimated 1.5 percent of Medicare beneficiaries experienced an event that contributed to their deaths, which projects to 15,000 patients in a single month.”
In a groundbreaking 1999 study, the Institute of Medicine estimated that medical errors killed between 44,000 and 98,000 patients at hospitals nationwide every year. However the Journal of Patient Safety said in a report released last year that the numbers may be as high as between 210,000 and 440,000 patients each year.
Every year, an estimated 4,000 cases of “retained surgical items— in other words, things accidentally left inside patients’ bodies—reported in the United States.
The Department of Veterans Affairs did not immediately respond to a request for comment for this article.
See the documents here: Institutional Disclosure Data Summary; Institutional Disclosures in FY2011; Institutional Disclosures in FY2012; and Institutional Disclosures in FY2013.
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Below you see that the ADA is under attack as people with disabilities are being squeezed from the workplace at the same time worker's compensation and disability laws are being 'reformed' such that workers will find it near impossible to prove an injury or a disease vector originated on the job.
The EEOC like OSHA is a Federal agency with an appointed director and we know OSHA has not been functioning for a few decades in protecting workers and it looks as though the EEOC is now doing the same.
Workplace Disability Discrimination Claims Hit Record
By Shaun Heasley January 29, 2013
More complaints of disability-related job discrimination were filed last year than ever before, new statistics show.
The U.S. Equal Employment Opportunity Commission received 26,379 claims of job bias citing disability issues in fiscal year 2012. That’s up slightly from 25,742 filed the prior year.
Of the disability-related cases handled last year, the EEOC said they found that allegations in 5,907 had merit.
Aside from disability, the EEOC monitors employment discrimination complaints based on a variety of factors including race, sex, age, religion and national origin.
Overall, the number of job bias complaints filed with the EEOC was down somewhat in 2012, with a total of 99,412 charges filed by private sector workers. Disability claims, however, have increased every year since 2005.
The reason worker's compensation and workplace discrimination cases are soaring is that the American worker is being exploited and abused with long work hours----broken shifts that kill sleep patterns----long exposure to operational procedures like repetitive motion and staring at computer screens that break people's health. At the same time working conditions worsen and people's health compromised the agencies that should be supporting workers like OSHA and EEOC are being led by corporate directors that look out for a corporations profits over the well-being of workers.
People fired are of course-----the disabled, seniors, and people of color---all within the protective window of EEOC. This article makes it appear that people are using EEOC as an excuse for the layoff----
BUT I THINK WITH THE EMPLOYMENT STATS SHOWING RECORD NUMBERS OF THESE EMPLOYEE GROUPS ON THE DOLE----THERE ARE A RECORD NUMBER OF CASES OF DISCRIMINATION.
EEOC Discrimination Claims Soar in Early 2010
By Fox Rothschild LLP on September 24, 2010 Posted in General Employment Discrimination
The Wall Street Journal reported today that claims of employment discrimination filed with the EEOC from November 2009 through April 2010, increased 60% over the same period one year ago, with 70,000 claims filed. Attorneys quoted in the article cited layoffs attributed to the economy as a major factor in this increase. For example, with an increase in layoffs, more employees who are in a "protected category" are bound to be among those terminated, and they are more likely to file claims of discrimination if a new job is not found quickly. One such category of claims relates to age, since older workers are sometimes over-represented in layoffs, even if unintentionally.
Another factor in this increase is the 2008 change in the federal age discrimination law. The law broadened the definition of disability and therefore put more pressure on employers to accommodate these employees. In a down economy, more employers are claiming that it is "too burdensome" to make the necessary accommodations, and are taking their chances and terminating such employees.
We have found an uptick in meritless claims filed by laid-off employees who have no other means of support, and seek to extract a possible settlement from employers by filing a simple and free EEOC claim.
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The Affordable Care Act has placed into the hands of corporate health institutions slated to profit from how health care access is managed the ability to define treatment and compensation charges and what constitutes on-the-job injury. What was once standards written from the public interest standpoint is now being re-written by corporations making sure these programs will be hard to access and wither on the vine.
Congress is writing law that makes defining on-the-job injury harder and the ability for disabled to receive long-time ADA workplace exemptions are disappearing. All of this is happening because Obama is a Clinton neo-liberal working for wealth and profit just as is the Republicans. If we elect REAL labor and justice candidates during primaries we can reverse this and bring back our public disability and workplace disability programs as before.
Remember, it is national labor unions and national justice organizations who support every election Clinton Wall Street neo-liberals doing all of this even as they protest against these actions.
SO, PLEASE MAKE SURE WE HAVE STRONG LEADERS IN LABOR AND JUSTICE AND POLS THAT ARE NOT WALL STREET AND CORPORATE!
States are eliminating their commitments to worker's comp and saying there is Federal agency coverage---but these Federal agencies are staffed by corporate directors that are outsourcing much of the work with the direction to slow the number of claims.
Workers Compensation Targeted By Business, Insurance Groups Across Country
Posted: 04/22/2011 9:08 am EDT Updated: 06/21/2011 5:12 am EDT Former cop Bill Fournier told the Maine state legislature last week about the time he responded to a crime scene and found a 4-year-old girl burned alive in an oven. The grisly 1984 murder sent his life off the rails, Fournier said, to the point where he once put a revolver in his mouth and cocked the hammer.
It isn’t something Fournier would like to revisit, but a subject dear to him was on the table: Reform of workers compensation laws.
Joined by other police officers, firefighters and paramedics, Fournier testified against a Maine bill that would diminish the role of psychiatric and emotional damage in determining a worker’s right to compensation after an injury. The hotly debated measure, sponsored by state Rep. Kerri Prescott (R), has drawn support from the Maine Chamber of Commerce and insurance interests and opposition from labor groups. Many workers, particularly first responders, have argued that mental and emotional injuries should carry no less weight than physical ones when it comes to compensation.
Kevin Gillis, the head of the Maine Workers’ Compensation Coordinating Council, an organization that represents businesses and insurers and backs the measure, says Fournier’s emotional testimony epitomizes a lot of the heated discussion surrounding workers comp in Maine and elsewhere right now.
“People can understand just enough to comment on it, but they still don’t fully understand it,” Gillis told HuffPost. “A lot of people don’t understand the significance or lack of significance of these [reforms]. You have to have a good grip on the whole statute.” Gillis insists the reforms are aimed at lawyers who manipulate the system, and he believes the proposed changes wouldn’t have affected Fournier’s case.
There’s a flurry of legislative activity around the country -- notably in Maine, North Carolina, Illinois, and Montana -- geared towards reining in the costs to employers of workers compensation claims. Maine Governor Paul LePage (R), who’s already sparked a high-profile battle with the state’s labor groups, went so far as to mention workers comp reform in his inaugural address. Illinois Governor Pat Quinn (D) recently told his state's enthusiastic Chamber of Commerce that workers comp reform will happen “this year.”
While some bipartisan efforts exist, Republicans generally push the reforms, which business groups and insurance trade associations support. And though many of these discussions have been brewing for years, the ongoing efforts seem to dovetail nicely with the anti-labor zeitgeist fostered in Wisconsin and Ohio, as stories of able-bodied workers gaming the system now abound in legislative halls.
A representative of the Workers Injury Law & Advocacy Group (WILG), which represents claimants’ attorneys, told HuffPost that “workers’ rights and benefits, nationwide, appear to be under greater attack this session.”
North Carolina serves as one of the prime battlegrounds, where a Republican-sponsored bill would cap the amount of time an injured worker can collect compensation at 500 weeks. Right now there is no time limit. The state's GOP has tried unsuccessfully to implement caps before, but now that the party controls both the House and the Senate for the first time in a century, the measure may have its best shot.
A study released by the Workers’ Compensation Research Institute last year deemed North Carolina’s workers comp costs among the highest of 15 states studied. Proponents of the reform argue higher taxes and insurance premiums for employers discourage businesses from settling or staying in the state, and the system is ripe for abuse without caps. Earlier this month, a scrum of injured workers and labor groups showed up at the state's assembly steps to protest the proposal.
“We believe there’s a number of provisions being proposed that would hurt workers,” said James Andrews, president of the AFL-CIO for North Carolina. He warns that the bill could make it harder for injured workers to change doctors and that it would redefine what “suitable” employment means. “It would require workers to take Walmart-type jobs in an effort to quickly return to work,” James said.
Sorting out the real costs and savings of reform hasn’t been easy. Ray Evans, the director of the North Carolina Rate Bureau, the state-chartered non-profit that determines insurance rates, said the impact of a cap isn’t clear and the discussion tends to veer off into emotionally charged territory.
“In this legislative environment, it’s difficult to separate the anecdotal evidence from what we consider more factual evidence,” said Evans, whose bureau doesn’t take a position on the possible reforms in North Carolina. “We hear all the time about people on disability out playing golf or basketball. We don’t know if that’s urban legend.”
In Illinois, members of both parties have vowed to tackle the workers comp issue. Quinn recently told the business community that reform could save local companies half a billion dollars. Calling for an overhaul of the state’s compensation commission, Quinn said, "Nobody's going to get scalped in the reform -- someone might get a hair cut -- but nobody's going to get scalped."
Although a few reforms would be possible in Illinois, one may fundamentally change the definition of a compensable injury, by requiring the worker to show that the accident was the "primary" factor in the resulting disability. The state head of the AFL-CIO has called this provision “deal-breaker” for labor. WILG argues that one Illinois bill would “effectively abolish" the Illinois Workers’ Compensation Act and put cases with the state’s circuit courts rather than with its compensation commission.
Last week, Montana Governor Brian Schweitzer (D) signed a bill pushed by the Republican-led legislature that will change the state's workers compensation system significantly, including limiting benefits to a five-year period (two-year extensions are possible) and making those injured during a break ineligible. Proponents said the measure will cut expenses by 25 percent in a state known to have both some of the highest workers comp costs in the country and some of the highest workplace injury rates.
The Montana reforms came after five years of negotiations, and it’s unlikely the bills in Maine and North Carolina will move swiftly given the resistance from labor groups. In the meantime, those following the developments expect more heated debate and hyperbolic talk in the statehouses.
Many people probably won’t understand their state's compensation systems -- or the implications of ongoing reforms -- until the time comes to file a claim. “For the most part, folks don’t have a good idea on the differences in workers compensation programs,” said Evans of the N.C. Rate Bureau. “You can ask a hundred different people on the street how it all works, and I’m not sure you’d get an informed answer.”
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