US , Daesh and Turkey the makings of a depraved (wealth, oil and Serin nerve gas) and deadly threesome.

PRESS TV

Daesh acquiring sarin nerve gas materials via Turkey: Turkish MP

Mon Dec 14, 2015 11:52PM

United Nations arms experts collecting samples as they inspect the site of a suspected chemical weapons strike near the Syrian capital Damascus (AFP)

 

The Daesh Takfiri terrorist group acquired the necessary materials to produce deadly sarin gas via Turkey, a Turkish MP says.


Citing evidence from a suddenly-closed criminal case, Eren Erdem, a member of Turkish main opposition Republican People's Party (CHP), told RT on Monday that Ankara had failed to investigate the supply routes used to provide Daesh with the ingredients of the toxic gas.
“There is data in this indictment. Chemical weapon materials are being brought to Turkey and being put together in Syria in camps of Daesh,” he said.

On August 21, 2013, a chemical weapon was used in the Ghouta area of Damascus suburbs. Hundreds of people died in the attack. According to reports, the rockets used in the attack were handmade and contained sarin.

Erdem, who claims the Turkish government is covering up the subject, brought the matter up in parliament on Thursday. He referred to a criminal case with the number 2013/12 opened by Adana’s General Prosecutor's Office.

Read More Here

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Daily Star

TOXIC TERROR: ISIS 'obtained nerve gas via Turkey' to use on the WEST

ISIS militants obtained the deadly nerve gas Sarin via Turkey sparking fears the murderous regime is producing chemical weapons to use against the West.

By Rory McKeown/Published 14th December 2015

THREAT: Claims have emerged ISIS obtained sarin gas material via Turkey

 

 

TWITTER  CLAIMS: Turkish MP Eren Erdem

“There are phone recordings of this shipment like ‘don’t worry about the border, we’ll take care of it’ and we also see the bureaucracy is being used”

Eren Erdem

Turkish MP Eren Erdem claims Daesh warmongers obtained the materials to produce the deadly chemical in Turkey – and said a cover-up may have taken place.

 

It was feared ISIS murderers may have smuggled the nerve gas into Europe by militants posing as migrants.

And officials believe ISIS are “aggressively developing chemical weapons” and even set up a new cell dedicated to creating weapons of mass destruction.

Read More Here

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 Sputnik

European MP Claims ‘US Doing Business on Daesh Oil’

© Flickr/ olle svensson

Europe

10:46 12.12.2015(updated 10:53 12.12.2015) 

Turkey is buying oil from Daesh terrorists at half the price and resells it to third countries, a Polish member of the European parliament said Friday, adding that the US shows a great deal of interest in the oil supplied by the terrorists.

Janusz Korwin-Mikke said that the United States was “doing business” on buying stolen oil from Daesh terrorists using Turkey as a middleman.

“I have information from America. America is doing business. Turkey is buying oil from the Caliphate [Daesh] at half the price and America is showing a great deal of interest in this oil,” the European MEP emphasized, adding that this information had been confirmed by top government officials in Lebanon.

Read More Here

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EXCLUSIVE: Sarin materials brought via Turkey & mixed in Syrian ISIS camps – Turkish MP to RT

Published time: 14 Dec, 2015 05:03Edited time: 14 Dec, 2015

Islamic State terrorists in Syria received all necessary materials to produce deadly sarin gas via Turkey, Turkish MP Eren Erdem has told RT, insisting there are grounds to believe a cover up has taken place.

TrendsIslamic State, Syria unrest

The main opposition Republican People's Party (CHP) member, Erdem, brought up the issue for public discussion in parliament last week, citing evidence from an abruptly-closed criminal case. He accused Ankara of failing to investigate Turkish supply routes used to provide terrorists with toxic sarin gas ingredients.

“There is data in this indictment. Chemical weapon materials are being brought to Turkey and being put together in Syria in camps of ISIS which was known as Iraqi Al Qaeda during that time," Erdem told RT.

Sarin gas is a military-grade chemical that was used in a notorious attack on Ghouta and several other neighborhoods near the Syrian capital of Damascus in 2013. The attacks were pinned on the Syrian leadership, who in turn agreed to get rid of all chemical weapons stockpiles under a UN-brokered deal amid an imminent threat of US intervention.

Addressing parliamentarians on Thursday, Erdem showed a copy of the criminal case number 2013/120 that was opened by the General Prosecutor's Office in the city of Adana in southern Turkey.
The investigation revealed that a number of Turkish citizens took part in negotiations with Islamic State (IS, formerly ISIS/ISIL) representatives on the supply of sarin gas. Pointing to evidence cited in the criminal case, he said that wiretapped phone conversations proved that an Al-Qaeda militant, Hayyam Kasap, acquired sarin.

“These are all detected. There are phone recordings of this shipment like ‘don't worry about the border, we’ll take care of it' and we also see the bureaucracy is being used,” continued Erdem.
Based on the gathered evidence Adana authorities conducted raids and arrested 13 suspects in the case. But a week later, inexplicably, the case was closed and all the suspects immediately crossed the Turkish-Syrian border, Erdem said.

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'America is a bomb waiting to explode'

Sam Gerrans is an English writer, translator, support counselor and activist. He also has professional backgrounds in media, strategic communications and technology. He is driven by commitment to ultimate meaning, and focused on authentic approaches to revelation and realpolitik.

Published time: 18 Oct, 2015 10:27

 

© Carlo Allegri / Reuters

9.3K8534

The United States is in decline. While not all major shocks to the system will be devastating, when the right one comes along, the outcome may be dramatic.

 

Not all explosives are the same. We all know you have to be careful with dynamite. Best to handle it gently and not smoke while you’re around it.

Semtex is different. You can drop it. You can throw it. You can put it in the fire. Nothing will happen. Nothing until you put the right detonator in it, that is.

To me, the US – and most of the supposedly free West – increasingly looks like a truck being systematically filled with Semtex.


READ MORE: 'US 2016 race: People sick of politics of personalities, want substantive debate' 

 
But it’s easy to counter cries of alarm with the fact that the truck is stable – because it’s true: you can hurl more boxes into the back without any real danger. Absent the right detonator, it is no more dangerous than a truckload of mayonnaise.

But add the right detonator and you’re just one click away from complete devastation.
We can see how fragile the U.S. is now by considering just four tendencies.

1. Destruction of farms and reliable food source

The average American is a long way from food when the shops are closed.
The Washington Post reports that the number of farms in the country has fallen by some 4 million from more than 6 million in 1935 to roughly 2 million in 2012.

And according to the College of Agriculture & Life Sciences, only about 2 percent of the US population live on farms.

That means that around 4.6 million people currently have the means to feed themselves.
Food supply logistics are extended, sometimes stretching thousands of miles. The shops have nothing more than a few days’ stock. A simple break in that supply line would clear the shops out in days.

© Stephen Lam / Reuters

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The Islamic State Is Raping 8-Year-Olds. And the World Is Doing Nothing.

 Iraqi refugees in Syria Wikipedia.org

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 POLITICO

By Vian Dakhil

October 07, 2015

 

Last week I arrived back home to Iraqi Kurdistan, exhausted but proud of a small but real triumph over the Islamic State. Three women and two toddlers came back with me—five human beings just rescued from enslavement by ISIL. For over a year, they were abused, raped and traded fighter to fighter because of one reason: our Yazid religion. I am determined to save every last one of the more than 2,000 Yazidi women and girls still waiting to be freed.

They thought they were abandoned. Their ISIL captors told them that no one wanted them, in their shame and defilement, and that no one was looking for them. But I insist on reaching out to them through pleas on Arabic radio and TV. I give them my phone number, and tell them that we love them and we want them back. Some brave women hear these messages and contact us, and a rescue mission commences. I answer the phone every time, determined to do all that I can, but it is little, and it is not enough. I know there will always be another call, another Yazidi who is terrified and broken and in need of hope, as the world looks the other way.

One of the women, clutching her 2-year-old child, was so distraught. The child kept asking for her 7-year-old sister, who had been taken away from her mother and enrolled in a religious institution where she would be forced to convert to Islam. Her mother had had no choice but to escape without her, and she told me she feared the girl would be raped at the hands of the militants. We have evidence of the militants raping our girls as young as age 8.

For that brief time in August 2014, the United States launched airstrikes to halt the advance of ISIL after its troops took over a third of Iraq, saving the Yazidi people from total massacre by ISIL troops. But since then, we’ve been abandoned and forgotten by Washington and the rest of the international community. For every story of a girl who has been rescued, there’s another one about a girl who is still in captivity, where she is starved, raped, beaten and sold—often to “fellow” Iraqis. And 500,000 Yazidis, a full 90 percent of the indigenous Yazidi population, are in displaced persons’ camps, living in abject misery and isolation with less than minimal sustenance. We languish in these camps, live without income, and without food, medicine or even shelter durable enough to keep the rain out. As long as ISIL remains intent on wiping my people off the map; and as long as the Iraqi and Kurdish Regional governments continue to see Yazidis as less than second-class citizens, unworthy of significant aid and attention, these horrors will continue.

Read More Here

TTIP : The Fleecing of a Nation. US Citizens sold out yet again by their government.

Published on
Tuesday, September 22, 2015
by

Warning: TTIP Aims To Defang Local Rules Against Hazardous Chemicals

New report finds that the Trans-Atlantic Trade and Investment Partnership poses a threat to state regulations against hazardous pesticides, products, and fracking chemicals

by
Sarah Lazare, staff writer

Fracking wells in McKenzie County, North Dakota. (Photo: Tim Evanson/flickr/cc)

The mammoth Trans-Atlantic Trade and Investment Partnership (TTIP) under secret negotiation between the United States and European Union is poised to slash the power of local governments to regulate toxins—from pesticides to fracking chemicals—the Center for International Environmental Law (CIEL) warned in a report released Tuesday.

Preempting the Public Interest: How TTIP Will Limit US States’ Public Health and Environmental Protections (pdf) is based on an analysis of the European Commission's proposed chapter on regulatory cooperation from the April 20 round of negotiations. The report follows other analyses of the text which conclude that the TTIP poses a threat to human rights, environmental protections, and democracy on both sides of the Atlantic.

Beyond the regulatory cooperation chapter, little else is known about the content of the closed-door negotiations over what is set to be the largest bilateral "trade" deal in history.
The chapter's contents, warns CIEL, highlight the direct threat the TTIP poses to public health and environmental protections on the U.S. state level. This is especially troublesome, the report argues, because federal regulations under the Toxic Substance Control Act have proven "egregiously ineffective"—and could be even further eroded, thanks to the influence of the chemical industry in Congress.

"The bottom line is if you're trying to make the U.S. compatible with an international standard, and you have minimal federal regulations on the U.S. side, and you have states that go beyond that, the provisions will be used to attack state chemical and pesticide regulations."
—Sharon Treat, report co-author

In contrast, some state governments have taken the lead in responding to the dangers posed by fracking chemicals, pesticides, and hazardous products by adopting "more than 250 laws and regulations protecting humans and the environment from exposure to toxic chemicals," the report says.

However, so-called "harmonization provisions" in the EU's proposal could force states to conform to the lowest common denominator—in this case weaker federal guidelines. As Sharon Treat, attorney, co-author of the report and former Maine state legislator, explained to Common Dreams, "The bottom line is if you're trying to make the U.S. compatible with an international standard, and you have minimal federal regulations on the U.S. side, and you have states that go beyond that, the provisions will be used to attack state chemical and pesticide regulations."

What's more, the report asserts, the proposed chapter calls for an imposition of "multiple procedural mandates—from an early warning system to regulatory exchanges to the trade and cost-benefit impact assessments—that will lead to a regulatory chill caused by delay, increased costs for government, fear of legal challenges, and heightened industry influence and conflicts of interest."
Beyond their demobilizing effect, such requirements could also expand the power of private interests in corporate tribunals, known as the investor-state dispute settlement (ISDS) systems.
"If you are requiring state and federal governments to do more studies to review whether a regulation could be done in a way that is less of an imposition on trade or big business, then you could bolster the case of the ISDS systems to block regulations," explained Treat. "That would be tipping the scales even further in favor of international corporations running roughshod over regulations and procedures to protect public health and the environment.

Given the continued secrecy of the talks, it is not known how the U.S. responded to the proposed chapter, but the researchers at CIEL say the EU's language alone is cause for alarm. CIEL warns that the "largest chemical and manufacturing corporations on both sides of the Atlantic" are playing a role in pressing the TTIP's regulatory agenda—and that the U.S. is likely pressing for a similar race to the bottom for EU member states.

Meanwhile, the Obama administration is negotiating the TTIP alongside two other secret trade deals: the Trans-Pacific Partnership and the Trade in Services Agreement. All three have come under stiff opposition from social movements and civil societies across the globe concerned that they will bolster corporate power at the expense of people and the planet. Some observers argue that these deals could collapse, in part due to their unpopularity and internal contradictions.

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House votes 390-33 to speed up VA firings. Obama vows the guilty will be held accountable and yet backs Eric Shinseki, directing him to investigate his own failed policies ?

Last I  checked the excuse for the shuffling that was  going on with  scheduling appointments.  Was not an  isolated incident as it was  being  done in more than one  VA Hospital.  Taking place due to  policies being implemented  to  monitor the productivity and efficiency of Hospital personnel and their respective departments. 

Protocols such as this are generally handed down from corporate hierarchy to regional and then local.   It is doubtful that regional or local management implemented these measures on their own and just happened to coincide with similar incidents in other  hospitals in the same way. 

If these protocols were being implemented and enforced  thrughout all VA Hospitals , logic would dictate that  they originated higher up the food chain and that local as well as regional management had a stake in the ultimate outcome of these assessments.  After all ,  corporate politics would dictate that promotions and rewards would directly correlate with the outcome of said assessments as well as departmental records.

To establish unrealistic goals without providing adequate means to accomplish said goals effectively.  As well as establishing a competitive situation without adequate control measures to keep the  overzealous and unscrupulous from doing exactly what has been done.  Is an obvious failure on the part of corporate management, Eric Shineski, in this case.  To gloss over that fact is naive at best and criminal at worst.  But then Mr. Obama is no stranger to criminal negligence , gross ineptitude and just plain ignorance of the actions taking place around him.  So I suppose he can sympathize.....

~Desert Rose~

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VA Secretary Eric Shinseki. (Reuters/Jonathan Ernst).

 The Washington Post

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• The Hill
  
  
  

  May 21, 2014, 06:13 pm

House votes 390-33 to speed up VA firings

By Cristina Marcos

The House on Wednesday overwhelmingly passed a bill to grant the Veterans Affairs secretary expanded authority to fire senior executives for poor performance.
The measure passed on a 390-33 vote amid allegations that veterans encountered delays in access to medical care at multiple VA hospitals across the country, leading to dozens of deaths. All 33 votes in opposition came from Democrats, including ledership Reps. Steny Hoyer (Md.) and James Clyburn (S.C.). House Minority Leader Nancy Pelosi (D-Calif.) voted to approve the measure.
Under the bill, the VA secretary would be authorized to dismiss senior executives or demote them to the civil service. It would require the VA secretary to notify Congress of such a firing or demotion within 30 days.House Veterans Affairs Committee Chairman Jeff Miller (R-Fla.) said the measure would help rid the department of incompetent employees in light of the controversy.
"The committee has received nothing but disturbing silence from the White House and only excuse after another from the Department of Veterans Affairs," Miller said.
Rep. Corrine Brown (D-Fla.) said the legislation would send a message that the VA would be held accountable.
"It is very important as we go into Memorial Day that we let the veterans know that we appreciate their service. And we also need to let them know that we're going to do all we can to make sure they have the quality health care they deserve," Brown said.
An administration official said the White House supports the overall goals of the legislation, but also had concerns that it could have unintended consequences.



Read More Here



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• The Washington Times

Obama vows fix to veterans’ health care troubles

By JULIE PACE and MATTHEW DALY

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Associated Press

Wednesday, May 21, 2014

• 
  
  Enlarge Photo
  President Barack Obama speaks in the Brady Press Briefing Room of the ... more >

WASHINGTON (AP) - With outrage mounting over veterans’ health care, President Barack Obama declared Wednesday that allegations of misconduct at VA hospitals will not be tolerated, and he left open the possibility that Secretary Eric Shinseki, a disabled war veteran, could be held to account.
“I will not stand for it - not as commander in chief but also not as an American,” Obama said following an Oval Office meeting with the embattled Shinseki.
Congress moved to keep up the pressure on the administration, with the House easily approving a measure Wednesday evening that would give the VA secretary more authority to fire or demote the 450 senior career employees who serve as hospital directors or executives in the agency’s 21 regions. The vote was 390 to 33.
Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, sponsored the measure, saying VA officials who have presided over mismanagement or negligence are more likely to receive bonuses or glowing performance reviews than any sort of punishment. He declared that a “widespread and systemic lack of accountability is exacerbating” the department’s problems.
The White House said it supported the goal of seeking greater accountability at the VA but had unspecified concerns about the legislation.
The growing furor surrounding the Department of Veterans Affairs centers on allegations of treatment delays and preventable deaths at VA hospitals. The department’s inspector general’s office says 26 facilities are being investigated nationwide, including a Phoenix hospital facing allegations that 40 people died while waiting for treatment and staff kept a secret list of patients in order to hide delays in care.
The allegations have raised fresh concerns about the Obama administration’s management of a department that has been struggling to keep up with the influx of new veterans returning home from the wars in Iraq and Afghanistan. Obama’s comments Wednesday - his first on the matter in more than three weeks - signaled a greater urgency by the White House to keep the matter from spiraling into a deeper political problem in a midterm election year.

Read More Here


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• The Washington Post

Possible drawbacks of the VA firing bill scheduled for Wednesday vote

• By Josh Hicks

• May 20 at 6:00 am

The House is set to vote this week on a bill that would give the head of the Department of Veterans Affairs authority to fire or demote senior executives for perceived performance problems without going through the usual administrative procedures.
House Majority Leader Eric Cantor (R-Va.) added the measure to the weekly docket on Thursday, the same date VA Secretary Eric Shinseki testified about reports that VA health clinics throughout the country have cooked their books to hide treatment delays, some of which may have affected patients who died while waiting for care.

VA Secretary Eric Shinseki. (Reuters/Jonathan Ernst).

Ironically, the American Legion has called for Shinseki’s removal because of the alleged coverups, along with other problems such as a longstanding backlog of disability claims and preventable deaths at various VA hospitals. If the secretary departs, his critics would have to wait for a replacement to fire senior officials for the recent controversy.
Shinseki said during the hearing that he is “mad as hell” about the reported treatment delays, and he vowed to stick around until he improves VA services for veterans or President Obama asks him to resign.
MORE: Shinseki faces tough questions on VA scandal, vows to ‘accomplish a mission’
Although firing VA officials may quell the recent outrage over reported coverups, the Senior Executives Association has raised concerns about the House bill. Below is a summary of the measure’s drawbacks, as outlined in recent statements from the group:

* Due process: Senior executives can appeal firings and demotions to an administrative panel known as the Merit Systems Protection Board, which determines whether the personnel actions were warranted. However, the hearings are informal and the decisions are non-binding for agency executives, unlike with rank-and-file employees.

The SEA said the House bill would rob employees of the right to recourse when department chiefs wrongly punish their workers. They also noted that accountability processes already exist for senior executives.

Agencies must provide a 30-day written notice when they decide to remove senior executives. The officials can then argue against removal, choose to resign, or return back to work at a lower position. They may also be eligible for immediate retirement.

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Obama Backs Shinseki Amid Calls to Resign (Updated)

By Steven Dennis Posted at 5:53 p.m. on May 5

Updated 6:22 p.m. | The White House is backing Veterans Affairs Secretary Eric Shinseki after he faced calls to resign Monday over allegations that veterans died waiting for care in Phoenix and other problems in his department.
“As the President said last week, we take the allegations around the Phoenix situation very seriously,” said Shin Inouye, a White House spokesman. “That’s why he immediately directed Secretary Shinseki to investigate, and Secretary Shinseki has also invited the independent Veterans Affairs Office of Inspector General to conduct a comprehensive review,” he said.
“We must ensure that our nation’s veterans get the benefits and services that they deserve and have earned. The President remains confident in Secretary Shinseki’s ability to lead the Department and to take appropriate action based on the IG’s findings.”
Earlier Monday, the American Legion called on Shinseki to resign, although the Veterans of Foreign Wars declined to do so. Sen. John McCain, R-Ariz., said he wants the investigation to go forward first. 


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• Obama: 'I Will Not Stand For' Misconduct At Veterans Affairs Hospitals

Senator Cornyn has called for an independent investigation into allegations that wait time data was manipulated at Department of Veterans Affairs clinics in Central Texas and San Antonio.

John Cornyn United States Senator (Texas)

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Senator demands independent investigation as VA scandal spreads

By Jeremy Schwartz

The chair of the Texas Senate’s veteran affairs committee on Monday called for an independent investigation into allegations that wait time data was manipulated at Department of Veterans Affairs clinics in Central Texas and San Antonio.
Sen. Sen. Leticia Van de Putte, D-San Antonio, made her comments as the burgeoning scandal over VA patient care reached the Rio Grande Valley, where a former VA doctor accused the department of delaying colonoscopies for veterans with cancer and jeopardizing veterans’ visits to non-VA specialists because the agency took so long to reimburse private providers.
In Austin, Van de Putte demanded accountability from top VA leaders over claims that scheduling clerks were trained to falsely input appointment data to make it appear that waiting times were far shorter than they really are. The VA aims to see patients within 14 days of their desired appointment dates, and medical centers are graded on their ability to hit those targets.
“It appears the motivation for the deception…was a personal pay day in the form of a VA performance bonus,” Van de Putte said. “Someone is responsible. These scheduling clerks didn’t just decide to falsify reports all over the country at the same time…The allegations show a pattern that crosses multiple clinics and shows the actions were condoned at a pretty high level.”
The claims of whistleblower Brian Turner, a VA scheduling clerk who said he saw data manipulation in Waco, Austin and San Antonio, were first reported by the American-Statesman last week.
On Monday, new allegations emerged against the VA Health Care Center in Harlingen, and officials with the VA’s Texas Valley Coastal Bend Health Care System, which oversees the facility. Dr. Richard Krugman, former associate chief of staff at the center, told investigators that “patient care was impacted by the VA’s requirements to cut costs,” according to documents obtained by the American-Statesman.

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Cornyn Demands Answers From VA Secretary

May 13 2014

WASHINGTON – U.S. Senator John Cornyn (R-TX) today announced on Fox News he has sent a letter to Veterans Affairs Secretary Eric Shinseki after several reports surfaced of abuse and mismanagement in VA clinics in Texas and across the country.  The letter asks several questions of Sec. Shinseki, and calls on the Secretary to provide answers during his testimony before the Senate Veterans’ Affairs Committee on Thursday, May 15. A video of Sen. Cornyn’s Fox News interview regarding VA failures can be viewed here. Sen. Cornyn’s questions for Sec. Shinseki include:
“Can you confirm that supervisors at VA facilities in Texas have not and are not ordering employees to ‘game the system’ by concealing wait times?
“Can you confirm that veterans diagnosed with cancer of any kind that requires chemotherapy are provided that treatment in a timely manner by the VA? 
“Can you confirm that any bonuses or pay raises are on hold for senior leaders at VA facilities in San Antonio, Austin, Waco, Harlingen, and all VA facilities where similar allegations have been made?
“Can you confirm that staff at facilities currently under investigation for allegations of falsified reports will not be assigned to investigate other VA facilities? 
“Can you confirm that documents are being preserved at all Texas VA facilities?”
The full text of the letter is below and attached.

May 13, 2014

The Honorable Eric K. Shinseki
Secretary of Veterans Affairs
810 Vermont Avenue, NW
Washington, DC  20420
Dear Secretary Shinseki:
I write to reiterate my deep concern regarding the numerous, troubling reports that continue to surface regarding mistreatment of our nation’s veterans at Department of Veterans Affairs (VA) facilities across the country.  These reports indicate that incidents—including the withholding of life-saving care from some veterans—were the result of a culture of cover-ups, indifference as to the health and welfare of our veterans, and a complete lack of accountability that pervades your Department.  Yet, the Administration’s response to these troubling revelations has been lethargic and its inaction puzzling.
During your testimony before the Senate Veterans’ Affairs Committee on Thursday, I call on you to provide direct, clear answers to these questions:
1.         According to recent reports, you have ordered a “face-to-face audit” of all Department of Veterans Affairs clinics.  Can you describe in detail how you intend for this audit to be conducted, its timeline for completion, and what measures are being taken to ensure these audits are conducted in an independent and transparent manner?  If the allegations are substantiated, what type of action are you willing to take to right these wrongs, and how will the responsible officials be held accountable?
2.         A whistleblower in Texas claims that during his time as a scheduling clerk for VA facilities in Austin, San Antonio, and Waco, he was directed by supervisors to hide true wait times by inputting false records into the VA’s scheduling system.  VA officials in San Antonio deny this, while VA officials in Austin claim employees may have been discouraged from using the electronic scheduling tool that would reveal long wait times, but that those orders did not come from “executive leadership.”  Can you confirm that supervisors at VA facilities in Texas have not and are not ordering employees to “game the system” by concealing wait times?
3.         An Austin-based surgeon recently contacted my office to inform me he is not accepting any further subcontracts from the VA due to failures in patient care that he has personally witnessed.  Specifically, he saw a veteran in August of 2013 who was referred to him by the VA after they detected a lesion they suspected was cancerous.  Already two months had lapsed between the time they detected the lesion and the time he saw the veteran.  This surgeon performed a biopsy and diagnosed it as laryngeal cancer.  He informed the VA that the veteran needed immediate chemotherapy – that they had a real chance to treat his cancer if they started chemotherapy right away.  Almost two months later, he followed up on his case only to learn the VA never provided chemotherapy, with no good excuse as to why.  The veteran died several days later.  Can you confirm that veterans diagnosed with cancer of any kind that requires chemotherapy are provided that treatment in a timely manner by the VA?
4.         A whistleblower in South Texas who formerly served as associate chief of staff for the VA Texas Valley Coastal Bend Health Care System in Harlingen, TX, told the Washington Examiner this week that roughly 15,000 patients who should have had the potentially life-saving colonoscopy procedure either did not receive it or were forced to wait longer than they should have.  He also claims that approximately 1,800 records were purged to give the false appearance of eliminating a backlog.  Can you confirm that veterans requiring colonoscopies to detect cancer are provided with the procedure in a timely manner?
5.         In 2012, VA medical facilities in Central Texas reported that 96 percent of veterans were seen by providers within 14 days of their preferred appointment date.  In the South Texas region that includes San Antonio, the statistics were even more impressive: 97 percent of veterans were seen within two weeks, according to annual performance reports.  Can you produce documents that show the original dates of veterans’ requests for appointments for 2012?
6.         According to public records, the director of the Phoenix VA hospital, where news investigations have discovered at least 40 veterans died while waiting for care and languishing on secret lists, received more than $9,000 in bonus pay in 2013.  Can you confirm that any bonuses or pay raises are on hold for senior leaders at VA facilities in San Antonio, Austin, Waco, Harlingen, and all VA facilities where similar allegations have been made?
7.         My staff attended a Quarterly Congressional Staffer and Veterans Service Organization Representative Meeting at the Central Texas Veterans Health Care System (CTVHS) Friday, May 9, 2014.  Sallie Houser-Hanfelder, director of the Central Texas Veterans Health Care System, told meeting attendees that, as part of the face-to-face audits you have ordered, a quality systems manager from CTVHS would be sent to another VA facility to assist with investigations there.  Can you confirm that staff at facilities currently under investigation for allegations of falsified reports will not be assigned to investigate other VA facilities?
8.         A former VA employee at the VA Greater Los Angeles Medical Center told the Daily Caller that employees at the Center destroyed veterans’ medical files in a systematic attempt to eliminate backlogged veteran medical exam requests.  The former employee said, “The waiting list counts against the hospital’s efficiency.  He said the chief of the Center’s Radiology Department initiated an “ongoing discussion in the department” to cancel exam requests and destroy veterans’ medical files so that no record of the exam requests would exist, thus artificially reducing the backlog.  In addition, you have been subpoenaed by the House Veterans Affairs Committee over concerns by Chairman Jeff Miller that evidence in Phoenix may have been destroyed after the Committee issued a document-preservation order on April 9.  A top VA official testified on April 24 that a spreadsheet of patient appointment records, which may have been a "secret list" proving misconduct, was shredded or discarded.  Can you confirm that documents are being preserved at all Texas VA facilities?
I look forward to your prompt and detailed responses to these pressing questions.
Sincerely,
JOHN CORNYN
United States Senator

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• Cornyn Demands Answers From VA Secretary
• VA wait times investigated in Texas

Former doctor at a VA facility in Arizona says the delays caused by scheduling practices used by VA staffers to improve scores may have contributed to the deaths of 40 patients.

 

• NBC News

David Kadlubowski / Corbis a day

Memos Show VA Staffers Have Been 'Gaming System' for Six Years

By Rich Gardella and Talesha Reynolds

Internal memos show the VA has been playing whack a mole for at least six years with employees who use dozens of different scheduling tricks to hide substantial delays in health care for America’s veterans. And whenever the VA tries to stop its staffers from “gaming the system,” the staffers come up with new techniques.

Whistleblowers around the country are now accusing the VA of hiding a backlog in patient care with bookkeeping tricks, and a former doctor at a VA facility in Arizona says the delays may have contributed to the deaths of 40 patients.

 In an April 26, 2010 memo, the VA’s deputy undersecretary for health administrative operations, William Schoenhard said, “It has come to my attention that in order to improve scores on assorted access measures, certain facilities have adopted use of inappropriate scheduling practices sometimes referred to as ‘gaming strategies.’ … This is not patient centered care.”

Schoenhard then listed two dozen different tactics identified in a 2008 study that facilities around the country were using to cut down on the officially recorded time that patients had to wait for care.

The techniques included pretending that appointments cancelled by the clinic were cancelled by the patient, and refusing to schedule appointments for patients when there was no appointment available within 30 days. Patients were told to wait a month and then call back.

Two of the techniques described in the memo closely resemble the methods described by the whistleblowers who have gone public recently with claims that VA facilities have disguised actual patient waiting time.

The 2010 memo discusses how a written appointment log book can be used to avoid entering long wait times into the electronic waiting list system, and forbids the use of any written log. Dr. Samuel Foote, the Arizona whistleblower, now says that as recently as 2013 the Phoenix VA was using paper records with actual patient wait times to avoid entering those wait times into the official electronic system.

The 2010 memo also describes how staffers manipulated the “Desired Date” of a patient’s appointment. The date the patient wants to see a doctor is supposed to be entered as the “Desired Date,” but those dates are often sooner than a doctor is available. Facilities were able to hide the difference between what the patient wanted and what the patient got, according to the memo, by either entering the wrong date, neglecting to enter any date or entering the earliest available date as the patient’s desired date.

The memo reveals that some clerks look inside the electronic scheduling system to see what dates are actually available before filling in the “Desired Date.” “[T]he clerk [finds] the availability of future appointments. Once a date/time is found, the clerk exits the system and then starts over using the identified date/time as the Desired Date.”

The method closely resembles what whistleblower Brian Turner alleges occurred at VA facilities in Austin and San Antonio within the past year and a half. It also mirrors what a coordinator at a facility in Wyoming seems to be advising schedulers to do in an email from June 2013.

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Senate, veterans will hear from Shinseki

Published  8:49 PM CDT May 14, 2014

(CNN) —A mounting crisis of deadly waiting times and allegations of cover-up at VA hospitals face Secretary of Veterans Affairs Eric Shinseki as he speaks to members of the U.S. Senate on Thursday.

With his job on the line and a growing number of critics calling for his resignation, Shinseki will go before the Veterans Affairs' Committee. The retired decorated Army general will be asked to explain just how the VA's wait-list scandal became such a mess.
Shinseki is likely to be grilled about delays at numerous VA hospitals and a long list of serious problems and allegations of falsifying wait times, many of which were exposed and reported by CNN.
For six months, CNN has been reporting on deadly delays in medical appointments suffered by veterans across the country and veterans who died or were seriously injured while waiting for appointments and care.
The most disturbing and striking problems emerged in Arizona last month as inside sources revealed to CNN details of a secret waiting list for veterans at the Phoenix VA. Charges were leveled that at least 40 American veterans died in Phoenix while waiting for care at the VA there, many of whom were placed on the secret list.
After Phoenix, allegations emerge nationwide
But even as the Phoenix VA's problems have riveted the nation's attention, numerous whistle-blowers from other VA hospitals across the country have stepped forward in recent weeks. They described similar delays in care for veterans and also varying schemes by officials at those facilities to hide the delays -- in some cases even falsify records or "cook the books."
The secret waiting list in Phoenix was part of an elaborate scheme designed by Veterans Affairs managers there who were trying to hide that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor, according to a recently retired top VA doctor and several high-level sources who spoke exclusively to CNN.
"The scheme was deliberately put in place to avoid the VA's own internal rules," said Dr. Sam Foote, a 24-year Phoenix VA physician who just retired this year and who appeared in an interview for the first time on CNN last month.
The VA requires its hospitals to provide care to patients in a timely manner, typically within 14 to 30 days.
"They [Phoenix VA officials] developed the secret waiting list," said Foote, a respected physician. He told CNN that the elaborate scheme in Phoenix involved shredding evidence to hide the long list of veterans waiting for appointments and care. Foote and the other sources say officials at the VA instructed their staff to not actually make doctor's appointments for veterans within the computer system.
Instead, Foote says, when a veteran is seeking an appointment, "they enter information into the computer and do a screen capture hard copy printout. They then do not save what was put into the computer so there's no record that you were ever here," he said.
According to Foote and the sources, the information was gathered on the secret electronic list and then the information that would show when veterans first began waiting for an appointment was actually destroyed.
"That hard copy, if you will, that has the patient demographic information is then taken and placed onto a secret electronic waiting list, and then the data that is on that paper is shredded," Foote said.
"So the only record that you have ever been there requesting care was on that secret list," he said. "And they wouldn't take you off that secret list until you had an appointment time that was less than 14 days so it would give the appearance that they were improving greatly the waiting times, when in fact they were not."
From the Phoenix VA officials: Denials of a list
Phoenix VA officials denied any knowledge of a secret list, and said they never ordered any staff to hide waiting times. They acknowledged some veterans may have died waiting for care there, but they said they did not have knowledge about why those veterans may have died.
The number of veterans who died recently waiting for care in Phoenix is at least 40, said Foote and the sources. "That's correct. The number's actually higher. ... I would say that 40, there's more than that that I know of, but 40's probably a good number," said Foote.
Thomas Breen, a Navy veteran, was one of those veterans in Phoenix who died, waiting for care on that secret list, according to Foote and several other inside VA sources who spoke to CNN.
As the veteran urinated blood, Breen's son, Teddy Barnes-Breen, and daughter-in-law, Sally, rushed him to the Phoenix VA Emergency room last fall. But they were told they would have to wait for any primary care appointment for him, despite a note indicating an "urgent" need on his chart from ER doctors.
No one called from the VA with a primary care appointment. Sally says she and her father-in-law called "numerous times" in an effort to try to get an urgent appointment for him. She says the response they got was less than helpful.
"Well, you know, we have other patients that are critical as well," Sally says she was told. "It's a seven-month waiting list. And you're gonna have to have patience."
Sally says she kept calling, day after day, from late September to October. She kept up the calls through November. But then she no longer had reason to call.
Thomas Breen died on November 30. The death certificate shows that he died from stage 4 bladder cancer. Months after the initial visit, Sally says she finally did get a call.
"They called me December 6. He's dead already."
"They did not treat him right," said Teddy.
Sally says the VA official told her, "We finally have that appointment. We have a primary for him.' I said, 'Really, you're a little too late, sweetheart.' "
The director of the Phoenix VA, Sharon Helman, was put on administrative leave by Shinseki two weeks ago, along with two of her top aides. But sources inside the VA in Phoenix tell CNN the wait times and problems are still ongoing there.
As a direct result of allegations by Foote and other insiders in Phoenix, investigators from the VA's Inspector General's Office have gone to Phoenix and have been conducting an investigation there for months.
CNN's ongoing investigation into VA health care
But months before revelations of what happened Phoenix came to light, CNN had reported about other veterans who died or were injured while waiting for care at different VA hospitals.
Last summer, CNN started investigating delays in care and appointment wait times at VA facilities across the country.
Since our first report on delays in care at two VA hospitals in Georgia and South Carolina ran in November of 2013, CNN has continued to uncover delays in care at many facilities across the country. Numerous VA staffers have stepped forward to become whistle-blowers and allege dangerously long wait times for veterans and varying efforts to cover them up by officials at the VA.
"I just try to live every day like it's my last day," said Barry Coates, a 44-year-old Gulf War vet who is one of the veterans who has suffered from a delay in care and who spoke to CNN in January.
Coates was having excruciating pain and rectal bleeding in 2011. For a year, the Army veteran went to several VA clinics and hospitals in South Carolina, trying to get help. But the VA's diagnosis was hemorrhoids, and aside from simple pain medication, he was only told he might need a colonoscopy yet not given any appointment for one.
"The problem was getting worse, and I was having more pain," Coates said, talking about one specific VA doctor who he saw every few months. "She again examined me and gave me some prescriptions for other things as far as pain and stuff like that and I noticed again she made another comment -- 'may need colonoscopy.'
"I told her that something needed to be done," said Coates. "But nothing was ever set up ... a consult was never set up. ... I had already been in pain and suffering from this problem for over six months, and it wasn't getting better," Coates said.

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