Los Angeles, California
March 27, 2013
(Today's date)
September 9, 2013
(Original date)
*(Denotes change made or additional information added to original blog)
**UPDATE (Denotes NEW information added after publishing the original blog)
Last week a federal judge, S. James Otero, USDC, Los Angeles, ruled that the West L.A. campus of the Department of Veteran Affairs abused its discretion in leasing land for "purposes 'totally divorced from the provision of healthcare'", L.A. Times, "Federal judge rules VA misused its sprawling West L.A. campus", August 29, 2013. Apparently, the West L.A. V.A.(Veteran Administration) had leased out property to various private organizations or individuals for the purpose of garnering revenue for the West L.A. site; and purportedly, the revenue obtained was for "veteran healthcare services". Id. However, even if that was the case, and the money would have to be traced to confirm this, the ACLU argued that there are presently homeless veterans with healthcare needs, e.g., post tramatic stress disorder (PTSD) and brain injuries, who are not being properly served (if they are being served at all), and the property or land being leased could be used to "house and help homeless veterans too disabled to seek outpatient services". Id.
While the ACLU places the priority of leasing the land for profit in terms of "putting the needs of private school students and college students over our veterans" (referring to a private K to 12 school that utilizes part of the West L.A. campus "as an athletic complex" and UCLA students who have used "the VA property in Jackie Robinson Stadium for nearly 50 years", Id.), I prefer to characterize the action as putting profits over our veterans (since there are various types of entities and/or individuals utilizing the leases, e.g., "Sodexho Marriot Laundry Services, which cleaned hotel linens on the property, and Twentieth Century Fox Television, which used its parcel to store sets", Id.; and the ultimate purpose of the leases is profit to the V.A.). That is, profits obtained to help or further help veterans is fine, but, general profits should never be given priority over the direct needs of veterans or the service, care, and concern for the welfare of veterans.
In the present case, the ACLU should not have been required to bring a lawsuit, on behalf of homeless veterans, in order for the VA to recognize that the needs of homeless veterans required it to utilize the properties first to provide homes and other services for homeless veterans. The VA's care and concern for its veterans should have lead it to that conclusion (the plight of homeless veterans on skid row has been well-publicized for years, and the VA must have known of those circumstances when it decided to leased properties on VA land to non-veterans rather than provide housing for veterans--especially in view of the fact that VA land is specifically assigned for use for veterans, and more specifically, for homeless veterans). And, because the VA didn't arrive at that conclusion, the VA placed "general" profit over the welfare of its veterans. I emphasize "general" profits because if the profits were specific, such as to provide homes to the homeless because there were no other available property or resources to provide homes and other sources, the profits might be sustainable. But, here, the profits are simply general profits, to be used for various purposes (only one of which might be healthcare services, and apparently, none of which is to provide housing and associated services for those suffering special physical ailments--otherwise, the VA would have provided these services without a lawsuit). Therefore, the West L.A. VA placed profits over the specific needs of some of its veterans, i.e., the homeless, and over the service, care, and concern of its veterans in general.
I am a veteran of the Vietnam Era war, and I utilize the healthcare services of the West L.A. VA (hereinafter "VA"). And, before I proceed any further, I want it to be clear that my comments henceforth are directed to the administrative aspect of the VA, not the healthcare aspect. For I have generally received good healthcare services from the VA, and my eye care services have been excellent, especially in the area of care and concern.
Moving on, I am also a poor (or indigent) veteran (how I became poor or indigent, since 2003, is a subject for another discussion, made elsewhere--but, for the present discussion, it is neither at issue nor relevant). Consequently, since at least about 2003, in utilizing *non-career out-patient veteran services, I have proceeded as an indigent veteran, which has required that co-payments which would ordinarily be made, be waived, upon satisfaction of a "means test" (that is, a demonstration that the veteran do not have the "means" to make the payment--and although I have never been informed of the definitive level of means, it is likely based on or around the federal poverty level). The actual "means test" itself is nothing more than a condensed income tax form, whereby a veteran must indicate his income level for the prior 12 months to show that he did not earn income in excess of the amount allowed to obtain a waiver. The basic difference between the "means test" form and the income tax form is that the income tax form ask for more information, and more personal information. But, the bottomline is the same for both: how much money did you earn the previous year. And, if one's income did not go beyond the treshhold amount allowed, you pass the means test, and your co-payments are waived (or you are not required to make them).
One final thing, the means test form offers the veteran the options of either paying the co-payments outright(because he believes that he can afford to and because he does not wish to divulge his personal income information) or providing the required personal information regarding his income to secure a waiver of payment. I provide the required information. The VA sends out means tests forms annually (with a self-addressed envelope enclosed for the form to be returned by mail). But, for the last few years (which includes this year), I've walked my test into the office because I continued to receive test forms after I mailed it in.
I will now provide a second example of how the administrative arm of the West L.A. VA places profits over service, care, and concern for its veterans, and specifically over service, care, and concern for me as a veteran, and how it might be doing so with other similarly-situated veterans, even if not in the exact same way. Although it may be on a smaller scale in terms of the income the VA obtained for the various leases of property discussed above, it is on the same scale in terms of the effect of the VA's lack of service, care, and concern for a veteran (in relation to making a profit), and, specifically, in regard to this veteran.
About a month and a half ago, I received a bill from the VA in the amount of $1182.23, purportedly for medical services and/or co-payments for prescriptions for the years 2005 and 2007. I had never received a bill during the actual years of 2005 and 2007, only this year (2013). Further, there was no proof attached to the bill that confirmed that I had actually incurred the services or prescriptions identified in the bill. For example, from the bill (in part):
05/02/2005 OUTPATI $144.25
05/04/2005 RX CO-P 22.00
01/08/2007 OUTPATI 52.00
01/08/2007 RX CO-P 56.00
And, it has never been proven thusfar that I am the one who incurred the services and charges in the bill. *Again, I never received a bill during the years 2005 and 2007.
Anyway, before I received the bill, I had received another means test form from the VA after I had already mailed one in. So, I decided to take both forms to the VA at the same time (to cut down on trips to the VA, it is quite a ways from where I live), to re-submit the means test form and to get an explanation about the medical bill.
After traveling to the VA office with both forms, I was advised that a separate office was handling means test forms, so I spent the remaining time in the initial office, i.e., CPAC (Consolidated Patient Account Centers).
Initially, in discussing the bill with the first primary worker, and later with a supervisor that was brought in, we never reached the issue of whether the bill was actually for me or for services that I incurred, because I stated that even if the bill was truly for services that I had obtained, the billing would be a mistake because I was indigent during those periods of time (and I continue to be indigent now), and I would not have been required to pay for the services (which is probably why I hadn't received a bill in 2005 and 2007).
The supervisor, during the course of the discussion, stated that she could eliminate or get rid of the bill, but she stated that the only way that she would do it was by me providing her proof that a means test had been filed during the years 2005 and 2007. She said that she could eliminate the bill without the means test but that "someone" might question it. Then, the primary worker checked some record and stated that the VA's system showed no record of a means test for me between the years 2002 to 2008. And, she stated that I was the only veteran with that indication. It should be noted that this set of CPAC workers were new (having relaced a crew about a year ago). I then stated that the VA must have maintained records as to whether I had submitted a means test or not, because all non-career veterans must submit a means form, even if a veteran can or choose to pay for services. Further, I did not maintain copies of any means test forms submitted during 2005 and 2007. How many veterans do?
So, the supervisor left me with the decision that she would only remove the bill if she received proof of a means test submitted for the years 2005 and 2007. Further, since I suggested that the VA should have records of the tests as well as other matters during that time period, she referred me to a one Earleen Young in the Patient Fund Section of the VA. The eventful matters demonstrating that the Administration places profits over the service, care, and concern of veterans, and demonstrating the 2nd example of such by the West L.A. V.A. now began to evolve.
Before going to see Ms. Young, I decided that I would try and search for prior income tax forms that covered the years 2005 and 2007. So, I went home to return another day.
Before proceeding further, these are the "strange or peculiar things" that had occurred already concerning this matter: (1) I had received a medical bill in 2013 for medical bills that purportedly accrued in 2005 and 2007--and I didn't receive a bill in 2005 and 2007--why was I just now receiving this bill? No one could provide me with an answer; (2) the medical bill provided no proof that the bill was truly services or prescriptions that I had received or incurred; and (3) the VA staff indicated that I was the only veteran (of probably all non-career vetrans) who did not have a means form for the years 2002 to 2008 on file.
After going home and conducting a search, I was able to find an income tax form and other proof that covered the years 2004 through 2006, demonstrating that I earned little or no income for those years. So, I returned with the documents another day to the CPAC office (around the last of July or first of August, 2013). The events demonstrating that the Administration placed profits over the service, care, and concern of me as a veteran now began to emerge.
EVENT #1
After I returned to the VA and the CPAC office and presented the documents(an income tax form filed for 2004 showing an adjusted gross income of $403.00) and/or proof (I didn't file income tax in 2005 and 2006 because I earned so little income) to the supervisor, Blance B., after having told her that I've been indigent since about 2003, she still refused to extract the bill. She said that she needed to see means test forms. This was the first event where it was clear that the Administration was placing profits (the health care bill) over its service, care, and concern for me as a veteran. There was no justifiable reason that Blance should not have accepted the income tax information in lieu of a means test form to eliminate the bill. It simply was more important to the Administration to collect the medical bill fee from an indigent veteran than it was to recognize, understand, and empathize with the plight of that veteran. It was the Administration's policy of putting profits over the welfare of veterans that caused Blance to be worried about "someone" (top level supervisors) questioning her wiping away the bill (even if she herself wanted to do so). So, I set out to visit Earleen Young regarding means test records (I tried to avoid this by submitting the income tax forms).
EVENT #2
When I met with Young and inquired about the means test records for the years 2005 and 2007, I stated that I had been told that there was no record of me filing a means test in 2005 and 2007, and that I wanted the records for those years, because I believe that I either filed one or one was not required. She stated that there were no means test records for that time. I told her that for several years there was no means test form submitted by veterans, and that the VA simply interviewed veterans and made a decision regarding ability to pay based on that interview, and therefore, the VA was solely responsible for those records. She maintained that there weren't any means test records or records of any other means test infomation. Further, she stated that she wasn't even at the VA during that time, so she didn't know anything about what went on then. And, she added, all of the people who handled means test records at that time are probably dead. I told her that I believe the VA had a duty to maintain those records. There was no response.
I told her that the need for the records was because of a dispute over the bill, which I showed her. She said that CPAC was responsible for the bill, and there was nothing that she could do. So, she referred me back to CPAC (who had referred me to her). I believe the VA was negligent in either losing or destroying the means test records, or there is a commission of fraud if the records are there. Either way, when Young determined that there were no records of a means test or no means test, I believe she had a duty to recommend to Blance to extract the bill based on the lack of records, and based on service to and care and concern for an indigent veteran. But, she didn't do it. This was the second event where the VA continued to place profits over the service, care, and concern of a veteran.
EVENT #3
After leaving Young, I returned to the CPAC office to speak with Blanche. After explaining to Blanche what had happened with Young, Blanche continued to maintain her earlier position that she would have to have means test records for 2005 and 2007 in order to extract the bill. This was the third event. Even without Young making a recommendation to extract the bill, Blanche should have extracted the bill based on the fact that there was a determination that there were no means test records for the applicable years (even if she had to contact Young and confirm it). That should have been enough for Blanche to extract the bill if she was giving priority to service, care, and concern for a veteran rather than to profits. But, again, she wasn't.
Subsequently, another woman in the CPAC office was called into the discussion. This lady then said that CPAC could eliminate the bill but that a supervisory authority would have to o.k. it. So she identified such an authority and wrote down the name, Shirin Mathai, Assistant Chief of HAS?. So, I asked if I could speak with him at that time. The new lady said that it would be better to call and make an appointment with him (and she gave me his number).
EVENT #4
I called Mathai at his office. He was not in, so I was connected to a voice mail. I left a message explaining the circumstances of the bill and also mentioned the names of Blanche and the other woman (I won't provide the other woman's name because, even though I know it, I believe she proceeded entirely in good faith, and there's no need to mention her name at this time). Mathai never returned my call. This was the fourth profit over veteran event. I believe Mathai, particularly under the circumstances (I explained in the voice mail that the two supervisors said that he could approve an extraction of the bill), had a duty to return the call promptly. Instead, he was discourteous and, again, placed profit over a veteran (knowing that without his input, I would continue to be responsible for the medical bill). And this was a higher level supervisor with authority to squash the bill.
EVENT #5
After Mathai did not return my call, I decided to return to the VA to try and see Mathai in person or make an appointment with him. I had an upcoming appointment at the VA so I decided that I would go to Mathai's office on the same day. When I arrived on the day of the appointment, I first went to the CPAC office and contacted Blanche. I told her that Mathai did not return my call, so I wanted to go to his office and speak with him. Blanche was initially reluctant to show me to his office (I believe because of his high level position), but after she spoke with someone else, she showed me to his office area and to a secretary in the area. I explained the circumstances to the secretary and asked to speak with Mathai or set up an appointment to speak with him. She then said that he wasn't in the office, but that she could contact him by e-mail. She showed me the e-mail that she was sending to him. I told her that I would go to my appointment and return later for a response to her e-mail. However, during my appointment, I received a call on my cellphone. It was Earleen (I didn't take the call, rather I checked the voicemail later). And she left a message to contact her before she would be leaving with a carpool. This was the fifth profit over veteran event. Mathai, rather than meeting with me himself or setting up an appointment to meet with him, *referred the matter back to Earleen, knowing that he was the one who could authorize the extraction of the bill, and learning after speaking with her, that I had already spoke with *her (and exhausted any remedy with her). This clearly was not only disrespectful to me as a person and a veteran (in not responding himself or personally), but it also continued to place profit over a veteran, and clearly displayed a lack of service to and care and concern for a veteran. He had no idea of what I would be discussing with him or what I would be presenting to him.
EVENT #6
After my appointment was complete and after Earleen called and left the message to call her, I went over to her office area to speak with her, rather than calling back. We did ultimately speak, and, as expected, nothing was accomplished. However, when we were speaking, she sat at a computer, going over my case, and she mentioned something about "admissions", i.e., admitted for treatment. This is speculation, but I believe she detected some defects in my record that would support me or my position. So, she said that she had to leave to travel with a carpool. But, twice she said that she would call me the next day (after I asked for confirmation). Finally, as she was leaving, she said that my means test for this year does not qualify me for a waiver, that is, the amount of money I made over 12 months (which is still near the federal poverty level--and its the most I've made over a 12 month period since about 2003). Earleen never called me the next day, August 23, 2013. And, Mathai never called either. This represents the sixth event of placing profit over a veteran. Mathai knew that my effort to contact him was for the purpose of approving the extraction of my medical bill. Yet, with discourtesy and disrespect, he refused to meet with me and discuss the matter. And, because payment of the medical bill would place a strain on my already indigent state, it displays a total lack of care and concern for me and my welfare as a veteran. It also vividly reveals the Administration's priority of profit over the welfare of a veteran.
EVENT #7
As I stated above, Earleen Young never called me back as she said she would. Therefore, this affected two things: one, we never resolved the issue of the questionable medical bill and two, Young, after indicating that I didn't qualify for a waiver this year, did not explain to me why I didn't qualify, or *what the threshhold level of income to qualify is, or whether the decision regarding qualification could be contested. In other words, after she blurted out that I didn't qualify, she never contacted me to set up an interview to explain the consequences. As a consequence, in the interim, I had received a bill that purportedly was produced after submission of my latest means test (which made up the $1182 total). The failure to contact me after the 8/22/13 meeting presents the seventh event that displayed the administration giving priority to profits from a medical bill payment over the service, care, and concern of a veteran. Even though the issue of the original bill had not been resolved at our last meeting, which allowed the bill to still be outstanding, and even though there had been no explanation or interview regarding the disqualification of a waiver, the administration did not contact me and act to resolve either matter, showing a desire to collect the bill notwithstanding the fact that the aforementioned issues regarding payment of the bill or any future bill had not been satisfied. Service to a veteran required the scheduling of an interview to explain the consequences of "not passing the means test", what the threshhold level of income is, and what are the available options of contesting a questionable determination of means test qualification. Care and concern for a veteran, especially an indigent one, required resolving the medical bill issues and the waiver qualification issues before continuing any future billing to avoid an unwarranted hardship on a veteran, and on this veteran.
EVENT #8
While awaiting a response from the VA, I have now received a bill for a payment of interest on the current, and disputed, bill. This represents the eighth event showing the Adminstration's priority of profits over service, care, and concern for a veteran. At minimmum, out of care and concern for the welfare of a veteran, and more specifically, this veteran, the VA should discontinue any future billing until the status of the current bill is properly resolved. Because this is not happening, the VA is not only treating this matter as an ordinary billing matter, without regard to my status as a veteran, but, it is also placing the profits of that billing over my circumstance as an indigent veteran.
So, while Judge Otero awaits a decision by the government as to whether it will appeal or not, he should consider the above information regarding the VA administration's true concern for its veterans in securing profits from the leased properties. It is likely that some of the profits from the leased land are going to healthcare of the veterans, but it is just as likely that some of the profits are going to other non-veteran related matters, based in part on the VA placing general profits before its care and concern for its veterans.
My next move, before considering other action, will be to speak with the Director of the VA.
UPDATE--September 21, 2013
On Wednesday, I visited the VA to try and set up an appointment to speak with the Director. However, I was informed by an officer in the new Veteran's Experience Office (formerly the Patient Advocacy Office) that I couldn't arrange an appointment with the Director, rather, I had to write a letter to the Director explaining why I wanted to meet with her or the reasons for the meeting. I was provided an address with a "code". But, why do I have to write a letter and provide an explanation in order to speak with the Director? And, if my reasons for wanting to meet with her are not satisfactory to her, does that mean that I will not be able to speak with her? Or, perhaps the reasons are prioritized to determine who will get to speak with her and who will not, depending on the reason?
Yet, a more fundamental problem with the letter-writing requirement is: what if a veteran can't write? Even if a veteran is not totally illiterate, he may be partially illiterate, in that he may not have sufficient or adequate writing skills. And, this is a very real possibility with older veterans who have lost their writing skills simply because of age. Are these unable-to-write veterans then precluded from meeting with the Director simply because they can't write a letter? If so, it would be an unjustifiable denial of access to the Director. And, if a veteran is unable to write a letter to the Director, the Director will never know that the veteran wanted to speak with her in the first place. So, any number of veterans will likely want to speak with the Director (and not get to speak with her), without the Director even knowing it. And, an equal problem would apply to the use of typewriters or computers, especially for older or senior veterans. All seniors may not have access to a typewriter or computer. If this is the case, they would not be able to type a letter for submission to the Director.
Moreover, having someone else write a letter for a veteran would probably be unacceptable for most veterans because the vast majority would likely consider the matter that they want to discuss with the Director private or confidential, even as to relatives or friends. And, even if a veteran himself or herself would not consider the matter to be private or confidential, the Director should consider all meetings with veterans private or confidential, unless subsequently waived by a veteran during or after the meeting.
The bottomline is: the letter-writing requirement for veterans in order for veterans to get access to speak with the Director should be abolished and/or withdrawn. Veterans should be able to simply make an appointment to speak with the Director. If the Director become overburdened with requests, she will have to work out a solution to the problem. But, if a Director becomes overburdened with requests, it will be some evidence that her subordinates are not performing their jobs satisfactorily, otherwise, a veteran would not need to speak with the Director. And, I believe that most veterans would not request to speak with a Director until they have exhausted their remedies with subordinates to the Director. As it stands, the letter-writing requirement is nothing more than an unnecessary obstacle to veterans having access to the Director, which should be an unburdened right of all veterans.
Nevertheless, I can write. So, I will comply with the directive and write the Director a short letter explaining why I want to meet with her.
I'll let you know the outcome.
*(Material deleted.)
Until next time, I'm out.
UPDATE--October 1, 2013
I have now sent out the letter. I await a response.
UPDATE--October 16, 2013
I still haven't received a response to my letter or an appointment.
UPDATE--November 4, 2013
I have now received another bill from the VA adding on more charges. Yet, I still have not received a response from the Director regarding an appointment to discuss whether or not I am responsible for the bill.
Consequently, at this point, I am convinced and I charge that this conduct on the part of the Administration is intentional and invidious. Further, I conclude that all of the conduct by all of the personnel prior to this latest bill I have received has been intentional and invidious. I no longer believe that it could be an interpretation of the facts or the documents that is supporting their conduct. Those actors include Blanche Burton, Earleen Young, Sharin Mathai, and the Director, Donna M. Beiter.
Finally, I have not mentioned this fact before because I was trying to get a resolution of this matter without raising the issue of race, but I am African American or Black. And, because I now conclude that the Administration's actions are intentional and invidious, I believe my race or color is a factor in the handling of this matter. Therefore, whatever actions that I may decide to take in the future, they will be on the basis of intentional and invidious conduct on the part of federal employees.
UPDATE--November 9, 2013
Two days ago, I dropped off a copy of the original letter I wrote to Director Donna M. Beiter to Beiter's office at the VA. Along the way, I was discouraged from going directly to her office (some VA official suggesting that I go through the Veteran Experience office), but I went anyway, to assure that the letter reached the Director, since I haven't heard from her since I originally sent the letter, September, 2013. I was able to leave the letter at her office. So, now I will await a response.
Also, yesterday, I received a letter from the VA's CPAC office in Las Vegas, Nevada. That letter only reduced to writing what the VA Administration has said all along, but providing no new information or proof of my liability for the bill. So, essentially, that letter adds nothing to the controversy, and I still need to speak to the Director.
UPDATE--December 4, 2013
I have now received another bill (charging interest on the disputed bill) from the VA's CPAC, yet, I still haven't been contacted by the Director, Donna M. Beiter, regarding an appointment to speak with her about the bill. It is clear that the matter must be resolved by the VA through proof of my incurring charges. Thusfar, the VA has offered no proof of my having received the services that they are charging me with, and the Director refuses to meet with me to discuss the matter.
Furthermore, even though CPAC's letter indicates that I am in co-payment status now, there has been no counsultation or discussion with me regarding how I arrived at or in that status or the criteria or standard which caused me to enter the status, or whether the standard can be challenged. I should have been summoned (figuratively)in for a status discussion to acknowledge my change of status, an explanation of why the status changed, and the ramifications of the change. The failure to do so amounts to poor management and a lack of concern for the rights and welfare of veterans.
**UPDATE--March 27, 2014
The VA continues to send me bills, but it still has not granted me an opportunity to speak with the Director to determine whether or not I actually owe the bill. So, now, every time I receive a bill without having had an opportunity to speak with the Director to assure that I owe the bill, I treat the bill as an act of harassment by the VA.
Moreover, the VA and Donna Beiter has apparently appealed the decision of Central District judge Otero finding that the VA and Beiter abused its discretion in leasing out the land for non-VA purposes. The problem is Beiter and the VA do not go to the 9th Cir. with "clean hands", and it should be denied relief on that basis alone. Beiter's treatment of my case alone causes her to go the Ninth Circuit Court with unclean hands. It is a basic principle of law that one seeking equity from a court of equity must go to court with "clean hands". Beiter's hands are dirty. And the dirt is her refusal to grant me a meeting to discuss the issue of whether I owe a bill and to discuss whether or not my income took me over the threshold of waiver, where the threshold was never discussed with me. The way things are going now, I will likely have to file a discrimination lawsuit just to obtain a hearing on my position that I do not owe a bill, at least none of the charges prior my latest or last classification. And, that discrimination lawsuit will be valid.
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