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The Denver VA Hospital Debacle

Caring for a vet at the VA Hospital in Portland

Caring for a vet at the VA Hospital in Portland

America engages in constant military activity and pays lip service to the honor and respect owed to the troops on the ground. But actions speak louder than words and, sad to say, once the veterans are back in the USA, the country does a lax job of taking care of them. House the Homeless has been looking at examples of both individual and institutional wrongdoing that end up being detrimental to veterans who are homeless or at risk of becoming homeless.

It isn’t just the government. Other entities have plenty of opportunity for wrongdoing. And it isn’t just homeless vets who get shortchanged. Having a place to live doesn’t guarantee timely attention or good care. The thing is, every adverse event that happens to a vet makes it more likely that she or he will at some point end up on the street. Once there, the climb back to conventional life is so much more difficult.

One of Four Troubled VA Projects

In mid-December, construction of a new Veterans Administration hospital ground to a halt, and a panel of three federal judges ruled that the VA was in breach of contract. The contractor Kiewit-Turner, which had kept working until $100 million of its own money was sunk into the project, was allowed to quit.

Only 62% completed, the new hospital was already over budget by hundreds of millions of dollars. It was supposed to replace the existing Denver VA hospital, in business since 1951 and described in a comment appended to this Wall Street Journal article as a “gilded rat hole.” If it is ever finished, it will serve over 80,000 vets, or nearly 500,000, depending on which news source you look at.

The original contract said Kiewit-Turner would complete 10 hospital buildings, a research and treatment center, a 30-bed rehab center, and three parking garages for $600 million. It required that construction begin even though plans had not been finalized. This backwards approach led the contractor to warn that the whole thing, as conceptualized, would cost over a billion dollars. Apparently the VA told the company to go ahead and keep on building, or else it would be in breach of contract. Reporter Ben Kesling wrote:

VA management problems led James Lynn, a top employee at the VA’s construction manager for the project, to describe it as having “the least effective and most dysfunctional staff on any project that he had ever seen.”

Then in January it was double-whammy time, as a VA whistleblower revealed how the existing Denver VA hospital had lied about its secret waiting lists that kept hundreds of veterans from getting timely care. Senator Jerry Moran of Kansas started a movement to cure the “system that rewards mediocrity and failure” by giving the VA secretary more power to discipline the high-ranking executives responsible for messes.

In 2012, Eric Shinseki had created a Construction Review Council to oversee VA projects and put some accountability in place, but it was too late to help the Denver project. And by the time Sen. Moran got on the case, after the nationwide scandal over waiting times in the VA medical system, Shinseki was no longer Secretary.

A New Start for VA Hospital Projects

Earlier this month, in the wake of hearings held by the House Veterans’ Affairs Committee, more details of the Denver hospital project emerged, like how multi-million dollar machines could not fit into the rooms designed for them, because nobody had taken correct measurements. It was determined that the final cost for the facility will work out to about $9.5 million for each of its 182 beds. Normal is, at most, $2 million per bed.

Meanwhile, the General Accounting Office added the Denver project to a growing list of other VA hospital projects—in Orlando, New Orleans, and Las Vegas—where similar bungling and a total disconnect with reality had run up hundreds of millions of dollars of cost overruns. Representative Mike Coffman of Colorado was quoted as saying:

The VA couldn’t lead starving troops to a chow hall when it comes to managing a construction project. They need to get out of the construction business.

Reporter Emily Wax-Thibodeaux of The Washington Post added:

Internal VA e-mails dating to 2010 show that VA contracting officials were ignored when they warned their supervisors about mounting cost overruns.

They were not only ignored, but fired, like the unfortunate whistleblower Adelino R. Gorospe, Jr., who was let go by Glenn Haggstrom, executive director of the Office of Acquisition, Logistics and Construction. Haggstorm is the same VA bigwig who was awarded more than $50,000 in performance bonuses for unexplained reasons, before retiring in the face of investigation of the Denver project.

As it stands, the Army Corps of Engineers has been given responsibility, and Kiewit-Turner is back on the job, and aside from a paltry emergency $56 million that was allotted, nobody knows where the rest of the funding will come from.

Let the Punishment Fit the Paycheck

Often, the people who cheat veterans work directly for the government, and are even high officials, but the public only learns about a small fraction of what goes on. The workings of the military bureaucracy keep the threat of retribution active. It is possible to make a case against anyone, so almost no one dares to report anybody, because they can be made to appear equally bad, even if they never did anything wrong. The threat hangs over every whistleblower that he or she will be next on the chopping block.

Apparently, there isn’t a lot of oversight, and the old question of “Who watches the watchdogs?” is appropriate. On the rare occasion when someone is caught doing something criminally culpable on the job, it might help if the punishment were proportionate to pay grade. If a top administrator steals, the sentence should be many times longer than it would be for an Army private.

Reactions?

Source: “VA Hospital Project Grinds to a Halt Amid Budget Overruns
WSJ.com, 12/10/14
Source: “Video: Denver VA reverses denials, admits using secret wait lists
Hotair.com, 01/30/15
Source: “VA building projects riddled with mistakes and cost overruns
WashingtonPost.com, 04/13/15
Image by Parker Knight

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Veterans are Being Shortchanged

Fighter JetIn my hometown, we often saw a “character” who, according to local legend, was a World War II veteran with shell shock. He lived in a shack by the railroad tracks and all he did was walk, all over town, all day, every day. Because there was only one of him, he was locally famous. Now, thousands of versions of “Joe Walk” live all over America.

When people are inducted into the military, the contract is supposed to be mutually enforceable. When an enlisted member or an officer violates the agreement, the consequences of military justice can be dire. But who is to stop the other party from breaking the trust? When the U.S. government misbehaves, who can call it to account? Who can make it meet its obligations to homeless veterans, veterans at risk of becoming homeless, and homeless civilians?

VA Administrator Behaving Badly

DeWayne Hamlin was arrested in Florida for sitting in a car drunk in the middle of the night, refusing a breathalyzer, and not having a prescription for his oxycodone. Leaving aside the question of why the police bothered someone who was merely sitting in a car and not, apparently, breaking any law, it happened.

A mug shot is not a good look for the chief administrator of a Veterans Administration hospital, a man who had achieved the highest rank bestowed upon career civil service employees, with a paycheck of nearly $180,000 a year. But we all make mistakes. The worrisome thing is that when the Washington Examiner looked into Hamlin’s attendance records, they discovered that he was in the habit of only showing up for two out of three work days. In a one-year period he was absent 80 days. That is a lot of downtime for someone in charge of the health of a large number of America’s vets. Reporter Luke Rosiak notes:

Veterans Affairs leadership has seldom fired or disciplined its own. Under severe scrutiny recently from Congress and the news media, department leaders occasionally accept retirements by employees… instead of pursuing disciplinary action.

Hamlin is alleged to have done his share to maintain a culture of intimidation and retaliation. When a lower-level employee reported his arrest to VA headquarters, he tried to get the whistleblower fired, and when an investigator didn’t agree, he tried to get the investigator fired. Even before this incident, he had sent around a memo warning everyone who worked for the VA Caribbean Health Care System that any and all complaints must be kept inside the organization, and no outside snitching would be tolerated.

Gambling Away VA Funds

Right around the same time, in Nashville, Birdie Anderson was sentenced to two years in prison for defrauding the Veterans Administration. She had received grants to buy a house for veterans, then a specially fitted van and another house. The first building was actually purchased, but was foreclosed on two years later. The veterans housed there, who according to the contract were to have stayed at least seven years, had to leave after being there less than three years.

The second residence and the van were never purchased, and Anderson is said to have gambled away $364,000 that was supposed to have brought some homeless veterans in off the street. Maranda Faris reported for the Tennessean that the convicted woman is a retired Army Reservist. An even more interesting detail is that she…

…also made false statements that she was a CEO of an organization within the Veterans Administration as well as having spent time in covert operations in Afghanistan during Operation Desert Storm. Anderson never did a tour of duty in Afghanistan, but remained at Fort Bragg, N.C., as a desk clerk during that time.

The VA has all the might and power of the U.S. government at its disposal, but in this case it could have performed due diligence without even going outside the agency. All it had to do was look inside its own database. But the VA failed to determine that this person did not really run an organization within the VA itself. It couldn’t even figure out whether or not a member of the military had ever been in Afghanistan.

Who is in charge of verifying the information on grant proposals? Who blithely hands out taxpayers’ money without doing the most rudimentary background checks on the applicants? Who gave away more than a third of a million dollars to someone who should not have gotten a penny? Who was asleep at the wheel? Who colluded in robbing homeless veterans? Why are they not Ms. Anderson’s cellmates?

Reactions?

Source: “Veterans Affairs hospital chief draws $179k salary despite missing 80 days a year,” WashingtonExaminer.com, 03/30/15
Source: “Woman gets 2 years for misusing $364K for homeless vets,” Tennessean.com, 04/18/14
Image by OccupyDemocrats.com

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Raw Deals for Homeless Vets

A Veteran's SaluteCompared to some other countries, America cares well for its military veterans—which is similar to being the prettiest corpse in the morgue, because any illusion of superiority is only relative. In absolute terms however, vets often find that service in the armed forces is a ticket to oblivion. Some can never get their lives back on track, the suicide rate is alarming, and an astonishing number of veterans also become part of the homeless demographic.

This is not to say that all veterans should be given free everything, forever. But what they are entitled to, they should not be cheated out of. A veteran should be returned to civilian society in a condition as close as possible to the state of well-being and functionality that he or she enjoyed before signing up. David Finkel wrote for The New Yorker:

If the studies prove correct, the wars in Iraq and Afghanistan have created roughly five hundred thousand mentally wounded American veterans.

Two causative factors are blamed: Post Traumatic Stress Disorder, which is said to affect between 20 and 30 percent of returning vets; and Traumatic Brain Injury. Dr. Mark Gordon believes that it’s all of a piece, and all traceable to TBI. Small, unrecognized, repeated concussions disrupt the body’s production of hormones, and the results are “depression, anxiety, nightmares, memory problems, personality changes, [and] suicidal thoughts.” For these patients, it very much looks like interventional endocrinology should be the VA’s main focus, rather than narcotics, anti-depressants, anti-psychotics, and other drugs of that kind.

It seems like pharmaceutical corporations, not veterans, are the main beneficiaries of VA policy. The trend is even more pronounced among active duty personnel, who appear to be insanely over-prescribed. For the New York Times, Richard A. Friedman wrote:

The number of prescriptions written for potentially habit-forming anti-anxiety medications—like Valium and Klonopin—rose 713 percent between 2005 and 2011. The use of sedating anticonvulsants—Topamax, Neurontin and Lyrica—increased 996 percent during this period.

There is an analogy, perhaps, between the military’s use of psychoactive drugs and the practice of pumping athletes full of steroids so they can continue to compete despite physical pain; athletes—and also soldiers—whose performance is chemically enhanced in this way may, however, unwittingly sustain more serious injuries as a result.

The last few words of that sentence are a big part of the problem. A soldier needs to be alert, not sedated. A soldier is in an environment where anxiety is entirely appropriate, and medicating it away can create a dangerous degree of relaxation that leads to more and worse injuries.

Mental illness is often tied to homelessness, and we know by now that the number of homeless vets is staggering:

Although flawless counts are impossible to come by… the U.S. Department of Housing and Urban Development (HUD) estimates that 49,933 veterans are homeless on any given night… About 1.4 million other veterans, meanwhile, are considered at risk of homelessness due to poverty, lack of support networks, and dismal living conditions in overcrowded or substandard housing.

For some reason the best numbers on incarcerated veterans are about ten years old, and even then, about 140,000 veterans were in state and federal prisons. Here is an interesting piece of information:

Combat service was not related to prevalence of recent mental health problems. Just over half of both combat and non-combat veterans reported any history of mental health problems.

There seems to be a revolving door between the military, the prison system, and homelessness. Kids who grow up homeless are attracted to the military life because it provides a living wage, structure, and a place to belong. For a long time, it was traditional for judges to give youthful offenders the choice between jail and enlistment. Some discharged veterans do crime because their brains are too messed up to have good judgment, or because poverty seems to offer no other alternative. Homeless vets wind up in jail. Vets who get out of jail wind up on the streets. Here are more details:

Veterans between the ages of 18 and 30 are twice as likely as adults in the general population to be homeless, and the risk of homelessness increases significantly among young veterans who are poor.

About 53% of individual homeless veterans have disabilities, compared with 41% of homeless non-veteran individuals.

Homeless veterans tend to experience homelessness longer than their non-veteran peers: Veterans spend an average of nearly six years homeless, compared to four years reported among non-veterans.

The average wait to get a disability claim processed is now eight months. Payments range from $127/month for a 10% disability to $2,769 for a full disability.

All these factors contribute to paint a very unflattering picture of the human misery behind America’s military might. Vets have the right to expect the help they need, and we can do better.


Source: “The Return,” NewYorker.com, 09/09/13
Source: “Wars on Drugs,” NYTimes.com, 04/06/13
Source: “Background and Statistics,” NCHY.org
Source: “Veteran Homelessness Facts,” Greendoors.org
Image by The U.S. Army

 

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Some Housing Solutions

shutteredAmerica is full of empty houses, a circumstance that House the Homeless
has been exploring to figure out why people can’t live in them. A Cleveland, Ohio, man took that question from theory to reality when he began to practice urban homesteading six years ago. Mr. Hayes is, by all reports, a model neighbor who maintains the small abandoned house in which he lives as well as possible, considering that he is not allowed either water or power.

He gets around these strictures by paying a neighbor to use some electricity via an extension cord, and collects rainwater to filter for drinking and to fill the toilet tank. A disability check covers his modest living expenses and those of his two dogs. The building’s owner is not even a real person, but a corporate entity of whom reporter Mark Naymik says:

The company, whose leaders are nearly impossible to track down, owes tens of thousands in back taxes and penalties on its properties. The company owes $27,000 alone on the house Mr. Hayes is living in.

But Mr. Hayes pays property taxes, and keeps the place neat, and helps an elderly neighbor. He asked a city council member:

Would you, please, introduce an amendment to the ordinance so that qualified people may put to good use properties that are verifiably abandoned?

Why is there not such a law in every city across the country? Curious journalist Matt Lemas took the question a step farther and explored the notion of letting people live in the 77,000 empty buildings owned by the U.S. Government. In contrast to Mr. Hayes’s minimalist dwelling, many of these places even have electrical service. That’s right—regulations keep the power on to satisfy “safety requirements” for the structures, while actual humans live unsafely outside in the dark and cold. In fact, the upkeep for empty government-owned buildings costs taxpayers $1.7 billion per year.

The Philadelphia Stabilization Program

House the Homeless is not Richard R. Troxell’s first project. He has been involved in many other programs and initiatives to improve the lives of people experiencing homelessness. In the 1980s he lived in a Philadelphia neighborhood where a 55-block area held 110 abandoned houses, the overwhelming majority of which were built from stone or brick.

The first step of his group’s master plan was to prevent further deterioration by securing doors and windows with plywood to keep the weather out. They negotiated a deal with the union to have the roofs repaired, and put sturdy Lexan in the windows. Crews gutted the interiors, businesses donated paint, and kids recruited from the anti-graffiti program painted the exterior trim. The result would be a sturdy structure with the soft parts stripped down and prepped. Richard recalls:

A local bank agreed to offer a mortgage with rehab and wrap-around loans so the buyers could purchase the shells and have money to rehabilitate them.

His group kept the lawns mowed and transformed vacant lots into community gardens. They opened talks with city authorities and HUD, looking for support from the Community Development Block Grant program so potential homeowners with the fixer-upper mindset could afford mortgages and rehabilitation loans.

Progress was moving along nicely when the drug epidemic hit. The Philadelphia neighborhood, like many others all across the country, became a war zone, and the group realized that it had to move quickly to stabilize the neighborhood as it was rapidly being turned into fortified crack houses. Charged with the impossible responsibility to fully, completely, and permanently pacify the neighborhood, the rehabilitation group found that financial government support was about to be pulled. A further response by the fast-thinking neighbors enabled them to go forward with their stabilization plan.

Absent the crack epidemic, the basic plan was solid. At the time, the United Nations was researching best practices as part of the International Year of Shelter for the Homeless. Richard was urged to submit the plan, under the name of “Permanent Housing of Homeless People in Philadelphia,” and received special recognition for it.

The whole story is in his book, Looking Up at the Bottom Line, along with many other fascinating and instructive episodes.

Source: “Homeless man pays property taxes after moving into abandoned Cleveland home to fulfill homesteading dream,” Cleveland.com, 02/20/14
Source: “Could We House the Homeless in America’s 77000 Empty Government Buildings?,” RYOT.org, 2014
Image by w.marsh