Does VA realignment plan demonstrate improvement?

Sgt Spencer Sikder - Tell the whole story, not part of it. I work in VISN 21, we cover all the Pacific Islands (HA, Guam, American Samoa, Manila) Northern California (Palo Alto, Fresno, San Francisco, Sacramento), and The Greater Reno Area. That is one of the largest areas, if not the largest area, we cover a few time zones. Think we need staff for that? Now take the VISN 19, UT, 1/3 of NV, most of CO, and part of NE, most of WY, a smidge of ND, and most of MT. Now what do you think the patient load is the same? Not likely Northern California has over 9 million people living in the area. I dare say the collective population of VISN 19 is not equal to that. So would it be safe to assume that VISN 21 might need a bigger staff, and VISN 19 might not need as much? Compare the apples to the apples and the oranges to the oranges.

As for the office digs, I can't say what they do in North Carolina, do they own the building, lease it, is it GSA? When they tried to get office space was this what was available for what they had? This is part of an operating budget, and if you think you are going to higher people to work in dump and retain them, you are disillusioned. Many of the people who work in those offices that you think are over paid or luxury digs, stop and think for one moment if that were a private medical facility, and what would that staff be getting paid, what would their bonuses be? I dare say many a VA director could leave public service chump money to go get a healthy six or seven figure salary at corporate American Health. Think that Specialist comes to work for the VA for the great salary they are getting?

You pay them dirt, give them dirt, you the patient will most likely be treated like dirt. Think about that for a moment, you want to be treated with respect, so do they.

CW3 Kevin Storm - Do you remember when VA operated under Regions and the facility's reported to them? How were the Regions operated then? As for your assertion that I indicated "over paid," I did not. What I did indicate that for some they live the life of Reily. For example, VISN 8 has offices on VA Bay Pines grounds. However, VISN 6 has theirs in a luxurious office bldg. Where is the cost coming from for VISN 6, from our healthcare. Interesting that you believe "many a VA director could leave public service chump money to go get a healthy six or seven figure salary at corporate American Health", however they choose not to. If I follow your response it appears because we offer them luxurious offices. I also see you injected bonuses, however, I said nothing about bonuses. However since you broach the subject let me give you my opinion on bonuses and the scandal that has arisen through the media. I disagree with the notion that "all" employees are hateful ingrates. I know hundreds with whom I worked with at 5 different VA facilities and interacted with many more at other facilities throughout the system. Them along with my staff worked long hard uncompensated hours for years and for what? The pittance of what they called a bonus that leadership extended to subordinate staff was embarrassing and insulting. However, it's this leadership that restricted funding for staffing and bonuses and what, I'm supposed to be enamored? Why is the funding restricted, because we have such high overhead that we didn't have when we were Regions. Are you familiar with the Nimmo effect? This happens more than you can imagine. In my 32 years, I have seen it time and time again. But, what the heck, $5,000 here, $10,000 there is pittance when we think some medical centers have budgets of over $100 million. However, this same $5,000 or $10,000 could be used to diagnose a black spot that was on a veteran's chest x-ray. How about spending some of that money to abate the Legionella that Pittsburgh has had trouble for a good 25 years that I am aware. You also don't know that when I attended a national conference as the Acting Associate Medical Center Director (at a mainland facility) at a prestigious university on federal electronic opportunities, I spoke about the electronic interface between Tripler Army Hospital and the VA on the opposite side of the building. An interface worthy of praise, especially at a time when DOD and VA corporate couldn't come to an agreement on seamless transition when it came to medical records. Before you judge my opinions, please read them carefully. You should find many where I defend the "hands on" staff at VA. Unlike many other leaders, I learned many years ago as a young Marine, that my success is a direct result of my Marines efforts. I never forgot that lesson.

Sgt Spencer Sikder - Sgt Skider, that was long before my time, so no I don't remember. Hateful ingrates? I don't know where you get that from. But if you are going to talk about expenses please get that right, the VA budget is separated between many different aspects, to simply say luxurious buildings, does not tell the whole story. If the VISN leader went out and selected it, yes you have a valid point. But your story doesn't tell that story, In fact that is not normally the case is it? When does a VISN leader get to go pick a building? A bid gets submitted and approved correct? Is this building perhaps a federal building? Is the federal building getting a special rate making it more advantageous to lease that option.

CW3 Kevin Storm - Actually in leasing and when it's over 10,000sf, VA requests GSA to obtain the space. However, VA defines the geographical limitations for where the space can be located. And in a market place where there is very few options, it's not surprising to get into the only luxurious office building in the area. Interestingly VISN 4, VISN 7 and VISN 8 to name a few are located on facility grounds within their network, so why isn't it more wide spread? Nimmo was an administrator that spent an exorbitant amount on his office furnishings. After this, any expenditures in excess of $5,000 for Director's suites required VACO approval. But like everything today, no one follows those rules because under the NPR, remember that one, some rules just didn't migrate to new policies. And yes, you are right, VA budget elements are separated as prescribed by the Appropriations Act. However, since Congress allocates the monies, they could allocate the more necessary for veterans care if the cost of operations, property maintenance, leases, etc. didn't cost so much. Just look at the three attempts to get an inventory system in place, well over $400,000,000.00. Ya think we could have cared for some of these veterans? Back to my assertion leadership needs an overhaul. There are a couple hundred thousand VA employees trying to do the right thing, but their hands are tied for lack of space, resources and staffing.