Governors Just Saying NO to WH and Refugees

Growing Number Of States Say They Will Not Accept Syrian Refugees

Governors in 13 states have all said they will stop or otherwise oppose accepting additional Syrian refugees in their states.

At a glance: Governors in more than a dozen states have spoken out against the Obama administration allowing additional Syrian refugees to be resettled in their states at this time. They are:

  1. Alabama
  2. Arizona
  3. Arkansas
  4. Florida
  5. Illinois
  6. Indiana
  7. Louisiana
  8. Massachusetts
  9. Michigan
  10. Mississippi
  11. North Carolina
  12. Ohio
  13. Texas
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Several state governors announced on Monday that they will not accept Syrian refugees following the attacks in Paris, citing concerns for security.

The governors of North Carolina, Arizona, Florida, Ohio, Mississippi, Louisiana, Illinois, Indiana, Massachusetts, Texas, and Arkansas announced measures on Monday to stop or oppose any additional Syrian refugees from resettling in their states. Alabama and Michigan made similar announcements on Sunday.

The terrorist attacks in Paris have brought renewed attention on the U.S. refugee program, specifically the threat that ISIS could exploit the process to infiltrate and attack the United States. Several Republican lawmakers and presidential candidates have called on the administration to stop taking Syrian refugees, citing security concerns.

The governors of Connecticut and Vermont, meanwhile, have backed the Obama administration’s policy, voicing their support for accepting refugees in their states.

Refugees are extensively vetted — the process takes on average 18 to 24 months — but senior U.S. officials have said they are concerned there is a lack of on-the-ground intelligence in Syria that could be useful in the screening process.

Louisiana Gov. Bobby Jindal issued an executive order on Monday instructing agencies in his state to “utilize all lawful means” to stop Syrian refugees from resettling in the state.

“All departments, budget units, agencies, offices, entities, and officers of the executive branch of the State of Louisiana are authorized and directed to utilize all lawful means to prevent the resettlement of Syrian refugees in the State of Louisiana while this Order is in effect,” the order reads.

“The Louisiana State Police, upon receiving information of a Syrian refugee already relocated within the State of Louisiana, are authorized and directed to utilize all lawful means to monitor and avert threats within the State of Louisiana,” reads another provision of the order.

In a letter sent to President Obama on Monday, Texas Gov. Greg Abbott announced that his state will also refuse to resettle Syrian refugees.

“Given the tragic attacks in Paris and the threats we have already seen, Texas cannot participate in any program that will result in Syrian refugees — any one of whom could be connected to terrorism — being resettled in Texas,” Abbott wrote in the letter. “Effective today, I am directing the Texas Health & Human Services Commission’s Refugee Resettlement Program to not participate in the resettlement of any Syrian refugees in the state of Texas. And I urge you, as president, to halt your plans to allow Syrians to be resettled anywhere in the United States.”

“Neither you nor any federal official can guarantee that Syrian refugees will not be part of any terroristic activity,” Abbott continued. “As such, opening our door to them irresponsibly exposes our fellow Americans to unacceptable peril.”

Ohio Gov. John Kasich similarly sent a letter to Obama, requesting that the federal government stop resettling Syrian refugees in Ohio.

“The governor doesn’t believe the U.S. should accept additional Syrian refugees because security and safety issues cannot be adequately addressed,” Kasich communications director Jim Lynch said. “The governor is writing to the President to ask him to stop, and to ask him to stop resettling them in Ohio. We are also looking at what additional steps Ohio can take to stop resettlement of these refugees.”

Florida Gov. Rick Scott, while ending state support for resettlement efforts, wrote in a letter to congressional leaders that it was his “understanding” that “the state does not have the authority to prevent the federal government from funding the relocation of these Syrian refugees to Florida even without state support.” As such, Scott called on Congress to prevent the Obama administration from using federal funds to support Syrian resettlement efforts.

Governor Mike Pence of Indiana said in a statement on Monday, “Effective immediately, I am directing all state agencies to suspend the resettlement of additional Syrian refugees in the state of Indiana pending assurances from the federal government that proper security measures have been achieved. Unless and until the state of Indiana receives assurances that proper security measures are in place, this policy will remain in full force and effect.”

Mississippi Gov. Phil Bryant said in a statement on Monday that he would do “everything humanly possible” to stop the Obama administration from placing Syrian refugees in the state.

“I’m currently working with the Mississippi Department of Public Safety and Mississippi Office of Homeland Security to determine the current status of any Syrian refugees that may be brought to our state in the near future,” Bryant said in a statement. “I will do everything humanly possible to stop any plans from the Obama administration to put Syrian refugees in Mississippi. The policy of bringing these individuals into the country is not only misguided, it is extremely dangerous. I’ll be notifying President Obama of my decision today to resist this potential action.”

Arkansas Gov. Asa Hutchinson wrote in a tweet on Monday that he too would oppose Syrian refugees being relocated to his state.

According to the Boston Globe, Massachusetts Gov. Charlie Baker told reporters on Monday he was “not interested” in accepting Syrian refugees. “I would say no as of right now,” Baker said. “No, I’m not interested in accepting refugees from Syria.”

“My view on this is the safety and security of the people of the Commonwealth of Mass. is my highest priority,” Baker added. “So I would set the bar very high on this.”

Arizona Gov. Doug Ducey said in a statement, “Given the horrifying events in Paris last week, I am calling for an immediate halt in the placement of any new refugees in Arizona.” Specifically, he called for the Obama administration to provide “immediate consultation” under the United States Refugee Act.

In a news conference, North Carolina Gov. Scott McCrory took similar action, saying that he was requesting that the Obama administration “cease” Syrian refugee resettlement in the state immediately “until we are thoroughly satisfied” that concerns about safety that he expressed are resolved.

Of the governors’ actions and statements, McCrory added that some of the governors will be meeting later this week: “I’m sure all of us will be speaking, as a group, in the very near future.”

Alabama Gov. Robert Bentley and Michigan Gov. Rick Snyder announced on Sunday that they would attempt to block Syrian refugees from relocating to their states after the Paris terror attacks.

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Full letter from Texas Gov. Greg Abbott:

View this embed ›

ID: 7354426

Full order from Louisiana Gov. Bobby Jindal:

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Full Florida Gov. Rick Scott letter:

Full Florida Gov. Rick Scott letter:

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Amid Paris Attacks, 5 More Released from Gitmo

Barack left the country too, headed for Turkey.

The nefarious outside legal council group CCR, which was assigned by former Attorney General Eric Holder is the group of lawyers of record for many of the detainees.

Pentagon Transfers 5 Guantanamo Detainees to the UAE as Battle Over Closure Heats Up

Days ahead of signing a legislative freeze on Guantanamo into law, the president defiantly moves five

Files: al Rahzihi    al Qadasi 

al Asani     al Busays     al Nahdi

Hours after President Barack Obama took off for the G20 conference in Turkey, another plane was wheels up, carrying five detainees from the military detention center in Guantanamo Bay, Cuba, to the United Arab Emirates.

The move of Ali Ahmad Muhammad al-Razihi, Khalid Abd-al-Jabbar Muhammad Uthman al-Qadasi, Adil Said al-Hajj Ubayd al-Busays, Sulayman Awad Bin Uqayl al-Nahdi, and Fahmi Salem Said al-Asani brings the total population to 107, with 48 more cleared to go.

The transfer comes just days ahead of Obama signing the annual defense authorization bill, in which lawmakers extended and added restrictions intended to freeze such moves into 2017, potentially dooming Obama’s campaign pledge and 2009 order to close Guantanamo.

The administration insists it will continue to use the transfers to chip away at the population. Sunday’s transfer also follows a string of single moves in recent weeks, a sign that a bureaucratic logjam at the Pentagon has loosened under presidential pressure.

But officials have acknowledged they won’t be able to achieve their goal of emptying the prison — or at least getting the population so low the cost of keeping them in Cuba becomes indefensibly high — unless they are able to move larger groups of detainees, such as they did Sunday, rather than one-by-one.

 

 

The move also takes on a defiant tone amid preemptive political outcry over the Obama administration’s ever-imminent plan to close Guantanamo, which officials say will include a series of options for alternative sites in the U.S., and its refusal to rule out executive action to ultimately shutter the facility in Cuba.

White House, College Campuses, Rolling Stone Magazine

Yup, I got a notion earlier today and with a few search terms and additional clicks….low and behold it seems it all began in 2013 and White House personnel and Joe Biden and Valerie Jarrett is at the core. The activists are invited to the White House to systematically launch protests at college campuses…..it is working.

From the White House website: Valerie Jarrett Chair of the White House Council on Women and Girls, and Senior Adviser and Assistant to the President for Intergovernmental Affairs and Public Engagement 

  1. Remember that fake 9000 word fake rape story at the University of Virginia posted in Rolling Stone? White House Adviser Introduced Fake Rape Story’s Jackie to ‘Rolling Stone’   The story turned out to be a hoax; Jackie’s tale was fiction. Now, in court documents we learn that the author of the piece, Sabrina Rubin Erdely, learned about Jackie from Emily Renda, an adviser on the White House Task Force to Protect Students from Sexual Assault, who told the Jackie story in Senate testimony months before the Rolling Stone story, Renda was also a UVA employee.  
  2. Then we have the Department of Education, which was headed by Arne Duncan and he recently stepped down. Catherine Lhamon, who heads the Department’s civil rights wing, was identified in a letter sent last month by University of Virginia Dean of Students Allen Groves to Steve Coll and Sheila Coronel, the two Columbia Journalism School deans who conducted a review of the Nov. 19 article, written by disgraced reporter Sabrina Rubin Erdely. Groves’ letter was included as a footnote to the Columbia deans’ report, which was released on Sunday and cataloged the failures and lies that led to the article’s publication.
  3. Then we have Joe Biden and one of his top aides, Lynn Rosenthal. WASHINGTON — Vice President Joe Biden is losing his top adviser on violence against women, The Huffington Post has learned. Lynn Rosenthal, who has been a senior adviser to Biden since July 2009, will step down Friday. She is moving on to become the Vice President of External Affairs at the National Domestic Violence Hotline, and will remain in Washington, D.C.

    Rosenthal has coordinated the White House’s efforts to reduce domestic violence homicides, address domestic violence in the workplace and raise awareness about the effects of violence on youth. She’s also served on the White House Council on Women and Girls.

    Violence against women is one of Biden’s signature issues. As a senator, he wrote the 1994 Violence Against Women Act, and he was instrumental in ushering through the law’s reauthorization as vice president in 2013, when House Republicans unexpectedly held it up over its inclusion of new protections for Native American victims of abuse.

    He regularly works to keep the issue in the spotlight. During remarks last month at the White House Tribal Nations Conference, he described domestic violence as an “epidemic” that “cuts to the very core of how we measure ourselves as a society.”

 

Iran Deal (JPOA) is Over, U.S. Relations, Broken

Iran Reneges On Nuclear Deal  

“Adoption Day”–the day participants would start the process of implementing their JCPOA commitments – was set for October 18. On that day, therefore, the US and the EU began preparatory measures for lifting the multiple sanctions that have crippled Iran’s economy since they were first imposed in 2005. Only three days later, on October 21, Ayatollah Khamenei published a letter of guidelines to Iranian President Hassan Rouhani about the JCPOA.

This letter, the Middle East Media Research Institute (MEMRI) reported, was posted on Khamenei’s website in Persian, tweeted from his Twitter account, posted on his Facebook page in English, and published in English by the Iran Broadcasting Authority. In this document, clearly the definitive statement of the conditions under which Iran would be willing to execute the JCPOA, Iran’s Supreme Leader sets nine new and unilateral conditions that fundamentally change what was agreed on July 14. In short, he has virtually declared the JCPOA a dead letter.

What are these nine new conditions?

First Khamenei demands that sanctions are lifted fully, not suspended, before Iran takes steps to meet its obligations under the agreement. In addition he asserts that any endorsement by the West of the “snapback” option (the reintroduction of sanctions should Iran fail to meet the terms of the agreement) will be considered “non-compliance with the JCPOA”.

Secondly: Any future sanctions against Iran for whatever reason, including terrorism or human rights violations, will “constitute a violation of the JCPOA,” and a reason for Iran to stop executing the agreement.

Thirdly: Under the JCPOA Iran is obligated to start changing the function of its nuclear reactor at Arak and shipping out most of its stockpile of enriched uranium. In his letter Khamenei declares that Iran will not carry out these actions until after the International Atomic Energy Agency (IAEA) closes its dossier on Iran, targeted for December 15. But the IAEA will not be able to report about Iran meeting its obligations regarding the Arak reactor and shipping out its enriched uranium by the target date, because Iran is not going to do so by then. In short, the JCPOA has been thwarted from the very start.

Fourth: Iran will change the purpose of the Arak reactor only after there is a signed agreement on an “alternative plan” and “sufficient guarantee” that it will be implemented. In other words, Iran intends to postpone fulfilling its obligations under the JCPOA regarding the Arak reactor to some unknown future date.

Fifth: Iran intends to postpone indefinitely the date set by the JCPOA for shipping out its enriched uranium to another country in exchange for yellowcake. Moreover Khamenei is demanding that Iran receive in exchange for the enriched uranium not raw uranium as per the JCPOA, but instead uranium that has been enriched, albeit to a lower level than the uranium it ships out.

Sixth: Khamenei instructs President Rouhani, while reducing Iran’s ability to enrich uranium under the JCPOA, immediately to expand Iran’s ability to enrich uranium on a 15-year long-term plan for 190,000 centrifuges. In short, he is nullifying the declared goal of the JCPOA, which is to reduce Iran’s nuclear enrichment capabilities.

Seventh: The Iranian Atomic Energy Organization must ensure continued nuclear research and development, in its various dimensions, so that in eight years’ time, Iran will not be lacking in enrichment technology.

Eighth: Khamenei declares that Iran must be involved in resolving queries about the JCPOA – a recipe for unending dispute and the ability to paralyze the execution of the agreement.

Ninth: A new committee tasked with monitoring the execution of the agreement is to be established – nominally to obviate any attempt by the US or the West to cheat, but in effect, a mechanism for creating perpetual obstacles to carrying out the agreement.

So far world opinion has turned a blind eye to Khamenei’s virtual rejection of the nuclear agreement. The US and the EU are proceeding enthusiastically with the first stages of dismantling their multiple sanctions regimes. Government officials and businessmen from around the globe are making a beeline for Tehran, eager to share in the vast commercial opportunities they see awaiting.

The nuclear agreement is the basis for Iran’s re-entry into the comity of nations, and Khamenei seems to be setting the stage for a battle of wills between Iran and the West. Will the West’s desire to come to terms with Iran outweigh Iran’s determination to give away less than their president has actually signed up to? Will the West delay the lifting of sanctions? Who will blink first?

Rouhani says U.S.-Iran ties could be restored but U.S. must apologize

ROME (Reuters) – The nuclear deal reached between world powers and Iran could lead to better relations between Tehran and Washington if the United States apologized for past behavior, Iranian President Hassan Rouhani was quoted as saying on Thursday.

The pragmatist president, who championed the July 14 deal, has pushed for closer engagement with the West since his 2013 landslide election win.

But Iran’s top authority, Supreme Leader Ayatollah Ali Khamenei, has continued to rule out normalizing ties with the “Great Satan”, as he routinely calls the United States.

In an interview with Italy’s Corriere della Sera newspaper, Rouhani suggested that the United States and Iran could open embassies in each other’s capitals after decades of mutual hostility, but said Washington should apologize, without going into further detail.

“One day these embassies will re-open but what counts is behavior and the Americans hold the key to this,” Rouhani told the newspaper ahead of a trip to Italy this weekend, his first to a European capital.

“If they modify their policies, correct errors committed in these 37 years and apologize to the Iranian people, the situation will change and good things can happen.”

Iran and Washington severed ties shortly after the 1979 Islamic revolution when radical students seized the U.S. embassy in Tehran and held 52 Americans hostage for over a year.

Relations came under further pressure in the last decade over Iran’s nuclear ambitions.

Under the nuclear deal reached in July, Iran will curb its nuclear program in exchange for an easing of sanctions on its economy. Tehran denied Western suspicions it wanted to develop an atomic bomb.

Khamenei, who has the final say on all state matters, gave his conditional approval to the deal with six world powers including the United States, but has warned against allowing any U.S. political or economic influence on Iran.

Rouhani said Washington would have to fulfill its part in the nuclear accord for relations to improve. The United States approved conditional sanctions waivers for Iran, though these will not take effect until Tehran has complied with the nuclear accord.

“The way this agreement is applied can have an impact on the future,” Rouhani said in the interview.

“If it is well applied it can lay the foundation for fewer tensions with the United States, creating the conditions to open a new era. But if the Americans don’t respect their part of the nuclear accord, then surely our relationship will remain as it has been in the past,” he said.

Rouhani is due to see the Italian prime minister and business leaders during his Nov. 14-15 visit to Rome and will also hold talks with Pope Francis.

He will then fly to Paris for talks on Nov. 16-17.

VA Scheduler Whistleblower/Confessions

FNC report and video here. Veterans Affairs Secretary Robert McDonald has made a point of giving out his personal contact information, to show how accessible he is as he works to overhaul the embattled agency.

But the bid backfired Thursday, after he urged one famous veteran dealing with poor treatment to contact him. When “Fox & Friends” tried his number, they reached his voicemail — and got a message to call back later as his voicemail was “full.”

– Bay Area veterans say they’re still facing excessive wait times for benefits and health care. The VA Inspector General found 307,000 veterans may have died waiting for access to the VA health care system.

Veterans who do get enrolled say significant delays for medical service persist.

“They gave me an appointment six months down the road, and then called to say they had to cancel,” said Winter Haven veteran Keith Brown. “It can be a year before you get the actual appointment.”

That conflicts with information provided by the Department of Veterans Affairs, which showing wait times have improved following the VA scandal of 2014.

Nick McSwain says there may be a reason for that. He said when he worked as a VA scheduler through the beginning of 2015, he was told to disregard patients’ desired dates for appointment, then note the actual scheduled date as the ‘desired’ date — thereby showing no delay based on what veterans requested.

“It says ‘What is the desired date’ (in the system) and instead of using that date, we use the appointment we actually give them so it shows no gap,” said McSwain.

He also claims veterans who complained had to wait even longer for future appointments.

“Vets who should have been seen top priority were passed over because of the way providers feel about this guy. They’d say ‘I hate this guy’ or ‘he’s annoying,” said McSwain, w

ho also noted that consults for specialty health care piled up when he worked in a scheduling center. “There have been times when stacks of consults disappeared.”

A spokeswoman for U.S. Rep. Gus Bilirakis said his district offices have opened 314 VA-related cases since January 2, 2015, pertaining to both benefits and health care.

FOX 13 asked the Department of Veterans Affairs to respond to a range of questions and issues raised by Thompson, Brown, and other veterans. The department answered our questions and provided data to show the VA is making progress and notable improvements since the national VA scandal broke in 2014.

The VA provided the following snapshot of data through November 1, 2015:

  1. Between June 1, 2014, and November 1, 2015, the electronic wait list (EWL) went from 56,271 appointments to 46,146, a 17.99 percent reduction.
  2. VHA created 2.5 million authorizations for Veterans to receive care in the private sector from October 29, 2014 through October 28, 2015. This represents a 3 percent increase in authorizations when compared to the same period in 2013/2014.

A spokeswoman at the James Haley Veterans Hospital and clinics also sent us an email including the following statement and response to our questions.

“James A. Haley Veterans’ Hospital and Clinics is a continuous improvement organization. We are always looking to improve processes and quality of care for our patients and their caregivers. As a matter of fact, we will be participating in the national VA Access Stand Down this Saturday. The Department of Veterans Affairs is committed to providing timely access to Veterans as determined by their clinical needs.  On Saturday, November 14, VA medical centers across the country will participate in a first ever National Access Stand Down.  A team of clinical leaders, administrators and volunteers will be on site at every VA medical center to reach out to all Veterans identified as having the most important and acute needs to make sure they can be seen either in VA or in the community – including here at JAHVH…”

The James A. Haley Veterans Hospital answered our questions as follows:

What are the current average wait times for primary care, specialty care and mental health care?

Our wait-times are published every two weeks, the same as other VA facilities and current and historical wait time and access data can be reviewed at: http://www.va.gov/health/access-audit.asp

Currently James A. Haley Veterans’ Hospital and Clinics average wait times are 1.33 days for Primary Care, 6.33 days for Specialty Care (just as in the public sector, length can vary significantly by Specialty Clinics) and 3.66 days for Mental Health.

JAHVH has more than 90,000 unique patients and we schedule between 4,000-5,000 appointments daily in all areas of our medical facilities and at our outpatient clinics and receive more than 46,000 consults per month in FY 15.

Every new consult is reviewed by a clinical provider as part of the triage process to determine the clinical urgency of the request. Patients are seen as soon as possible based on clinical review – the more acute the need – the faster the patient is scheduled for an appointment on average.
Do lengthy hold times by phone to schedule a doctor or specialist persist? 

Our average wait time to answer the phone is 49 seconds in FY 15 (the national goal is less than 30 seconds) and our abandonment rate is 3.9% (the national goal is less than 5%), but depending on the location within the medical center a person is calling, hold times and speed to answer the phones can vary. We recognize this can be one of the biggest areas of dissatisfaction with patients and the medical center has established a workgroup that is working to improve telephone access to all areas. Additionally, patients are encouraged to use secure messaging if possible to consult with their health care providers.

Are there safeguards to prevent veterans seeking medical appointments from being left on hold indefinitely?  If so, can they be worked around?

The phone system has different features throughout the medical center based on the volume of calls and staffing level of clinic areas.  One tool we use in high volume areas is the Automatic Call Distributor (ACD) lines. These lines will automatically roll over to the next available operator after a certain length of time. Also some clinics are piloting the use a call back feature for patients who choose not to wait on hold.  Secure messaging is always another option that patients can use to communicate with their providers, and if a patient has difficulty reaching a provider, we encourage patients to reach out to the Service Liaisons or Patient Advocates Office.

Do veterans in the Tampa Bay area continue to encounter lengthy delays to see a doctor or specialist once appointments are booked?

Again, wait times vary based on the type of care, but our average wait times range from 1.33 to 6.33 days. If a patient is unable to be seen at our facilities within 30 days of the clinically indicated/preferred date, that patient is offered care through the Choice program and is then eligible to receive care in the community. Wait times in the community can also be lengthy based on the availability of certain specialty care required and can be a longer wait than VA care in some cases.

We are continuously and proactively reviewing our high demand specialty areas to help further increase capacity and efficiencies. For example, we do “Super Saturday Clinics” in both Ortho and GI to reduce some of the current patient wait times and are actively working to fill vacant provider positions. JAHVH hiring emphasis has been on Patient Aligned Care Teams (Primary Care) and high demand Specialty Care Services to increase access, including Orthopedics, GI, Ophthalmology and Radiology and we’ve filled over 100 new FTE positions under VACAA funding including providers, nurses and support positions.

During FY 14, JAHVH activated more than 300,000 square feet of new space, which opened up space for specialty care to expand. JAHVH increased specialty care spaces from 34 to 84 exam rooms for a net increase of about 150%, including an additional:

  • 18 in Ortho
  • 14 in GI
  • 17 in Neurology to open in first quarter of FY16

Additionally, extended hours and weekend appointments are offered at Tampa, New Port Richey Outpatient Clinic, and Lakeland Community Based Outpatient Clinic.

How are consults (enabling veterans to seek specialty care) organized and accounted for to prevent them from getting lost?

Consults are managed and organized in compliance with the National Consult Management Business Rules. All notes are kept in individual patient records.

JAHVH also has a Consult Management Committee (CMC) and designated consult managers within each service who are responsible for ensuring the consults do not get lost. The CMC is a standing medical center-level committee designated to receive, monitor, analyze and address all aspects of consult management to meet the facility’s mission and commitment to timeliness of care, provide support to enhance communication of Veterans’ needs, and outcome of treatment.  As part of these activities, the CMC functions to coordinate the assessment, implementation, and management of consults and related VISTA structures with all other appropriate entities and reports these activities as appropriate. The CMC identifies opportunities for improvement, and recommends corrective action plans.

Have schedulers within the VA health care system ever been told by VA management to disregard regulations in any way?

Schedulers are trained to follow all scheduling guidelines. Refresher training is provided to schedulers when scheduling errors are identified through observation, periodic and scheduled audits, etc. There was refresher scheduling training completed for all staff who have scheduling options conducted between July – September 2015. Any staff that did not complete this training had their scheduling access removed.

Specifically, have schedulers been told to disregard ‘desired’ appointment dates, to avoid gaps between ‘desired’ dates and scheduled dates?  

Employees are fully and regularly trained and should never disregard regulations when making an appointment for patients. JAHVH is audited by both internal and external organizations to review and ensure data and appointment policies and procedures are followed correctly.  JAHVH executive leadership does not advocate or condone any data manipulation or scheduling irregularities. Should an instance of irregularity be identified, it would be reviewed and corrective action would be taken as necessary.

Have veterans who complain about poor service or delays been adversely affected (with longer waits) as a result of their complaints?

We encourage anyone with a specific concern to contact the hospital’s team of Patient Advocacy Specialists that work as liaisons for the Director’s Office and are on staff specifically to assist Veterans with any issues or concerns they may have. Additionally, we have Service Liaisons, who field incoming calls from Veterans and either answer their questions or route the individuals to the appropriate office to handle their concerns. JAHVH follows national scheduling guidelines and reviews all appointment and consult requests to ensure they are scheduled timely according to the patients’ clinical needs and condition.

For veterans who complain they are unable to utilize their choice cards as they would like, how does VA respond?

JAHVH follows the CHOICE Program rules based on the VACAA law that state a Veteran is eligible for non-VA care in the community if he/she lives more than 40 miles from a VA Facility (to include CBOCs even if they don’t offer the specialty) or if based on long wait times (patients that have an appointment scheduled greater than 30 days from when the clinically indicated/preferred date). Veterans may file an “excessive burden” appeal. Additionally, on July 31, 2015, the President signed Public Law 114-41, the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015. Title IV, the VA Budget and Choice Improvement Act, makes several changes to the Veterans Choice Program. We are currently awaiting implementation guidance of these changes. More information about the choice program can be found: http://www.va.gov/opa/choiceact/