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Date: March 21, 2025

Prepared for: Senator Rand Paul; Department of Veterans Affairs: Secretary Doug Collins; Department of Government Efficiency; Congressional Veterans Affairs Committees

Executive Summary:

This briefing document summarizes the key concerns and proposed reforms put forth by the "Veterans for VAMC Change & Transformation," a collective of veterans with extensive experience navigating the Veterans Health Administration (VHA) system. Their central argument is that VAMCs prioritize managing veteran behavior and implementing budget cuts at the leadership level over ensuring timely access to appropriate medical care for service-connected injuries. They allege that veterans advocating for change face retaliatory measures, including placement on Disruptive Behavior Committees (DBC) and unwarranted law enforcement scrutiny. Looking ahead to March 2025, their focus shifts to holding VISN and VAMC leadership accountable for operational practices and federal spending. They also outline specific expectations for a newly appointed administration regarding primary and mental healthcare access, second opinions, Patient Advocate roles, and the VA Hotline.

Main Themes and Important Ideas:

1. Denial of Health Care and Focus on Veteran Behavior:

• Core Issue: The central grievance is that veterans with approved VA claims for      injury are being denied or delayed in receiving necessary medical care.
• Misplaced Priorities: The group contends that VAMCs prioritize managing veteran behavior      through the Disruptive Behavior Committee and alleged "Red Flag"      law enforcement actions, rather than addressing their healthcare needs.
• Quote: "In every case, time and effort is placed on Behavior while      the access to proper and appropriate Medical Care is denied, or worse,      ignored."
• Impact on Advocates: Veterans actively seeking to address these issues report being      targeted with negative repercussions.
• Quote: "...a great majority are not only placed on the Disruptive      Behavior Committee but are also given a Red Flag for Law Enforcement to      illegally stalk and harass us in our homes and neighborhoods..."

2. Allegations of Retaliation and Silencing of Advocacy:

• Disruptive Behavior Committee      Misuse: The group believes the DBC is      being used punitively against veterans who advocate for better healthcare      and accountability.
• Unwarranted Law Enforcement      Involvement: They claim to be subjected to      illegal stalking and harassment by law enforcement, allegedly at the      behest of the VAMC.
• Congressional Complicity: The group alleges that some female members of Congress are actively      working to silence veteran advocates on social media.
• Quote: "...as evidenced by at least 2 Female Congress Women who are      actively using Social Media to silence any Veterans advocating for      Transformation and Accountability."

3. Scrutiny of VA Leadership and Federal Spending:

• Target of Accountability: The group's focus in March 2025 shifts to holding VISN (Veterans      Integrated Services Network) leadership (Top 5), VAMC Directors, Chiefs of      Staff, and Section Chiefs accountable.
• Payroll Cutbacks: They observed VA leadership implementing payroll cuts by laying off      probationary federal employees in February 2025.
• Federal Credit Card Usage: The group highlights the Department Of Government Efficiency (DOGE)      examination of federal credit card usage by federal employees,      particularly those with criminal convictions in decision-making positions      within VAMCs.
• Quote: "The DOGE has begun examining the use of Federal Credit Cards      by Federal Employees – as you all know, we established several &      highlighted one, Federal Employee with a Criminal Conviction in Decision      Making positions within the VAMC area who are in possession of one of      those Federal Credit Cards."
• Manufactured Hysteria Regarding      Benefit Cuts: The group asserts that rumors of      cuts to veteran healthcare benefits are intentionally spread by VISN      leadership to divert attention from their own accountability.
• Quote: "First and foremost – the rumors of Cuts to Veterans      Healthcare Benefits. This is a manufactured hysteria entirely managed by      the Veterans Integrated Services Network Leadership nationwide. It’s a      complete lie."

4. Proposed Reforms and Expectations for a New Administration:

The group outlines specific expectations for a newly appointed administration, focusing on improving access and accountability:

• Primary Medical Care:
  • No referral required for       Psychiatry/Mental Health and Optometry/Dental (for qualified claims).
• Primary Mental Health Care:
  • Separate, dedicated primary       psychiatrist without referral.
• Requests for 2nd Opinions:Inside      VA: Coordinated by the Patient Advocate.
• Community Care: Immediate referral upon request, no billing for qualified claims.
• Patient Advocate Realignment of      Priorities:
  • Represent the veteran, not the       VAMC/employees.
  • Facilitate successful outcomes       of 2nd opinion referrals.
  • Facilitate veteran       representation for grievance escalation.
  • Patient Advocate success       measured by reduction in veterans escalated to the DBC.
  • Facilitate veteran       representation before the DBC in their favor.
  • Immediate (within 3 business       hours) verbal communication of DBC decisions.
• VA Hotline (Washington DC):
  • Hotline usage indicates Patient       Advocate mission failure.
  • DC-level monitoring of all       calls.
  • VISN Patient Advocate copied       only.
  • VAMC Patient Advocate direct       communication with DC on issue progress and resolution.
  • VAMC Patient Advocate informs       VISN Patient Advocate of updates.

5. Gratuitous Service Offering:

• In January 2025, the group      applied to the Department of Government Efficiency (DOGE) as Gratis      Vendors under Article 2, to offer their education, expertise, and      experience to the government as an act of service.
• Homeland Security reportedly met      with the group to verify their sincerity.

Conclusion:

"Veterans for VAMC Change & Transformation" presents a concerning picture of the current state of veterans' healthcare access within the VHA system. They allege a systemic issue where leadership prioritizes managing veteran behavior and implementing budget cuts over providing necessary medical care, particularly for service-connected injuries. Their proposed reforms aim to empower veterans, streamline access to care (especially mental health), and realign the role of Patient Ad