MANDATED REPORT to OSHA on the VA

MANDATED REPORT to OSHA on the VA COVER LETTER Per California Penal Codes as well as 42 Federal Code and wic Dr. Richard L. Matteoli CA License 22647 CDR, DC, USN, (ret.), FMF Monterey, CA REQUESTING IMMEDIATE WHISTLEBLOWER PROTECTION FROM FURTHER RETALIATION FOR MYSELF; MONTEREY VA-DoD CLINIC including DR. NICHOLAS SASSON; MONTEREY COUNTY OFFICE, CALIFORNIA STATE VA; USING FBI INVESTIGATION WATSONVILLE, CA OFFICE Documentation provided with full case before VA Resolution Board. This request includes Report Recommendations as part of Counselling. Prior to present circumstances involving National Security regarding a new factor introduced in linking all prior Mandated Reports it was recently reported that the NATO is studying an issue in the Middle East to individual and social acculturation of violence, abuse and PTSD. Study being conducted by a person I have long time knowledge of. NOT specifically discussed in this Mandated Report Cover Letter. Enclosures including certain physicians’ masturbation video to a male genital surgical procedure on subject sent separate. 1 CONTENTS Introduction - 3 Veteran Contractual Rights Societal Responsibility Subcultural Criminology - 4 MENS REA MALUM PROHIBITUM MALUM IN SE MALPRACTICE HOBBS Act Mail and Wire Fraud RICO Act FERES Doctrine Little Tucker Act Sherman Act Clayton Act Homicide – Team Predation – Civil Conspiracy Clinical Impropriety - 8 Pharmacology Hearing Loss and Tinnitus Disability Ratings - 9 Shared Responsibility Reorganization - 10 Internal Structural Integration Department of Defense Integration External Civil Integration VA Employee and Contractor UCMJ Accountability - 14 2 INTRODUCTION VETERAN CONTRACTURAL RIGHTS 5 U.S.C. 2302, Section 7 IG ACT; 41 U.S.C. 4705; 3.9 FAR, 48 C.F.R. Part 3; inclusive WPA 1: DoD integrating with VA. EVERY Veteran signed a DoD Contract, even if Drafted. 2: Veteran proof of his/her Contract fulfillment, and how fulfilled, is the DD214. 3: Veteran Contract with DoD transfers to VA with all contractual rights including medical care. 4: As Contractors Veteran Rights extend EQUALLY as if the Veteran is also a VA employee(r). 5: VETERANS have the right to seek WHISTLEBLOWER PROTECTION from OSHA. DoD Directive 1241.1 Reservist Rights a Lesson for All. 1: Injury when on any kind of Duty is to be covered. There are NO minimum Days on Duty. 2: There IS NO WAITING TIME for eligibility to receive Service Related VA Care. INTENT of CONTRACT Contract Intent is based on Promises Made whether explicit, by inference or Common Knowledge within the social fabric. The veteran has all reasonable rights to be treated with International Usual and Customary Standards of Care and in a timely appropriate manner. SOCIETAL RESPONSIBILITY The woman becomes the vehicle of nature. The man becomes the vehicle of society, the social order, the social purpose. The woman is life. The man is the servant of life… Life has overtaken her. Woman is what it is all about, the giving of birth and the giving of nourishment. Without him she would become overwhelmed. Joseph Campbell, The Power of Myth. ALL Service Members understand, respect and give service to and are Servants of. YET: When does the Servant become a Slave? When does the Servant become a Sacrifice? There is blatant socio-functional Sexual Discrimination against males and also, at least exclusive in one respect, female Servants of Life and its Social. A demographic study of sexual ratios to occurrences of Veteran Deaths, Denials, Improper Pharmacology and Structural Avoidances of Eligibility, Access, Delays, Treatment, and Red Flagging is required. Immediate social maternal Life concerns that too often become out-of-hand, mostly without individual and social responsibility, do not negate Servant rights especially when Contractual. X X 3 SUBCULTURAL CRIMINOLOGY MENS REA MENS REA a guilty mind; the mental state accompanying a forbidden act. For an act to constitute a criminal offense, the act usually must be illegal and accompanied by a requisite mental state. Criminal offensives are usually defined with reference to one of four recognized criminal states of mind that accompanies the actor’s conduct: (1) intentionally; (2) knowingly; (3) recklessly; and, (4) grossly [criminally,] negligent. The mens rea may be GENERAL, i.e., a general intent to do the prohibited act, or SPECIFIC, which means that a special mental element is required for a particular offense such as “assault with intent to rape” or larceny which requires a specific intent to appropriate another’s property. In a criminal prosecution, the state must prove beyond a reasonable doubt that the required mental state coexisted with the doing of the proscribed act. Defenses of insanity, intoxication and mistake may either nullify or mitigate the existence of a SPECIFIC MENS REA. Crimes that are malum prohibitum often do not require any specific mens rea. See 343 U.S. 790. These are usually crimes of strict liability. MALUM PROHIBITUM MALUM PROHIBITUM Lat: wrong because it is prohibited: made unlawful by statute for the public welfare, but not inherently evil and not involving moral turpitude. Refers to acts prohibited solely because of the existence of statutes. It is contradistinguished from malum in se. For example: driving at excessive speed, is malum prohibitum because statutes prohibit as a result of a determination that it is dangerous to the community, though it may not be inherently dangerous; whereas, reckless driving would be regarded a as malum in se. 4 MALUM IN SE MALUM IN SE - Lat: evil in itself; “naturally evil, as adjudged by the sense of a civilized community.” It refers to an “act or case involving illegality from the very nature of the transaction, upon principles of natural, moral and public law.” For example, murder is “malum in se” because even without a specific criminal prohibition the community would think it to be evil and wrongful act. Compare malum prohibitum. MALPRACTICE MALPRACTICE a professional’s improper or immoral conduct in the performance of duties, done either intentionally or through carelessness or ignorance. The term is commonly applied to a physician, surgeon, dentist, lawyer, or public officer to denote the negligent or unskillful performance of duties resulting from such person’s professional relationship with patients or clients. Steven H. Gifis, Law Dictionary, Barron’s HOBBS ACT – 18 U.S.C. §1951 Illegal for Federal Government Employees to get BONUSES and considered BRIBERY. The HOBBS ACT prohibits actual or attempted robbery or extortion affecting interstate or foreign commerce. Section 1951 also proscribes conspiracy to commit robbery or extortion without reference to the conspiracy statute at 18 U.S.C. § 371. Although the Hobbs Act was enacted as a statute to combat racketeering in labor-management disputes, the statute is frequently used in connection with cases involving public corruption, commercial disputes, and corruption directed at members of labor unions. Jurisdiction: US Department of Labor. Extortion under color of official right or extortion by a public official through misuse of his/her office is supervised by the Public Integrity Section, Criminal Division. Extortion and robbery in labor-management disputes is supervised by the Labor-Management Unit of the Organized Crime and Gang Section, Criminal Division. All other extortion and robbery offenses not involving public officials or labor-management disputes are supervised by the Organized Crime and Gang Section, Criminal Division. The three most common statutes used against Bribery are in 18 U.S.C. §666 (a) certain programs receiving government funding, (b) honest services fraud; and, (c) extortion under color of official right: The coercive element is provided by the public office itself, Evans v. U. s. 504 U.S. 255 (1992). Some courts have held that the HOBBS ACT can be applied to past and present public officials, as well as to ones who presently occupy a public office at the time the corrupt payment occurs. The court held in the affirmative the question whether, within the meaning of the Hobbs Act, it is a crime for candidates for political office to conspire to affect commerce by extortion induced under color of official right during a time frame beginning before the election but not ending until the candidates have obtained public office. Courts have upheld elected officials under color of official right where the public officials induced a third party to pay out money. (See: Congress designates IRS to pay selected VA employees BONUSES). 5 MAIL FRAUD - 18 U.S.C. §1341 and WIRE FRAUD – 18 U.S.C. §1343 Scheme to Defraud, deprive Honest Services, Bribery, Failure to Disclose, Conflict Interest Mail and Wire Fraud statutes are to combat the Common Law crime of Larceny by Trick. Mail Fraud requires: (a) scheme to defraud, (b) use of interstate communications through the Postal Service or private carrier. Wire Fraud is through, in part: (a) telephone calls and (b) e-mails. Involved are, in part: (a) deprive another the right to Honest Services – 18 U.S.C. §1346 arising, in part, from: (b) Hobbs type Bribery (c) Failure to Disclose (d) Conflict of Interest. RICO ACT – 18 U.S.C. §1962 Government Employee Racketeering -> Bonuses -> with their Union as Representatives RICO requires a Pattern of Behavior involving two or more aspects of Racketeering. Public officials are NOT exempt, but under a Higher Standard. (a) Impossible to otherwise designate a government office and its official NOT to affect or NOT act through Interstate Commerce. (b) uses, in part, Mail Fraud, Wire Fraud, Bribery, Hobbs Act violations. (c) Requires prosecution with Forfeiture of Assets gained, fine and prison. SHERMAN ANTITRUST ACT - 15 U.S.C. §§1-7 Government contracts, combinations, conspiracies, commerce, customer allocations The Sherman Act prohibits (a) contracts, combinations, or conspiracies in restraint of interstate commerce or foreign trade, and (b) monopolization, attempts to monopolize, or conspiracies to monopolize interstate commerce or foreign trade. While every violation of this Act is technically a felony, the Department reserves criminal prosecution for so called “naked” or “per se” unlawful restraints of trade among competitors, e.g., price fixing, bid rigging, and customer and territorial allocation agreements. Criminal violations of this Act carry a maximum fine of $100 million for defendant (being the government is a corporation, $1,000,000 for other persons, and a maximum prison sentence of ten years per person. Thus if deserved benefits for any reason are withheld creating victim transfer of funds as Insurance Policies, Loss of Supplemental Disability Insurance, Sale of Transportation or any asset transfer by veteran to survive through loss of income especially necessary for life and liberty a criminal act has occurred. This means if a veteran must give up monthly income so to live, a violation has occurred due to confiscation of veteran assets and Free Use thereof. CLAYTON ANTITRUST ACT - 15 U.S.C. §§12-27; 29 U.S.C. §§52-53 Government contracts creating non-competitive monopoly The Clayton Act prohibits corporate and other mergers – and acquisition of assets of competing companies, where the effect of such action may be substantially to lessen competition or tend to create a monopoly. Anticompetitive tying and exclusive dealing contracts are also prohibited, as are certain interlocking directorates. Violations of this Act are prosecuted civilly. 6 FERES DOCTRINE – 340 U.S. 135 (1950) Cannot sue the military The Feres Doctrine extends the English Common Law of Sovereign Immunity even from negligence. DoD transfers to the VA what it cannot, and at times will not, medically provide. This is true except in cases of non-treatment for communicable diseases endangering the public. LITTLE TUCKER ACT – 28 U.S.C. §1346 Can sue military if released without Communicable Disease treatment as TB and STDs Tuberculosis is and always has been a Public Health Care concern. California, and presumably every State in the United States, has a Mortality and Morbidity monthly Newsletter for all Health Care Providers to receive by mail if they choose to subscribe. This has been available since before 1970. In the 1970’s California would send Emergency Notices if a local occurrence or outbreak occurred mostly due to migrants and international visitors. The VA requires Temporary Disability if contact occurred in Asia or Southwest Asia. Yet Tuberculosis is area endemic in places as Alaska and should also be covered due to Training Exercises. If the Tuberculosis is NOT active, and at the minimum contact is shown by a positive TB test, Prophylaxis may be indicated – especially if a lung lesion, though inactive, occurs. If Tuberculosis is active they must be isolated. Ebola patients brought to the United States should and have been properly isolated in Tuberculosis specified isolation units. BUMED does not provide prophylaxis in certain cases, yet required necessary Liver Monitoring due to drug toxicity. The VA provides Prophylaxis but their unspoken Policy and Procedures disallows proper Standard of Care Liver Monitoring. Yet BUMED Tuberculosis Protocol requires Prophylaxis WITH Liver Monitoring. The VA is basically a DoD extension to fulfill Contractual Obligations of the United States. BUMED Instruction: BUMED INSTRUCTION 6224.8 HOMICIDE - TEAM PREDATION – CIVIL CONSPIRACY HOMICIDE any killing of a human being by another human being; most commonly used to refer to an unlawful homicide such as murder or manslaughter. “The destruction of the life of one human being by the act, agency, procurement or culpable omission of another. The destruction of life must be complete by such act or agency; but although the injury which caused death might not, under other circumstances, have proved fatal, yet if such injury be the cause of death, without it appearing that there has been any gross neglect or improper treatment by some other than the defendant. . . it would be homicide.” ACCESSORY one who aids or contributes in a secondary way or assists in or contributes to crime as a subordinate. ACCOMPLICE an individual who voluntarily engages with another in the commission or attempted commission of a crime. AID AND ABET to actively, knowingly, intentionally, or purposefully facilitate or assist another individual in the commission or attempted commission of a crime. Steven H. Gifis, Law Dictionary, Barron’s 7 CLINICAL IMPROPRIETY PHARMACOLOGY Improper pharmacological use of medications is a leading cause of Health Care caused Mortality and Morbidity. Iatrogenic Pathophysiology. The Physicians’ Desk Reference is a book containing prescription drug Material Safety Data Sheets (MSDS), given by the pharmacist with each prescription. Needed is a Directive to prescribe, treat and if needed test accordingly. It would be wise for the VA to take the lead in Health Care by setting up in each Region a Collegial Pharmacy Review Help-Line that will aid physicians with patients requiring a multitude of prescriptions as well as a Hot Line for professionals asking something to be reviewed without fear of Retaliation. Quality Control. Always: Safety First. HEARING LOSS and TINNITUS Veterans Affairs denies approximately 50,000 Hearing Loss and Tinnitus Claims for Disability annually. ALL denied Disability Claims must be reviewed. The VA uses only the Hearing Aid test that tests to 4000Hz. This is a Function test, as is the military’s test to 6000Hz. International Usual and Customary Standards for diagnosing Hearing Loss Pathology, at the minimum, starts Diagnostic testing at 8000Hz. Quality Control. The VA will then establish trained analysists that can perform all Hearing Loss and Tinnitus Disability Claims via computer communications with Agent assigned, per Agent request. Then cut and paste into Claim Decision. Other situations may functionally apply? The temporary Tinnitus Notch for noise damage ranges from 4000Hz to 2000Hz. VA testing only to 4000Hz does not allow for a complete viewing to determine Service Connected harm which might not even necessarily be fully inclusive due to other factors as chemical contamination or pharmaceuticals. 8 DISABILITY RATINGS: SHARED RESPONSIBILITY EXAMPLE: HEARING LOSS 1: Establish Legal International Usual and Customary Diagnostic Testing for Auditory Pathology to 8000Hzx 2: Maintain Hearing Aid Standards to 4000Hz 3: Use Graph similar to Example Photo. 4: Make Graph Overlay for each year of life. 5: Graph Overlay to include Range of Normalcy. 6: Hearing Loss Greater than Range of Normalcy is Pathology: Unilateral - Bilateral. 7: Establish if Service Connection applies. 8: Establish Claimant Lifestyle. 9: Establish Percent (%) Shared Responsibility if applies. 10: Shared Responsibility may be calculated as 50% Equity; or, otherwise different. EXAMPLE: TINNITUS 1: Determine Existence and Severity of Tinnitus also with affecting Cognitive Hearing Loss. 2: Establish Cause and Multiple Causes of Tinnitus. 3: Establish Claimant Lifestyle and Truthfulness. 4: Establish Percent (%) Shared Responsibility if applies. 5: Shared Responsibility may be calculated as 50% Equity; or, otherwise different. EXAMPLE: CARDIOLOGY 1: Respect civilian, other Federal and State diagnoses which are proven more correct than VA. 2: AVOID Specialist MISDIRECTION in Diagnosis using unnamed different Procedure Codes. 3: Note whether disease is Progressive or resolvable with treatment and recurrence possibility. 4: Atherosclerosis may be consolidated into this Specialty Claims Agent Responsibility. 5: Shared Responsibility may be calculated as 30%, 50% or 70% Equity; or, otherwise different. EXAMPLE: CONSOLIDATION 1: Note that workplace Safety has increased compared to past military work environments. 2: Use all newly established Procedure Code Guidelines to be mandatory inclusion with Claim. 3: Factor Latency of Clinical Presentation as Heavy Metal Poisoning and Alexithymia-PTSD. 4: Note whether each is Progressive or resolvable with treatment and recurrence possibility. 5: Shared Responsibility may be calculated as 33% to 67% Equity; or, otherwise different. FUTURE 1: Establish reasonable amount Specialty Case Claims Sections to interact with Claims Agents. 2: Promote to Disability Case Claims Agent from within those who have completed all rotations. 3: Promote from within to Manager Disability Case Claims Agents those who have completed a designated time as a Disability Case Claims Agent. Corpsmen, Medics extra 5% on application. 9 REORGANIZATION Veterans Affairs failures are mainly structural. They are overwhelmed making inefficiency a way of life that leads to loss of discipline thus opening an avenue for criminal behavior to enter, flourish and become institutionalized. Veterans Affairs requires metamorphosis, not destruction. Metamorphosis involves a taking apart, rearrangement and putting back together. This means how it relates both as a society within itself as well as how it relates outside itself as a place within society as a whole. The following are recommendations to initiate discussion for improvement to best serve the patient that then serves society as well. This involves three basic aspects in its existence. To illustrate: 1. Veterans Affairs Structural Integration – Internal 2. Military Integration - Internal <-> External 3. Civil Integration - External INTERNAL VETERANS AFFAIRS STRUCTURAL INTEGRATION CLINICAL 1: Pharmaceuticals: Improper use of pharmaceuticals is the leading cause of death in Health Care. It is industry wide. The VA is not different except that pharmaceutical impropriety has become its own Industrial Standard. Cure is within the grasp of Veterans Affairs. Only a couple of steps are necessary to solve this problem: a) Physician’s Desk Reference (PDR): Simply issue a Directive that medications, with all facets required in its dispensation and proper use are to be in accordance to the Material Safety Data Sheet (MSDS) found in the PDR and given to the patient when they pick up their prescription both in house and emphasis given the patient for home care. And, strictly enforce it. b) Pharmaceutical Resource Facilities: Each Region needs to establish a Pharmaceutical Resource Facility. It must be Collegial at all times. It should be Management staffed by Pharmacists. This is where physicians can phone with questions especially regarding patients on complex medication program of treatment, a Review section that flags complex cases for review and some patients put on an update review schedule for the treating physician as well as a Hotline for VA employees with concerns and with NO FEAR OF RETALIATION. This has long time been discussed by professionals since my time stationed at Great Lakes 1984-1986. TAKE THE NECESSARY LEAD. 10 Yet, it must be noted that there is leeway in use of medications depending on the patient’s condition, where they are at within the course of their Treatment Plan as well as certain times and places variation might be best to test current treatment efficacy. 2: International Usual and Customary Standards of Care: Veterans Affairs in many ways is open to liability by practicing Below the International Usual and Customary Standards of Care. One case alone, beyond improper use of medications, is the Hearing Loss and Tinnitus Pathologic examination. The VA denies approximately 50,000 such cases per year. They must all be reviewed and retesting required is new test is found appropriate for a correct PATHOLOGIC Diagnosis. a) To accomplish this correction of past impropriety each Region can set up a Hearing Loss and Tinnitus Review facility. Staffing may consist of new employees. With proper training they may become Technical Specialists for such Disability Claims. The Standard Claims Agent can forward the Test and all Clinic notes with Patient History and, if available, civilian diagnostics. The Review Specialist then does the Disability Protocol and returns the final decision to the Standard Claims Agent. If the Standard Claims Agent accepts after his/her review this then will be the official Decision to which the Clamant may respond. b) RESULT: creates an Internal Review process among Veterans Affairs professionals. c) This Procedural Protocol may be duplicated in other specialties and sub-specialties as Veterans Affairs deems efficient. d) Insurance companies hire retired and disabled physicians, dentists and other Health Care Providers on a Full Time as well as a Part Time basis. HARD ASSET REALLOCATION: PHASE I A main problem with Veterans Affairs is construction and maintenance of Hard Assets. The Hard Asset to be first assessed would be the VA Hospitals themselves. Hard Asset Reallocation is already part of Veterans Affairs Hospital affiliations with Medical Schools and an avenue to seriously look into this program that should be used and expanded if possible when greater efficiency is shown to be established. Hard Asset Reallocation in use, but entirely forgotten, is existent in at least two California Veterans Affairs agreements with two California Medical Schools. These two are: a) Mather Veterans Affairs with University of California Davis Medical School. Sacramento County sold its County Hospital to the State of California for $1 (one dollar) in which new Davis Medical School could use for both didactics yet mostly patient treatment. Yet it also maintained its County Hospital status for a treatment facility for the poor. I used to cover the Dental Clinic for a friend when gone where both the poor were treated and the Medical School patients were located for their treatment b) Palo Alto Veterans Affairs with Stanford University Medical School. Palo Alto County Hospital was merged into Stanford University Medical School in like manner as Sacramento County Hospital with UC Davis Medical School. c) SOLUTION: Sell (or Lease) all VA Hospitals to existing Medical Schools whether public or private that the VA has a relationship with. Maintenance now totally belongs to the State or Medical Schools. Phase II belongs to the VA and the DoD into the school. 11 DEPARTMENT OF DEFENSE INTEGRATION Veterans Affairs is currently integrating with the Department of Defense. SOFT ASSET REALLOCATION: PHASE II At the same time Veterans Affairs sells its Hospital Hard Assets to the associated medical schools, the medical schools LEASE BACK the hospital to the VA Residencies for the same price of $1 (One Dollar) and maintain the relationship including Medical Residencies. Soft Asset Reallocation will benefit Veterans Affairs, Medical Schools and most of all patients served as well as society in general. Put in other words, it is a win-win-win-win restructuring: a) TRICARE is a DoD Insurance Program set up as a standard insurance company where care provided is set to Industry Standards thus allowing maneuvering to keep up with advances in Health Care, not be involved in government stagnation and not be involved in other social programs as paying a premium to fund the Death Penalty of/by its patients. b) Medical schools may then bill Tricare, social security, private insurance c) Monies above and beyond collection and maintenance costs may then be reallocated back to the Medical School-Veteran Affairs partnership. d) Monies may be spent on VA requested needs as new and upgraded equipment, supplies and disposable treatment items. e) Integration with Medical Research may be extended into non-treating colleges and Universities. f) Electronic Shared Health Care Records, secure in each Agency, HIPPA transferred upon PROPER request and establish PROPER SOAP Noting. PATIENT CARE REALLOCATION: PHASE III a) b) c) d) e) f) g) Give Tricare Insurance Options to Veterans as either a Primary or Secondary Carrier. Maintain focus on treating Service Connected Disabilities Upgrade then maintain Increased Reserve Readiness Maximize Shared Civilian Health Care Assets and Inter-service Cooperation Maximize Educational Health Care Assets increasing Research Capabilities Eliminates Majority Travel Reimbursements and other Ancillary Expenses COST: Dental Clinics to be installed by the Medical Schools from monies provided by insurance payments. 12 RESTRUCTURING RESERVE HEALTH CARE ASSETS INTO VA-DoD: PHASE IV VBA REGIONS VHA REGIONS It is imperative to maintain the health of both Active Duty and Reservists. Dental Class 3 and Class 4 are the military’s greatest problem in Readiness. With Reserve Recalls dentistry is often needed before In-Country Deployment resulting in Delayed Response times when maximum Total Force efficiency is required. Full Command Structure upon DoD determination. Restructuring DoD into VA for Humanitarian and National Emergencies a) Restructure Non-Combat Geneva Convention Code assets into DoD war time functions for each Branch of Service. b) DoD as well as Each Branch of Service may have upon determination the ability to issue Stand-By Orders as they see fit to emergent situations within their scope of function and interests therein. Seriousness and Heads-Up may be within a Coded Seriousness of potential Threat. FUNCTIONAL SCENERIO: Hurricane Katrina. c) Reserve Military Assets includes all Support Functions to make Command and Control fluid and timely. LOGISTICS. d) AIR FORCE and USPHS: VA Hospitals function as a Rear Echelon Fleet Hospital. 1) Command and Control belongs to the Air Force. 2) Administrative functions for all Branched of Services are to be Deployed to the VA Hospital. 3) Orders are to be written while assets are Deployed as when 9/11 occurred one of our New York FORCEMED (USMC) Units IMMEDIATELY went to the scene. 4) VA and Medical Schools to assist. e) ARMY functions as a MASH Element and should be Deployed to VA Clinics outside immediate Hospital access and/or Triage assessed for Medical Evacuation to the VA Hospital/Fleet Hospital. f) NAVY functions where most needed whether at the VA Fleet Hospital, VA Clinic MASH scenario AND USMC Attached FORCEMED First Responder in highly most mobile BATTALION AID STATIONS. g) ALL AIR ASSETS and MOTOR TRANSPORT Reserve Components function according to Branch of Service and/or where needed. This includes AIR NATIONAL GUARD. h) SECURITY Presence as determined by each Branch of Service, DoD, Joint Chiefs command decisions. i) RESULT: 1) Purpose and Function Maximized. 2) DoD secures PRIMARY use of their Assets before other Agencies as DHS and the IRS. 3) Civilian Assets will volunteer. 13 EXTERNAL CIVIL INTEGRATION Veterans who rate a disability should be given Tricare for Life and allowed to seek civilian health care if more expedient and as a Supplemental Insurance to Social Security Disability. All Veterans should automatically be given Tricare for Life when they turn 65, the current retirement age as a Supplemental secondary insurance to Social Security. Being Tricare is a DoD government insurance program other branches of our government should be allowed to use and participate in its benefits. Administration for other than DoD use would best be through Department of Health and Human Services (DHHS) and be as a replacement for many instead of Obamacare. The premium rates would be far less. The vetted Obamacare insurance companies are the same as the insurance companies lost by many due to Obamacare, and the insurance company’s profits are higher with Obamacare. The program exists, web site up and running and all that would be necessary is to use their existing Family Plans to choose from and put a Code Number for the coverage program just as any other insurance coverage identification clarification. By using Tricare through DHHS instead of Obamacare it will transfer Administration of Health Care away from Department of Homeland Security (DHS) and the Internal Revenue Service (IRS) and put any form of National Health Care where it belongs, to put in other words, health care should be run by health care professionals. It all depends on what society truly desires in health care. By using Tricare instead of Obamacare eliminated would, in part, be: a) Elimination of the Death Penalty clause where people are paying for executions. b) More appropriately eliminate the possibility of the Saudi invention of a Wifi activated Lethal Dose in the soon to be required computer chip. c) Reduce politically favored exemptions as well as contractual fraud. d) Eliminate stagnation of treatment to allow industry standards of treatment updates which is how Tricare is set up to do. 14 VA EMPLOYEE and CONTRACTOR UCMJ ACCOUNTABILITY 10 U.S. CODE CHAPTER 47: UCMJ ALL employees of Veterans Affairs who have ever served in any Branch of the United States Uniformed Services are still under the Uniform Code of Military Justice (UCMJ) and subject to recall for non-judicial punishment. This includes the very probable loss of Benefits and Retirement Pay if applicable. Included in this are those who are NOT Veterans Affairs employees but Health Care Providers who while in the military performed illicit medical studies of a criminal nature that leads to improper medical care and the disciplining of those who object to their improper use of medicine. This includes VA patients. The VA is supporting medical procedures that may become a part of PTSD through the causation of Alexithymia. To deepen VA culpability the very social structure also, besides the very medical procedure that causes actual brain changes, may cause Alexithymia. Two sections of the UCMJ that they may be prosecuted under include, in part, Article 2 and Article 15. They state, in part: 10 U.S. CODE § 802 - ARTICLE 2 UCMJ a) Retired members of a regular component of the Armed Forces who are entitled to retirement pay are subject to the provisions of the UCMJ. . . and may be tried to courtmartial for violations of the UCMJ that occurred while they were on active duty or while in a retired status. b) Retired Reserve Component Soldiers are subject to recall to active duty for the investigation of UCMJ offenses they are alleged to have committed while in Title 10 status, for trial by court-martial, or for proceedings under UCMJ, Article 15. ARTICLE 15 UCMJ a) Forfeitures imposed under the UCMJ, Article 15 may even be applied against retirement pay. 15 

MANDATED REPORT to OSHA on the VA COVER LETTER Per California Penal Codes as well as 42 Federal Code and wic Dr. Richard L. Matteoli CA License 22647 CDR, DC, USN, (ret.), FMF Monterey, CA REQUESTING IMMEDIATE WHISTLEBLOWER PROTECTION FROM FURTHER RETALIATION FOR MYSELF; MONTEREY VA-DoD CLINIC including DR. NICHOLAS SASSON; MONTEREY COUNTY OFFICE, CALIFORNIA STATE VA; USING FBI INVESTIGATION WATSONVILLE, CA OFFICE Documentation provided with full case before VA Resolution Board. This request includes Report Recommendations as part of Counselling. Prior to present circumstances involving National Security regarding a new factor introduced in linking all prior Mandated Reports it was recently reported that the CIA-NATO is studying an issue in the Middle East to individual and social acculturation of violence, abuse and PTSD. Study being conducted by a person I have long time knowledge of. NOT specifically discussed in this Mandated Report Cover Letter. Enclosures including certain physicians’ masturbation video to a male genital surgical procedure on subject sent separate. 1 CONTENTS Introduction - 3 Veteran Contractual Rights Societal Responsibility Subcultural Criminology - 4 MENS REA MALUM PROHIBITUM MALUM IN SE MALPRACTICE HOBBS Act Mail and Wire Fraud RICO Act FERES Doctrine Little Tucker Act Sherman Act Clayton Act Homicide – Team Predation – Civil Conspiracy Clinical Impropriety - 8 Pharmacology Hearing Loss and Tinnitus Disability Ratings - 9 Shared Responsibility Reorganization - 10 Internal Structural Integration Department of Defense Integration External Civil Integration VA Employee and Contractor UCMJ Accountability - 14 2 INTRODUCTION VETERAN CONTRACTURAL RIGHTS 5 U.S.C. 2302, Section 7 IG ACT; 41 U.S.C. 4705; 3.9 FAR, 48 C.F.R. Part 3; inclusive WPA 1: DoD integrating with VA. EVERY Veteran signed a DoD Contract, even if Drafted. 2: Veteran proof of his/her Contract fulfillment, and how fulfilled, is the DD214. 3: Veteran Contract with DoD transfers to VA with all contractual rights including medical care. 4: As Contractors Veteran Rights extend EQUALLY as if the Veteran is also a VA employee(r). 5: VETERANS have the right to seek WHISTLEBLOWER PROTECTION from OSHA. DoD Directive 1241.1 Reservist Rights a Lesson for All. 1: Injury when on any kind of Duty is to be covered. There are NO minimum Days on Duty. 2: There IS NO WAITING TIME for eligibility to receive Service Related VA Care. INTENT of CONTRACT Contract Intent is based on Promises Made whether explicit, by inference or Common Knowledge within the social fabric. The veteran has all reasonable rights to be treated with International Usual and Customary Standards of Care and in a timely appropriate manner. SOCIETAL RESPONSIBILITY The woman becomes the vehicle of nature. The man becomes the vehicle of society, the social order, the social purpose. The woman is life. The man is the servant of life… Life has overtaken her. Woman is what it is all about, the giving of birth and the giving of nourishment. Without him she would become overwhelmed. Joseph Campbell, The Power of Myth. ALL Service Members understand, respect and give service to and are Servants of. YET: When does the Servant become a Slave? When does the Servant become a Sacrifice? There is blatant socio-functional Sexual Discrimination against males and also, at least exclusive in one respect, female Servants of Life and its Social. A demographic study of sexual ratios to occurrences of Veteran Deaths, Denials, Improper Pharmacology and Structural Avoidances of Eligibility, Access, Delays, Treatment, and Red Flagging is required. Immediate social maternal Life concerns that too often become out-of-hand, mostly without individual and social responsibility, do not negate Servant rights especially when Contractual. X X 3 SUBCULTURAL CRIMINOLOGY MENS REA MENS REA a guilty mind; the mental state accompanying a forbidden act. For an act to constitute a criminal offense, the act usually must be illegal and accompanied by a requisite mental state. Criminal offensives are usually defined with reference to one of four recognized criminal states of mind that accompanies the actor’s conduct: (1) intentionally; (2) knowingly; (3) recklessly; and, (4) grossly [criminally,] negligent. The mens rea may be GENERAL, i.e., a general intent to do the prohibited act, or SPECIFIC, which means that a special mental element is required for a particular offense such as “assault with intent to rape” or larceny which requires a specific intent to appropriate another’s property. In a criminal prosecution, the state must prove beyond a reasonable doubt that the required mental state coexisted with the doing of the proscribed act. Defenses of insanity, intoxication and mistake may either nullify or mitigate the existence of a SPECIFIC MENS REA. Crimes that are malum prohibitum often do not require any specific mens rea. See 343 U.S. 790. These are usually crimes of strict liability. MALUM PROHIBITUM MALUM PROHIBITUM Lat: wrong because it is prohibited: made unlawful by statute for the public welfare, but not inherently evil and not involving moral turpitude. Refers to acts prohibited solely because of the existence of statutes. It is contradistinguished from malum in se. For example: driving at excessive speed, is malum prohibitum because statutes prohibit as a result of a determination that it is dangerous to the community, though it may not be inherently dangerous; whereas, reckless driving would be regarded a as malum in se. 4 MALUM IN SE MALUM IN SE - Lat: evil in itself; “naturally evil, as adjudged by the sense of a civilized community.” It refers to an “act or case involving illegality from the very nature of the transaction, upon principles of natural, moral and public law.” For example, murder is “malum in se” because even without a specific criminal prohibition the community would think it to be evil and wrongful act. Compare malum prohibitum. MALPRACTICE MALPRACTICE a professional’s improper or immoral conduct in the performance of duties, done either intentionally or through carelessness or ignorance. The term is commonly applied to a physician, surgeon, dentist, lawyer, or public officer to denote the negligent or unskillful performance of duties resulting from such person’s professional relationship with patients or clients. Steven H. Gifis, Law Dictionary, Barron’s HOBBS ACT – 18 U.S.C. §1951 Illegal for Federal Government Employees to get BONUSES and considered BRIBERY. The HOBBS ACT prohibits actual or attempted robbery or extortion affecting interstate or foreign commerce. Section 1951 also proscribes conspiracy to commit robbery or extortion without reference to the conspiracy statute at 18 U.S.C. § 371. Although the Hobbs Act was enacted as a statute to combat racketeering in labor-management disputes, the statute is frequently used in connection with cases involving public corruption, commercial disputes, and corruption directed at members of labor unions. Jurisdiction: US Department of Labor. Extortion under color of official right or extortion by a public official through misuse of his/her office is supervised by the Public Integrity Section, Criminal Division. Extortion and robbery in labor-management disputes is supervised by the Labor-Management Unit of the Organized Crime and Gang Section, Criminal Division. All other extortion and robbery offenses not involving public officials or labor-management disputes are supervised by the Organized Crime and Gang Section, Criminal Division. The three most common statutes used against Bribery are in 18 U.S.C. §666 (a) certain programs receiving government funding, (b) honest services fraud; and, (c) extortion under color of official right: The coercive element is provided by the public office itself, Evans v. U. s. 504 U.S. 255 (1992). Some courts have held that the HOBBS ACT can be applied to past and present public officials, as well as to ones who presently occupy a public office at the time the corrupt payment occurs. The court held in the affirmative the question whether, within the meaning of the Hobbs Act, it is a crime for candidates for political office to conspire to affect commerce by extortion induced under color of official right during a time frame beginning before the election but not ending until the candidates have obtained public office. Courts have upheld elected officials under color of official right where the public officials induced a third party to pay out money. (See: Congress designates IRS to pay selected VA employees BONUSES). 5 MAIL FRAUD - 18 U.S.C. §1341 and WIRE FRAUD – 18 U.S.C. §1343 Scheme to Defraud, deprive Honest Services, Bribery, Failure to Disclose, Conflict Interest Mail and Wire Fraud statutes are to combat the Common Law crime of Larceny by Trick. Mail Fraud requires: (a) scheme to defraud, (b) use of interstate communications through the Postal Service or private carrier. Wire Fraud is through, in part: (a) telephone calls and (b) e-mails. Involved are, in part: (a) deprive another the right to Honest Services – 18 U.S.C. §1346 arising, in part, from: (b) Hobbs type Bribery (c) Failure to Disclose (d) Conflict of Interest. RICO ACT – 18 U.S.C. §1962 Government Employee Racketeering -> Bonuses -> with their Union as Representatives RICO requires a Pattern of Behavior involving two or more aspects of Racketeering. Public officials are NOT exempt, but under a Higher Standard. (a) Impossible to otherwise designate a government office and its official NOT to affect or NOT act through Interstate Commerce. (b) uses, in part, Mail Fraud, Wire Fraud, Bribery, Hobbs Act violations. (c) Requires prosecution with Forfeiture of Assets gained, fine and prison. SHERMAN ANTITRUST ACT - 15 U.S.C. §§1-7 Government contracts, combinations, conspiracies, commerce, customer allocations The Sherman Act prohibits (a) contracts, combinations, or conspiracies in restraint of interstate commerce or foreign trade, and (b) monopolization, attempts to monopolize, or conspiracies to monopolize interstate commerce or foreign trade. While every violation of this Act is technically a felony, the Department reserves criminal prosecution for so called “naked” or “per se” unlawful restraints of trade among competitors, e.g., price fixing, bid rigging, and customer and territorial allocation agreements. Criminal violations of this Act carry a maximum fine of $100 million for defendant (being the government is a corporation, $1,000,000 for other persons, and a maximum prison sentence of ten years per person. Thus if deserved benefits for any reason are withheld creating victim transfer of funds as Insurance Policies, Loss of Supplemental Disability Insurance, Sale of Transportation or any asset transfer by veteran to survive through loss of income especially necessary for life and liberty a criminal act has occurred. This means if a veteran must give up monthly income so to live, a violation has occurred due to confiscation of veteran assets and Free Use thereof. CLAYTON ANTITRUST ACT - 15 U.S.C. §§12-27; 29 U.S.C. §§52-53 Government contracts creating non-competitive monopoly The Clayton Act prohibits corporate and other mergers – and acquisition of assets of competing companies, where the effect of such action may be substantially to lessen competition or tend to create a monopoly. Anticompetitive tying and exclusive dealing contracts are also prohibited, as are certain interlocking directorates. Violations of this Act are prosecuted civilly. 6 FERES DOCTRINE – 340 U.S. 135 (1950) Cannot sue the military The Feres Doctrine extends the English Common Law of Sovereign Immunity even from negligence. DoD transfers to the VA what it cannot, and at times will not, medically provide. This is true except in cases of non-treatment for communicable diseases endangering the public. LITTLE TUCKER ACT – 28 U.S.C. §1346 Can sue military if released without Communicable Disease treatment as TB and STDs Tuberculosis is and always has been a Public Health Care concern. California, and presumably every State in the United States, has a Mortality and Morbidity monthly Newsletter for all Health Care Providers to receive by mail if they choose to subscribe. This has been available since before 1970. In the 1970’s California would send Emergency Notices if a local occurrence or outbreak occurred mostly due to migrants and international visitors. The VA requires Temporary Disability if contact occurred in Asia or Southwest Asia. Yet Tuberculosis is area endemic in places as Alaska and should also be covered due to Training Exercises. If the Tuberculosis is NOT active, and at the minimum contact is shown by a positive TB test, Prophylaxis may be indicated – especially if a lung lesion, though inactive, occurs. If Tuberculosis is active they must be isolated. Ebola patients brought to the United States should and have been properly isolated in Tuberculosis specified isolation units. BUMED does not provide prophylaxis in certain cases, yet required necessary Liver Monitoring due to drug toxicity. The VA provides Prophylaxis but their unspoken Policy and Procedures disallows proper Standard of Care Liver Monitoring. Yet BUMED Tuberculosis Protocol requires Prophylaxis WITH Liver Monitoring. The VA is basically a DoD extension to fulfill Contractual Obligations of the United States. BUMED Instruction: BUMED INSTRUCTION 6224.8 HOMICIDE - TEAM PREDATION – CIVIL CONSPIRACY HOMICIDE any killing of a human being by another human being; most commonly used to refer to an unlawful homicide such as murder or manslaughter. “The destruction of the life of one human being by the act, agency, procurement or culpable omission of another. The destruction of life must be complete by such act or agency; but although the injury which caused death might not, under other circumstances, have proved fatal, yet if such injury be the cause of death, without it appearing that there has been any gross neglect or improper treatment by some other than the defendant. . . it would be homicide.” ACCESSORY one who aids or contributes in a secondary way or assists in or contributes to crime as a subordinate. ACCOMPLICE an individual who voluntarily engages with another in the commission or attempted commission of a crime. AID AND ABET to actively, knowingly, intentionally, or purposefully facilitate or assist another individual in the commission or attempted commission of a crime. Steven H. Gifis, Law Dictionary, Barron’s 7 CLINICAL IMPROPRIETY PHARMACOLOGY Improper pharmacological use of medications is a leading cause of Health Care caused Mortality and Morbidity. Iatrogenic Pathophysiology. The Physicians’ Desk Reference is a book containing prescription drug Material Safety Data Sheets (MSDS), given by the pharmacist with each prescription. Needed is a Directive to prescribe, treat and if needed test accordingly. It would be wise for the VA to take the lead in Health Care by setting up in each Region a Collegial Pharmacy Review Help-Line that will aid physicians with patients requiring a multitude of prescriptions as well as a Hot Line for professionals asking something to be reviewed without fear of Retaliation. Quality Control. Always: Safety First. HEARING LOSS and TINNITUS Veterans Affairs denies approximately 50,000 Hearing Loss and Tinnitus Claims for Disability annually. ALL denied Disability Claims must be reviewed. The VA uses only the Hearing Aid test that tests to 4000Hz. This is a Function test, as is the military’s test to 6000Hz. International Usual and Customary Standards for diagnosing Hearing Loss Pathology, at the minimum, starts Diagnostic testing at 8000Hz. Quality Control. The VA will then establish trained analysists that can perform all Hearing Loss and Tinnitus Disability Claims via computer communications with Agent assigned, per Agent request. Then cut and paste into Claim Decision. Other situations may functionally apply? The temporary Tinnitus Notch for noise damage ranges from 4000Hz to 2000Hz. VA testing only to 4000Hz does not allow for a complete viewing to determine Service Connected harm which might not even necessarily be fully inclusive due to other factors as chemical contamination or pharmaceuticals. 8 DISABILITY RATINGS: SHARED RESPONSIBILITY EXAMPLE: HEARING LOSS 1: Establish Legal International Usual and Customary Diagnostic Testing for Auditory Pathology to 8000Hzx 2: Maintain Hearing Aid Standards to 4000Hz 3: Use Graph similar to Example Photo. 4: Make Graph Overlay for each year of life. 5: Graph Overlay to include Range of Normalcy. 6: Hearing Loss Greater than Range of Normalcy is Pathology: Unilateral - Bilateral. 7: Establish if Service Connection applies. 8: Establish Claimant Lifestyle. 9: Establish Percent (%) Shared Responsibility if applies. 10: Shared Responsibility may be calculated as 50% Equity; or, otherwise different. EXAMPLE: TINNITUS 1: Determine Existence and Severity of Tinnitus also with affecting Cognitive Hearing Loss. 2: Establish Cause and Multiple Causes of Tinnitus. 3: Establish Claimant Lifestyle and Truthfulness. 4: Establish Percent (%) Shared Responsibility if applies. 5: Shared Responsibility may be calculated as 50% Equity; or, otherwise different. EXAMPLE: CARDIOLOGY 1: Respect civilian, other Federal and State diagnoses which are proven more correct than VA. 2: AVOID Specialist MISDIRECTION in Diagnosis using unnamed different Procedure Codes. 3: Note whether disease is Progressive or resolvable with treatment and recurrence possibility. 4: Atherosclerosis may be consolidated into this Specialty Claims Agent Responsibility. 5: Shared Responsibility may be calculated as 30%, 50% or 70% Equity; or, otherwise different. EXAMPLE: CONSOLIDATION 1: Note that workplace Safety has increased compared to past military work environments. 2: Use all newly established Procedure Code Guidelines to be mandatory inclusion with Claim. 3: Factor Latency of Clinical Presentation as Heavy Metal Poisoning and Alexithymia-PTSD. 4: Note whether each is Progressive or resolvable with treatment and recurrence possibility. 5: Shared Responsibility may be calculated as 33% to 67% Equity; or, otherwise different. FUTURE 1: Establish reasonable amount Specialty Case Claims Sections to interact with Claims Agents. 2: Promote to Disability Case Claims Agent from within those who have completed all rotations. 3: Promote from within to Manager Disability Case Claims Agents those who have completed a designated time as a Disability Case Claims Agent. Corpsmen, Medics extra 5% on application. 9 REORGANIZATION Veterans Affairs failures are mainly structural. They are overwhelmed making inefficiency a way of life that leads to loss of discipline thus opening an avenue for criminal behavior to enter, flourish and become institutionalized. Veterans Affairs requires metamorphosis, not destruction. Metamorphosis involves a taking apart, rearrangement and putting back together. This means how it relates both as a society within itself as well as how it relates outside itself as a place within society as a whole. The following are recommendations to initiate discussion for improvement to best serve the patient that then serves society as well. This involves three basic aspects in its existence. To illustrate: 1. Veterans Affairs Structural Integration – Internal 2. Military Integration - Internal <-> External 3. Civil Integration - External INTERNAL VETERANS AFFAIRS STRUCTURAL INTEGRATION CLINICAL 1: Pharmaceuticals: Improper use of pharmaceuticals is the leading cause of death in Health Care. It is industry wide. The VA is not different except that pharmaceutical impropriety has become its own Industrial Standard. Cure is within the grasp of Veterans Affairs. Only a couple of steps are necessary to solve this problem: a) Physician’s Desk Reference (PDR): Simply issue a Directive that medications, with all facets required in its dispensation and proper use are to be in accordance to the Material Safety Data Sheet (MSDS) found in the PDR and given to the patient when they pick up their prescription both in house and emphasis given the patient for home care. And, strictly enforce it. b) Pharmaceutical Resource Facilities: Each Region needs to establish a Pharmaceutical Resource Facility. It must be Collegial at all times. It should be Management staffed by Pharmacists. This is where physicians can phone with questions especially regarding patients on complex medication program of treatment, a Review section that flags complex cases for review and some patients put on an update review schedule for the treating physician as well as a Hotline for VA employees with concerns and with NO FEAR OF RETALIATION. This has long time been discussed by professionals since my time stationed at Great Lakes 1984-1986. TAKE THE NECESSARY LEAD. 10 Yet, it must be noted that there is leeway in use of medications depending on the patient’s condition, where they are at within the course of their Treatment Plan as well as certain times and places variation might be best to test current treatment efficacy. 2: International Usual and Customary Standards of Care: Veterans Affairs in many ways is open to liability by practicing Below the International Usual and Customary Standards of Care. One case alone, beyond improper use of medications, is the Hearing Loss and Tinnitus Pathologic examination. The VA denies approximately 50,000 such cases per year. They must all be reviewed and retesting required is new test is found appropriate for a correct PATHOLOGIC Diagnosis. a) To accomplish this correction of past impropriety each Region can set up a Hearing Loss and Tinnitus Review facility. Staffing may consist of new employees. With proper training they may become Technical Specialists for such Disability Claims. The Standard Claims Agent can forward the Test and all Clinic notes with Patient History and, if available, civilian diagnostics. The Review Specialist then does the Disability Protocol and returns the final decision to the Standard Claims Agent. If the Standard Claims Agent accepts after his/her review this then will be the official Decision to which the Clamant may respond. b) RESULT: creates an Internal Review process among Veterans Affairs professionals. c) This Procedural Protocol may be duplicated in other specialties and sub-specialties as Veterans Affairs deems efficient. d) Insurance companies hire retired and disabled physicians, dentists and other Health Care Providers on a Full Time as well as a Part Time basis. HARD ASSET REALLOCATION: PHASE I A main problem with Veterans Affairs is construction and maintenance of Hard Assets. The Hard Asset to be first assessed would be the VA Hospitals themselves. Hard Asset Reallocation is already part of Veterans Affairs Hospital affiliations with Medical Schools and an avenue to seriously look into this program that should be used and expanded if possible when greater efficiency is shown to be established. Hard Asset Reallocation in use, but entirely forgotten, is existent in at least two California Veterans Affairs agreements with two California Medical Schools. These two are: a) Mather Veterans Affairs with University of California Davis Medical School. Sacramento County sold its County Hospital to the State of California for $1 (one dollar) in which new Davis Medical School could use for both didactics yet mostly patient treatment. Yet it also maintained its County Hospital status for a treatment facility for the poor. I used to cover the Dental Clinic for a friend when gone where both the poor were treated and the Medical School patients were located for their treatment b) Palo Alto Veterans Affairs with Stanford University Medical School. Palo Alto County Hospital was merged into Stanford University Medical School in like manner as Sacramento County Hospital with UC Davis Medical School. c) SOLUTION: Sell (or Lease) all VA Hospitals to existing Medical Schools whether public or private that the VA has a relationship with. Maintenance now totally belongs to the State or Medical Schools. Phase II belongs to the VA and the DoD into the school. 11 DEPARTMENT OF DEFENSE INTEGRATION Veterans Affairs is currently integrating with the Department of Defense. SOFT ASSET REALLOCATION: PHASE II At the same time Veterans Affairs sells its Hospital Hard Assets to the associated medical schools, the medical schools LEASE BACK the hospital to the VA Residencies for the same price of $1 (One Dollar) and maintain the relationship including Medical Residencies. Soft Asset Reallocation will benefit Veterans Affairs, Medical Schools and most of all patients served as well as society in general. Put in other words, it is a win-win-win-win restructuring: a) TRICARE is a DoD Insurance Program set up as a standard insurance company where care provided is set to Industry Standards thus allowing maneuvering to keep up with advances in Health Care, not be involved in government stagnation and not be involved in other social programs as paying a premium to fund the Death Penalty of/by its patients. b) Medical schools may then bill Tricare, social security, private insurance c) Monies above and beyond collection and maintenance costs may then be reallocated back to the Medical School-Veteran Affairs partnership. d) Monies may be spent on VA requested needs as new and upgraded equipment, supplies and disposable treatment items. e) Integration with Medical Research may be extended into non-treating colleges and Universities. f) Electronic Shared Health Care Records, secure in each Agency, HIPPA transferred upon PROPER request and establish PROPER SOAP Noting. PATIENT CARE REALLOCATION: PHASE III a) b) c) d) e) f) g) Give Tricare Insurance Options to Veterans as either a Primary or Secondary Carrier. Maintain focus on treating Service Connected Disabilities Upgrade then maintain Increased Reserve Readiness Maximize Shared Civilian Health Care Assets and Inter-service Cooperation Maximize Educational Health Care Assets increasing Research Capabilities Eliminates Majority Travel Reimbursements and other Ancillary Expenses COST: Dental Clinics to be installed by the Medical Schools from monies provided by insurance payments. 12 RESTRUCTURING RESERVE HEALTH CARE ASSETS INTO VA-DoD: PHASE IV VBA REGIONS VHA REGIONS It is imperative to maintain the health of both Active Duty and Reservists. Dental Class 3 and Class 4 are the military’s greatest problem in Readiness. With Reserve Recalls dentistry is often needed before In-Country Deployment resulting in Delayed Response times when maximum Total Force efficiency is required. Full Command Structure upon DoD determination. Restructuring DoD into VA for Humanitarian and National Emergencies a) Restructure Non-Combat Geneva Convention Code assets into DoD war time functions for each Branch of Service. b) DoD as well as Each Branch of Service may have upon determination the ability to issue Stand-By Orders as they see fit to emergent situations within their scope of function and interests therein. Seriousness and Heads-Up may be within a Coded Seriousness of potential Threat. FUNCTIONAL SCENERIO: Hurricane Katrina. c) Reserve Military Assets includes all Support Functions to make Command and Control fluid and timely. LOGISTICS. d) AIR FORCE and USPHS: VA Hospitals function as a Rear Echelon Fleet Hospital. 1) Command and Control belongs to the Air Force. 2) Administrative functions for all Branched of Services are to be Deployed to the VA Hospital. 3) Orders are to be written while assets are Deployed as when 9/11 occurred one of our New York FORCEMED (USMC) Units IMMEDIATELY went to the scene. 4) VA and Medical Schools to assist. e) ARMY functions as a MASH Element and should be Deployed to VA Clinics outside immediate Hospital access and/or Triage assessed for Medical Evacuation to the VA Hospital/Fleet Hospital. f) NAVY functions where most needed whether at the VA Fleet Hospital, VA Clinic MASH scenario AND USMC Attached FORCEMED First Responder in highly most mobile BATTALION AID STATIONS. g) ALL AIR ASSETS and MOTOR TRANSPORT Reserve Components function according to Branch of Service and/or where needed. This includes AIR NATIONAL GUARD. h) SECURITY Presence as determined by each Branch of Service, DoD, Joint Chiefs command decisions. i) RESULT: 1) Purpose and Function Maximized. 2) DoD secures PRIMARY use of their Assets before other Agencies as DHS and the IRS. 3) Civilian Assets will volunteer. 13 EXTERNAL CIVIL INTEGRATION Veterans who rate a disability should be given Tricare for Life and allowed to seek civilian health care if more expedient and as a Supplemental Insurance to Social Security Disability. All Veterans should automatically be given Tricare for Life when they turn 65, the current retirement age as a Supplemental secondary insurance to Social Security. Being Tricare is a DoD government insurance program other branches of our government should be allowed to use and participate in its benefits. Administration for other than DoD use would best be through Department of Health and Human Services (DHHS) and be as a replacement for many instead of Obamacare. The premium rates would be far less. The vetted Obamacare insurance companies are the same as the insurance companies lost by many due to Obamacare, and the insurance company’s profits are higher with Obamacare. The program exists, web site up and running and all that would be necessary is to use their existing Family Plans to choose from and put a Code Number for the coverage program just as any other insurance coverage identification clarification. By using Tricare through DHHS instead of Obamacare it will transfer Administration of Health Care away from Department of Homeland Security (DHS) and the Internal Revenue Service (IRS) and put any form of National Health Care where it belongs, to put in other words, health care should be run by health care professionals. It all depends on what society truly desires in health care. By using Tricare instead of Obamacare eliminated would, in part, be: a) Elimination of the Death Penalty clause where people are paying for executions. b) More appropriately eliminate the possibility of the Saudi invention of a Wifi activated Lethal Dose in the soon to be required computer chip. c) Reduce politically favored exemptions as well as contractual fraud. d) Eliminate stagnation of treatment to allow industry standards of treatment updates which is how Tricare is set up to do. 14 VA EMPLOYEE and CONTRACTOR UCMJ ACCOUNTABILITY 10 U.S. CODE CHAPTER 47: UCMJ ALL employees of Veterans Affairs who have ever served in any Branch of the United States Uniformed Services are still under the Uniform Code of Military Justice (UCMJ) and subject to recall for non-judicial punishment. This includes the very probable loss of Benefits and Retirement Pay if applicable. Included in this are those who are NOT Veterans Affairs employees but Health Care Providers who while in the military performed illicit medical studies of a criminal nature that leads to improper medical care and the disciplining of those who object to their improper use of medicine. This includes VA patients. The VA is supporting medical procedures that may become a part of PTSD through the causation of Alexithymia. To deepen VA culpability the very social structure also, besides the very medical procedure that causes actual brain changes, may cause Alexithymia. Two sections of the UCMJ that they may be prosecuted under include, in part, Article 2 and Article 15. They state, in part: 10 U.S. CODE § 802 - ARTICLE 2 UCMJ a) Retired members of a regular component of the Armed Forces who are entitled to retirement pay are subject to the provisions of the UCMJ. . . and may be tried to courtmartial for violations of the UCMJ that occurred while they were on active duty or while in a retired status. b) Retired Reserve Component Soldiers are subject to recall to active duty for the investigation of UCMJ offenses they are alleged to have committed while in Title 10 status, for trial by court-martial, or for proceedings under UCMJ, Article 15. ARTICLE 15 UCMJ a) Forfeitures imposed under the UCMJ, Article 15 may even be applied against retirement pay. 15