VA Mental Health Provider Venting / Problem-solving / Peer Support Thread

[WisNeuro]

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That's a very, very partisan and dramatic-sounding letter. I'm not surprised.

And yeah, it sounds like they're saying all telework employees need to be back in-office within 30 days, unless there's a valid exception.

I'm no lawyer, but I wonder about incoming lawsuits, especially if an employee's contract/hiring documents specified some set amount of telework (or it's general availability).

Oh, I'm assuming law firms for the Trump Admin and AFGE are going to make out very well in the next four years.

 

[cara susanna]

There's a Minneapolis politician who posted about the VA hiring freeze and how Minneapolis VA is rescinding offers, and there are all these replies of like "YOU'RE LYING."

That's a very, very partisan and dramatic-sounding letter. I'm not surprised.

And yeah, it sounds like they're saying all telework employees need to be back in-office within 30 days, unless there's a valid exception.

I'm no lawyer, but I wonder about incoming lawsuits, especially if an employee's contract/hiring documents specified some set amount of telework (or it's general availability).

The "like everyone else" really got me. My brother and sister (private sector) both telework.

 

[AcronymAllergy]

There's a Minneapolis politician who posted about the VA hiring freeze and how Minneapolis VA is rescinding offers, and there are all these replies of like "YOU'RE LYING."



The "like everyone else" really got me. My brother and sister (private sector) both telework.

Exactly. I know plenty of people who telework part- or full-time. Maybe not as much in healthcare, but even there, it's not like there's a shortage of MH providers offering teletherapy, many of whom have no physical office space.

And yeah, I'm not at all surprised that there are some people nowadays who choose to completely disregard as false anything that goes against their stereotypes and preconceived notions of truth. It's a shame it's a politician spreading the misinformation, considering he has direct access to first-hand sources, but that's also not surprising. "Say or do something that may be unpopular with my base, even if I've overtly supported those things in the past? LIES! FAKE NEWS!!"

 

[WisNeuro]

There's a Minneapolis politician who posted about the VA hiring freeze and how Minneapolis VA is rescinding offers, and there are all these replies of like "YOU'RE LYING."



The "like everyone else" really got me. My brother and sister (private sector) both telework.

I know many people at that VA, and they are definitely rescinding offers. Another good friend who is telework in pharm, got funding to hire 22 positions for high needs areas, just had rescind all of those offers. Have fun with those waitlists Vets! This is what you voted for.

 

[mind_over_matter277]

Wonder how this would impact internships and postdoctoral programs?

 

[VAsocialwork]

Any way this can be fought with union? Anyone tried reaching out to union rep? Even with this memorandum we have still heard nothing.

 

[cara susanna]

We already have a staff therapist leaving (taking retirement) because of all that's going down. We are already down to a skeleton crew, and this is going to make things even worse. I have no idea what we're going to do.

 

[Neurocaterpillar]

My current internship program is coming to an end after my year due to hiring issues and lack of supervisors, just as an example. So I think it may impact trainees quite a bit indirectly

Same - our internship training program is also coming to an end (this is a VA)

 

[Fan_of_Meehl]

We already have a staff therapist leaving (taking retirement) because of all that's going down. We are already down to a skeleton crew, and this is going to make things even worse. I have no idea what we're going to do.

And, as recently as yesterday, veterans were providing testimony to Congressional committes in hearings critical of the wait times for MH appointments at VA. They were also complaining about lack of 'proper' recognition of distinctive diagnosis/treatments available for 'complex PTSD (as opposed to vanilla/canonical PTSD)' but that's a whole 'nother story. They were complaining that they had to seek a community care provider to provide the 'correct' and 'necessary' intervention of Internal Family Systems Therapy for their cPTSD. Fun tumes ahead.

 

[Shiori]

We just rescinded an offer this morning to a psychologist who was already supposed to be here, but they were stuck in HR hell. I am heartbroken because they would have been an amazing addition to the team.

 

[mind_over_matter277]

We just rescinded an offer this morning to a psychologist who was already supposed to be here, but they were stuck in HR hell. I am heartbroken because they would have been an amazing addition to the team.

VA has been instructed to rescind every and all offers before 1/20/25 and with a start date no later than 2/08. I have heard that they have rescinded offers with earlier start dates as well?

 

[futureapppsy2]

Down to 17 VHA jobs posted on USAJOBS (and those are all from the same couple of sites, so I suspect HR there just hasn’t has time to remove them yet) and zero for VBA.

 

[WisNeuro]

 

[Fan_of_Meehl]

It's definitely smokin, at this point...

 

[IWillSurvive]

So you can be hired into a position that is designated as remote in the job title but be required to come back into the office? Am I missing something? Seems like I should have some greater protection here than a teleworker.

 

[AcronymAllergy]

And, as recently as yesterday, veterans were providing testimony to Congressional committes in hearings critical of the wait times for MH appointments at VA. They were also complaining about lack of 'proper' recognition of distinctive diagnosis/treatments available for 'complex PTSD (as opposed to vanilla/canonical PTSD)' but that's a whole 'nother story. They were complaining that they had to seek a community care provider to provide the 'correct' and 'necessary' intervention of Internal Family Systems Therapy for their cPTSD. Fun tumes ahead.

I was about to say--they'll have no problem finding many providers in the community willing to make that diagnosis. Double so for those who have little to no experience working with veterans.

And obviously the solution to reducing wait times is to...make clinical staff easier to fire and freeze their hiring. Even with exceptions for psychologists, VA (or OPM) has poisoned the well with the folks they've knee-jerk rescinded offers for.

I wonder if someone involved in this whole decision-making process is a part owner of a large practice network poised to begin taking on large government contracts to provide clinical services en masse.

 

[VAsocialwork]

I was about to say--they'll have no problem finding many providers in the community willing to make that diagnosis. Double so for those who have little to no experience working with veterans.

And obviously the solution to reducing wait times is to...make clinical staff easier to fire and freeze their hiring. Even with exceptions for psychologists, VA (or OPM) has poisoned the well with the folks they've knee-jerk rescinded offers for.

I wonder if someone involved in this whole decision-making process is a part owner of a large practice network poised to begin taking on large government contracts to provide clinical services en masse.

I assume this whole thing was a knee jerk reaction to wanting to fire DEI and other bureaucrats without any concern of medical specialties getting caught in crossfire. All some dumb cascading effect of a tweet by Vivek or Elon joking about how if they were forced to come in every day, the targeted feds would quit. It makes zero practical sense and will only cause staff retention to drop and hurt veterans. Of course it’s necessary for retention to keep telework. They did a hiring freeze to ensure no DEI new hires. That’s what it comes down to

 

[Sanman]

I was about to say--they'll have no problem finding many providers in the community willing to make that diagnosis. Double so for those who have little to no experience working with veterans.

And obviously the solution to reducing wait times is to...make clinical staff easier to fire and freeze their hiring. Even with exceptions for psychologists, VA (or OPM) has poisoned the well with the folks they've knee-jerk rescinded offers for.

I wonder if someone involved in this whole decision-making process is a part owner of a large practice network poised to begin taking on large government contracts to provide clinical services en masse.

That already happened during the George W Bush administration with C&P evals....Anthony Principi.

 

[Sanman]

I assume this whole thing was a knee jerk reaction to wanting to fire DEI and other bureaucrats without any concern of medical specialties getting caught in crossfire. All some dumb cascading effect of a tweet by Vivek or Elon joking about how if they were forced to come in every day, the targeted feds would quit. It makes zero practical sense and will only cause staff retention to drop and hurt veterans. Of course it’s necessary for retention to keep telework. They did a hiring freeze to ensure no DEI new hires. That’s what it comes down to

They did a hiring freeze to make sure no one in the government could be hired until they had a plan to fire who they wanted. DEI or not. This is "draining the swamp".

 

[Shiori]

I know I complained about it before, but can our biggest controversy go back to being whether we participate in ESA/service dog form completion?

 

[quickpsych]

I wonder if someone involved in this whole decision-making process is a part owner of a large practice network poised to begin taking on large government contracts to provide clinical services en masse.

I'm sure the private equity firms that own many of the hospitals, skilled nursing facilities, online mental health "platforms" are salivating at the prospect at possible getting VA contracts (and maybe even the real estate the VA buildings stand on if Trump and his "advisors" decide to sell of federal property to "save money").

Just speculation obviously, but private equity has poisoned so many industries and so many institutions, why not the government ones?

 

[Fan_of_Meehl]

I'm sure the private equity firms that own many of the hospitals, skilled nursing facilities, online mental health "platforms" are salivating at the prospect at possible getting VA contracts (and maybe even the real estate the VA buildings stand on if Trump and his "advisors" decide to sell of federal property to "save money").

Just speculation obviously, but private equity has poisoned so many industries and so many institutions, why not the government ones?

That would be quite the rude awakening and debacle. It would be very interesting to witness the reactions of veteran MH patients to the sorts of expectations, boundaries, and consequences inherent to general MH practice outside the VA setting.

 

[Sanman]

That would be quite the rude awakening and debacle. It would be very interesting to witness the reactions of veteran MH patients to the sorts of expectatuons, boundaries, and consequences inherent to general MH practice outside the VA setting.

You too can experience the joys of angry veterans simply by clicking accept on the C&P examiner position where they will pay you the princely sum of $150-200 to engage in an increased risk of bodily harm to yourself with no health insurance or worker's comp should you be attacked in the parking lot or office.

 

[Fan_of_Meehl]

You too can experience the joys of angry veterans simply by clicking accept on the C&P examiner position where they will pay you the princely sum of $150-200 to engage in a increased risk of bodily harm to yourself with no health insurance or worker's comp should you be attacked in the parking lot or office.

I'm really starting to think that we should just allow veterans to 'self-certify' that they have PTSD at this point. The end results wouldn't be much different and we'd avoid a lot of wasted time/effort, gnashing of teeth, complaints and pretense. Let them set their own s/c percentages as well and watch both wait times for outpatient MH appointments and C&P exams/appeals drop by 80-90% overnight.

 

[cara susanna]

I just got invited to be a speaker for a DEI seminar series. Hrmmmm

Just got word that this series was cancelled. Not surprising but still sad.

 

[Shiori]

I notice the folks who are the most gleeful about all this chaos at my site have jobs that could easily be removed as wasteful too. Someone else is always "government bloat" and they are, of course, indispensable.

 

[ccpsych16]

Folks on Reddit are saying they’ve had offers reinstated at VA. Nurses and social workers, seemed critical/essential. I hope that extends to all MH, because we are also a bare bones crew and multiple CBOCs don’t even have a Section Chief. At least one was in the hiring pipeline, but now…

 

[psy.d. 2021]

Oh, I'm assuming law firms for the Trump Admin and AFGE are going to make out very well in the next four years.

AFGE needs to tie this telework/remote return to office stuff for awhile in lawsuits

 

[AcronymAllergy]

I'm really starting to think that we should just allow veterans to 'self-certify' that they have PTSD at this point. The end results wouldn't be much different and we'd avoid a lot of wasted time/effort, gnashing of teeth, complaints and pretense. Let them set their own s/c percentages as well and watch both wait times for outpatient MH appointments and C&P exams/appeals drop by 80-90% overnight.

Until evaluators are able to actually diagnose (or not) based on the available data without every appeal ultimately being granted, yep.

 

[AcronymAllergy]

You too can experience the joys of angry veterans simply by clicking accept on the C&P examiner position where they will pay you the princely sum of $150-200 to engage in an increased risk of bodily harm to yourself with no health insurance or worker's comp should you be attacked in the parking lot or office.

And there might be even more money to be made in the clinical space. Plenty of providers are hesitant to participate in forensic work (and/or aren't qualified for such), but imagine the windfall for large healthcare companies/venture capital whatevers getting juicy community care contracts to provide healthcare and then giving ~40-50% of what they bill to the clinicians. Wouldn't be surprised if coinciding with this are new EOs that "streamline" the government contracting system to eliminate any semblance of fair bidding, conflicts of interest exclusions, etc.

In those situations, I also have doubts about any boundaries that would actually be established. It seems like it'd end up being VA 2.0: similar situation to VA, but with providers who are less well-trained and/or experienced (because who else would take those rates) and with fewer resources (e.g., multidisciplinary care and referrals, shared medical records) available.

 

[WisNeuro]

AFGE needs to tie this telework/remote return to office stuff for awhile in lawsuits

Considering which federal courts have been packed with far right wing fringe figures, I wouldn't hold out hope there.

 

[cara susanna]

Our facility is interpreting the telework order as more related to specific agencies as opposed to individual front line staff

 

[Shiori]

Our facility is interpreting the telework order as more related to specific agencies as opposed to individual front line staff

Ours said the same thing. ELT asked program managers to continue being very specific about when the employees are in the office vs teleworking. We update all of our contracts regularly, so I don't think that'll be an issue. The way they phrased it made it sound like people were losing track of their employees? I didn't think too deeply about it.

 

[cara susanna]

Hey, it's a normal complaint this time:

Why does VVC make the patient enter their address AND have the provider ask them to verbally provide it so we can document in the note? Seems incredibly redundant.

 

[tn15an]

Hey, it's a normal complaint this time:

Why does VVC make the patient enter their address AND have the provider ask them to verbally provide it so we can document in the note? Seems incredibly redundant.

Because people blindly enter their home address when they are actually out of the country and now you are practicing without a license because you assumed the address was correct

 

[cara susanna]

Because people blindly enter their home address when they are actually out of the country and now you are practicing without a license because you assumed the address was correct

Right, I get knowing the general location, but our VVC note makes you write in the address (or asks you to. I often don't, lol)

 

[Sanman]

Right, I get knowing the general location, but our VVC note makes you write in the address (or asks you to. I often don't, lol)

You should always do it. If something happens and it is not documented in the note...lawsuit. This just basic cya. If it is not written down then it did not happen.

 

[Shiori]

OPM is getting clowned for their suspicious looking email that goes against all the TMS trainings.

 

[cara susanna]

You should always do it. If something happens and it is not documented in the note...lawsuit. This just basic cya. If it is not written down then it did not happen.

I just document that the specific address was input into the VVC session. What usually happens is like: "I'm at my friend's house." "What's the address?" "uh, I entered it when I logged on..."

 

[cara susanna]

There are stories about VA police going around hospitals and taking down any DEIA materials from offices (has not happened here, at least not yet - our leadership right now is saying that these initiatives will not impact patient care)

Edit: I just found out that we had to remove patient-facing materials. At one VA hospital, they aren't even allowed to have anything in the provider offices either (including those safe zone triangles)

 

[Shiori]

That doesn't feel dystopian at all.

 

[cara susanna]

I was so fired up I talked to our manager and apparently the patient-facing materials have since been replaced. Our facility's interpretation of this order seems quite different from other VAs, though, from what I'm hearing (and I'm grateful for that)

 

[Shiori]

It seems like people are panicking and taking action without it being needed yet. Our stance seems to be mostly comply with the concrete stuff, but stay on standby with the assumption most things will keep changing to something less extreme.

 

[Sanman]

I was so fired up I talked to our manager and apparently the patient-facing materials have since been replaced. Our facility's interpretation of this order seems quite different from other VAs, though, from what I'm hearing (and I'm grateful for that)

Does that DEI snitching directive have a phone number? I feel like someone needs to anonymously call in and report VA police for DEI activities. Nothing like a bunch of false reports to get things rolling. Investigate everyone!

 

[Fan_of_Meehl]

That doesn't feel dystopian at all.

There are stories about VA police going around hospitals and taking down any DEIA materials from offices (has not happened here, at least not yet - our leadership right now is saying that these initiatives will not impact patient care)

Edit: I just found out that we had to remove patient-facing materials. At one VA hospital, they aren't even allowed to have anything in the provider offices either (including those safe zone triangles)

Are the police really necessary? Are they expecting the DEIA materials to offer physical resistance? This is so VA. 'We are sending armed officers to physically remove any pictures of rainbows. Please comply or you will be exterminated. Be sure to be on time for the daily 'Safety Meeting.' We wub you xoxoxoxoxox! Your Friendly VA Admin...kissykissykissy!'

 

[psychedaboutpsych123]

Does that DEI snitching directive have a phone number? I feel like someone needs to anonymously call in and report VA police for DEI activities. Nothing like a bunch of false reports to get things rolling. Investigate everyone!

Word on the reddit street is that the DEI email got spammed with people posting Simpsons quotes and links to adult websites

 

[cara susanna]

Word on the reddit street is that the DEI email got spammed with people posting Simpsons quotes and links to adult websites

Yup, there was an article about it

 

[WisNeuro]

Word on the reddit street is that the DEI email got spammed with people posting Simpsons quotes and links to adult websites

 

[WisNeuro]

BTW, I have definitely been e-mailing that link with various "reports" over the last day. I encourage everyone to submit their best rat****ery reports.

[email protected]

 

[Action_Potential]

[emoji[emoji6][emoji6]][emoji6][emoji[emoji6][emoji6]][emoji[emoji6]]" data-quote="AcronymAllergy" data-source="post: 0" class="bbCodeBlock bbCodeBlock--expandable bbCodeBlock--quote js-expandWatch">

I wonder if someone involved in this whole decision-making process is a part owner of a large practice network poised to begin taking on large government contracts to provide clinical services en masse.

It’s almost like Amazon purchasing OneMedical, and their one-size fits all approach to mental healthcare using health coaches and masters level clinicians, could benefit from this…