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week of April 19, 2009. I am writing withthe hope, time permitting, you will be so kind as to inform our Representatives of some of the more significant eoncems AFOE. LOCAL 1882 Officers, and many others, have concerning care of the Veteran patients at this health care facility 2. Providers! Privileging/Credentialing: Some months ago, AFGE leammed that this ‘Agency is foreing unsolicited Privileges/Credentials upon the Providers who work here, Example: Providers (M.D., PhD., Physician Assistants, Nurse Practitioners) spply for a positon at this Medical Center and there is an agreement between the (Chief of Staff and the Providers that they will work as an outpatient provider inthe Ambulatory Care Outpatient Clini, Monday through Friday, administrative hours. ‘The Provider accepts the positon and moves here. Once on board, the newly hited Providers are handed «different set of Privleges/Credentials and told to sign them, ‘The Providers will state that the Privileges/Credentials are not what he/she agreed to prior to being hired. Regardless the Providers are foreed to sign the new Privileges/Credentals, or lose their jobs. This has meant that Providers who have come here must work: Outpatient; in addition to Inpatient and Urgent Care ~- which also means they are working off shifts, s Oy ‘These Providers become anxious and concermed since many of them have not worked Urgent care since their Residency. At tis facility, there are extremely ill patients presenting at Urgent Care —and we do not have an Emergency Room nor an ICU. ‘Therefore, offen times, the patients who present to Urgent Care are more lke Emergency Room candidates. And, gain, the Providers I speak of have specialty in ‘outpatient clini patient cae; therefore, it is often time the Urgent Care RN's who are re-rienting the Dr.’ to the Urgent Care needs ofthe Veteran patients, 1of3 a4 Another example of forcing privileges/eredentials on Providers is: A memo is prepared by administration which reads: ‘I am requesting the following additions to ‘my clinical privileges-—"Ventilator Management,” ete, The canned memo is handed to the provider for their signature. Typically, the Provider will respond: “There must bbe some mistake. I did not request these privileges.” They will be told ~~ “You must sign the paperwork!" Keep in mind that many of the outpatient providers will not hhave worked with ventilators since perhaps residency years and yet are expected ta be ‘competent after signature on a memo and viewing a 20 minute video. ‘A second serious concern is the fact that many of the Veterans served at this facility are prescribed large quantities of narcotics, ‘There are providers and Registered Pharmacists who refuse to prescribe orto fill large quantities of narcotic prescriptions as ordered by the Chief of Staff, Dr. David Houlihan. Tt is a known fact that ifthe providers or pharmacists refuse to follow Dr. Houlihan's orders, they will be yelled at and perhaps fired. Quite recently a Pharmacist refused to fill an order for 1,000 narcotic tablets for a 30 day supply for ‘one of Dr. Houlihan’s patients —- the Pharmacist viewed the order as “unethical.” ‘This Pharmacist received a verbal thrashing from the Chief of Sta. (Many providers hhave left because of the harassment). This type of pressure makes it difficult forthe Droviders to “do the right thing” forthe patients 1 some of the patients do not receive the narcotics they request, they will goto the Patient Advocate and file a complaint against the Provider, (NOTE: The 2 Agency Patient Advocate positions report drecly to the Chief of Staff, which appears to be si conflict of interest and unethical.) When a patient visits the Patient Advocate with a ‘complaint against a Provider, ths is tallied against the provider and viewed as a “negative event.” Recently, a Provider was terminated/ired because she received “too ‘many complaints.” Some ofthese complaints were due tothe fact she would not reorder narcotics for some of the patients who appeared tobe at risk for further ‘addiction/abuse. Additionally, this same Provider challenged the fact that she was forced to signed Privileges/Credentals she did not agree to prior to being hired. ‘The Chie of StafThas instructed the providers they are not to do *ineldrug sereens” prior to ordering narcotics for patients, because the screening can be “inaccurate” For example, if a Veteran patent had been prescribed narcotics and came in erly, prior renewal date, to get more of the prescription naeotc, there could be reason to question what may be happening withthe drug; and, in some cases Providers may have ordered «urinefdrug seen. A urine screen could show ifthe patient sori nat ingesting the medication. A clean or trace, urine could very well indicate the Veteran patient is not himvbersel actually consuming the narcoties, There are several Veteran patents with narcotic contacts here ~~ regardless, very often these veteran are able o continue to receive narcotics mos times they request. To the best ‘of my knowledge, most Providers ~ per instruction ~ no longer oder urineldrug screens as an assessment oo pris to ordering re-ordering narcotic medications. ‘Many of the patients call Dr. Houlihan “The Candy Man” because ofthe easy access to narcotic drugs/medications at this facility. 20f3‘There have been several unexplained deaths at this Medical Center. In 2008, there ‘were three 3) suicides of veterans while sitting in parked vehicles on the Medical Center grounds. These patents were counseled by PsychiatrisChief of Staff Dr David Houlihan, Please know we have many concems for our Veterans and for the Employees. Ihave taken the liberty to attempt to explain two (2) of the most significant concems at this time. If you are able to assist the Veterans, AFGE and many others will be etemally ‘grateful. If, on the other, there i a different venue I should be taking; e.g contacting the Office of Inspector General ~ please so inform and I will do what it takes to ensure «safer care environment for our US. of A. Wartiors Respectfully Submitted, Lin Elinghyeen ‘Executive VP / Chief Negotiator / Steward ABGE LOCAL 1882 AFL-CIO VA. Medical Center 500 B, Veterans Street ‘Tomah, WI $4660 W-~ (608) 372-3878 C~ (507) 459-9669 Fax (608) 372-1689 3083 a A9 1 ko Aug. ter: QUESTIONS For LEADERSHIP men Ker, Line Yoo ¢ fickl, 1, Why is the Chief of Staff allowed 1o create a hostile working environment? “There have been complaints from health care staff — they are afraid thet ‘Dr. Houlthan will get them fired. ...as he has dseiplined/or made lie dificult for many providers (Dr.'s, Nurse Practitioners, Physicians ‘Assistans) as well as Nursing staff. ‘Why ist that so many providers (psychiatrist, psychologists) don’t stay here for long? (tis because they won't put up with Dr. Houlihan's yelling and threatening behaviors.) Itis reported that Dr, Houlihan doesn't physically/personally se and evaluate the inpatients on Acute Mental Health unit from their date of ‘admission up through their day of discharge. 77Does Dr. Houlihan merely ‘write patients’ prescriptions without physically assessing the patients? ‘Some employees have reported that several inpatients have asked Dr “HRoulihan when he will evaluate them and the Dr. wil tll the veteran that tne wil be beck later or ata specific hour of the day or night. Most often the Dr. does not show up! There have been veteran inpatients who have fot gone tothe dining room fo eat a meal, as they sit hy the elevator ‘because they don’t want to miss Dr. Houlihan's entrance onto the unit ‘Nursing staff have brought the patients their dinner trays asthe patents wait by the elevator! “There have been reports that Dr. Houlihan, after being off work for days/weeks, will re-write patients’ prescriptions/orders without physically being present and re-evaluating the patients. (This most frequently occurs ‘when Dr. Houlihan has been gone and there has been a visiting psychiatrist working in his place. Dr. Houlihan will re-write these orders from his home.) Dr. Houlihan does not telephone the mursing staff for an ‘update on the patients’ conditions. In fact, the nurses only lear ofthe ‘medication changes by happenstance/by luck! ‘Why does Leadership allow Dr. Houlihan to yell and seream ~ sometimes profanities, ~ at the providers and the nursing staff? thas been reported that Dr. Houlihan was involved in a witnessed event ‘wherein he verbally abused a patient. We understand thatthe VISN/Regional Office did an investigation. What was the outcome of that investigation? (There were 5 staff who witnessed this ~- and nothing was done about it! Dr. Houlihan yelled atthe patient; got in the patient's face; ‘and forcefully several times knocked his leg against the patients knee ‘This was a psych patient, debilitated, and siting in a wheelchair!) Lof22. Union Officers informed us that ata Labor/Management meeting on or about May 2007, Stan Johnson, former Director, informed all in attendance that Nursing had reoeived $8 Million dollars for staffing, It is a question for many V. A. employees as to where the money was spent! What was this money requested for? What was it spent on? (This Agency is short staffed ~ by approx. 25-30 RN's at ime ofthis writing) 3. Per some workers, there was money allocated for Neuro Virus vaccine ~ but instead of putting money towards the vaccine ~~ a flashing sign was purchased and placed outside bldg. 400, Admissions Bldg. August 7, 2008Elinghuysen, i a a From: Etinghuysen, Linda Sent: ‘Weshesday, July 28, 2008 1.04 PM To: Molnar, Jerid 0. (SES); Gregar, Sandra K; Houthan, David J; Everson, Lynda J; chant, Davis P ce: ‘Streeter, Diane H:; Haase, Kut, Hake, Jeanette; Lois Ames! Subject: Counsdling/Adverse Actonsiajor Adverse Actions 1 amwrting in reference to what occured on July 14, 2009 when Dr. Chris M. Kirkpatrick and I met in Dechant’s office wit: Dr. Loethen, Dr. Linder, and David Dechant. 2. Iwas taken off guard because Dr. K called me at 8:45am July 24, 2009 asking if would help him and be with him at this meeting. It sounded tke he had heard of tis meeting a short time before his cal to me ~ he didnt say that bt that was my perception. | asked Dr. Kto meet with me prior to going to Dechant’soffee. Shortly after Dr. Karrived to speak with me, t received cll from Dechant askin "for my assistance at 8am ins office.” 3. When Or. Kand | arrived at Dechant’ ffce those present were Dr, Loethen, Or. Linder, David Dechant. 4. Thisisnot to ever ever to occur again! Mr. Molnar you and oth know the history ofthis and past practice and fimess was totally ignored, by-passed and deliberate 5. Past Practice for Termination: Director, one AFGE Officer, employee —-no HR; no other person 6. Past Practice for Discipline: Manager, one AFGE Officer or Steward of employees’ choice, employee-—no other person 7. HR Specialist does not hie an fie; they advise. Perio. Dechant acted like the boss ing Or. K. Dechant’s ‘name was onthe Termination memo. No, oh no, never again! The responsibilty of the termination memo and ‘the termination meeting sts withthe Director who isthe only authority to fire/terminate. Perio. 8, What occured that day isa grievous offense a inst ust. Justice means "aleness” not “lust Us." Sz Many people wha knew and loved Chis called him "Or K” thus my endearing reference to him. Pe flinghagan fre VB Chl Negotiation AGL focal 1082 AELEO WA Modal Center Toma W! 54660 W-608:372,3971, 6 66278 (C-507 459.9669 Far 60872-1689(Cris Kirkpatrick - LinkedIn Page | of Chris Kirkpatrick (nical Psychologst at Veterans Adminstration Current Clinical Psychologist at Veterans ‘Administration Connections 1 connection Industry Health, Watiness and Fitness Chris Clinical Psychologist Veterans Administration (Governmant Agency; 10,001 or more employees: Heath, Wain Current holds this postion patrick’s Experience ‘sp swwwlinkedln.comipulchris-irkparich/11/401/271 ‘nsr2009JUNEAU COUNTY SHERIFF'S DEPARTMENT VOLUNTARY STATEMENT pe nia Doha e ocak a TTT pate or sinTH:_-aA7- /95 3 STREET ADDRESS: MWY 767 U.S. Huy Jd) © emvisrarezie:_/Ngvst WE" 53799 J, home 608 S97 HBP TeverHone: (DOF) 517 Y7 > —Trexe ano wnre me enousn anousoe Wes CHO | VOLUNTARILY WAKE THE FOLLOWING WRITTEN STATEMENT 0 THE JUNEAU COUNTY SHERIFP'S DEPARTHENT. 2 bom NeOSYA Ui hat 2 yee Aha fry lh Heveryerrd ante et ov b Plein call Ol) > doh. thon Bi Chet 1 thee AQ bays brilers MA rinomr Teh, | HAVE READ THIS STATEMENT, AND NOW SION IT AS BEING TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. f a sronnunex Mai Eohvwt —— mmesssrouarne: en Ak oare £14 3007 rme_Y°00 _ amfou, pace_/ _or_!__PAGESPage 1 of From "Bowe, Scott” > Sent Thursday, July 16, 2009 12:08 pm “Fo "ogoenring@ee juneau.¥.us" Subject Kirkpatick Ben, Kirkpatrick ved at W10120 Rush Re, Black River Fall from September of 2008 to June 30,2009, Kickpatrc’s landlord was: John Peasley M/W, DOB: 07-24-70 2022 Booth. Milwaukee, Wi 53212 414-254-0607 Kickpatiek’s neighbor was: Debra Finck F/W, DOB: 06-12-61 10126 Rush Rd. Black River Falls, Wi 54615, 715-284-6455 kirkpatric’s giend was reportedly: Kelly Willams 3260 N, Clark Apt #308 Chicago. 60657 773-346-5812? (last # may not be 22) Scott R. Bowe Dee i. accra vn sts Foe gisiaecise a scatbone -nspsetiwisemail wise-edu/co juneau.wi.usiprint html 7162009yw) bom bei Wi. - awPp l= Co l ( bra ad Mack e = &® ae to please e Qa kr “y dee, ,JUNEAU COUNTY SHERIFF'S DEPARTMENT ‘Crime Scene Entry Log F-04310 ty BA HE lead "og ate eleine Shae Goyette | 39 “Pesta Tau ‘NOTICE: ALL PERSONS ENTERING SCENE MUST READ AND SIGN. *#* Only persons authorized by a Juneau County Supervisor o Detetve shall be permitted to enter erne scene. ‘Thos persons enfeig the time sen maybe required to give bond, a, Sher et sles Pee Rain Toso — 7 flan HY “i ihael™ 1s oo gus? a Mlgl Tale, *9 a Bae witty OME aS SI yectter =)450 (eine Sceve Sa) Lil BEY in ANDRE eer abate a Cheme Scene Ton Lhedes Fosee(Pacler Cormers OF ee _| oe a a ena 73 Tor SE eT aie ea aia 1 Tae oe aT aE a aE To Tae aT Tar aa co ea — 7 a CIDA 77DEPARTMENT OF Memorandum VETERANS AFFAIRS ou April 30, 2009 rom GaryJ. Loethen, PhD., ext. 66414 sy Written Counseling tw Chris M. Kirkpatrick, Psy.D, L._ On April 20, 2009, I spake with psychologist Chris Kirkpatick, Psy.D. regarding information I received from the COS stating that Dr. Kirkpatrick had been criticizing the Physician Assistant (PA) assigned to the Residential Program, 2. Itwas noted that Dr. Kirkpatrick specifically criticized the PA for doing psychotherapy, ‘as well as for what medications the PA was prescribing forthe veterans inthe program. In addition, Dr. Kirkpatrci’s criticisms of the PA were done infront of fellow co-workers inthe Residential Program's multidiseiplinary treatment team. 3. Tinstructed Dr. Kirkpatrick to discontinue the aforementioned behaviors, It was pointed fut that Dr. Kirkpatrick isnot the PA's supervisor, and therefore shou not he "eneating" patients about what medications they are on 4. Dr. Kirkpatrick was cautioned about engaging in any further criticisms of the PA, advised {o focus on his own work, and counseled that he should avoid advising on medications asi is notin his scope of practice CZ signature Hl : | pasts Employee (Original and one copy)