Ron Kind says investigation underway into Tomah VA allegations

Investigation looking into 2 areas

The Veterans Health Administration (VHA) and the Office of Accountability Review (OAR) have begun their joint investigation into allegations that the Tomah VA over-prescribed pain medication to veterans.

U.S. Rep. Ron Kind made the announcement on Friday morning at his office in La Crosse. He said investigators will look into opiate prescription use and level of dosage in pain management practice, and they’ll look into any type of alleged culture of intimidation that may exist at the VA.

Kind said the allegations are being taken very seriously and the investigation should take between four and six weeks to complete.

The bottom line, Kind said, is to make sure veterans are getting the proper care they need. Kind is also promoting the idea of establishing a pain management team at every VA center across the nation. He said that will make it a more collaborative, more integrated approach so it doesn’t come down to the decision of one treating doctor.

About two years ago, Kind received an anonymous complaint about the increasing number of opiate prescriptions at the Tomah VA. Kind sent the complaint to the Office of the Inspector General, which they conducted a two and a half year investigation, but the investigation led to nothing. Now a new investigation is underway and Kind is hoping for a better outcome.

“This is unacceptable. We can’t have our VAs functioning like this,” said Kind. “We have to find out if there is a treating doctor way outside the parameter of treatment. That needs to be addressed, or what incentive that doctor has to over-prescribe.”

For the past week, state representatives have been meeting with the Tomah VA and Washington officials about the allegations ousted in a report released last week by the Center for Investigative Reporting.

“I got a tip,” said Aaron Glantz, a reporter with the Center for Investigative Reporting.

The investigation started many months ago when Glantz talked to a Tomah VA worker.

“He filed a whistleblower complaint and it went nowhere,” said Glantz.

So Glantz decided to take a look at the complaint.

“It was disturbing to me,” said Glantz. “I started to dig and the more I dug, the more disturbing revelations came to me.”

“Data showed the number of opiate prescriptions had quintupled over the period of time this Dr. Houlihan had been there,” said Glantz.

Dr. David Houlihan became the Tomah VA hospital’s chief of staff in 2005. After hearing more allegations against Dr. Houlihan and how he had allegedly created a hostile work environment, Glantz continued to dig deeper.

“You know I am a skeptical journalist. People overestimate things all the time and you have to check to make sure they are telling the truth. But no matter how ridiculous or extreme or horrifying the allegation was that people were bringing to me, that when I checked it against documents or corroborated with other sources, it turned out to be true,” said Glantz.

At that point in the investigation, Glantz knew something had to be done.

“The good news now is that it is not a secret,” said Glantz.

And now Glantz isn’t the only one listening. Here is the complete interview with Glantz and the steps he went through in his investigation into the Tomah VA.

“Earlier this week, I, along with Sen. Tammy Baldwin, sent a letter to the current Veterans Affairs Secretary Robert McDonald asking him to conduct another formal investigation out of the VA Department itself,” said Kind.

The doctor on whom the investigation is focused has been reassigned and his dispensing authority revoked as well.

The Tomah VA released a statement on Friday that said, “The Tomah VA supports and will fully cooperate with the investigation as the VA’s review these allegations. The Tomah VA supports a comprehensive effort to improve the quality of life for Veterans suffering from chronic pain. A multidisciplinary OSI (Opioid Safety Initiative) team collaborates weekly with providers to develop comprehensive pain management treatment plans to safely reduce the opioid burden of chronic pain patients. In support of Complementary and Alternative Medicine programs, Tomah VAMC offers such modalities as, aquatic therapy, meditation, healing touch therapy, chronic low-back pain groups, and chiropractic therapy. VISN 12 implemented a clinical reminder for Urine Drug Screen (UDS) completion. This was placed into effect for provider use June 2014. Tomah UDS rate has increased since its implementation to almost 60%. In support of a multi-faceted approach to pain management, a VISN 12 Provider Pain School education program was offered to providers in Sept 2013 and March 2014.  Education was also provided to providers on Urine Drug Screen and Long Term Consent for Opioid Therapy in July 2014.  Education and instruction was provided on Wisconsin State Prescription Drug Monitoring Program.”

The VA also released a statement on Friday that said, “The Department of Veterans Affairs is actively reviewing allegations of retaliatory behavior and over-medication at Tomah VA Medical Center.  Within the next two weeks, a clinical review team consisting of specialists from the Veterans Health Administration will go to Tomah to review medication prescription practices there.  Additionally, VA will send representatives from the Office of Accountability Review to look into allegations of retaliatory behavior. The Tomah VAMC Chief of Staff has been temporarily reassigned to support the Veterans Integrated Service Network (VISN) 12 office pending the outcome of the investigation. While performing these administrative duties, he will not be seeing patients or prescribing medication.”