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VA aims to improve oversight of drugs, increase employee testing

STARS AND STRIPES

By NIKKI WENTLING | STARS AND STRIPES Published: February 27, 2017

WASHINGTON — Officials for the Department of Veterans Affairs said Monday that the agency would improve its tracking of controlled substances and increase employee drug tests following reports of weak monitoring inside VA facilities and instances of missing and stolen prescriptions.

The Government Accountability Office and VA Office of Inspector General – both of which act as VA watchdogs – testified at a House hearing that lapses allowed doctors, nurses and other VA health care providers to be hired without drug tests. When pressed to provide an estimate, Randal Williamson, an official with the GAO, said approximately 85 to 90 percent of VA facilities were insufficiently tracking controlled substances, such as opioids.

“It’s clear to me that the VA, and God bless them, are doing a horrible job when it comes to this issue,” Rep. Bruce Poliquin, R-Maine, said during the hearing held by the subcommittee on oversight for the House Veterans’ Affairs Committee.

There have been thousands of cases of opioid theft and missing prescriptions since 2010 at VA facilities, but employees were disciplined in only a small fraction of them, The Associated Press reported earlier Monday.

The hearing was an attempt to address the watchdog reports about the lack of oversight of controlled substances.

When Poliquin grilled Carolyn Clancy, a VA deputy undersecretary for health, about whether employees were being held responsible, Clancy said a “fair number” had been convicted. She told Poliquin the VA would provide him a list.

The Justice Department announced earlier this month that three VA pharmacy technicians in Little Rock, Ark., were indicted on drug-related charges. They are accused of taking more than $77,000 worth of oxycodone, hydrocodone and other drugs. The theft was uncovered only after a VA inspector general found a large amount of medication was missing.

In another case, an anesthesiologist at the West Los Angeles VA pleaded guilty in 2015 to theft and drug charges after he injected controlled substances and collapsed while treating a veteran.

Speaking to the need for pre-employment drug screenings, Keith Berge, a consultant with the Mayo Clinic, testified Monday.

“You might be letting an employee who would test positive – and, in fact, is an addict – into an area where they can get their hands on drugs,” he said.

Concerned Veterans of America, a conservative-leaning advocacy group, said the issue highlighted the need to give the VA secretary stronger authority to fire employees.

“It’s nearly impossible to get fired at the VA, so employees who steal drugs or engage in criminal activity don’t necessarily expect any immediate ramifications for their actions,” CVA Policy Director Dan Caldwell wrote in an email.

Clancy testified all new employees are now going through pre-employment screenings, and others who weren’t tested originally – including 220 at the Atlanta VA Medical Center -- are being screened. The VA also held a conference call with hundreds of its clinics last week to go over plans for more inspections of controlled substances, Clancy said, and the department is considering more internal audits.

She disputed Williamson’s estimate of how many VA facilities weren’t properly tracking prescriptions, calling it a “slightly pessimistic projection.”

The hearing on Monday also led to questions about the VA’s mail drug program.

Clancy testified the VA has 2,405 reports of missing controlled substances from January 2014 to March 2016, 91.4 percent of which, she said, were lost after the VA mailed them to veterans through the U.S. Postal Service or a commercial mail service.

She testified only 1.5 percent of cases of missing controlled substances were instances of theft by VA employees.

Rep. Neal Dunn, R-Fla., a surgeon, said he didn’t think those statistics were accurate and accused the VA of blaming the postal service for their errors.

Williamson said he also was “suspicious” of Clancy’s data and said the VA “doesn’t have a very good reporting system.”

Rep. Phil Roe, R-Tenn., questioned whether the VA should continue the mail drug program if that’s where most of the losses happen. Poliquin also proposed the VA stop mailing controlled substances.

“You’re right, this is an area that’s not working as well as it should,” said Michael Valentino, a chief consultant with the VA. “If veterans had to come in and get controlled substances, though, I think it could create unintended consequences. Some of our veterans live very far away.”

Clancy said the program works for other types of medications, but conceded there might be “a lot of other options” for how the VA handles controlled substances.

wentling.nikki@stripes.com
Twitter: @nikkiwentling

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