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Tomah VA employee: ‘We have forgotten who we work for’

By   /   December 6, 2016  /   No Comments

Part 36 of 47 in the series Tomah VA Scandal

UPDATED: 8:47 p.m. to include comments from Tomah VAMC spokesman Matthew Gowan

MADISON, Wis. — Despite promises to fix past failures and pledges to correct “systemic” problems, a “culture of fear” continues at the Tomah Veterans Affairs Medical Center, current and former employees tell Wisconsin Watchdog.

“I know people who have worked here for many years; the problems still persist. They’re putting a good face on it but they are doing nothing,” said an employee who works in medicine at the troubled veterans hospital. He asked not to be identified, fearing retribution at a medical facility known for retaliation.

“They took away the ‘Candyman,’ but other providers still are pushing medications. The amount that they are still giving is insane,” the insider said.

The scandal-plagued hospital grabbed national headlines following investigative reports that exposed providers overprescribing prescription drugs to veterans at alarming — even deadly — levels.

The prescription policies, according to whistleblower and federal reports, were pushed by Dr. David Houlihan, the hospital’s chief of staff. He was commonly referred to as the “Candyman” and Tomah was known as “Candy Land” because of the prevalence of prescription drugs.

PROBLEMS PERSIST: Sources tell Wisconsin Watchdog that drug problems and employee apathy continue to dog the Tomah VA Medical Center.

PROBLEMS PERSIST: Sources tell Wisconsin Watchdog that drug problems and employee apathy continue to dog the Tomah VA Medical Center.

An August 2015 VA Inspector General report found that Marine veteran Jason Simcakoski died Aug. 30, 2014, from “mixed drug toxicity.” The patient had taken 13 prescribed medications, including several known to cause respiratory depression, over a 24-hour period at the hospital. Staff psychiatrists ordered the prescriptions, adding them to Simcakoski’s long list of medications prior to his death.

A lengthy report issued in May by the Senate Homeland Security and Governmental Affairs Committee found “systemic failures and preventable tragedies” at the Tomah VA center, and noted a “culture of fear” punctuated by retaliation against whistleblowers.

“We still have vets, tons of them I see firsthand, overusing medications,” said one source who works on the hospital campus.

Last year, as federal investigators looked into allegations of drug abuse at the medical facility, police were making arrests of alleged narcotics pushers on the hospital grounds.

Drug addiction continues to drive illegal prescription drug sales in and around Tomah, sources say, and strung-out veterans around the hospital routinely look for a fix.

“The profound addition that’s here, it’s amazing. They’re pushing out Suboxone,” the Tomah employee said, referring to the opioid medicine used to treat narcotic addiction. “I see the wife of a patient coming here dealing.”

“People come in here and they have brand new trucks. I think, ‘How do you have a truck, you don’t have a job? You are a disabled veteran and you bought a $40,000 truck,” the insider said. “A lot of them are turning around and selling their narcotics. Some have 95-year-old parents and they’re getting their parents’ meds.”

The Senate committee report claims Houlihan and the psychiatrist’s nurse practitioner may have been “impaired” during a 2012 interview with VA officials.

“It is actually one of the shocking findings of our investigation,” said Sen. Ron Johnson, R-Wis., chairman of the Senate Homeland Security and Governmental Affairs Committee. “When the inspection team originally came here from the Office of Inspector General — these are doctors assessing the condition of Dr. Houlihan and his nurse practitioner — they wondered whether or not they were impaired,” Johnson said at a committee hearing on the report.

Acting Medical Center Victoria Brahm is trying to make Tomah more presentable, but you can’t hide the ugliness beneath, one source said.


In an email to Wisconsin Watchdog Tuesday evening, Public Affairs Officer Matthew Gowan said the Opioid Safety Initiative has and continues to be a major priority at the Tomah VAMC. In the past year, the hospital has collaborated with the Veterans Integrated Network 12 headquarters to incorporate an Academic Detailing team to review the medical centers most complex chronic pain patients, and provide additional recommendations for their care. And health care leaders established a Pain University to assess and customize alternative whole-health pain strategies for veterans.

“When we announced completion of our 100-Day Plan the number of Chronic Opioid Patients on > (greater than) 200 Morphine Equivalent Daily Dose was reduced by 23%. The number of Chronic Opioid Patients on > 400 Morphine Equivalent Daily Dose was reduced by 24%,” Gowan wrote.

“In addition, opioid treatment agreement compliance rose from 39% (from FY2015 Q1) to 98% and Urine Drug Screen compliance rose from 56.8% to 88%. The Tomah VAMC has also mandated the use of the Wisconsin State Prescription Drug Monitoring Program to ensure patients are not obtaining opioid medications from multiple providers.”

Johnson has defended Brahm, saying she has been making strides in changing policy and the culture of the troubled VA hospital. Those positive changes, Johnson said, were evident in how administrators quickly addressed a recent health failure.

As Wisconsin Watchdog reported last week, 592 veterans may have been exposed to HIV, hepatitis C and other infections after a dentist at the Tomah hospital failed to follow standard infection control procedures for months.

The dentist has since resigned, according to The Associated Press. His name has yet to be released. He was expected to appear in front of a review board as he faces administrative proceedings prior to his resignation, according to UPI.

Brahm told news outlets that a temporary dental assistant reported the violations to  the dental chief on Oct. 20, the after the violations allegedly occurred. “We took action Oct. 21,” she said.

The hospital employee who spoke to Wisconsin Watchdog said Brahm is trying to implement policy changes but they mean nothing if doctors and staff fail to follow them.

The VA finds itself in a Catch-22. As the agency moves to implement new policies and procedures on opioid prescriptions, it is dealing with frustration among the veterans who have come to depend on painkillers.

“Last month the VA informed me that they will no longer be supplying disabled veterans with pain medications … everyone is being cut off permanently,” a veteran in the VA system told Wisconsin Watchdog. “We have veterans who will be in agony without pain medications as their bodies are broken. The VA doesn’t care. They passed out pain medications like candy for decades. Now they are stopping all of them.”

As the Minneapolis Star Tribune reported in July 2015, “During an 11-year period ending in 2013, the number of prescriptions from the VA for pain meds like oxycodone and morphine surged 259 percent nationally.”

Employee morale continues to be a struggle, although a Tomah VA Medical Center questionnaire, Connecting Workplace Perceptions to Organizational Health, appears to show some signs of improvement.

The annual assessment, obtained by Wisconsin Watchdog, shows small gains or slight declines in key areas such as engagement, workload, job control, and speaking up about concerns (a 1.85 percent decline). Employees reported reduced problems with burnout and turnover.

What remains elusive, one Tomah source said, is staff’s emphasis on the people they are there to serve.

“We need to watch out for veterans. That doesn’t happen, and that speaks to the culture,” the insider said. “We have forgotten who we work for here, and how bad it is.”

Part of 47 in the series Tomah VA Scandal
  1. After damaging silence, Baldwin now calls for probe of troubled VA center
  2. Legal expert says U.S. Sen Tammy Baldwin is in full ‘damage control’
  3. Baldwin aide breaks silence, alleges senator engaged in ‘coverup’
  4. Baldwin’s public relations team kicks into high gear following ethics complaint
  5. Ethics watchdog urges Senate committee to investigate Baldwin
  6. Tammy Baldwin’s political fixer is helping Hillary attack voter ID
  7. Senate committee asking if FBI missed the call in veteran’s death at VA
  8. When lawmakers failed Wisconsin’s veterans
  9. Is political pressure behind Lin Ellinghuysen’s differing accounts on VA memo?
  10. Bernie Sanders failed to act in deadly VA scandal, whistleblower says
  11. Does government union chief’s threat show AFGE’s hand on veterans care?
  12. What would Russ Feingold’s 1992 self say to the 2015 version?
  13. Ad attacking Feingold asserts veterans died because of ‘politicians who looked the other way’
  14. Feingold’s campaign caught up in VA scandal memo war
  15. PolitiFact Wisconsin trusts Russ Feingold to deliver its facts
  16. Sources: Ron Kind received call from Jason Simcakoski not long before Marine’s tragic death
  17. Captain Campaign Finance Reform, Russ Feingold, changes ‘dark money’ tune
  18. Baldwin talks transparency while keeping her secrets in Tomah VA scandal
  19. Ron Kind knew about Tomah VA abuse years before the story broke
  20. Ron Kind now solving Tomah VA scandal one press release at a time
  21. Tammy Baldwin silent on her failures as she blasts Tomah VA medical center
  22. Tomah VA whistleblower says he’s getting pressure from unhappy Dems
  23. Feingold’s facts fail again in face of Tomah scandal
  24. Senate field hearing to shine more light on Tomah VA scandal
  25. Tomah VA supervisor accused of misconduct gets promoted
  26. Senate hearing to look deeper into scandal-plagued Tomah VA hospital
  27. Kind flees questions, Senate committee turns up heat on Tomah VA hospital scandal
  28. Report: Tomah VA hospital story is one of ‘systemic failures’
  29. Tomah VA hospital whistleblower: ‘It will not change’
  30. Ron Kind breaks silence on call from veteran victim at Tomah VA hospital
  31. VA union holds rally to save itself, Tomah whistleblower says
  32. Sound familiar? Illinois Rep. Tammy Duckworth accused of retaliation at VA
  33. Emails say Tomah VA patient reached out to Feingold, Kind, in 2008 about abuse
  34. Johnson: Hold accountable those who put Tomah veterans at risk of HIV, hepatitis
  35. Veteran jumps out of third-floor window at Tomah VA hospital
  36. Tomah VA employee: ‘We have forgotten who we work for’
  37. Congressional committees want answers on Tomah VA hospital
  38. Senators ask Pence, Trump transition team, to hold troubled VA accountable
  39. Veterans advocate: VA hospitals’ ‘improvement’ doesn’t tell whole story
  40. Tomah VA Medical Center’s ‘Candy Man’ stripped of license
  41. Opinions differ on whether it’s ‘meet the new boss, same as the old boss’ at Tomah VA
  42. Latest data show Tomah VA hospital improving in opioid prescriptions, veteran satisfaction
  43. VA secretary nominee faces little resistance, lots of challenges
  44. Insiders: Tomah VA troubles continue with nurse shortage, neglectful care
  45. VA whistleblower has questions for Congressman Ron Kind
  46. Johnson brings back whistleblower protection bill as Sunshine Week opens
  47. Iraq war veteran burned by ‘very frustrating process’ at VA


M.D. Kittle is bureau chief of Wisconsin Watchdog and First Amendment Reporter for Watchdog.org. Kittle is a 25-year veteran of print, broadcast and online media. He is the recipient of several awards for journalism excellence from The Associated Press, Inland Press, the Wisconsin Broadcasters Association, and others. He is also a member of Investigative Reporters & Editors. Kittle's extensive series on Wisconsin's unconstitutional John Doe investigations was the basis of a 2014 documentary on Glenn Beck's TheBlaze. His work has been featured in Town Hall, Fox News, NewsMax, and other national publications, and his reporting has been cited by news outlets nationwide. Kittle is a fill-in talk show host on the Jay Weber Show and the Vicki McKenna Show in Milwaukee and Madison.