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Latest data show Tomah VA hospital improving in opioid prescriptions, veteran satisfaction

By   /   February 6, 2017  /   News  /   No Comments

Part 42 of 47 in the series Tomah VA Scandal

MADISON, Wis. — Despite reports of ongoing painkiller prescription practices and health care delivery concerns at the Tomah Veterans Affairs Medical Center, the scandal-plagued hospital has noted considerable improvement over the past 18 months, according to new data obtained by Wisconsin Watchdog.

AP file photo

IMPROVING TOMAH?: New data show strides being made on opioid prescriptions at the Tomah VA Medical Center. But problems linger, insiders say.

The facility, described by veterans as “Candyland” because of its practice of overprescribing opioids, has seen pronounced declines in highly addictive painkiller prescriptions, according to a Tomah VAMC fact sheet. While the numbers fluctuate, the report snapshot found:

  • A 48 percent reduction in the amount of veterans receiving both opioids and benzodiazepines, the class of highly addictive sedative and muscle relaxant drugs.
  • A 49 percent decline in the number of veterans receiving greater than 100 morphine equivalent milligram daily dosages.
  • A 73 percent drop in the number of vets receiving greater than 400 morphine equivalent milligram dosages.

“Each veteran’s case is looked at individually through the Opioid Safety Initiative Committee and Academic Detailing at the (Veterans Integrated Services Network),” said Tomah VA spokesman Matthew Gowan.

The Opioid Safety Initiative is a “comprehensive effort to improve the quality of life for the hundreds of thousands of veterans suffering from chronic pain,” according to the U.S. Department of Veterans Affairs.

Launched in October 2013 in Minneapolis, the initiative aims to lower opioid dependency by alleviating patient pain through non-prescription methods.

The Tomah VA Medical Center’s alarming opioid over-prescription practices led to the August 2014 death of 35-year-old veteran Marine Jason Simcakoski, according to multiple federal investigations into the hospital.

Dr. David Houlihan, the facility’s chief of staff, was fired in late 2015 following investigative reports and whistleblower accounts of painkiller addiction abuse and retaliation against employees who dared bring the problems to light. Last month, a state board stripped Houlihan of his medical license and declared the physician referred to as the “Candy Man” ineligible to practice medicine in Wisconsin.

RELATED: Tomah VA’s “Candy Man” stripped of license

Also last month, the VA named Victoria Brahm to lead the troubled medical center. Brahm has served as acting director since October 2015.

While VA officials are praising Brahm for her leadership and celebrating her appointment, sources inside the medical center say prescription drug abuse and other health care delivery concerns remain a problem.

“While this has changed some ways drugs are processed, the problem with over-prescribing and veterans’ abuse of medication still lingers,” a source who works at the hospital told Wisconsin Watchdog. The source asked not to be identified for fear of retaliation.

“We have many veterans who lash out at the pharmacy and pharmacist and technicians who see the dispensing practices as insane,” the source added.

In December, an employee who works in medicine at the veterans hospital said the amount of painkillers still being prescribed is “insane.”

“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,” the insider said. “They took away the Candy Man, but other providers still are pushing medications.

Last month, Gowan said the VA’s Opioid Safety Initiative has been very successful, although hospital officials hear criticism on “both ends of the spectrum.”

“We have some who say, ‘You’re just stoning veterans out of their minds over here,’ and then you have others who say, ‘You’re just taking needed medications away from veterans,’” Gowan said. “It’s really more something in the middle. Each veteran is being looked at by multiple teams. We’re talking about prescription practices attempting to deal with people suffering with chronic pain plus mental health issues.”

Nationally, the number of risky dosages of opioids prescribed to veterans has dropped by double digits, according to a study published in the Journal of Pain.

As the University of Michigan Institute for Healthcare Policy and Innovation reported last month, “Over a two-year period, high-dose opioid prescribing declined by 16 percent, and very-high-dose opioid prescribing dropped by 24 percent.”

“The number of patients receiving both opioids and sedatives, which can be lethal when combined, dropped by 21 percent,” the institute reported.

The study examined the Opioid Safety Initiative across all of the nation’s 141 VA hospitals.

Gowan noted other quality data since October 2015:

  • More than 90 percent of veterans at the Tomah VA hospital report they were “completely satisfied” or “satisfied” with the timeliness of their appointments.
  • In 2016, 98.5 percent of completed appointments were within 30 days of the veteran’s preferred date, 90.3 percent were within 7 days and 17.2 percent were same-day appointments. During the same time frame, average wait times for completed appointments were 2.4 days for primary care, 5.7 days for specialty care and 1.8 days for mental health care.
  • In fiscal year 2016, Tomah improved its quality ranking from 77 to 41.
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.