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Subcommittee on Oversight & Investigations Hearing to Assess VA’s Risks for Drug Diversion

Today, the Subcommittee on Oversight and Investigations, chaired by Rep. Jack Bergman (R-Mich.), held a hearing to examine a recently released GAO report’s findings that lack of oversight and internal controls for prescription opioids and employee accountability put VA medical centers at risk for drug diversion.

You can view Chairman Bergman's opening remarks from today's hearing here:

Opening remarks as prepared for delivery:

Today, we will address the lack of oversight and internal controls regarding controlled substances within the Veterans Health Administration that leave facilities open to drug diversion and veteran harm.

The diversion of drugs from VA health care facilities is an incredible patient safety issue that puts veterans, VA employees, and the public at tremendous risk. Unfortunately, the news has recently been filled with story after story of drug diversion within VA. In Little Rock, Arkansas, a VA pharmacy technician reportedly used his access to medical suppliers’ websites to order and divert 4,000 oxycodone pills, over 3,000 hydrocodone pills, and more than 14,000 Viagra and Cialis pills at a cost to VA of more than $70,000. This technician was allegedly selling these drugs on the street where they had a value of more than $160,000. At a VA facility in Florida, a registered nurse was apparently stealing oxycodone and hydromorphone from the hospital to feed her addiction. Keep in mind, these are medications that should have been going to veterans for their care.

These issues are in part a result of VA having inadequate procedures in place to safeguard against theft and diversion of controlled substances. A recent Government Accountability Office audit requested by this Committee found that one VA medical center missed 43% of their required monthly inspections, mostly in critical care areas such as the operating room and the intensive care unit. In addition, three other facilities did not follow all of VHA’s requirements for inspections of controlled substances. This is not the first instance where weaknesses were identified in VA’s controlled substance inspection program.

In 2009 and 2014, the VA Office of Inspector General found that some medical facilities were not conducting monthly inspections and some inspections were incomplete. VA has been given multiple opportunities to address these concerns. This leaves me wondering what VA is doing to repair the lax oversight and apparent absence of accountability regarding these issues within VHA. To make matters worse, there are also issues with drug testing employees to ensure that they suitable to provide care to veterans.

A 2015 Office of Inspector General report found that VA medical centers were not conducting pre-employment and random drug tests for testing designated positions in many instances across VHA, which amounted to tens of thousands of employees not receiving drug tests required by the Drug Free Workplace program. Most recently, in January 2017, the OIG found high backlogs in background checks, to include drug testing, for high-risk positions at the Atlanta VA Medical Center. It is precisely these tools that have been put in place to help protect patients and health care organizations from drug diversion and harm, however VA does not seem to be taking them as seriously as it should.

Based on the oversight reports and the numerous diversion incidents we will discuss today, I am concerned that VA’s controlled substance oversight program is not working and that staff who fail to follow proper procedures are not being held accountable for violations. In case after case, what we see are examples of drugs being diverted for personal use or personal gain, yet there does not seem to be much progress being made by VA to correct the glaring problems that allow it to happen. What is even more concerning is that programs to help deter diversion or identify illegal employee drug use are not being implemented consistently within the VA health system.

We are in the midst of an opioid epidemic, and it is time for VA to start making effective changes to avoid putting veterans and the employees who serve them at risk.