Government and Regulations
Chief of staff and psychiatrist at the Tomah VAMC in Wisconsin, David J. Houlihan, MD, who was placed on administrative leave in January due to allegations of overprescribing narcotic pain killers and retaliatory behavior, was dismissed, effective November 9. Dr. Houlihan’s clinical privileges were also revoked.
Dr. Houlihan was known to many as the “candy man,” a name dating back as far as 2004, the Tomah VAMC referred to as “candy land,” both according to a 2015 report from the VA Office of Inspector General (OIG).
Unlike other VA officials forced out of their positions during times of controversy, including Tomah’s own director, Col (Ret) Mario V. DeSanctis, USAF, who was removed in September, Dr. Houlihan will not be able to negotiate a settlement, including retirement.
Related: VHA Under Harsh Criticism From OIG, GAO
“The letter communicating [the employee’s] removal specified a future effective date because, by VA policy, Title 38 employees are not subject to immediate termination but are generally entitled to receive notice of the decision to terminate at least five days prior to the effective date of action,” a VA spokesman said.
Although the investigation has come to a head, Dr. Houlihan spent the past 10 months on paid leave, a practice that many veterans’ groups and congressional leaders are trying to eliminate with H.R. 1994—the VA Accountability Act of 2015.
Related: Veterans’ Health and Opioid Safety—Contexts, Risks, and Outreach Implications
The bill, introduced in the U.S. House of Representatives in April, prohibits a demoted VA employee from being placed on administrative leave or any other category of paid leave while an appeal is going on. The bill also streamlines the appeals process, allowing the employee 7 days to appeal the decision and an administrative judge 45 days to make a final decision; thereafter, the original decision becomes final. The VA Accountability Act of 2015 passed the House 256-170 on July 29 and awaits a vote in the U.S. Senate.
Senator Tammy Baldwin (D-WI) said Monday that Dr. Houlihan’s firing and revocation of his license were “long overdue” but show that “change is possible and provides new-found hope that trust can be restored” at VA.
Related: VA Hospital Deficiencies Contributed to Marine’s Death
This past summer, the OIG determined a number of deficiencies in hospital operations at the Tomah VAMC as a result of the investigation of 35-year-old marine Jason Simcakoski’s death. Among the deficiencies were incorrect prescribing practices. Neither of the 2 psychiatrists treating Mr. Simcakoski had obtained informed consent for buprenorphine/naloxone, which was administered with an off-label indication beginning the day prior to his death. One of the 2 psychiatrists was fired as a result of the investigation.
