Senator Tammy Baldwin (above) is a US Senator from Wisconsin. Her office issued the following last week:
For Immediate Release
Tuesday, December 22, 2015
Contact: press@baldwin.senate.gov
(202) 224 – 6225
Bipartisan Omnibus Big Win for Wisconsin Veterans
As
a member of the Senate Appropriations Committee, Baldwin secured
several bipartisan provisions for Wisconsin veterans and their families
WASHINGTON, D.C. – U.S. Senator Tammy
Baldwin released the following statement after President Obama signed
into law the Consolidated Appropriations Act of 2016, which included
several provisions
Senator Baldwin championed on behalf of Wisconsin veterans and their
families:
“I
was proud to usher in this legislation which rolls back devastating
budget cuts to veterans and includes many reforms that I have fought for
and support. As a member of the Senate Appropriations
Committee, I fought to include provisions in this legislation that
would improve transparency of VA Office of Inspector General reports,
strengthen protections for whistleblowers, and provide stronger
oversight of the VA’s prescribing practices. These are
significant reforms that take a serious step in the right direction to
ensure we address underlying challenges at the VA.”
Earlier this month, the
Senate Committee on Veterans’ Affairs passed an updated
version of Senator Baldwin’s Jason Simcakoski Memorial Opioid Safety Act,
a bill aimed at providing safer and more effective pain management
services to our nation’s veterans.
Senate Committee on Veterans’ Affairs Chairman Johnny Isakson (R-GA)
said Senator Baldwin’s bill would be viewed as one of the “great
accomplishments” of the committee.
As a member of the Senate Appropriations Committee, Senator Baldwin championed the following provisions in the new law:
Opioid Drug Abuse Prevention Funding
Senator Baldwin is a strong supporter of
increased funding for opioid and prescription drug abuse prevention,
treatment and research programs. As a member of the Senate
Appropriations Committee,
Senator Baldwin led a call to strengthen federal investments
to combat the growing prescription drug and opioid abuse epidemic in America, including support for the Centers for Disease
Control and Prevention’s (CDC) Prevention for States program.
As a result of Senator Baldwin’s advocacy, the Consolidated
Appropriations Act of 2016 includes robust funding for opioid abuse
prevention efforts at the CDC and the Substance Abuse &
Mental Health Services Administration (SAMHSA), including $70 million
for CDC’s prescription drug abuse overdose prevention and monitoring
activities. This investment allows CDC to strengthen and expand its
prevention program to all 50 states and to continue
to develop safe opioid prescribing guidelines.
VA Inspector General Transparency Improvements
Senator Baldwin, along with
Appropriations Subcommittee on MilCon/VA Chairman Mark Kirk (R-IL),
authored a provision regarding increasing transparency at the VA Office
of Inspector General
(OIG). Based on an amendment Senator Baldwin included in S.579, the
Inspector General Empowerment Act, the joint Baldwin-Kirk amendment
would amend current law to ensure that when the VA OIG completes a
report, it is promptly shared with the VA Secretary,
Congress, and the public. This bill language would help address
failures of transparency and agency oversight by requiring
recommendations made by the VA OIG during investigations, audits or
other reports to be sent directly to the VA Secretary. In addition,
these recommendations would be available to the public and submitted
directly to relevant Congressional oversight committees. Lastly, if the
Inspector General initiated an investigation based on information
provided by an individual, the recommendations would
also be shared with that individual.
Drug Diversion at Veterans Health Administration Facilities
As a member of the Senate Appropriations
Committee, Senator Baldwin successfully worked to include language in
the Consolidated Appropriations Act of 2016 that urges the Drug
Enforcement Administration
(DEA) to maintain open communication with the Veterans Health
Administration (VHA) and treat investigations of drug diversion in VHA
facilities as a priority. DEA shall report to the Committee within 90
days after the enactment of this act on its drug diversion
investigations involving VHA facilities and to report on the status of
investigations on a quarterly basis thereafter.
The initial report shall include: the
number of ongoing DEA drug diversion investigations into VHA facilities,
the number of DEA drug diversion investigations into VHA facilities
concluded
in the prior year, an analysis of trends in DEA and VHA drug diversion
investigations over the past 10 years, the number of investigations that
resulted in indictments, a review of factors that may be leading to
drug diversion including VHA prescription drug
prescribing practices, and recommendations or best practices to prevent
drug diversion from VHA facilities.
Whistleblower Enhancement for VA Medical Professionals
Closes an existing legal loophole that
harms VA medical professionals who have experienced whistleblower
retaliation in the form of a negative personnel evaluation. Currently,
the Office of
Special Counsel (OSC) cannot investigate these types of retaliation
because VA medical professional personnel evaluations are governed by
Title 38; while OSC’s relevant investigatory power is limited to
personnel evaluations governed by Title 5. Senator Baldwin’s
provision would address this inconsistency in the law by including
personnel reviews governed by Title 38 within the scope of potential
retaliatory personnel actions that OSC can investigate.
Update of Joint VA and DoD Clinical Practice Guidelines
To help address the prescription drug
abuse and overdose epidemic, Senator Baldwin included a provision
requiring the VA, working with DoD, to update the joint VA-DoD Clinical
Practice Guideline
(CPG) for the Management of Opioid Therapy (OT) for Chronic Pain, which
has not been updated since 2010. In addition, to ensure prescribers
have the most up-to-date science, VA will be required to adopt the safe
opioid prescribing guidelines for chronic, non-cancer
pain in outpatient settings currently being developed by the Centers
for Disease Control and Prevention (CDC).
Expanded Access to Opioid Receptor Antagonists
Opioid receptor antagonists, such as
naloxone, are drugs that reverse the effects of opioids, including
respiratory depression, and, in certain cases, can prevent death.
Indeed, the VA’s year-old
Overdose Education and Naloxone Distribution (OEND) program, which
dispenses take-home naloxone kit prescriptions to at-risk veterans, has
been credited with saving 33 lives by reversing opioid overdoses.
Senator Baldwin included a provision to expand this
program, ensuring every VA medical facility is equipped with opioid
receptor antagonists, as well as to improve provider and pharmacist
education on overdose prevention strategies.
Joint Executive Council Working Group on Opioids and Pain Management
Senator
Baldwin authored a provision to create a new joint VA-DoD working group
to focus on patient pain management and opioid therapy. This working
group would be established within the
DoD-VA Joint Executive Council—an existing forum for senior leadership
at both Departments to develop policies and programs to address
overlapping priorities—and would cover, at minimum, opioid prescribing
practices, acute and chronic pain management, complementary
and integrated health, and the concurrent use of opioids and
prescription drugs for mental health issues, including benzodiazepines.
The working group would help combat the VA’s continued overreliance on
opioids for pain management; limit instances of VA providers
prescribing opioids for mental health treatment, which is non-compliant
with joint VA-DoD Clinical Practice Guidelines; and improve patient
care during the DoD-VA transition.
Enhancing VHA Opioid Safety Efforts
VA has had some success improving the
safe use of opioids to treat pain, including through the Opioid Safety
Initiative (OSI) and the use of the Opioid Therapy Risk Report tool.
However,
capability gaps exist in these initiatives, and more needs to be done.
To help reduce rates of opioid addiction and fatal overdose, it is
critical that real-time data is available at the individual prescriber
and pharmacist level as well as the pharmacy management
level to prevent inappropriate prescribing before it occurs.
Senator Baldwin included a provision
that directs the VA to develop and deploy mechanisms for including
real-time patient information on existing opioid prescriptions within
VHA as well as
patient controlled substances prescription information in the state
prescription drug monitoring programs. The mechanisms must also alert a
provider or pharmacist in real-time that an opioid or benzodiazepine
prescription would be inappropriate and protect
against “double-prescribing” when an in-patient continues to receive
take-home opioid prescriptions despite being treated with opioids at a
VA facility. The provision further directs VA to submit information on
controlled substances prescriptions to state
prescription drug monitoring programs.
GAO Audit of VA Opioid Therapy
According
to the CDC, in 2012, health care providers wrote 259 million
prescriptions for opioid pain relievers, which is enough for every
American adult to have a bottle of pills. This drastic
increase has also been seen in local VA facilities, including the Tomah
VAMC in Wisconsin. To strengthen oversight of VA opioid prescribing
practices, Senator Baldwin included a provision directing the Government
Accountability Office, in consultation with
the Department of Veterans Affairs, to report to Congress on the
effectiveness of the VA Opioid Safety Initiative and overall opioid
prescribing practices throughout the VA system. This report shall
include recommendations on improvements to the Opioid Safety
Initiative, deaths involving veterans prescribed opioids, overall
opioid prescription rates and indications at all VA facilities,
including facilities and prescribers that are among the top ten percent
in the nation regarding the percent of their patient
population receiving opioids and the average dose per patient. In
addition, the report shall note the use of benzodiazepines and opioid
concomitantly and their prescription rates and indications along with
facilities and prescribers that are among the top
ten percent in the nation regarding the percent of their patient
population receiving opioids and the average dose per patient.
VISN Pain Management Boards and Complementary and Integrative Health
To
further help reduce the inappropriate use of opioids and improve
treatment for chronic pain such as through the use of complementary and
integrative health, Senator Baldwin included a provision
that encourages the VA to establish a pain management board within each
Veterans Integrated Service Network (VISN) comprised of health care
professionals and—to give veterans a greater role in their care—veteran
patients and/or family members of a veteran
patient. The pain management boards would serve as a resource for the
region’s facilities, patients, and family members; provide best
practices recommendations for pain management to the VA facilities
within its region, including patient, family member and
medical perspectives; provide an annual report to the Secretary of
Veterans Affairs about pain management practices within its region,
which would then be sent to Congress.
GAO Report High Risk List
In
2015 GAO placed VHA on its annual High Risk List, identifying VHA
programs as high-risk due to their greater vulnerabilities to fraud,
waste, abuse, and mismanagement or the need for transformation
to address economy, efficiency, or effectiveness challenges.
Accordingly, Senator Baldwin included language to require the VA
Secretary to issue to Congress quarterly progress reports on Department
action to address GAO findings and recommendations.
Armed Forces Retirement Home (AFRH)
The
bill includes a provision authored by Senator Baldwin requiring the
AFRH to report on actions taken to implement recommendations made by the
Department of Defense Inspector General (DoD
IG) in a July 2014 report.