The VA could be unprepared for major disasters or terrorist attacks, watchdog audit finds

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Ever since 9/11, the Department of Veterans Affairs has had a plan in place to provide medicine and supplies to veterans in the event of a major emergency.

Part of that plan includes caches of necessary drugs, supplies, and equipment to bridge the gap between the supplies VA hospitals have on hand and any federal relief that could come in the aftermath of a terrorist attack, biological or natural disaster. 

But a recent VA watchdog audit shows the emergency response and cache program is woefully lacking, including both missing and excesses of certain drugs, failure to conduct mandatory inspections and regular emergency drills, wasted soon-to-expire drugs and overall lack of oversight.

"These deficiencies, if not corrected, may not only compromise VA's ability to mobilize in the event of an emergency but could also result in missed opportunities to leverage soon-to-expire (but still usable) drugs and medical supplies," the Inspector General's audit said. 

Since federal aid can take days to reach areas in crisis, the caches of supplies and medication are meant to provide for "immediate deployment" and have also been used in response to local or national shortages of certain medications and supplies "in life-threatening situations," the audit said. 

As of 2018, there are 141 emergency caches at VA hospitals nationwide, with many different drugs and supplies, including some that carry drugs to treat medical needs arising from a nuclear disaster. The caches are equipped to help treat nearly a quarter million people collectively. 

When the Office of the Inspector General visited a random sampling of cache locations last year, it found:

  • 100 percent had expired drugs;
  • Nearly 50 percent were not fully stocked;
  • 30 percent had excessive amounts of drugs;
  • Management did not always conduct required inspections or activation exercises;
  • Hospitals missed chances to use expiring drugs in the caches;
  • No one was in charge of ensuring that the emergency program was "mission ready." 

The Inspector General's report recommended that the Veterans Health Administration train staff on how to do wall-to-wall inventories of the emergency supplies and complete them at each site, make sure to use drugs before they expire, keep a national database for inventory and provide more leadership. 

"The importance of an effective Emergency Cache Program cannot be overstated," said Larry Reinkemeyer, assistant inspector general for audits and evaluations at the OIG. "The OIG found that VHA did not effectively manage the program and that VHA officials had no assurances the caches would be ready to mobilize in the event of an emergency. As a result, VHA risks not having the drugs and supplies necessary to meet the emergency needs it might face for mass casualty events." 

VA leadership said it was continuing to make improvements "to ensure the readiness" of the emergency program since the audit, including the training and inventories and a master inventory file has been created. VA has also created a process to re-label all expired or extra medication and fix other issues with missing, excess or expired medication. 

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