Veterans Affairs changes thousands of prescription deliveries to other carriers over USPS delays

A U.S. Postal Service (U.S.P.S.) worker unpacks packages from a truck on December 02, 2019 in San Francisco, California.
A U.S. Postal Service (U.S.P.S.) worker unpacks packages from a truck on December 02, 2019 in San Francisco, California. Photo credit Photo by Justin Sullivan/Getty Images

The Department of Veterans Affairs is moving thousands of prescription deliveries from the U.S. Postal Service to other carriers because of delays across the country, internal VA memos show.

After slowdowns meant some veterans didn't receive prescriptions on time this summer, VA must now contend not only with the coronavirus pandemic, but record holiday mail volumes, too.

In a memo to VA officials this week, a pharmacy system leader said the department was monitoring and working on delivery delays with carriers. Specifically, "USPS is really struggling," according to the memo obtained by Connecting Vets, which was sent to the VISN Pharmacist Executives (VPE) Committee by Mariano Franchi, deputy chief consultant at VA's Consolidated Mail Outpatient Pharmacy (CMOP) system.

The vast majority of VA prescriptions are fulfilled by mail from a group of seven massive, automated hub pharmacies across the country, the CMOP system. That centralized pharmacy system processes about 80% to 90% of all VA outpatient prescriptions and almost all (90%) of those are typically shipped through USPS. The other prescriptions are usually filled at local VA medical facilities, though in some cases VA may use alternative carriers such as FedEX and UPS.

VA's mail-order pharmacy system processes about 120 million prescriptions per year, nearly half a million prescriptions daily and each working day, more than 330,000 veterans receive a package of prescriptions in the mail, according to the department. Veterans who live further from VA medical facilities, especially in rural and remote areas of the country, often depend on mail-order prescriptions.

The delays VA faces now are hitting some areas especially hard, according to the memo, including:
- Pennsylvania
- West Virginia
- North Carolina
- Georgia
- Ohio
- Michigan
- Missouri
- Colorado
- Arizona
- Parts of Illinois, Kentucky, Mississippi and Memphis, Tennessee, along with some other zip codes.

"We are working with UPS to move about 33,000 packages per day from USPS to UPS second-day air," the memo reads. "We are also working with FedEx and USPS to try to alleviate log jams."

The memo also mentioned plans to "ask for COVID funds to help cover the increased costs associated with the shipping carrier changes" but didn't detail where those funds would come from.

The switch from USPS for some packages was expected to begin as soon as this week, according to the memo.

VA officials downplayed any delays or switching carriers, arguing such moves are part of normal operations.

"VA continually monitors prescription delivery times throughout the country and the department always uses a variety of methods to ensure timely delivery, including in-person pharmacies, USPS, and commercial carriers," VA Press Secretary Christina Noel told Connecting Vets. "CMOP VA continually monitors prescription delivery times throughout the country and the department always uses a variety of methods to ensure timely delivery, including in-person pharmacies, USPS, and commercial carriers."

In emails to veterans this week, however, some VA medical centers warned of possible mail delays.

"Due to COVID-19 and an increase in holiday mail, the United States Postal Service is experiencing an increase in delays by 146.9% over the previous two weeks period," the Maryland VA Healthcare System said in an email announcement. "We are asking Veterans to call the Pharmacy Service if they are experiencing delays with medication deliveries."

Maryland was not on VA's list of areas experiencing increased delays that appeared in the memo.

Similar to delays VA faced in the summer, recent slowdowns could mean interruptions in veterans receiving medications, forcing VA to expedite some orders to ensure veterans receive their prescriptions in time. Switching carriers can drive up costs and create confusion for some VA patients with different tracking, signature requirements and overall delivery service (not all carriers deliver to the same places or on the same days, such as Saturday deliver). Tracking is already proving difficult for some veterans, since some packages are scanned multiple times in the same place or showing no movement or scan for multiple days because of delays.

Controlled substances are especially difficult to deal with during interruptions or delays, since they require more advanced tracking and accountability, especially if replacements are necessary when a package fails to arrive on time.

Cole Butterfield, an Army veteran and American Postal Workers Union leader in Oregon, said he was not surprised VA was diverting some of its mail-order prescriptions as USPS faces a record season. He said his wife, a disabled veteran who relies on USPS for her medication, has not seen an interruption in deliveries so far like she did during the summer.

"I work at a small (USPS) plant and this is the busiest peak season I've ever seen," Butterfield told Connecting Vets. "My first-line supervisor just told me today that our plant is experiencing a 53% increase from last year."

To try to keep up, USPS is temporarily expediting its hiring process, running parcel processing machines nearly 23 hours per day instead of the usual two shifts, non-machinable packages are being sorted 24-hours per day "by nearly every available employee," Butterfield said. "It's sort of an all-hands situation."

USPS is mandated to accept all customers as long as postage is paid for, but private companies such as FedEx and UPS can be more selective. When they're more selective and USPS is the only option, the Postal Service can become increasingly overwhelmed.

"We're already past our maximums," Butterfield said. "That said, postal workers are working tons of overtime to get customers their mail. Most postal workers I know have a passion for this job. The holiday season is our time to shine, but this year the pandemic and PMG DeJoy's destructive changes (temporarily halted by the courts) have really tested us."

Reach Abbie Bennett: abbie@connectingvets.com or @AbbieRBennett. Sign up for the Connecting Vets weekly newsletter to get more stories like this delivered to your inbox.