Wisconsin Lawmakers Take On VA OIG Over Tomah VA Scandal


Tomah VA

Benjamin KrauseThe Tomah VA scandal involving excessive prescriptions linked to veteran deaths has escalated resulting in Wisconsin lawmakers taking VA to task over failures to reign in questionable prescriptive practices.

Three Tomah VA medical staffers are under investigation by the State of Wisconsin for failing to follow healthy prescriptive standards. These failures are linked to at least one veteran death. Senator Ron Johnson has called for the resignation of VA OIG head Richard Griffin for OIG’s failure to properly investigate the problems once already.

Is it just me, or isn’t it about time our states start to protect us from the reckless practices of VA employees?

I think it is high time our states start standing up to the VA across the country. Their employees are not above the law, but the fed has failed to keep its veterans safe. Now, it is time for states to flex their might by revoking licenses these federal employees depend on.



The State of Wisconsin is taking on VA for the agency’s failure to hold its own medical staff accountable. If a doctor is licensed in the state, the state has the authority to revoke the license for problems like those alleged at the Tomah VA.

Reporter Daniel Bice wrote:

The state has opened an investigation of a doctor dubbed the “Candy Man” and two other individuals tied to the death of a patient at the Tomah VA Medical Center.

An official confirmed that the state Department of Safety and Professional Services is investigating David Houlihan, chief of staff at the troubled Tomah facility.

Houlihan had been given the nickname “Candy Man” by some vets for his supposedly easy and widespread distribution of painkillers. He wrote at least some of the prescriptions for a 35-year-old Marine Corps vet who died at the medical center in August.

A nurse and pharmacist who worked with Houlihan are also under investigation by the state.

State officials have the authority to issue reprimands or suspend or strip the state licenses of medical professionals in Wisconsin. The state could also refer the matter for criminal prosecution.



VA OIG supposedly investigated Tomah VA over questionable prescriptive practices recently, but the report was about as soft-hitting as the final report on Phoenix VA.

According to reporter Aaron Glantz:

For many, it was déjà vu, since the same allegations had been scrutinized for two years by the VA’s Office of Inspector General – in a report that has never been released officially. That left some questioning whether the agency charged with caring for America’s military veterans is capable of policing itself.

“We need the FBI to come in here,” said Linda Ellinghuysen, a registered nurse and president of the local chapter of the American Federation of Government Employees, which represents about 900 medical and support staff at the facility.

Politicians and hospital employees alike remain suspicious about why they never saw the earlier report. Some say inspectors were not thorough before, and ask why they should assume this review will be any different.



Republican lawmakers are hitting hard on VA’s failure to police itself. Now, the state is punching back with its own investigation and lawmakers are calling for VA OIG Richard Griffin to step down. I think it’s high time someone else take over the lead role in light of Griffin’s continued failures to hold wrongdoers accountable.

Reporter Daniel Bice wrote:

On Jan. 14, Sen. Ron Johnson, the Republican chairman of the Senate Committee on Homeland Security and Governmental Affairs, joined with Rep. Sean Duffy, R-Wis., in writing a letter to Richard J. Griffin, the acting director of the VA’s Office of Inspector General, asking for a fresh investigation of the Tomah VA.

A week later, Johnson wrote to President Barack Obama demanding the appointment of a new inspector general. “The problems surrounding the Tomah VAMC have led veterans and VA employees to question not only the leadership at the facility but at the VA Office of Inspector General,” he wrote.

Veterans advocates consider the suppression of the inspector general’s report on the Tomah VA part of a larger pattern at the agency, which has a reputation of keeping damning information secret rather than sharing its problems with Congress and the public.





Similar Posts


  1. It’s death by design at the PHX VAMC.

    One practitioner, a psychiatrist keeps a wall-size mural in his office of a graveyard, tombstones…. and has his name printed in (18″) Font across the mural

    It’s his way of giving vets / the patients a one-finger salute!
    You can’t beat that, for a psyche clinic,…huh?

  2. Sometime last year, Gov. Scott not only tried to enter a VA (which he was denied access) but he also tried suing the VA. It was on the news here. After that NOTHING more was said. It’s as if nothing had happened, NOTHING!!!!!

  3. Any one of you people actually have real physical chronic pain???Broken back,spinal cord damage,M.S.,nerve damage??,,.,no?????then who are u to tell anyone how much they are too suffer physical pain?????Are you some kind of psychic,,,,No-0ne has the right to tell anyone how much physical pain someone is to endure,thats tortureous,,and by all this propaganda, and poisen pens by people who are not Doctors,who are not true physical chronic pain patients,who know nothing about these patients medical history,,who are you to tell any of them how much they should suffer physical pain???By these poisen pens writing all this PROPAGANDA about legitimate physical pain suffers,,u are now forcing them to endure physical pain…Why not go down to Florida and tell the 17 families a day who a family member has choosed DEATH OVER ENDUREING,THEIR PHYSICAL PAIN,,, they have gone soo far in florida now legitimate chronic physical pain patients cannot get there NEEDED medicine to relief their physical pain,,,because of propaganda like this guy,,,What business is it of yours to tell another human being how much physical pain they should suffer???R u GOD??where does this arrogance to purposely HURT another humanbeing come from???because all this propaganda is hurting legitimate chronic physical pain suffer’s to the point now they cannot get their mediine for real physically painful conditions,soo much so its efffecting 17 a day who choosed death over enduring thier physical pain not 1 more minute,,,Thier death are on the hands of the propagandeous poisen pen writters,,,Don’t write about them do u,,,,,paita

  4. My sympathies go out to everyone that’s dealing or has dealt with these troublesome VAs and their corrupt systems and personnel.

    It seems to me that the only way to really ferret out and start solving these problematic VAs is by using covert investigations by a combined effort of federal and state. As long as these “inspections” into a suspected VA medical center and it’s personnel remains strictly overt (in other words,the facility knows there is an inspection coming) the given VA medical center will have a chance to “clean things up” prior to the inspection and the problems will never really be fixed. But if the facility is none the wiser then things might actually get taken care of.

    A combination of both overt and covert investigations/inspections into a troublesome VA would be the thing.

    That said, and I hope I’m not cursing myself here, I seem to be very fortunate to live in Vermont. I worked full time and better (usually better) both military and civilian for over 30 years. Over the last 13 of those years my disability rating, which was initially assigned at 40% for 3 internal physical disabilities, slowly increased to 90% until I finally reached the point where I could not work any longer (late 2007). In late 2010 I was granted 100% TDIU and have been that way ever since.

    I have been with the VA Medical Center in White River Jct, VT since the beginning and for the most part have had good to excellent care. If any major surgeries had to be done, I was sent down to the Boston, MA VA medical campus where I was always treated well. During one particular trip to the emergency room at the small civilian hospital where I live (I live 2 hours north of White River Jct) my VA had me immediately shipped down to them by ambulance and gave me the care that I really needed (the local hospital wanted to put me into emergency surgery that would have turned out not to be necessary). Everything was paid for by the VA.

    This VA Medical Center in White River Jct, VT was recently inspected and passed with only a few minor infractions–nothing serious at all. My experience with this VA facility wasn’t without it’s bumps now and then but after taking care of both my parents and my experience with civilian hospitals during that time, I’ll take my VA facility here in Vermont any day.

    Guess I better not ever move away from Vermont?

    1. It only takes one person to come there and make it like other VA facilities.

      Count your blessings.while they last. Remember they transfer people around when they run out their welcome at another VA or the other facility thinks they may crumble and they would be in trouble.

      Cover your butt.so keep your eyes and ears open.it maybe coming sooner than later. To your local VA.

      You seen on this site from veterans all over the country that it’s broken.

      The OIG office needs reform and a new leader with common sense and honesty and does what’s right for the veterans and it’s citizens.

      Lyes.will sooner or later will get caught in their lye.because after awhile they will forget what the original lye was and they slip up and if someone does not catch it and stop it.

      The lye will stay alive and the person they lyed about will have to live a life of missory !

      Be above board and take pride in their job well done for the citizens of these United state’s and not a special few who are distroying the very fabric of our union.

  5. My EX- V.A. Clinic Dr. Whom I`ve never met, Prescribed me a Class A Narcotic for pain for over two years. If we were the only two people in a room we would`nt recognize each other. In Most states that is a Felony to prescribe without examining the patient. But, Like clockwork he was signing off of this Morphine that thru V.A. I`ve been on for 16 years via FedEx or UPS to my door. that could strip him of his license to practice. He also with his brother has a thriving Very Lucrative Private Practice with the initial Appointment is a modest $180.00 for your first office visit. He got replaced for charging for appointments that Me personally had 12 Appointments in a year That said I Kept. I had two, One just for labs. So, I`m sure he did`nt choose me “ONLY” others were also having appointments they “kept” without actually going. An Ethical Doctor, Would never think of doing this. Ripping off the Federal Govt GREED My friends has NO BOUNDS. Or Ethics. I was an army Medic. 45 yrs ago Some stuff you kept under lock & Key. You signed for Alcohol swabs. & the old Glass bottles with the metal ring of Saline IV`s Everything. They The Army kept a watch over what you were issued.

    NOTHING You can say will surprise me. There is a “Rotten Spot” In the V.A. From the TOP DOWN. It`s mostly Management.

  6. I have filed a complaint with the Indiana Dental Board about Dr. Leslie Brooks ignoring my 100% SC husbands dental needs for 3 years. Now he may need a bone graft on his jaw from an infection he is still fighting. A SF-95 is definitely in the works but more importantly the Indy VA dental clinic needs to be closed down.

    1. Robin, I myself have been fighting the Indy VA since I left the Seattle VA in Aug of ’14. I came back to the Indy VA in Sept. ’14 and they now say that my service connected disability that I have had and was being treated for at the Seattle VA no longer exists. How can a disability that I was taking a chronic pain med for and it has been in my VA record for 30 yrs. magically be cured just by moving and visiting the Indy VA?
      I think there is more of this VA that needs looked into than just the dental. I can believe what you are saying about this VA as now my PCP has agreed to treat me with a narcotic pain med for a condition that he states I do not have. Weird? How can he do that?. I will find out tomorrow when I see him.
      Have you contacted the patient advocate or anyone else at the Indy VA? If not I can send you the names of the people I continually e-mailed, called, and kept bothering and that may have helped in my case. I have no faith in the Indy VA. I keep hoping I am wrong and that it will change; however, I don’t see that happening.
      I do feel sorry for your troubles and I know how you feel having your concerns and problems not addressed by this VA.

      1. Michael Stephens is on the benefits side. We are having issues with him as well. I would suggest calling Sen Coats office at 317-554-0750 and asking for Nicole Owens his VA liaison. She has been very helpful for us.

        Do you have your paperwork showing SC? I believe that after 20 years it cannot be changed but Mr. Krause would be a better judge than I. It is what I have been told by the VA itself.

        Seattle is part of VISN 20? Alaska is and they are completely FUBAR’d. Nothing would surprise me with regards to them. 20 years of my husband’s active duty medical records went poof last seen in Alaska.

        If I can be of any help I will gladly help you.

      2. Robin, thanks for the info. I have not tried Coats but I have talked to Michael and I pretty much got nowhere with him either. The problem with the Indy VA is they will not, they refuse to look at my last 10 yrs. of treatment from the Seattle VA. They have had me start completely over and they say they cannot find anything wrong with my knees and therefore, I do not need the chronic pain meds.
        I was just awarded an increase from 20% to 40% at the beginning of ’14 for this disability (after six yrs. of denials and appeals. they went all the way back for my increase and back pay) and it is in my records. I have taken some of the Seattle VA records that show things with me to my appointments and they refuse to look at them. I was told by different people at the Indy VA (Dr’s, PA’s Ortho surgeons, and others) that if I wanted “that ” type of treatment then I would have to move back to WA to get it. It is such a mess. I have had to deal with a 10+ pain level 24/7 now for four months now. I can’t get a job because of no meds, my options are limited for this condition and I am at my whit’s end with them. I have two and a half tubs of my medical records and nothing. I am ready to move back to WA so I can have a life and become employed again. I was able to do that out there and can’t here.
        Thanks again for the info and I will contact Coats office to see what they can do. Maybe something will come out of this.

      3. Good luck tomorrow at your appointment, figure8fan. Hope you get the meds you need to make the trip back to WA comfortably. If you call Coats’ office, be careful. I dealt with Ms. Owens. She’s a nice enough person, but she indicated to me that she was a personal friend of at least one of the patient advocates at the Indy VA. Don’t be surprised if you get radio silence from Owens if you complain about your frustrations with the patient advocate.

      4. usedtoliveinindy, I would say that surprises me that she would be a close friend of the Patient advocate but then again we are talking about the VA. Thanks for the encouragement and I hope that I don’t have to move back to WA. I have nothing there as IN is my home. I am just about done with this VA and having to use up what I have saved to live because of the Indy VA is starting to take a toll on me and I may be forced to move. Either way I will still be on here as we need to stick together and help each other.
        Thanks again.

      5. Just a quick update on my appointment. I went to my appointment and my PCP did not seem as if he was 100% behind the decision to prescribe me my pain meds again. I am now back on them and I can now start to put my life back together again. It is still funny how he can prescribe a chronic pain med when the Indy VA still states that I have nothing wrong with my knees even though the Seattle VA does show this. Maybe my continuous complaining and not letting up did some good. I wish my fellow vets that have had to deal with this and have had their meds taken away will get what they should be getting again. It is not fair that those of us who need these are now having so much trouble because of a few. Keep fighting for what you should be getting and need.

      6. U know why he final gave u your meds,,because of someone like me,,,For 5 years I was told it was ,”panic attacks,”,,it was the ekg machine going hay wire,,it was me,,messing w/my leads,,,5 YEARS,,EXSCREWTIATING chest pain,,,couldn’t breath,coudn;t eat,,lost 80 pounds in 4 month,,80pounds,,,all these educated Dr/s blaming me,,a 28 year old WOMEN,,no-way can anyone live w/inverted T-waves,,S.T. segmasnts changes that should of killed any man,,,then final,,a collapsed lung on the left side,,,1st they tried to blame my doctor,,UNTIL his reputation was on the line and he actually did a M.R.I. on my spinal cord,,BINGO,, tumors in my thoracic spinal cord RIGHT BEHIND MY HEART pushing the entire cord to the left,thus my spine,my body to the left,,,all along these educated MALE doctors it was my fault,,,,,17 cardiac ablations later,major spinal surgery where they brake your back bone to get at the tumors,,not just 1 bone ,,7 back bones,,,your back will never be the same,,once its broken,,but my doctors learned,they were humbled,,and were taught by my body,,that x-rays don’t tell the whole story,that machines don’t make u sick or not sic,,and we are ALL humans,,,,,best to side w/no pain and suffering beause of emphathy,compassion,,because if anyone’s body is enduring physical pain,,there is a reason for it,and sometimes all these machines don’t tell you whats happening inside the body,,i had probally 20 chest x-rays out there,,no-one thought to look at my spinal cord,,but I suffered physical pain everyday of my life for 5 years w/no meds,,i was 1/2 dead by the time I actual got help,,1/2 dead,,,my next course of action was to simple end the physical pain myself,,So all these arrogant asses who sit here w/there poisen pens and write about this who have no physical pain what so ever,,go to hell,,,cause that is where u will end up for not having the humane compassion to allow chronic physical pain patients to have there NEEDED medicine to end there physical pain,,,anyone of these chronic pain patient tht choose to end their physical pain by death,,there death is on your hands and your hands alone!!!paita

      7. paita, I know that you have been having problems with the VA as most of us have been. I was given the chronic pain meds due to the fact that I have had this disability for 30 yrs. I have done everything possible for my disability. I was on chronic pain meds before I moved from the Seattle VA to the Indy VA. The Indy VA took my meds away because they refused to look at my Seattle VA records. My constant complaining of the disconnect from one VA to another and doing it in a manner that was logical and clear made the final difference. I was on the chronic pain med for over two yrs. in WA and then had to go through the Indy VA’s mess of not wanting to continue the med. I had to do what was right and the end result was the right one for me. Sometimes the VA doesn’t want to do things until you complain and complain and continue to push them while doing so in a proper manner to show them that you are right.

  7. While in the Houston VA for a couple weeks in the 1990’s, I was sent to another civilian hospital there for a test the VA could not do. The contrast between the two hospitals was shocking. One was clean, well staffed with people concerned and the other was the VA. All over the civilian hospital were signs stating if a patient felt their care was substandard, they should contact the Texas state board of medical licensure, with an 800 number to call. I’ve founding conflicting information about whether VA health care providers have to be licensed in the state they are in. Here in CO, doctors and nurses have to be licensed, and they have to disclose publicly whether they have had any adverse action against them.

    Whether states will take action or not, I say veterans need to start flooding these boards with complaints over this lousy care. Perhaps only then will this get the attention it deserves.

  8. I have been asking for a couple of years why this guy hasn’t been replaced by an appointed director. The State Dept. went 5 years with just an acting IG. Withing six months of appointment we heard of billions in waste around the world (mostly construction items).

    I don’t know how many of you read the IG reports. If you do, you can read between the lines of the coverups which are on-going over several IG visits at certain VA locations. Filthy, dangerous hospital rooms, stroke victims put at great risk, MRI techs not asking the proper or, in some cases not asking at all, basic questions, improper medical record keeping and the list goes on.

    The BS at the end is special. It is where the Medical Center Director, VISn director, or RO Director say they agree these are problems and they promised to have them fixed by such and such date. The IG ends up by usually issuing the statement that they will monitor the improvements (little bit of psychology on the part of the IG) and will visit those items at the next visit. So, to end my story (and this take of an IG report) .. after the visit every thing is again fine in VA land …..not, sometimes they will return, more often than not, you never hear of the follow up..

  9. I think all states should do something like this. It would give the public a better view of what us vets have to deal with. They see the warm and fuzzy “we care and will do this or that…” answers and think that it will be fixed. They do not realize that we have been fighting the VA for so many years and nothing has really changed at all. Hopefully something will come form this that may become a model for the other states to use to look into the VA and how it really works.

  10. Great advice Ben, it is time that the states aggressively prosecute VA officials and medical professionals who continue to “skate” out of responsibility. I would request that Senator Johnson and the Wisconsin AG go after the Medical Center Director, his (her) Deputy, and the Tomah staff for what is obviously another “hide and destroy” the evidence scandal.

    Remember it starting with the destruction of veteran’s claims files (wasn’t it called File gate?) which not only has not stopped, but spread to medical files, all of which are federal crimes. If the criminal US AG will not prosecute, federal prosecutors from the states should.

  11. This is what it takes to REIGN in govt. BEAURACRACY. VIGILENCE /PATIENCE. The Vets that this VA harmed may not get bthe BENEFITS, but with the “PUBLIC EYE” on them the VA must CLEAN UP their POLICIES. God is on our side.

  12. After requesting an OIG investigation back in 2010, when antipsychotic medications were given to my husband (3 at one time) Haloperidol, Risperidone, and Seroquel, not to treat a condition but to chemically restrain, nothing was done. The Black Box Warning Label at the time from the FDA, stated DO NOT GIVE TO ELDERLY PATIENTS WITH DEMENTIA, MAY CAUSE HEART ATTACK, STROKE OR EVEN DEATH. He was 78. You would think that a doctor would check the warning labels. Since then my husband has been in a wheelchair.

    When I requested the report from the Freedom of Information Office, I received a bad copy that was unreadable and most of the information redacted. In December 2013, I learned that my husband did in fact have a stroke during the time those medications were being administered from the Office of the Medical Inspector. Also caused the onset of Parkinson, but the claim for Parkinson Disease keeps being denied and nothing was done about the stroke. Therefore, this is not a surprise to me. Nothing has been done and we still have to fight for ever claim submitted. The medical records tells quite a story. They continued to give those drugs even after I requested them to stop.

    It is very sad, events such as these have been reported at other VA Medical Centers and nothing was done. It might have saved lives. I think every individual that had knowledge of these horrendous acts should be put on trial for criminal negligence.

    1. Carolyn, sorry to hear about your husband. One option could be to file an SF-95 if you believe your husband was harmed by medical malpractice (basically negligence). You only have two years from the date you had knowledge that your husband was harmed by VA medical staffers from negligence.

      1. Thank you Ben, I am trying to get that done. All the many complaints I filed about medications given to my husband and it is as though they went into a black hole. I even have a conversation in which a doctor and a nurse called me shortly after I sent the complaint to the Justice Department. Still nothing was done.

        Again, thank you.

Comments are closed.