Baldwin Demands VA Tighten Opioid Prescribing, Abide by Jason’s Law to Protect Veterans

WASHINGTON, D.C. - Today, U.S. Senator Tammy Baldwin (D-WI) led her colleagues in demanding the Department of Veterans Affairs (VA) strengthen compliance with Jason's Law and improve the VA's opioid prescribing practices for our veterans. Baldwin's call comes after a report exposed internal VA audits found lagging compliance with Jason's Law and recent reporting exposed severe staffing shortages at VA medical centers across Wisconsin.

"The opioid and substance use disorder epidemic continues to have deadly impacts across the country making the VA pain and opioid safety programs critical to our veterans' safety. We were troubled to see the lack of progress in compliance over recent years," wrote the Senators in a letter to Secretary of Veterans Affairs Doug Collins. "Jason's Law and the Comprehensive Addiction and Recovery Act are saving lives, but VA must reach full compliance to continue this work and fulfill our nation's promise to deliver world-class care to our veterans. There is urgency in ensuring each Veterans Health Administration facility achieves full compliance with the law and that funding is swiftly and effectively utilized."

Signed into law in 2016, Senator Baldwin's Jason Simcakoski Memorial Opioid Safety Act focuses on strengthening the VA's opioid prescribing guidelines and improving pain management services.

A recent report published by the Office of the Inspector General at the Department of Veterans Affairs identified internal VA audits that found there has not been significant improvement in compliance with Jason's Law since 2019. In response, Baldwin is calling for the VA to develop a plan to achieve 100% compliance and identify the resources needed to do so. Additionally, Baldwin is demanding that the VA spend every dollar available for opioid safety and treatment.

In addition to Senator Baldwin, the letter was co-signed by Senators Angus King (I-ME), Jeanne Shaheen (D-NH), Raphael Warnock (D-GA), Ben Ray Luján (D-NM), Andy Kim (D-NJ), Richard Durbin (D-IL), Tim Kaine (D-VA), and Mazie Hirono (D-HI).

The full text of the letter is available here and below.

Dear Secretary Collins,

We write to raise concerns regarding compliance with the Jason Simcakoski Memorial and Promise Act (Jason's Law) that was signed into law as part of the Comprehensive Addiction and Recovery Act of 2016. Earlier this year, the Office of the Inspector General published its report on oversight of the VA's Pain Management, Opioid Safety, and Prescriptions Drug Monitoring Program, including its use of appropriated funds and compliance with Jason's Law. We write to draw your attention to the findings in this report and request your plan to achieve 100% compliance with the law.

Jason's Law requires all Veterans Health Administration facilities to have a pain management team responsible for coordinating and overseeing pain management therapy for pain unrelated to cancer. The opioid and substance use disorder epidemic continues to have deadly impacts across the country making the VA pain and opioid safety programs critical to our veterans' safety. We were troubled to see the lack of progress in compliance over recent years. The Inspector General reported that the Veteran's Health Administration audits of pain management teams found 32% of facilities were not in full compliance with the law in September 2019, and by October 2024, the share of facilities not in full compliance had risen to 33%. We do note that during the same timeframe, the percentage of facilities that were partially compliant increased from 28% to 32%, leading to a decrease in the number of facilities that were noncompliant (4% down to 1%). Despite the modest progress indicated by these numbers, we ask that your response include a plan to bring all facilities to full compliance.

The Inspector General identified several causes for the lack of compliance, including a lack of clarity regarding the standards for Pain Management Teams, their composition, function, and responsibilities, including how these requirements vary across types of medical facilities. It is our understanding that the Department has been working for several years to update this guidance. Please provide us with information on which individuals or organizations contributed recommendations for the new directive and how that input was collected, along with a timeline for its expected distribution.

The Inspector General noted additional barriers to compliance. For example, delays in the hiring process or long wait times to approve positions and hiring actions negatively impact medical facilities' ability to hire members of pain management teams to achieve compliance. Other factors include difficulties in attracting suitable candidates due to nationwide shortages of certain specialties or in rural locations and a possible lack of VA competitiveness when compared to other medical employers. Please provide your evaluation of all factors that impact the hiring of staff for pain management teams and your plan to address these factors in a way that will substantially improve compliance with the law. Please include your methods of measuring progress for each factor identified and a timeline for achieving full compliance. Please include resources needed, including funding, statutory language, coordination with other government agencies, or other needs.

An additional challenge the Inspector General identified was the lack of expenditure of Congressionally-appropriated funds for opioid safety and treatment programs. Congress includes funding designated for the implementation of the Comprehensive Addiction and Recovery Act in annual appropriations bills. In fiscal year 2022, however, the Department did not spend over $93 million, accounting for 44% of the appropriated funds provided for this purpose. This indicator did improve, with the Department's unexpended funds dropping to $33 million (16%) in fiscal year 2023 and $9 million (4%) in fiscal year 2024. We appreciate the attention the Department showed to this account that led to improved efficiency in utilizing the funds for their intended purpose, but underscore that VA should be spending every dollar available for opioid safety and treatment. Please provide us with your analysis of any difficulties that remain in fully expending the appropriated funds each fiscal year. Please also provide your expenditure rate for fiscal year 2025.

Jason's Law and the Comprehensive Addiction and Recovery Act are saving lives, but VA must reach full compliance to continue this work and fulfill our nation's promise to deliver world-class care to our veterans. There is urgency in ensuring each Veterans Health Administration facility achieves full compliance with the law and that funding is swiftly and effectively utilized. Thank you for your attention to this critically important, lifesaving matter. We look forward to working together to fulfill our shared responsibility to those who have sacrificed so much in service to our nation.

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