The psychiatrist at the center of a prescription drug scandal at the Tomah Veterans Affairs Medical Center, Wisconsin, was fired without any settlement or negotiation, VA officials said Monday.

Medical center Chief of Staff Dr. David Houlihan had been on administrative leave since Jan. 16 while VA officials looked into allegations he improperly prescribed painkillers and other medications to the extent he had earned the nickname "Candy Man" by some veterans.

The Associated Press broke news of Houlihan's termination Friday afternoon; VA officials later released a statement confirming his relief effective Nov. 9 and added Monday that he was fired and not allowed to retire, as other VA administrators embroiled in scandals, including another at the Tomah VA, previously have been allowed to do.

His clinical privileges also have been revoked, VA officials said.

"The letter communicating [the employee's] removal specified a future effective date because, by VA policy, Title 38 employees are not subject to immediate termination, but are generally entitled to receive notice of the decision to terminate at least five days prior to the effective date of the action," a VA spokesman said.

Houlihan is the second official to be fired from the facility; medical center director Mario DeSanctis left in September, but he entered into a settlement with VA that allowed him to resign in lieu of removal, according to House Veterans' Affairs Committee Chairman Jeff Miller, R-Fla.

Miller on Monday said Houlihan's dismissal is "genuinely surprising," given that VA fires officials "so infrequently."

"The curious nature of  Houlihan's departure coupled with the fact that he is still on paid leave nearly 10 months after VA began investigating him underscores the unfortunate truth that department leaders refuse to admit: It is much too difficult to fire failed VA employees," Miller said.

"This past January, VA senior leaders became aware of allegations that the Tomah VAMC chief of staff engaged in improper opioid prescribing practices and retaliatory behavior … based on results of reviews, his removal from federal service and revocation of clinical privileges was proposed on Sept. 17," VA officials said in a written statement.

Houlihan and other officials at the Tomah VA have been under scrutiny since the Center for Investigative Reporting reported in January that the medical center had a 14-fold increase in the number of prescribed oxycodone pills from 2004 to 2012, from 50,000 to 712,000.

Veterans at the hospital told a reporter that distribution was so rampant, they nicknamed the place "Candy Land," and Houlihan was known as the Candy Man.

A second clinician involved in the scandal, nurse practitioner Deborah Frasher, has been on administrative leave since March.

The VA Office of Inspector General launched an investigation in 2011 into the number of narcotics prescriptions distributed at Tomah as well as allegations of drug trafficking, mismanagement and intimidation of pharmacists by hospital administrators and doctors.

But the OIG was not able to "substantiate the majority of the allegations" and closed the case in 2014 without publicly releasing the report, raising questions of a cover-up or concerted effort to protect those in question.

The Center for Investigative Reporting article launched another round of inquiries into the prescribing practices at the facility and highlighted the death of former Marine Jason Simcakoski, who died Aug. 30, 2014, in the hospital's short-stay mental health unit from "mixed drug toxicity," having taken 13 prescribed medications, including several that cause respiratory depression, within a 24-hour period.

Sen. Tammy Baldwin, D-Wis., said Monday that Houlihan's firing and revocation of his license were "long overdue" but show that "change is possible and provides new-found hope that trust can be restored" at VA.

"That trust has been broken and it needs to be fixed. That is why I have introduced [legislation] that has earned the support of his family and a number of veteran service organizations to provide the VA with the tools it needs to help prevent this type of tragedy from occurring to other veterans and their families," Baldwin said.

In late September, a veterans group erected a billboard near the Tomah VA Medical Center, calling for change at VA, saying "VA is Lying, Veterans are dying!"

Ryan Honl, a former Tomah employee, whistleblower and member of the "VA is Lying" Facebook group, said he hopes Houlihan will face criminal charges.

"In the real world, people would be amazed if you didn't get criminally charged for harming patients and retaliating against those who exposed it," Honl said.

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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