TOMAH, Wis. — The Tomah Veterans Affairs Medical Center has adopted another plan to improve patient care at the troubled facility.

The release of the 100-day plan on Friday came almost 11 months after reports surfaced that veterans at the center were prescribed excessive doses of opioid pain-killers and that employees who spoke out faced retaliation from top officials, the La Crosse Tribune reported Saturday.

The plan, which follows a 30-day plan announced in May, outlines steps for improving access to care, employee engagement and restoring trust. Among other things, it calls for recruitment of psychiatric staff, employee forums and listening sessions, and opening an employee wellness center.

Over the past year, citing staff shortages, the Tomah VA has closed an inpatient psychiatric unit, halted psychiatric admissions to a residential treatment center and permanently cut urgent care hours.

The new plan calls for possibly extended hours at some satellite outpatient clinics but no restoration of urgent care hours. VA spokesman Matthew Gowan said the priority is to hire enough psychiatric providers to staff the hospital's 11-bed inpatient unit.

"That's our number one thing . to get that thing re-opened," Gowan said.

Several Tomah VA officials — including its former director, Mario Desanctis, and its former chief of staff, David Houlihan — have been fired since the problems emerged.

In August, the VA's inspector general ruled that deficiencies in care led to the death last year of patient Jason Simcakoski. The investigation found that psychiatrists did not discuss the hazards of a synthetic opiate prescribed to the 35-year-old Marine Corps veteran and did not have anti-overdose medicine on hand.

Dr. Carolyn Clancy, who was then the VA's interim undersecretary for health, testified at a congressional hearing in March that "an apparent culture of fear at the facility compromised patient care and impacted staff satisfaction and morale."

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