Florida lawmakers in Washington, D.C., are demanding accountability from the Miami Veterans Affairs Medical Center’s leadership for their alleged failure to heed an employee’s concerns about the reliability of the facility’s HIV testing methods.
U.S. Sen. Marco Rubio, a Florida Republican, issued a letter on Friday calling for an investigation into the Miami VAMC and urging VA Sec. David Shulkin to “hold the appropriate officials accountable” after eight military veterans who were tested for HIV received a different result when screened for a second time by an outside lab.
“This is unacceptable, and our nation’s veterans deserve better,” Rubio said in the letter. He also urged Shulkin to follow the recommendations of an independent federal investigator and ensure that every VA facility in the country is using the latest HIV testing methods.
Rubio’s letter follows a March 5 request from a bipartisan congressional delegation of South Florida lawmakers calling for an investigation into the Miami VAMC following a Miami Herald report about the HIV testing discrepancies.
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The letter, signed by Reps. Carlos Curbelo, Mario Diaz-Balart, Ileana Ros-Lehtinen and Frederica Wilson, was addressed to the chairman of the House Committee on Veterans Affairs and requested an investigation to determine “how this happened, who was responsible, to what extent this is a problem throughout the VA medical system, and what we need to do to get the Miami VAMC up to the high standard our veterans deserve.”
Shane Suzuki, public affairs officer for the Miami VA Healthcare System, which oversees the medical center, said administrators reiterated their “strong disagreement” with allegations that the facility had not complied with HIV testing requirements.
Suzuki referenced the VA’s own investigation from January 2017, which did not substantiate the worker’s allegations.
“Rather, VA confirmed compliance with VA and CDC recommendations and did not validate a public health risk,” Suzuki said in the statement. “A comprehensive review of patients revealed they were tested under the appropriate CDC-approved alternative HIV testing procedures pending the receipt and installation of new laboratory equipment.”
The federal healthcare center, which serves about 150,000 veterans in Monroe, Miami-Dade and Broward counties, was investigated by the Department of Veterans Affairs in October 2016.
The U.S. Office of Special Counsel said it prompted the VA to investigate a worker’s concerns that the Miami facility was slow to adopt the latest HIV testing methods as required by an agency mandate.
VA investigators reported that they were unable to substantiate the worker’s claims. But the OSC blasted the agency’s investigation, noting that VA investigators loosely interpreted the deadline for the Miami facility to comply with the HIV testing requirements.
In a letter to President Donald Trump, Special Counsel Henry J. Kerner said Miami VAMC administrators ignored the worker’s concerns until after he complained to the OSC in May 2016 and then made his whistle-blowing public by hand delivering a notice to Miami VAMC Director Paul Russo on June 30, 2016.
“I am incredulous that compliance with Directive 1113 [the policy] and implementation of fourth generation HIV testing occurred only after Mr. Miguel’s disclosures and OSC’s intercession,” Kerner wrote in the letter to President Trump.
The new HIV testing policy was implemented in May 2015 and involves general processes and programs for HIV testing as part of the VA’s routine medical care. It includes guidance from the Centers for Disease Control and Prevention for recommended and alternate testing sequences that updated the standard used since 1987.
Each VA medical facility is required to establish a written testing policy, and to follow requirements and processes for obtaining oral consent for HIV testing. The policy also details procedures for performing HIV tests and establishes timely notification of results in order to link newly diagnosed patients with the appropriate medical care.
VA facilities were required to comply with the directive by May 2016. But the worker alleged that Miami VAMC officials ignored his repeated concerns and continued using outdated HIV testing even after the deadline.
Though the Miami VAMC had repurposed a piece of lab equipment in October 2015 to comply with one of the testing protocols, according to the OSC, the facility continued to use outdated methods for confirmatory testing.
In September 2016, the Miami VAMC began sending HIV test samples to Quest Diagnostics, an outside lab, for confirmatory testing because the equipment needed to perform those secondary tests had not yet been ordered. The OSC said the employee responsible for procurement had been on extended leave.
The necessary equipment was not installed and completed at the Miami facility until December 2016, about seven months after the deadline, according to the OSC.
During their investigation of the Miami facility, VA officials identified eight veterans whose HIV test results from outside labs differed from the Miami VAMC’s test results — including one patient who was deemed “high risk” for HIV and tested positive for the virus after follow-up screening.
In a second case, the Miami VAMC tried at least five times between June and December 2016 to contact a veteran with differing HIV test results. Eventually, the veteran returned for repeat screening and tested positive for HIV. The remaining six veterans with differing results returned to the Miami VAMC for retesting and were negative.