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Legislation would suspend those who don't notify of Legionnaires' disease

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By Adam Smeltz
Tuesday, May 7, 2013, 1:33 p.m.

Regional directors in the Department of Veterans Affairs who fail to notify state and county health officials of infectious-disease cases could face suspension or more severe discipline under a bill introduced on Tuesday by Sen. Bob Casey Jr.

Casey, D-Scranton, pledged to strengthen transparency and accountability standards for the nation's 152 VA medical centers and nearly 1,400 outpatient clinics because of a deadly Legionnaires' disease outbreak in 2011 and 2012 in the VA Pittsburgh Healthcare System. As many as 21 veterans contracted Legionnaires', a form of pneumonia, from contaminated water on VA campuses in Oakland and O'Hara, the Centers for Disease Control and Prevention found. Five of them died.

Casey doesn't know whether his legislation would have stopped the outbreak, but said it should shore up lackluster communication inside the VA network.

“One of the real problems here was this inability to have a rigorous notification system in place, this failure to have in place a structured and effective communication system so the guy who knows something about the water system and the pipes is interacting with the scientists and the infectious-disease people,” Casey said.

Pittsburgh VA officials “could have and probably should have” shared information more readily with public health agencies during the Legionnaires' outbreak, acting state Secretary of Health Michael Wolf told the Tribune-Review.

A Trib investigation published in March revealed that VA hospitals, as federal facilities, fall outside state health rules that require other hospitals to report cases of infectious diseases. Although many VA facilities comply voluntarily, they are under no legal liability to do so.

Casey's bill, which the Senate Committee on Veterans Affairs will review, specifies requirements for VA facilities. He said the legislation is intended to “help ensure an outbreak like this never goes unreported again.”

The bill would require regional VA directors to alert state and county health departments to cases of CDC-listed notifiable infectious diseases within 24 hours of confirmation.

In each case, the CDC, national VA officials, the patient's primary-care provider and next-of-kin and VA workers in the affected hospital would receive alerts.

The VA Office of Inspector General would have to submit annual compliance reports to Congress and investigate compliance failures. Regional VA directors found to be responsible would be suspended, and the VA secretary could order additional discipline “as the secretary considers appropriate,” according to the bill.

The VA would not comment on the legislation but is “directly engaged” with Congress on the issue, spokesman Mark Ballesteros said.

Casey's bill is similar to legislation introduced last week by Rep. Mike Coffman, a Colorado Republican who chairs the Oversight Subcommittee of the House Committee on Veterans' Affairs.

Other House legislation developed in consultation with Casey's office and members of the Pennsylvania delegation will be introduced soon, said Matt Dinkel, a spokesman for Rep. Mike Doyle, D-Forest Hills.

Adam Smeltz is a Trib Total Media staff writer. Reach him at 412-380-5676 or

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