Emergency Cache Program: Ineffective Management Impairs Mission Readiness

The VA Office of Inspector General (OIG) audited the Veterans Health Administration’s (VHA’s) Emergency Cache Program to determine whether it is maintained in a mission-ready status. VA established the program in 2002 following the 9/11 attacks to ensure drugs and medical supplies are available following a local mass casualty event. Valued at $44 million, VA maintains emergency caches at 141 VA medical facilities around the country. The audit team surveyed the managers of all emergency caches and conducted unannounced inspections at 26 randomly selected emergency cache locations in February 2018. The audit team found expired, missing, or excess drugs, or a combination of, at all 141 emergency caches. There were no required wall-to-wall inventories, and cache managers were not aware of the extent inventories were affected by expired, missing, or excess drugs. As a result of ineffective management, the mission ready status of the caches was impaired. The OIG recommended that VHA establish policies and implement procedures to improve the oversight and management of the program, including developing requirements that all emergency caches perform annual wall-to-wall inventories and improving cache inventory management processes. The OIG also recommended VHA update directives specifying oversight responsibilities, assess whether the program is properly aligned within VA, and coordinate with other VA offices to determine appropriate roles and responsibilities. Finally, the OIG recommended that VHA conduct a comprehensive assessment of the caches’ inventories to identify drugs and supplies that can be used in medical facilities’ general operations and develop a mechanism to ensure medical facilities are maximizing the use of the items before they expire.