GAO urges reforms in program for wounded service members

DoD and VA Health Care: GAO Study released

The Preamble:

In 2007, following reports of poor case management for outpatients at Walter Reed Army Medical Center, the Departments of Defense (DOD) and Veterans Affairs (VA) jointly developed the Federal Recovery Coordination Program (FRCP) to coordinate the clinical and nonclinical services needed by severely wounded, ill, and injured servicemembers and veterans. The FRCP, which continues to expand, is administered by VA, and the care coordinators, called Federal Recovery Coordinators (FRC), are VA employees. This report examines (1) whether servicemembers and veterans who need FRCP services are being identified and enrolled in the program, (2) staffing challenges confronting the FRCP, and (3) challenges facing the FRCP in its efforts to coordinate care for enrollees. GAO reviewed FRCP policies and procedures and conducted over 170 interviews of FRCP officials, FRCs, headquarters officials and staff of DOD and VA case management programs, and staff at medical facilities where FRCs are located.

The Synopsis:

• Mar 29, 2011

It’s unclear whether the four-year-old Federal Recovery Coordination Program — designed to better manage the outpatient care of service members severely wounded in combat— is reaching those who need it most, according to a Government Accountability Office report.

The report, released March 23, looked at the FRCP, a joint effort by the Defense and Veterans Affairs departments, created following reports of poor case management for outpatients at Walter Reed Army Medical Center.

Program care coordinators, called Federal Recovery Coordinators (who are VA employees), cannot readily identify potential enrollees using existing data sources because neither DOD nor VA information systems classify service members and veterans as “severely wounded, ill, and injured,” according to GAO. Consequently, the system must depend on referrals to fill its enrollment, which means that the most needy candidates could fall through the cracks, the report said.

“FRCP leadership does not systematically review these (enrollment) decisions to ensure that these criteria are applied appropriately so that referred individuals who could benefit from the program are enrolled, and that individuals who could be served by less intensive services are referred to other programs,” the report said.

Another problem is that the FRCP has not clearly defined a process for making staffing decisions, the report said, and the program needs to clarify how it decides to place care coordinators at DOD and VA facilities. GAO advised VA to establish a system to oversee enrollment decisions and to develop a rationale for placement of care coordinators.

From January 2008 — when enrollment began — through September 2010, FRCP provided services to a total of 1,268 service members and vets. As of September 2010, the program had 607 active enrollees and 20 care coordinators.

To see more, go to: www.gao.gov/highlights/d11250high.pdf

(H/T Jane)