VA Health Care:

VA Needs to Improve Accuracy of Reported Wait Times for Blind Rehabilitation Services

GAO-04-949: Published: Jul 22, 2004. Publicly Released: Jul 22, 2004.

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The Department of Veterans Affairs (VA) provides rehabilitation services to legally blind veterans. These services are intended to help them acquire the skills necessary to become more independent. Almost all of VA's rehabilitation services for legally blind veterans are provided at Blind Rehabilitation Centers (BRC), an inpatient program. VA reported that the average length of time a veteran waited to be admitted to a BRC increased from 168 to 210 days from fiscal years 1999 through 2003. GAO was asked to examine the accuracy of veterans' wait times for admission to BRCs. GAO's objective was to determine whether the average wait times for veterans seeking admission to BRCs reported by VA were accurate. GAO reviewed VA policies and procedures for determining the average length of time veterans wait to be admitted to a BRC. GAO also visited 5 of VA's 10 BRCs to evaluate the reliability of the data used to calculate wait times.

GAO found that the average length of time VA reported that veterans wait for admission to BRCs was inaccurate. Some data used to calculate wait times were incomplete or incorrect. For example, at one BRC GAO found that one or more of the data elements used to calculate the wait times--the date the BRC received the application, the earliest admission date offered to the veteran, and the date the veteran was admitted to the BRC--were missing from 31 percent of the records and incorrect in 13 percent of the records. GAO also found missing or inaccurate data at two other BRCs. In addition, GAO found that BRCs used different procedures for their calculations, which also contributed to the inaccurate average wait times. For example, two BRCs correctly ended the wait times calculations on the earliest admission date offered to the veteran, while the other three BRCs ended the wait times calculations on the date the veteran was admitted to the BRC. To enable VA to accurately assess wait times, it is essential for VA to develop more comprehensive instructions to calculate average wait times and for BRCs to adhere to them.

Status Legend:

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  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: To improve VA's ability to effectively manage care for legally blind veterans, the Secretary of Veterans Affairs should direct the Under Secretary for Health to instruct the program office to develop more specific instructions for calculating wait times.

    Agency Affected: Department of Veterans Affairs

    Status: Closed - Implemented

    Comments: 9/05: Originally, VA stated it would issue an information letter to address the recommendation to develop more specific instructions for calculating wait times, but subsequently decided to develop a directive. Wanda Washington indicated that the directive should be finalized in September 2005. 6/06: VHA Directive 2005-048, Referral to Inpatient Blind Rehabilitation Centers and Calculation of the Waiting Time Prior to Admission, was published on October 21, 2005. This directive includes instructions for the calculation of waiting times for admission to the inpatient blind rehabilitation centers (BRCs). The Blind Rehabilitation Center draft handbook contains the instructions from VHA Directive 2005-048. This handbook is expected to be released to the field no later than the end of second quarter Fiscal Year (FY) 2007. In FYs 2005 and 2006, VHA provided training for staff on the newly released Blind Rehabilitation Version 5.0 database, which will maintain all administrative data relevant to application management. This nationwide training is complete.

    Recommendation: To improve VA's ability to effectively manage care for legally blind veterans, the Secretary of Veterans Affairs should direct the Under Secretary for Health to instruct the BRCs to adhere to these instructions by developing procedures to compile complete and accurate information on the length of time veterans wait for admission to BRCs.

    Agency Affected: Department of Veterans Affairs

    Status: Closed - Implemented

    Comments: 6/06: VA stated that VHA Directive 2005-048, Referral to Inpatient Blind Rehabilitation Centers and Calculation of the Waiting Time Prior to Admission, was published on October 21, 2005. This directive specifies procedures for the calculation of waiting times for admission to the inpatient blind rehabilitation centers (BRCs). VHA's Blind Rehabilitation Service staff is currently using the existing national database to accurately record waiting times. Monthly statistical reports are submitted by all BRCs to VHA Central Office. VHA Blind Rehabilitation Service is presently deploying the Blind Rehabilitation Service Version 5.0 Database, which will compile complete and accurate information on waiting times. Full implementation is expected by December 2006.

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