Returned Peace Corps Volunteers:

Labor and Peace Corps Need Joint Approach to Monitor Access to and Quality of Health Care Benefits

GAO-13-27: Published: Nov 19, 2012. Publicly Released: Nov 19, 2012.

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Linda T. Kohn
(202) 512-7114
kohnl@gao.gov

 

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What GAO Found

From 2009 through 2011, the Department of Labor (DOL) provided a total of about $36 million in Federal Employees' Compensation Act (FECA) benefits--health and other benefits--for Peace Corps volunteers who have returned from service abroad (volunteers). Specifically, DOL provided about $22 million in health care benefits for these volunteers in the form of reimbursements for medical expenses related to service-connected injuries and illnesses, and $13.8 million in other benefits, such as reimbursement for travel expenses incurred when seeking medical care. During this period, approximately 1,400 volunteers each year received these health care benefits under the FECA program. The most common types of medical conditions for which DOL provided reimbursements were mental, emotional, and nervous conditions; dental; other/nonclassified diseases; and infectious or parasitic diseases. These four medical conditions accounted for more than a quarter of all medical reimbursements for volunteers under FECA from 2009 through 2011.

In general, neither DOL nor the Peace Corps use all available information in the four areas GAO reviewed to monitor access and quality of FECA benefits for volunteers. GAO found that the Peace Corps uses information in just one of the areas--volunteers' awareness of the FECA program; however, in general, neither agency uses information in the remaining three areas. These areas are (1) information on volunteers' knowledge of FECA program and application requirements, such as required medical documentation; (2) information on DOL's timeliness in reviewing FECA applications and reimbursing medical expenses, and on the level of customer satisfaction; and (3) availability of FECA-registered medical providers. By not using information available to the agencies, DOL and the Peace Corps are missing an opportunity to determine whether, or to what extent, volunteers face access and quality issues in the FECA program. For example, DOL and the Peace Corps may not be able to determine the extent to which there are limitations in the availability of FECA-registered providers for certain medical specialties.

DOL and the Peace Corps each have certain responsibilities related to the provision of FECA benefits for eligible volunteers, and each has information that could be used for monitoring. From DOL's perspective, volunteers do not represent a large proportion of the overall FECA population. However, FECA is a relatively larger issue from the Peace Corps' perspective. The volunteers are a unique population compared to others who receive benefits under FECA, and the FECA costs associated with volunteers represent a growing portion of the Peace Corps' annual budget. Neither agency has all the information GAO reviewed, and the agencies generally do not work together to use available information to monitor the accessibility and quality of FECA benefits for volunteers. As a result, DOL and the Peace Corps are missing an opportunity to make use of the available information to help ensure the accessibility and quality of FECA benefits for volunteers. GAO recommends that the Secretary of Labor and the Director of the Peace Corps jointly develop and implement an approach for working together to use available agency information to monitor the access to and quality of FECA benefits provided to volunteers. Neither DOL nor the Peace Corps indicated whether or not they agreed with GAO's recommendation. Instead, the agencies provided additional context related to the provision of FECA benefits.

Why GAO Did This Study

Peace Corps volunteers who suffer a service-connected illness or injury are eligible to receive certain health care and other benefits under FECA--a workers' compensation program administered by DOL. FECA provides health care benefits--reimbursements for medical expenses--to federal employees and volunteers for illnesses or injuries that DOL determines are service-connected.

GAO was mandated to report on the access and quality of health care benefits for Peace Corps volunteers. This report (1) identifies the health care and other benefits provided to volunteers from 2009 through 2011 under the FECA program, and (2) examines the extent to which DOL and the Peace Corps use available agency information to monitor the accessibility and quality of FECA health care benefits provided to volunteers. GAO reviewed agency documents, interviewed agency officials, and analyzed DOL data. GAO developed a framework with four areas to define access and quality and examined available information in these areas that could be used for monitoring.

What GAO Recommends

GAO recommends that the Secretary of Labor and the Director of the Peace Corps jointly develop and implement an approach for working together to use available agency information to monitor the access to and quality of FECA benefits provided to volunteers.

Neither DOL nor the Peace Corps indicated whether or not they agreed with GAO’s recommendation. Instead, the agencies provided additional context related to the provision of FECA benefits.

For more information, contact Linda T. Kohn at (202) 512-7114 or kohnl@gao.gov.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: The Department of Labor (DOL) and the Peace Corps provided information in May 2017 on their approach for working together to monitor the access and quality of FECA benefits provided to volunteers. For example, the agencies have agreed to meet quarterly to collectively monitor data and develop solutions to improve access and quality of care. Specifically, they will review data on claims filed, benefits paid, and inquiries received by volunteers. In addition, the agencies have worked together to share information provided to volunteers, such as documents outlining application requirements, to ensure that they are accurate and up-to-date to facilitate the claims process. The Peace Corps also hired a nurse case manager to assist returned volunteers with FECA claims to improve access and quality of care. This nurse works with DOL's Lead FECA Nurse Case Manager to assist in the claims submission and subsequent case management process.

    Recommendation: The Secretary of Labor and the Director of the Peace Corps should jointly develop and implement an approach for working together to use available information to monitor the access to and quality of FECA benefits provided to returned volunteers.

    Agency Affected: Department of Labor

  2. Status: Closed - Implemented

    Comments: The Department of Labor (DOL) and the Peace Corps provided information in May 2017 on their approach for working together to monitor the access and quality of FECA benefits provided to volunteers. For example, the agencies have agreed to meet quarterly to collectively monitor data and develop solutions to improve access and quality of care. Specifically, they will review data on claims filed, benefits paid, and inquiries received by volunteers. In addition, the agencies have worked together to share information provided to volunteers, such as documents outlining application requirements, to ensure that they are accurate and up-to-date to facilitate the claims process. The Peace Corps also hired a nurse case manager to assist returned volunteers with FECA claims to improve access and quality of care. This nurse works with DOL's Lead FECA Nurse Case Manager to assist in the claims submission and subsequent case management process.

    Recommendation: The Secretary of Labor and the Director of the Peace Corps should jointly develop and implement an approach for working together to use available information to monitor the access to and quality of FECA benefits provided to returned volunteers.

    Agency Affected: Peace Corps

 

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