Readjustment Counseling Service:

Vet Centers Address Multiple Client Problems, but Improvement Is Needed

HEHS-96-113: Published: Jul 17, 1996. Publicly Released: Jul 17, 1996.

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Pursuant to a congressional request, GAO reviewed the Department of Veterans Affairs' (VA) Vet Center program, focusing on: (1) the individuals served and the services provided; and (2) VA methodology for determining whether Vet Center services are appropriate and effective.

GAO found that: (1) vet centers help certain veterans make a successful transition from military to civilian life; (2) vet center services range from assistance with basic needs and benefits to drug and alcohol abuse and post-traumatic stress disorder (PTSD) counseling; (3) veterans who have more serious psychological problems, such as PTSD, visit vet centers more often than veterans with employment or benefit concerns; (4) about 283,000 new clients used vet centers during fiscal years 1993 through 1995; (5) many veterans have social concerns that can be addressed by other VA and non-VA programs, thus limiting the number of center visits needed; (6) client visits are generally recorded accurately in the workload reporting system, but program managers and supervisors lack the information needed to oversee the program and monitor staff activities and resources; and (7) VA has established standards for determining whether treatment plans are appropriate, but it has not developed a systematic approach for demonstrating that vet center services are effective in meeting veterans' psychological needs.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: In VA's 60-day response to the report, the Secretary, while taking issue with part of GAO's basis for this recommendation, acknowledged limitations in the Activity Reporting System and stated that RCS was coordinating needed technical changes to upgrade its information collection capabilities. RCS initiated steps in this direction by establishing an internal work group to identify system needs and requested an external assessment by the VA Advisory Committee on the Readjustment of Vietnam and Other War Veterans. As a result of these efforts, data collection capabilities have been upgraded in the areas of: (1) time spent in direct service activities; (2) systematic tracking of referrals; (3) crisis intervention work; and (4) community work in support of a broad range of veteran-related functions. VA closed its tracking of this recommendation based on a March 12, 1997, status report on these actions.

    Recommendation: The Secretary of Veterans Affairs should direct the Readjustment Counseling Service (RCS) to make changes to the Activity Reporting System so that it will more accurately reflect Vet Center activity and staff resources used.

    Agency Affected: Department of Veterans Affairs

  2. Status: Closed - Implemented

    Comments: In VA's 60-day response to the report, the Secretary stated that this recommendation had been implemented. He noted that RCS's policies and processes for clinical documentation of client records provide appropriate direction for Vet Center staff to fulfill necessary requirements and that monitoring of compliance with these policies and processes is an ongoing activity. He stated that RCS program officials would share the findings in the report with all Vet Centers and continue to provide consistent guidance about the importance of accurate and complete documentation.

    Recommendation: The Secretary of Veterans Affairs should direct RCS to require Vet Center counselors to properly document the care provided to veterans.

    Agency Affected: Department of Veterans Affairs

  3. Status: Closed - Implemented

    Comments: The Secretary of VA's 60-day response to the report stated that RCS had made positive strides in developing valid, ongoing measurements of program effectiveness. He noted that performance measurement is a key component of the Veterans Health Administration's major restructuring initiative, and every program, including RCS, was actively involved in defining and implementing reliable measurements. Finally, he noted that RCS was also monitoring the development of national standards for behavioral health organizations in the private sector for potential application within the VA system.

    Recommendation: The Secretary of Veterans Affairs should direct RCS to develop a method for demonstrating, on a continuing basis, the effectiveness of the Vet Center program.

    Agency Affected: Department of Veterans Affairs

 

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