Peace Corps:

Long-Needed Improvements to Volunteers' Health Care System

NSIAD-91-213: Published: Jul 3, 1991. Publicly Released: Jul 3, 1991.

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Pursuant to a congressional request, GAO reviewed the Peace Corps' health care system for its volunteers, focusing on whether: (1) volunteers received a level of health care comparable to what they would have received in the United States; and (2) former volunteers with service-related medical conditions were aware of and receiving their health care entitlement.

GAO found that: (1) 73 percent of former volunteers surveyed were satisfied with the quality of health care that Peace Corps medical officers provided; (2) the Peace Corps' health care system did not ensure that volunteers received approximately the same level of care available in the United States; (3) the Peace Corps did not follow its selection policy for hiring medical officers, provide adequate in-house training, or provide sufficient procedures for monitoring their activities; (4) due to inadequate guidelines and controls, some medical officers contracted by the Peace Corps were not qualified to provide the level of health care required by the specific conditions of a country, were unfamiliar with or untrained in Peace Corps diagnostic and treatment procedures, and provided care that was beyond their competence or that violated Peace Corps guidelines; (5) the Peace Corps did not subject its health care system to a medical review by an independent accrediting organization; (6) although former Peace Corps volunteers are entitled to Federal Employees Compensation Act (FECA) benefits for service-related health problems, and the Peace Corps described such benefits in its volunteer manual, many former volunteers were not aware of their benefit entitlements; (7) the Peace Corps inadequately assisted former volunteers in filing their FECA claims; and (8) the Peace Corps took such corrective actions to improve its health care system as improving the FECA system, providing medical officer orientation funds, planning an independent medical review, conducting annual training conferences, instituting an improved monitoring form to emphasize quality-of-care issues, procedures, and developing a informational benefits video.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: The Peace Corps has implemented the recommendation to institute an independent evaluation by the Joint Commission on Accreditation of Health Care Organizations. It has also followed through on those improvements planned at the time the review was completed.

    Recommendation: The Director, Peace Corps, should follow through on the initiatives announced and those it has begun to implement, including a plan to institute an independent evaluation by the Joint Commission on Accreditation of Healthcare Organizations or a similar organization, to improve the Peace Corps' health care system.

    Agency Affected: Peace Corps

  2. Status: Closed - Implemented

    Comments: The agency issued a handbook describing how to file claims and distributed it to volunteers attending the annual meeting in August 1991. The Peace Corps has also sent mailings to approximately 100,000 former volunteers notifying them of their health care benefits. For all practical purposes, this implements the GAO recommendation to notify all former volunteers.

    Recommendation: The Director, Peace Corps, should inform all former volunteers of the FECA entitlement. Returned Peace Corps volunteer groups, the National Council for Returned Volunteers, and the Peace Corps publications sent to former volunteers could be used to disseminate this information.

    Agency Affected: Peace Corps

 

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