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Highlights

Pursuant to a congressional request, GAO reviewed the Department of Veterans Affairs' (VA) implementation of the Persian Gulf Spouse and Children Examination Program, focusing on: (1) outreach efforts; (2) obstacles to family members' participation; and (3) contracting issues.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs 1. In an effort to improve participation rates in the Persian Gulf Spouse and Children Examination Program, the Secretary-designate of Veterans Affairs should direct the Under Secretary for Health to simplify the process for requesting and scheduling examinations.
Closed - Implemented
P.L. 105-368 granted VA authority to use its fee-basis contract authority to provide examinations to dependents of Persian Gulf veterans. Examinations were previously provided under VA's contractual arrangements with affiliated medical schools, which were not always conveniently located or interested in participating in the program. Local physicians can now complete examinations when the veteran's family cannot travel to affiliated medical centers.
Department of Veterans Affairs 2. In an effort to improve participation rates in the Persian Gulf Spouse and Children Examination Program, the Secretary-designate of Veterans Affairs should direct the Under Secretary for Health to offer examinations in more locations and seek approval to reimburse participants who are required to travel long distances to receive examinations.
Closed - Implemented
In lieu of reimbursement for travel expenses, VA uses its fee-basis authority to contract with local physicians to provide required examinations. This process eliminates the former hardships of long and potentially expensive trips for some families not located near participating affiliated medical centers.
Department of Veterans Affairs 3. In an effort to improve participation rates in the Persian Gulf Spouse and Children Examination Program, the Secretary-designate of Veterans Affairs should direct the Under Secretary for Health to enhance the capacity of the Office of Public Health and Environmental Hazards to monitor program implementation by field personnel.
Closed - Implemented
VA coordinating facilities are required to submit monthly reports showing the status of all requests for examinations. For those examinations requested prior to initiation of fee-basis arrangements with local physicians, coordinating facilities are encouraged to contact veterans' families when possible to determine whether they are still interested in participating in the program.

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