VA Mental Health Services Public Report — November 2014 (PDF)
Source: U.S. Department of Veterans Affairs
The following report is designed to give Veterans, their families, and the broader community information about the mental health treatment programs offered by the Department of Veterans Affairs (VA). It documents the rapid growth in demand for VA mental health services during the past decade, some of the challenges this has created, and ways in which VA has responded. VA measures the resources available to address Veterans’ mental health needs, and this report highlights some of these, including budgeting for mental health care, staffing and space for mental health programs, and use of technology to improve access to treatment. The report also presents information about Veterans’ experience of care, including the types and amount of mental health services received and Veterans’ opinions about access and quality of care. VA has ongoing efforts to use this information to address areas of concern and improve the quality of VA mental health treatment.
PTSD Research Quarterly — Impact of Mass Shootings (PDF)
Source: National Center for PTSD (VA)
Norris (2007) provided an excellent introduction to the literature on mass shootings. Our goal is to provide an update on this literature. Norris focused on individual, as well as broader community factors in examining responses to mass shootings. Our guide focuses solely on quantitative studies examining factors at the level of the individual that appear to be related to adjustment following a mass shooting.
Our definition of a mass shooting involves an individual (with few exceptions, a male), acting alone and with generally personal rather than political motivation, entering a densely populated space and shooting as many people as possible. In addition, while not required in the definition, the shooter typically takes, his or her, own life. Our guide to the literature proceeds chronologically, with an emphasis on studies that use longitudinal data.
CRS — Veterans’ Benefits: The Department of Veterans Affairs and the Duty to Assist Claimants (September 26, 2014)
Veterans’ Benefits: The Department of Veterans Affairs and the Duty to Assist Claimant (PDF)
Source: Congressional Research Service (via Federation of American Scientists)
The Department of Veterans Affairs (VA) provides an array of benefits to veterans and to certain members of their families. These benefits include disability compensation and pensions, education benefits, survivor benefits, medical treatment, life insurance, vocational rehabilitation, and burial and memorial benefits. In order to apply for these benefits, in most circumstances, the claimant will send an application to his or her local VA Regional Office or apply online. Once a veteran has filed an application for benefits with the VA, the agency has a unique obligation to the claimant when adjudicating the claim—the VA has a “duty to assist” the claimant throughout the claim process.
Review of the Veterans Health Administration’s Use of Reverse Auction Acquisition (PDF)
Source: U.S. Department of Veterans, Office of Inspector General
The VA Office of Inspector General (OIG) conducted a review of the Veterans Health Administration’s (VHA) use of commercial reverse auctions to procure products and services. The review determined that the methodology used to calculate and report savings by using reverse auctions greatly overstated any actual savings and did not comply with VHA’s Standard Operating Procedure (SOP). VHA’s mandatory requirement to use reverse auctions violated VA’s policy for using priority sources such as FSS contracts. Over 93 percent of the contract files reviewed did not contain proper documentation to validate the use of reverse auctions in accordance with VHA’s SOP. The review also determined that contracting officials run the risk of purchasing gray market items by using reverse auctions.
See also: Administrative Investigation, Conduct Prejudicial to the Government and Interference of a VA Official for the Financial Benefit of a Contractor, Veterans Health Administration, Procurement & Logistics Office, Washington, DC (PDF)
Audit of VBA’s Efforts to Effectively Obtain Veterans’ Service Treatment Records (PDF)
Source: U.S. Department of Veterans Affairs, Office of Inspector General
This audit was Congressionally required by the Consolidated Appropriations Act, 2014. The Act directed the Department of Veterans Affairs (VA) Office of Inspector General (OIG), in coordination with the Department of Defense (DoD) OIG, to examine the processes and procedures for transmitting service treatment records (STRs) and personnel records from DoD to VA. We focused our efforts on the Veterans Benefits Administration’s (VBA) processes and timeliness of requesting paper STRs and providing them to VA Regional Office (VARO) staff that need the records to make decisions on veterans’ disability compensation claims. We also assessed initial timeliness of receiving electronic STRs from DoD, which is a process that began in January 2014.
We determined that DoD is not timely in providing VBA electronic STRs. From January 1 through June 3, 2014, VBA submitted 7,278 STR requests to DoD for veterans who submitted claims and separated from military service on or after January 1, 2014. Of those, DoD only completed 2,111 requests (29 percent) and 5,167 requests (71 percent) were pending. Of the 2,111 completed STR requests, 377 requests (18 percent) were received by VBA within 45 calendar days of the veterans’ separation from military service. This occurred because DoD reported experiencing challenges and delays implementing the process of transmitting electronic STRs to VBA.
Based on a review of 400 statistically selected original disability compensation claims completed during calendar year 2013, we identified delays within VBA’s processes. Delays occurred with VARO staff establishing claims, requesting STRs, and receiving requested STRs. Overall, we attributed a total of about 131 days to these actions. Delays occurred primarily because of VBA’s focus on eliminating the disability claims backlog. As a result of these delays, DoD and VBA need to improve timeliness of their current STR processes in order for VBA to achieve its timeliness goal of processing all claims within 125 days.
We made recommendations to the Under Secretary for Benefits to improve VBA’s processes of requesting and providing STRs to VARO staff. The Under Secretary for Benefits concurred with our recommendations and provided an acceptable action plan. We will follow up on the implementation of the corrective actions.
Review of Alleged Patient Deaths, Patient Wait Times, and Scheduling Practices at the Phoenix VA Health Care System
Review of Alleged Patient Deaths, Patient Wait Times, and Scheduling Practices at the Phoenix VA Health Care System (PDF)
Source: U.S. Department of Veterans Affairs, Office of Inspector General
This is the final report addressing allegations of gross mismanagement of VA resources, criminal misconduct by senior leadership, systemic patient safety issues, and possible wrongful deaths at the Phoenix VA Health Care System. The OIG found patients at the Phoenix VA Health Care System experienced access barriers that adversely affected the quality of primary and specialty care provided for them. Patients frequently encountered obstacles when patients or their providers attempted to establish care, when they needed outpatient appointments after hospitalizations or emergency department visits, and when seeking care while traveling or temporarily living in Phoenix.
In February 2014, a whistleblower alleged that 40 veterans died waiting for an appointment but the whistleblower did not provide us with a list of 40 patient names. However, we conducted a broader review of 3,409 veteran patients identified from multiple sources, including the electronic wait list, various paper wait lists, the OIG Hotline, the U.S. House Veterans Affairs Committee and other congressional sources, and media reports. We were unable to assert that the absence of timely quality care caused the deaths of these veterans.
This report includes case reviews of 45 patients who experienced unacceptable and troubling lapses in follow-up, coordination, quality, and continuity of care. The patients discussed reflect both patients who were negatively impacted by care delays (28 patients including 6 deaths), as well as patients whose care deviated from the expected standard independent of delays (17 patients including 14 deaths). In addition to 1,400 veterans waiting to receive a scheduled primary care appointment who were appropriately included on the Phoenix VA Health Care System Electronic Wait List, we identified over 3,500 additional veterans. Many of the 3,500 veterans were on what we determined to be unofficial wait lists and were at risk of never obtaining their requested or necessary appointments.
Since the Phoenix VA Health Care System story first appeared in the national media, the OIG received approximately 225 allegations regarding health care at Phoenix and approximately 445 allegations regarding manipulated wait times at other VA medical facilities. The VA OIG Office of Investigations opened investigations at 93 sites of care in response to allegations of wait time manipulations. We are coordinating our investigations with the Department of Justice and the Federal Bureau of Investigation.
DoD and VA Take New Steps to Support the Mental Health Needs of Service Members and Veterans (PDF)
Source: U.S. Department of Defense/U.S. Department of Veterans Affairs
Today, President Obama will announce 19 new executive actions that the Departments of Veterans Affairs (VA) and Defense (DoD) are taking to improve the mental health of service members, veterans and their families. Today’s announcement builds on the actions the Departments have taken in response to the President’s 2012 Executive Order on service members, veterans and their families’ mental health. In response to the Executive Order, VA has increased its mental health staffing, expanded the capacity of the Veterans Crisis Line, and enhanced its partnerships with community mental health providers. DoD is reviewing its mental health outreach programs to prioritize those with the greatest impact; DoD and VA worked to increase suicide prevention awareness and, DoD, VA and the National Institutes of Health jointly developed the National Research Action Plan on military and veteran’s mental health to better coordinate federal research efforts. These efforts and actions represent the latest in DoD and the VA’s continued commitment to ensure that this Administration is working to fulfill our promise s to service members, veterans and their families, and we will continue to look for additional ways to do so in this space, both thorough our work and work with the private sector.