DOD AND VA HEALTH CARE Federal Recovery Coordination Program Continues to Expand but Faces Significant Challenges

Why GAO Did This Study

In 2007, following reports of poor case management for outpatients at Walter Reed Army Medical Center, the Departments of Defense (DOD) and Veterans Affairs (VA) jointly developed the Federal Recovery Coordination Program (FRCP) to coordinate the clinical and nonclinical services needed by severely wounded, ill, and injured servicemembers and veterans. The FRCP, which continues to expand, is administered by VA, and the care coordinators, called Federal Recovery Coordinators (FRC), are VA employees. This report examines

(1) whether servicemembers and veterans who need FRCP services are being identified and enrolled in the program,

(2) staffing challenges confronting the FRCP, and

(3) challenges facing the FRCP in its efforts to coordinate care for enrollees.

GAO reviewed FRCP policies and procedures and conducted over 170 interviews of FRCP officials, FRCs, headquarters officials and staff of DOD and VA case management programs, and staff at medical facilities where FRCs are located.

What GAO Recommends

GAO recommends that VA direct the FRCP Executive Director to establish systematic oversight of enrollment decisions, complete development of a workload assessment tool, document staffing decisions, and develop and document a rationale for FRC placement. GAO received comments from DOD and VA; VA concurred with GAO’s recommendations.

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More Veterans To Receive Options for Living Independently Under New VHA Partnership with National Resource Center for Participant-Directed Services - RWJF

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Veterans of all ages with disabilities will gain additional support in 28 states under a new program designed to help them live independently, with more choice and control over the services they receive in their homes. Through a contract with the Veterans Health Administration (VHA), the National Resource Center for Participant-Directed Services (NRCPDS) will provide training and assistance to VA Medical Centers that are implementing participant-directed services for Veterans.

In 2008, the U.S. Administration on Aging’s Community Living Program partnered with VHA to create the Veteran Directed Home and Community-Based Services (VD-HCBS) Program. The Program allows Veterans of all ages to have more control over services provided in their homes to allow them to continue to live independently in their communities. Veterans enrolled in the program can manage their own flexible spending budgets, decide for themselves what mix of goods and services can best meet their needs, hire and supervise their own workers, including family and friends, and purchase items or services that help them live more independently. We call this approach "participant direction."

The NRCPDS at Boston College is the only national center of its kind that helps people of all ages and disabilities get the support they need to live as independently as possible. The Center provides research, policy, training and assistance for participant-directed programs. In addition, NRCPDS has a National Participant Network that works with these programs to ensure that they are designed and implemented with the needs and preferences of the individual at their core. The Center will offer a wide variety of training and technical assistance to staff at VA Medical Centers for the benefit of Veterans in the VD-HCBS Programs.

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