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Poor Coordination Between VA, DoD Continues to Hamper Wounded Warrior Program

by U.S. Medicine

November 1, 2011

WASHINGTON — Poor synchronization between DoD and VA may be leading to a worsening of patient-care coordination. If the two departments do not start working together quickly to solve the issue, it could adversely affect the health of the veterans they are meant to be serving, government investigators warned. 

Poor Coordination

buerkle.jpgIn 2007, Congress ordered the creation of a Federal Recovery Coordination Program (FRCP) to act as a single point of contact for severely injured veterans as they moved between the DoD and VA healthcare systems. The program was meant to be a joint initiative but is currently run solely out of VA. A March Government Accountability Office (GAO) report showed that the FRCP is competing with other services, including DoD’s own Recovery Coordination Program. As a result, the single point of contact that Congress envisioned does not exist.

This led to a House VA Committee meeting in May in which legislators took VA and DoD officials to task for their poor partnering and what seemed like unwillingness by DoD to give VA recovery coordinators sufficient access to patients.

The two departments were ordered to devise a plan to fix these problems. Three months after the request, VA and DoD sent a letter to Congress saying the departments are considering several options. However, they would not identify those options, and the letter noted that none had been finalized.

A follow-up report by GAO released last month notes that this indecision has been seen before and that prior attempts by VA and DoD to collaborate to solve this issue have led to the identification of various options but never any actual movement to resolve duplication, overlap and conflict between its recovery-coordination programs.

According to GAO, patients’ enrollment in multiple-coordination programs — not only in DoD and VA, but also in individual military services — results in multiple care coordinators and case managers. Lack of information exchange and poor coordination between the programs has resulted in redundancy, confusion and frustration for enrollees.

Poor Coordination Between VA, DoD Continues to Hamper Wounded Warrior Program Cont.

One recovery coordinator surveyed by GAO said his enrollees have, on average, eight case managers affiliated with different programs. A survey of FRCP enrollees found that 75% of them also were enrolled in one of the military wounded warrior programs.

“Consequently, the intended purpose of these programs — to better manage and facilitate care and services — may actually have the opposite effect,” the October GAO report states.

Little Progress

VA has made some progress in addressing the previously-identified problems,  GAO officials said at the follow-up House VA Health Subcommittee hearing last month. Those problems included management issues related to FRCP enrollment decisions, FRC’s caseloads and program staffing needs.

However, DoD has provided only limited assistance, and only with the recommendation regarding enrollment. An e-mail was sent in June to the commanders of all the military services’ wounded warrior programs stating that they should refer all severely wounded, ill and injured servicemembers who could be benefited to the FRCP for evaluation. According to VA, no noticeable change in referral numbers or patterns from DoD have been noticed since that e-mail was sent.

Without better interdepartmental cooperation, GAO predicts that, not only will these problems persist, they also will eventually worsen as enrollment continues to grow.

This news was a source of frustration for committee members, who requested, for the third time, that VA and DoD create a detailed plan to address GAO recommendations.

“The inability of the two departments to work together has added yet another burdensome bureaucratic maze for our wounded warriors and their families to navigate at a time when recovery and reintegration should be their only focus,” said Rep. Anne Marie Buerkle, R-NY, subcommittee chair. “It is clear to me that the FRCP is failing to meet its mission.”

House Committee on Vetrans’ Affairs

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