October 21, 2021

News

News Network

VA Vet Centers: Evaluations Needed of Expectations for Counselor Productivity and Centers’ Staffing

19 min read
<div>The Veterans Health Administration's (VHA) Readjustment Counseling Service (RCS) provides counseling through 300 Vet Centers, which can be found in community settings and are separate from other VHA facilities. RCS has set expectations for counselor productivity at Vet Centers. For example, one expectation is for counselors to achieve an average of 1.5 visits for each hour they provide direct services. However, RCS officials told GAO that they have not conducted, and do not have plans to conduct, an evaluation of the expectations. VA Vet Center Productivity Expectations for Counselors Although most counselors met the productivity expectations in fiscal year 2019, counselors GAO spoke with said the expectations led them to change work practices in ways that could negatively affect client care. For example, counselors at one Vet Center told GAO that, to meet productivity expectations, they spend less time with each client to fit more clients into their schedules. Without an evaluation of its productivity expectations, RCS lacks reasonable assurance that it is identifying any unintended or potentially negative effects of the expectations on counselor practices and client care. RCS officials told GAO that by the start of fiscal year 2021 they plan to implement a staffing model to identify criteria for determining staffing needs at Vet Centers. The model incorporates data on counselors' productivity (work hours and number of visits), and total clients to determine criteria for adding or removing a counselor position from a Vet Center. However, the model does not fully address key practices in staffing model design GAO identified in previous work. For example, the model does not include the input of Vet Center counselors, or client data associated with directors, who also provide counseling. As a result, RCS is at risk of making decisions about Vet Center staffing that may not be responsive to changing client needs. Shortages of mental health staff within VHA coupled with the increasing veteran demand for mental health services highlight the critical importance of ensuring appropriate Vet Center staffing. VHA's RCS provided counseling (individual, group, marriage, and family) and outreach services through Vet Centers to more than 300,000 veterans and their families in fiscal year 2019. In 2017, RCS implemented changes to expectations that it uses to assess Vet Center counselor productivity, setting expectations for counselors' percentage of time with clients and number of client visits. GAO was asked to review Vet Center productivity expectations for counselors and staffing. Among other issues, this report examines the extent to which VHA (1) evaluates its productivity expectations; and (2) assesses Vet Centers' staffing needs. To do this work, GAO reviewed RCS documentation regarding counselors' productivity expectations and analyzed RCS data on counselor productivity expectations and staffing, for fiscal year 2019. GAO interviewed RCS leadership, including district directors, and directors and counselors from 12 Vet Centers, selected for variation in geographic location and total number of clients, among other factors. GAO is making four recommendations, including that VHA (1) evaluate Vet Center productivity expectations for counselors; and (2) develop and implement a staffing model that incorporates key practices. The Department of Veterans Affairs concurred with GAO's recommendations and identified actions VHA is taking to implement them. For more information, contact Debra A. Draper at (202) 512-7114 or draperd@gao.gov.</div>

What GAO Found

The Veterans Health Administration’s (VHA) Readjustment Counseling Service (RCS) provides counseling through 300 Vet Centers, which can be found in community settings and are separate from other VHA facilities. RCS has set expectations for counselor productivity at Vet Centers. For example, one expectation is for counselors to achieve an average of 1.5 visits for each hour they provide direct services. However, RCS officials told GAO that they have not conducted, and do not have plans to conduct, an evaluation of the expectations.

VA Vet Center Productivity Expectations for Counselors

Although most counselors met the productivity expectations in fiscal year 2019, counselors GAO spoke with said the expectations led them to change work practices in ways that could negatively affect client care. For example, counselors at one Vet Center told GAO that, to meet productivity expectations, they spend less time with each client to fit more clients into their schedules. Without an evaluation of its productivity expectations, RCS lacks reasonable assurance that it is identifying any unintended or potentially negative effects of the expectations on counselor practices and client care.

RCS officials told GAO that by the start of fiscal year 2021 they plan to implement a staffing model to identify criteria for determining staffing needs at Vet Centers. The model incorporates data on counselors’ productivity (work hours and number of visits), and total clients to determine criteria for adding or removing a counselor position from a Vet Center. However, the model does not fully address key practices in staffing model design GAO identified in previous work. For example, the model does not include the input of Vet Center counselors, or client data associated with directors, who also provide counseling. As a result, RCS is at risk of making decisions about Vet Center staffing that may not be responsive to changing client needs. Shortages of mental health staff within VHA coupled with the increasing veteran demand for mental health services highlight the critical importance of ensuring appropriate Vet Center staffing.

Why GAO Did This Study

VHA’s RCS provided counseling (individual, group, marriage, and family) and outreach services through Vet Centers to more than 300,000 veterans and their families in fiscal year 2019. In 2017, RCS implemented changes to expectations that it uses to assess Vet Center counselor productivity, setting expectations for counselors’ percentage of time with clients and number of client visits.

GAO was asked to review Vet Center productivity expectations for counselors and staffing. Among other issues, this report examines the extent to which VHA (1) evaluates its productivity expectations; and (2) assesses Vet Centers’ staffing needs. To do this work, GAO reviewed RCS documentation regarding counselors’ productivity expectations and analyzed RCS data on counselor productivity expectations and staffing, for fiscal year 2019. GAO interviewed RCS leadership, including district directors, and directors and counselors from 12 Vet Centers, selected for variation in geographic location and total number of clients, among other factors.

What GAO Recommends

GAO is making four recommendations, including that VHA (1) evaluate Vet Center productivity expectations for counselors; and (2) develop and implement a staffing model that incorporates key practices. The Department of Veterans Affairs concurred with GAO’s recommendations and identified actions VHA is taking to implement them.

For more information, contact Debra A. Draper at (202) 512-7114 or draperd@gao.gov.

News Network

  • Justice Department Files Race Discrimination Lawsuit Against Housing Authority in Oklahoma
    In Crime News
    The Justice Department announced today that it has filed a lawsuit alleging that the Housing Authority of the Town of Lone Wolf, Oklahoma, along with its former employees, David Haynes and Myrna Hess, violated the Fair Housing Act and Title VI of the Civil Rights Act of 1964 when they denied housing to an African-American applicant and her young child because of their race. 
    [Read More…]
  • NASA Juno Takes First Images of Jovian Moon Ganymede’s North Pole
    In Space
    Infrared images from [Read More…]
  • Owner of Michigan Payroll Tax Services Firm Charged With Employment Tax Fraud
    In Crime News
    A federal grand jury in Detroit, Michigan, returned an indictment today charging a Farwell, Michigan, businessman with failing to pay payroll taxes to the Internal Revenue Service (IRS) and failing to file his own returns, announced Principal Deputy Assistant Attorney General Richard E. Zuckerman of the Justice Department’s Tax Division and U.S. Attorney Matthew Schneider for the Eastern District of Michigan.
    [Read More…]
  • Indiana Man Charged with Hate Crime for Making Racially-Motivated Threats Towards Black Neighbor, and With Unlawful Possession of Firearms
    In Crime News
    The Justice Department announced today that Shepherd Hoehn, 50, has been charged by criminal complaint in federal district court with one count of violating 42 U.S.C. § 3631 for making threats to intimidate and interfere with his African-American neighbor because of the neighbor’s race and because of his use and enjoyment of his property, as well as two counts of violating 18 U.S.C. § 922(g) for unlawfully possessing firearms.
    [Read More…]
  • Statement from Acting Solicitor General Jeffrey B. Wall on the Passing of Former Solicitor General Drew S. Days III
    In Crime News
    Today, Acting Solicitor General Jeffrey B. Wall issued the following statement on the passing of former Solicitor General Drew S. Days III:
    [Read More…]
  • Army Logistics: Container Handling Equipment Requirements, Contracts, and Inventory
    In U.S GAO News
    What GAO FoundThe Army’s requirements for container handling equipment have changed since 1998 from focusing on "break bulk" to focusing on containerized distribution, and the Army has awarded contracts and issued delivery orders to reflect those changing requirements.The 1998 Operational Requirements Document indicated that cargo would be transported to secure locations in containers and then to troops in “break bulk,” without using containers. Capabilities that would later be filled by Container Handling Units (CHU)/Enhanced Container Handling Units (E-CHU) and Container Transfer Enhancements (CTE) were identified for the requirement to transport cargo in containers. The Container Roll-in/out Platform (CROP) was identified as a capability for the requirement to transport “break bulk” cargo without containers. Flatracks, the existing capability since 1994 to move both containerized and “break bulk” cargo, were no longer identified as a capability in the 1998 document. As a result, in a 2001 strategy, the Army eliminated the use of flatracks and transitioned funding to CROP procurement. The Army awarded a contract in December 2002 for up to 3,997 CROPs and awarded another contract in June 2006, from which it ordered 32,917 CROPs.According to Army documentation, from 2008 through 2010, warfighters in Iraq and Afghanistan identified an unanticipated and urgent need for flatracks to move cargo in containers to forward operating units, in order to better protect items being moved along hazardous routes. After the Army’s 2001 strategy eliminated the use of flatracks, Army officials stated that the ability to move containers to forward operating units was limited. Further, as of 2010, Army officials said that there was insufficient inventory of and training on CHUs/E-CHUs to meet the urgent needs for container distribution because the Army had not anticipated the need to move containers to forward operating units, and the CTE had not yet been fielded. As a result of the urgent need to move cargo in containers, the Army awarded a contract in August 2010 for 3,227 flatracks.In February 2012, the Army issued the Distribution Enablers Study, which revisited the capabilities needed for “break bulk” and containerized cargo distribution. This study included the E-CHU in its analysis, because more E-CHUs had been fielded to units, and the CTE, which completed testing in 2011. The Distribution Enablers Study recommended using the E-CHU paired with the CTE, because this combination provides three times more capacity to distribute cargo than flatracks alone. As a result, in June 2012, the Army ordered 180 CTEs.Requirements for container handling equipment are continuing to be updated and may change due to DOD's plans to reduce the size of the Army. A Capability Production Document—expected to be issued in late summer 2013 to update the 1998 Operational Requirements Document—is to provide updated requirements to include current technologies for CROPs, E-CHUs, and CTEs and is expected to add the flatrack capability for Army Corps of Engineers bridge units.Army officials said thatplans are also being completed for each piece of container handling equipment—based on the 2012 Distribution Enablers Study—that will identify the quantity and type of equipment to be sent to units.Additionally, Army officials said that the Army is conducting a tactical wheeled vehicle reduction study, due to be completed in late 2013 or early 2014 that could affect requirements for container handling equipment.To increase its ability to move containerized cargo, the Army plans to increase its June 2013 inventory of 1,241 E-CHUs and no CTEs to a fiscal year 2018 inventory of 6,035 E-CHUs and 6,324 CTEs. To move “break bulk” cargo, the Army had 47,228 CROPs and 4,342 flatracks as of June 2013. There is no future funding programmed for CROPs or flatracks, but the inventory is expected to increase because some CROPs and flatracks have been procured but have not yet been provided to units. By fiscal year 2018, the Army expects to have 48,397 CROPs and 7,241 flatracks.Why GAO Did This StudyContainer handling equipment provides Army commanders with the flexibility to respond to rapidly shifting operations by supplying the capability to transport critical cargo. To support a versatile and expandable distribution system, the Army has five types of container handling equipment to carry both containerized and non-containerized (or "break bulk") cargo: flatracks, CROPs, CHUs, E-CHUs, and CTEs. Flatracks, which can carry both containerized and "break bulk" cargo, and CROPs, which can carry only "break bulk" cargo, are structural steel frames. CHUs and E-CHUs attach to the lifting arm of a truck and allow for upload and offload of containers. The CTE is a modification to a trailer which allows the container to roll onto the trailer while being pushed by the CHU/E-CHU.GAO was mandated to provide a report to the congressional defense committees on the acquisition plan, requirement, and inventory for container handling equipment in the Army. Objectives for this report were to describe (1) how the requirements for container handling equipment have changed since 1998 and when the corresponding contracts were awarded or delivery orders issued and (2) the current and projected inventories of container handling equipment.For more information contact Zina D. Merritt at (202) 512-5257 or merrittz@gao.gov.
    [Read More…]
  • Man Pleads Guilty to the Sexual Abuse of a Two-Year-Old and a Seven-Year-Old Child in Order to Produce Images of the Abuse
    In Crime News
    A Maryland man pleaded guilty today to two counts of production of child pornography and one count of possession of child pornography, in connection with his sexual abuse of two minor children.
    [Read More…]
  • Secretary Antony J. Blinken Remarks at the Virtual Kenya-U.S. Interagency Clean Energy Event
    In Crime Control and Security News
    Antony J. Blinken, [Read More…]
  • ‘Disk Detective’ Needs Your Help Finding Disks Where Planets Form
    In Space
    Members of the public [Read More…]
  • Former Subcontractor Sentenced for Obstruction of Justice
    In Crime News
    A former subcontractor for the U.S. Marines Corps was sentenced today to 18 months in prison for destroying records in connection with a federal investigation of bribery and procurement fraud at Marine Corps Base Camp Lejeune (MCBCL), located in Jacksonville, North Carolina, announced Acting Assistant Attorney General Nicholas L. McQuaid of the Justice Department’s Criminal Division.
    [Read More…]
  • Aryeh Lightstone Designated as U.S. Special Envoy for Economic Normalization
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Justice Department Reaches Settlement with Old Dominion University to Resolve Disability Discrimination Complaint
    In Crime News
    Today the Justice Department announced a settlement agreement with Old Dominion University (ODU) in Norfolk, Virginia, to resolve its investigation into a complaint that ODU discriminated and retaliated against a graduate student based on disability and her related request for reasonable modifications of policy. The Civil Rights Division conducted the investigation under Title II of the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973.
    [Read More…]
  • Mississippi Prison’s Deputy Warden Charged with Civil Rights Offense for Beating Inmate
    In Crime News
    The Justice Department announced yesterday that a federal grand jury indicted Melvin Hilson, 49, currently a deputy warden at the Mississippi State Penitentiary, for repeatedly striking an inmate and knocking him to the ground, resulting in injury to the inmate.
    [Read More…]
  • Acting Assistant Secretary for South and Central Asian Affairs Dean Thompson, Deputy Assistant Secretary for Arabian Peninsula Affairs, Bureau of Near Eastern Affairs Daniel Benaim, and Principal Deputy Assistant Secretary for European and Eurasian Affairs Dereck Hogan On the Secretary’s Upcoming Travel to Qatar and Germany
    In Crime Control and Security News
    Dean Thompson, Acting [Read More…]
  • Global War on Terrorism: Reported Obligations for the Department of Defense
    In U.S GAO News
    Since 2001, Congress has provided the Department of Defense (DOD) with hundreds of billions of dollars in supplemental and annual appropriations for military operations in support of the Global War on Terrorism (GWOT). DOD's reported annual obligations for GWOT have shown a steady increase from about $0.2 billion in fiscal year 2001 to about $139.8 billion in fiscal year 2007. To continue GWOT operations, the President requested $189.3 billion in appropriations for DOD in fiscal year 2008. Through December 2007, Congress has provided DOD with about $86.8 billion of this request, including $16.8 billion for Mine Resistant Ambush Protected vehicles. As of February 2008, Congress has not taken action on the remaining $102.5 billion. The United States' commitments to GWOT will likely involve the continued investment of significant resources, requiring decision makers to consider difficult trade-offs as the nation faces an increasing long-range fiscal challenge. The magnitude of future costs will depend on several direct and indirect cost variables and, in some cases, decisions that have not yet been made. DOD's future costs will likely be affected by the pace and duration of operations, the types of facilities needed to support troops overseas, redeployment plans, and the amount of equipment to be repaired or replaced. DOD compiles and reports monthly and cumulative incremental obligations incurred to support GWOT in a monthly Supplemental and Cost of War Execution Report. DOD leadership uses this report, along with other information, to advise Congress on the costs of the war and to formulate future GWOT budget requests. DOD reports these obligations by appropriation, contingency operation, and military service or defense agency. The monthly cost reports are typically compiled within the 45 days after the end of the reporting month in which the obligations are incurred. DOD has prepared monthly reports on the obligations incurred for its involvement in GWOT since fiscal year 2001. Section 1221 of the National Defense Authorization Act for Fiscal Year 2006 requires GAO to submit quarterly updates to Congress on the costs of Operation Iraqi Freedom and Operation Enduring Freedom based on DOD's monthly Supplemental and Cost of War Execution Reports. This report, which responds to this requirement, contains our analysis of DOD's reported obligations for military operations in support of GWOT through December 2007. Specifically, we assessed (1) DOD's cumulative appropriations and reported obligations for military operations in support of GWOT and (2) DOD's fiscal year 2008 reported obligations through December 2007, the latest data available for GWOT by military service and appropriation account.From fiscal year 2001 through December 2007, Congress has provided DOD with about $635.9 billion for its efforts in support of GWOT. DOD has reported obligations of about $527 billion for military operations in support of the war from fiscal year 2001 through fiscal year 2007 and for fiscal year 2008 through December 2007. The $108.9 billion difference between DOD's GWOT appropriations and reported obligations can generally be attributed to certain fiscal year 2008 appropriations and multiyear funding for procurement; military construction; and research, development, test, and evaluation from previous GWOT-related appropriations that have yet to be obligated, and obligations for classified and other activities, which are not reported in DOD's cost-of-war reports. Of DOD's total cumulative reported obligations for GWOT through December 2007 (about $527 billion), about $406.2 billion is for operations in and around Iraq as part of Operation Iraqi Freedom, and about $92.9 billion is for operations in Afghanistan, the Horn of Africa, the Philippines, and elsewhere as part of Operation Enduring Freedom. The remaining about $28 billion is for operations in defense of the homeland as part of Operation Noble Eagle. DOD's reported obligations for Operation Iraqi Freedom have consistently increased each fiscal year since operations began. The increases in reported obligations for Operation Iraqi Freedom are in part because of continued costs for military personnel, such as military pay and allowances for mobilized reservists, and for rising operation and maintenance expenses, such as higher contract costs for housing, food, and services and higher fuel costs. In contrast, DOD's reported obligations for Operation Noble Eagle have consistently decreased since fiscal year 2003, largely because of the completion of repairs to the Pentagon and upgrades in security at military installations that were onetime costs, as well as a reduction in combat air patrols and in the number of reserve personnel guarding government installations. In fiscal year 2008, through December 2007, DOD's total reported obligations of about $34.8 billion are about one quarter of the total amount of obligations it reported for all of fiscal year 2007. Reported obligations for Operation Iraqi Freedom continue to account for the largest portion of total reported GWOT obligations by operation--about $28.1 billion. In contrast, reported obligations associated with Operation Enduring Freedom total about $6.6 billion, and reported obligations associated with Operation Noble Eagle total about $49.6 million. The Army accounts for the largest portion of reported obligations for fiscal year 2008 through December 2007--about $27.2 billion, nearly 11 times higher than the almost $2.5 billion in obligations reported for the Air Force, the military service with the next greatest reported amount. Reported obligations for procurement account for about 27 percent of reported obligations, or about $9.4 billion. Of the $43.6 billion provided to DOD for procurement in fiscal year 2007, approximately 21 percent, or $9.1 billion, has yet to be obligated and remains available in fiscal year 2008.
    [Read More…]
  • Justice Department Acts To Shut Down Fraudulent Websites Exploiting The Covid-19 Pandemic
    In Crime News
    The United States Department of Justice announced today that it has obtained a Temporary Restraining Order in federal court to combat fraud related to the coronavirus (COVID-19) pandemic. The enforcement action, filed in Tampa, Florida, is part of the Justice Department’s ongoing efforts prioritizing the detection, investigation, and prosecution of illegal conduct related to the pandemic. The action was brought based on an investigation conducted by United States Immigration and Customs Enforcement’s (ICE) Homeland Security Investigations (HSI), in coordination with the Vietnam Ministry of Public Security.
    [Read More…]
  • Michigan Man Indicted for Hate Crimes After Attacking African-American Teenagers
    In Crime News
    The Justice Department announced today that Lee Mouat, 42, has been indicted for federal hate crimes. Mouat is charged with two counts of violating 18 U.S.C. § 249 by willfully causing bodily injury to a Black teenager and attempting to cause bodily injury to another Black teenager, through the use of a dangerous weapon, because of the teenagers’ race. Mouat was previously charged with the former count by criminal complaint in federal district court on Oct. 13, 2020.
    [Read More…]
  • Pain Clinic Medical Providers Sentenced for Their Roles in Operating Pill Mills in Tennessee
    In Crime News
    Three defendants, all of whom are nurse practitioners, were sentenced to prison for their roles in prescribing massive quantities of opioids from pill mills in Knoxville, Tennessee.
    [Read More…]
  • Singaporean Shipping Company Fined $12 Million in a Multi-District Case for Concealing Illegal Discharges of Oily Water and Garbage and a Hazardous Condition
    In Crime News
    Pacific Carriers Limited (PCL), a Singapore-based company that owns subsidiaries engaged in international shipping, was sentenced today in federal court before U.S. District Court Judge Louise Flanagan in New Bern, North Carolina, after pleading guilty to violations of the Act to Prevent Pollution from Ships, obstruction of justice, and for a failure to notify the U.S. Coast Guard of a hazardous condition on the Motor Vessel (M/V) Pac Antares.
    [Read More…]
  • Man Sentenced for Engaging in Illicit Sexual Conduct with Minors in the Republic of Kenya
    In Crime News
    A Pennsylvania man was sentenced today to over 15 years in prison plus a lifetime of supervised release, and ordered to pay $16,000 in restitution for engaging in illicit sexual conduct in a foreign place.
    [Read More…]
Network News © 2005 Area.Control.Network™ All rights reserved.