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Open Recommendations

Veterans Community Care Program: VA Needs to Strengthen Contract Oversight
GAO-24-106390
Aug 21, 2024
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3 Open Recommendations
Agency Affected Recommendation Status
Department of Veterans Affairs The Secretary of VA should ensure that the Assistant Under Secretary for Health for IVC establishes a complete set of documentation for oversight of the Community Care contracts, including documentation of clear and complete procedures and the identification of roles and responsibilities. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Secretary of VA should ensure that the Assistant Under Secretary for Health for IVC assesses whether the oversight and reporting responsibilities of the program manager position outlined in the Quality Assurance Surveillance Plans are being effectively fulfilled by current processes and, if not, updates the plans as appropriate. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Secretary of VA should ensure that the Assistant Under Secretary for Health for IVC develops a formal lessons learned process, consistent with leading practices, for the Community Care contracts to inform VA's plans for the next set of contracts and its continuing oversight efforts. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Veterans Health Care: VA's Video Telehealth Access Program Would Benefit from Performance Goals and Measures
GAO-24-106743
Aug 01, 2024
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2 Open Recommendations
Agency Affected Recommendation Status
Office of the Under Secretary for Health The Under Secretary of Health should ensure the Office of Connected Care develops performance goals and related measures for the ATLAS Program that are objective, quantifiable, and measurable. (Recommendation 1)
Open
As of September 2024, we have not received an update from VA on actions taken to address this recommendation. When we confirm what action the agency has taken in response to this recommendation, we will provide updated information.
Office of the Under Secretary for Health The Under Secretary of Health should ensure the Office of Connected Care uses the information collected for the performance goals and measures to assess program effectiveness and efficiency on an ongoing basis and make any needed improvements. (Recommendation 2)
Open
As of September 2024, we have not received an update from VA on actions taken to address this recommendation. When we confirm what action the agency has taken in response to this recommendation, we will provide updated information.

Veterans Health Care: Opportunities Exist to Improve Assessment of Network Adequacy for Mental Health
GAO-24-106410
Jun 03, 2024
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2 Open Recommendations
Agency Affected Recommendation Status
Department of Veterans Affairs The Undersecretary for Health should assess the risks associated with VA's methodology for calculating specialty care network adequacy and revise its approach accordingly. (Recommendation 1)
Open
VA concurred with this recommendation. In November 2024, VA officials reported that the Veterans Health Administration (VHA) was in the process of assessing the methodology for specialty care network adequacy calculations and the requirements in VHA's current community care contracts to identify risks and opportunities for improvement. According to officials, VHA is conducting this assessment in conjunction with its activities to prepare for the next generation of community care contracts. For example, officials stated that one activity to prepare for the next community care contract is the development of a detailed operational plan that will include key objectives and milestones intended to enhance oversight and ensure that contractors maintain an adequate network. VHA is aiming to complete its assessment in early 2025. When VHA completes its assessment and preparations for the next generation of community care contracts, we will review these actions and evaluate whether they are sufficient to address our recommendation.
Department of Veterans Affairs The Undersecretary for Health should ensure that VA facility staff systematically capture the reasons for community care appointment scheduling challenges and use this information to help address those challenges. (Recommendation 2)
Open
VA concurred in principle with this recommendation. In its response to the draft report, VA said that it had put in place mechanisms to track community care appointment scheduling challenges. However, VA said it had not mandated the capture and reporting of reasons for scheduling delays due, in part, to the need for stronger contractual requirements that would require the contractor to act on the reasons. In December 2024, VA stated that it continued to use these mechanisms, which include, for example, contractually required monthly meetings between the contractors and VA facilities, and the development of a ticketing system for VA facility staff to document recurring community care access issues. VA officials reported that they are using these mechanisms because requiring facility staff to systematically capture the reasons for appointment scheduling challenges would increase the administrative workload of VA staff. VA officials also stated that they are planning to conduct an analysis of scheduling challenges based on data obtained through these mechanisms. To the extent that such an analysis allows VA to comprehensively identify scheduling challenges, we will evaluate whether these actions are sufficient to address our recommendation.

Veterans Health: VA Should Improve Its Monitoring of Severe Maternal Complications and Mental Health Screenings
GAO-24-106209
Jan 16, 2024
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1 Open Recommendations
Agency Affected Recommendation Status
Department of Veterans Affairs The Secretary of Veterans Affairs should ensure that OWH finalizes the development of and implements a systematic process to compile and review data on MCC screening of veterans for mental health conditions on an ongoing basis. This process should include data on MCCs' completion of required mental health screenings, as well as screening results. (Recommendation 2)
Open
VA concurred with this recommendation. VA indicated in its agency comments that it expected to develop a process to compile and review data on when maternity care coordinators complete required mental health screenings as well as the screening results. As of August 2024, VA stated that it was in the process of refining a dashboard it plans to use for this purpose. According to VA, these refinements, which VA indicated it expects to complete in December 2024, will address end user requirements and maximize the dashboard's effectiveness and report functionality. GAO will continue to monitor the status of this recommendation and consider VA's actions once completed.
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