What GAO Discovered
The Veterans Well being Administration (VHA) offers intensive psychological well being look after veterans with critical psychological sickness—issues leading to critical perform impairment, comparable to schizophrenia or bipolar dysfunction. To observe veterans’ entry to its inpatient, residential, and outpatient intensive psychological well being care packages, VHA analyzes the extent to which veterans use these packages. It additionally analyzes efficiency knowledge, comparable to how lengthy veterans anticipate residential care and the ratio of sufferers to program employees. Nevertheless, VHA doesn’t analyze its knowledge by rurality to check program utilization and efficiency for veterans residing in rural areas with these residing in city areas. Doing so would assist VHA perceive the extent to which packages successfully attain rural veterans.
In analyzing VHA’s fiscal yr 2021 knowledge, GAO discovered rural veterans used intensive psychological well being care packages at decrease charges than their city counterparts. For instance, the speed at which rural veterans used outpatient care was roughly 21 %, in contrast with a utilization price of 79 % for city veterans (see determine). VHA knowledge present 27 % of veterans with critical psychological sickness who acquired VHA care lived in a rural space in the identical yr. In keeping with VHA officers, there could also be numerous causes rural veterans use care lower than city veterans, comparable to different demographic variations.
Proportion of Rural and City Veterans Utilizing VHA Intensive Psychological Well being Care, Fiscal Yr 2021
Observe: Inpatient packages, comparable to a hospital keep, are for veterans experiencing acute psychological well being disaster. Residential packages present residential and remedy companies. Outpatient packages present remedy companies to veterans. GAO makes use of the time period “rural veteran” to incorporate veterans residing in rural, extremely rural, and insular island areas.
In 2021, VHA up to date its pointers for establishing inpatient and residential intensive psychological well being care packages to account for projected demand and geographic knowledge, comparable to the placement of the place veterans dwell. Nevertheless, pointers for its outpatient intensive psychological well being care packages don’t account for the place veterans dwell. For instance, pointers for establishing rural-focused packages “strongly encourage” institution in rural areas however don’t in any other case establish parameters services ought to use in doing so, comparable to the place veterans dwell or drive instances for reaching a facility. Assessing and updating, as acceptable, its pointers for establishing outpatient packages to incorporate such parameters can be per the Division of Veterans Affairs’ targets of bettering entry to look after rural veterans and veterans with critical psychological sickness.
Why GAO Did This Research
Severe psychological sickness is a persistent and rising concern for our nation’s veterans. Analysis exhibits veterans with critical psychological sickness who dwell in rural areas can face challenges accessing this care, comparable to lengthy drive instances to services.
The Sgt. Ketchum Rural Veterans Psychological Well being Act of 2021 included a provision for GAO to check the intensive psychological well being care that VHA makes accessible to rural veterans. Amongst different goals, this report examines the data VHA makes use of to observe entry to such care, what these knowledge present about rural veterans’ entry, and the rules VHA makes use of to determine packages for rural veterans.
GAO reviewed VHA documentation and insurance policies on its intensive psychological well being care packages and financial yr 2021 knowledge (most up-to-date accessible) on utilization and efficiency for these packages. GAO additionally interviewed VHA officers and officers from three well being care programs chosen for geographic and program variation.
