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Veterans Health Administration Overwhelmed by Caregiver Applications

Delays in applications due to outdated IT system

AP
December 3, 2014

The Department of Veterans Affairs continues to struggle to meet the demands of applications for a program intended to assist family members caring for wounded veterans, according to testimony at a House Veterans Affairs subcommittee on Wednesday.

"The number of applications we’re getting every month is 500. We had anticipated that the number of applications would eventually reach a plateau, but that hasn’t happened," said Dr. Maureen McCarthy, the deputy chief of patient care services at the Veterans Health Administration (VHA).

The VHA’s Family Caregiver Program began in May of 2011, a year after the president signed it into law. Officials initially estimated that 4,000 eligible caregivers would enroll in the program within the first three years. By May of 2014, more than 15,000 caregivers were approved for the program—nearly quadruple the original estimate.

The Government Accountability Office released a report in September 2014 evaluating the program and found that in addition to "significantly underestimat[ing]" the demand for services, the program was hamstrung by an outdated information technology (IT) system.

VA officials agreed with the findings and vowed to make changes, but investigators at the Government Accountability Office told lawmakers on Wednesday that the agency has not sufficiently addressed issues with the computer system.

"We are concerned that VA’s proposed actions only partially address this recommendation. A VHA official explained that no one knows how long it will take to develop the new IT system, or how long it will be before data from the system are available," said Randall Williamson, director of health care at the GAO.

"However, the substance of our recommendation is focused on using comprehensive workload data from the new IT system as the foundation of a data-driven program analysis."

Without that data, Williamson noted, the VHA cannot "be positioned to make sound, well-informed decisions about the program, potentially allowing it to continue to struggle to meet the needs of the caregivers of seriously wounded and injured veterans."

In her opening remarks, McCarthy said the VHA has identified funding in the budget for 2015 to "support the development of a new IT solution," as well as funding to "stabilize the current system."

Lawmakers repeatedly noted that while more research, specifically cost-benefit analysis, is needed to determine the overall success of the program, most of those currently enrolled find the service beneficial. The problem, they say, is getting through the backlog so applicants can receive the services.

McCarthy later testified that part of the problem is that the mental health issues often take time to identify.

"Some of the signature moves of this [program] are things that may not really show up ‘til later. We have very many veterans with mental health conditions who are eligible for the Caregiver Program, and I’m not sure we had anticipated that there would be that many."

"But nevertheless," McCarthy added, "that’s why we’re here to provide and we’re doing what we can. We have IT solutions in the works. We have reorganizations of how we’ll do the evaluations of the program, and so forth, in the works."

It is unclear when the new system will be ready. Williamson told lawmakers the GAO has not been given a specific date.

"You’re right," he told the committee, "in the past in the VA, as far as developing and implementing IT systems has not been good, in many respects. I don’t think the program knows—we don’t know when that new system that we recommended will be rolled out."

Published under: Veterans Affairs