System Leaders’ Response to Allegations Related to Access to Behavioral Health Care at the El Paso VA Health Care System in Texas

The VA Office of Inspector General (OIG) reviewed system leaders’ actions taken in response to allegations related to access to behavioral health care and patient privacy at the El Paso VA Health Care System (system) in Texas and evaluated whether the system sustained the actions. In August 2022, the OIG received allegations that patients who presented at the system for behavioral health services were denied care, patients who declined virtual care did not receive appointments, and behavioral health clinic staff violated patient privacy. The OIG requested a written response to the allegations in November 2022. The OIG initiated an inspection after reviewing subsequent system responses in February and July 2023. The OIG determined the actions taken by system leaders, including those initiated before the OIG inspection and those implemented after OIG inquiries, ensured that the system’s behavioral health clinic staff did not deny patients access to care, and that patients were seen in the time frame and at the location that met their preferences and needs. The OIG also determined that actions taken by system leaders ensured patient privacy was maintained during behavioral health services for which patients used tablets. While conducting the inspection, the OIG identified a potential vulnerability resulting from the varied locations of providers and the settings in which patients receive care. While no cases of concern were identified, due to some system providers residing in Texas and New Mexico, and virtual providers residing in different states altogether, the OIG noted potential issues arising from advice given by providers in emergent and urgent patient situations who may not be versed in state-specific emergency detention order laws. The OIG made one recommendation to the System Director related to system policies and guidance aligning with federal and state laws.