Intimate Partner Violence Assistance Program Implementation Status and Barriers to Compliance

The VA Office of Inspector General (OIG) conducted a national review of the Intimate Partner Violence Assistance Program (IPVAP) to evaluate implementation status and identify perceived barriers to compliance. The OIG conducted a national survey of IPVAP coordinators, Veterans Integrated Service Network (VISN) lead coordinators, and VISN champions and interviewed select IPVAP coordinators and VISN champions. The OIG found over half of Veterans Health Administration (VHA) facilities did not have the required IPVAP protocol, which may contribute to leader and staff confusion and lack of knowledge about IPVAP roles, responsibilities, process, and procedures. The IPVAP coordinator may be a collateral duty, and 82 percent reported over half of their time was dedicated to the role. The IPVAP coordinators serving the facility with the most patients and the least patients reported dedicated time between zero and 25 percent. Although training is required, the majority of IPVAP coordinators reported providing training at fewer than half of new employee orientation sessions and to fewer than half of intimate partner violence (IPV) screeners. Fourteen percent of IPVAP coordinators reported that their facilities did not implement routine IPV screening, and IPVAP coordinators described challenges in IPV screening without a clinical reminder or mandatory status. Although IPVAP coordinators are responsible for program evaluation, the OIG found that VHA did not establish standardized program evaluation methods or measures. VISN champions identified the need for clearer role expectations, mandatory screening completion, and a designated VISN coordinator. About half of VISN lead coordinators reported dissatisfaction with support from the VISN champion. The OIG made seven recommendations to the Under Secretary for Health related to medical center IPVAP protocols, IPVAP coordinators’ dedicated time and population needs, administrative staff support, IPV staff training, IPV screening requirements, program evaluation processes, and VISN IPVAP champion and lead coordinator roles and oversight functions.