The VA Office of Inspector General (OIG) conducted a national review to evaluate Veterans Health Administration’s (VHA’s) implementation of the PACT Act of 2022, which mandated veteran toxic exposure screenings, and required clinical staff training.
Section 603 of the PACT Act mandated that, within 90 days of the date of enactment, VHA implement a health screen to identify potential toxic exposures during military service. The Act requires VHA to screen veterans and address issues specific to toxic exposures during military service.
VHA developed a method of screening, and as of November 30, 2023, screened over four million of the nine million enrolled veterans. VHA also complied with requirements to train clinical staff to “identify, treat, and assess the impact on veterans of illnesses related to toxic exposures.”
VHA issued memorandums to Veterans Integrated Service Network (VISN) and facility directors requiring additional toxic exposure screening training for clinical staff. However, 21.4 percent of clinical staff completed training prior to performing a screening during the period November 8, 2022, through January 9, 2023. Although training compliance increased after VHA issued additional guidance in January 2023, many veterans were likely screened by clinical staff who had not completed training.
The OIG did not assess the impact of screening on primary care workload, but VHA leaders acknowledged toxic exposure screening adds to workload and had not evaluated nor considered mitigating efforts for the additional workload burden.
The OIG made two recommendations to the Under Secretary for Health related to assessing training noncompliance and evaluating the impact of toxic exposure screening on primary care.
