VISN 12 Needs to Improve How It Administers the Veterans Community Care Program

This review found VISN 12 medical facilities (covering parts of Illinois, Indiana, Michigan, and Wisconsin) did not consistently identify veterans eligible for community care, inform them of their care options, and deliver timely care. Among the causes, schedulers lacked the means to identify all available appointments. VHA guidance was also uneven, requiring schedulers to check all eligibility criteria for new patients but only wait times for established patients, hindering care option notifications to existing patients.
VISN 12 took 44 days on average from scheduling to appointment for community care and 35 days for VA care—exceeding timeliness goals. In addition, it had about 250 consults incomplete for longer than one year.
The VISN 12 director concurred with the OIG’s recommendations to improve scheduler performance. The OIG has two planned follow-up national reviews regarding eligibility and care option notifications, as well as on timeliness of care.