Breadcrumb

Review of Alleged Untimely Care at VHA’s Community Based Outpatient Clinic Colorado Springs, CO

Report Information

Issue Date
Report Number
15-02472-46
VISN
State
Colorado
District
VA Office
Veterans Health Administration (VHA)
Report Author
Office of Audits and Evaluations
Report Type
Audit
Recommendations
4
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
In January 2015, the Office of Inspector General received an allegation that the PFC Floyd K. Lindstrom Outpatient Clinic, a Community Based Outpatient Clinic (CBOC) in Colorado Springs, CO, did not provide veterans’ access to the Veterans Choice Program when the CBOC did not provide veterans timely VA care. One affected veteran sent the complaint, along with examples of issues affecting clinic services provided in audiology, mental health, neurology, optometry, orthopedic, and primary care. We substantiated the allegation that the veteran, as well as other eligible Colorado Springs veterans, did not receive timely care in the six reviewed services. We reviewed 150 referrals for specialty care consults and 300 primary care appointments. Of the 450 consults and appointments, 288 veterans encountered wait times in excess of 30 days. For all 288 veterans, VA staff either did not add them to the Veterans Choice List (VCL) or did not add them to the VCL in a timely manner. For 59 of the 288 veterans, scheduling staff used incorrect dates that made it appear the appointment wait time was less than 30 days. For 229 of the 288 veterans with appointments over 30 days, NVCC staff did not add 173 veterans at the CBOCs in the Eastern Colorado Health Care System (ECHCS) to the VCL in a timely manner and they did not add 56 veterans to the list at all. In addition, scheduling staff did not take timely action on 94 consults and primary care appointment requests. As a result, VA staff did not fully use Veterans Choice Program funds to afford CBOC Colorado Springs veterans the opportunity to receive timely care. We recommended that the ECHCS Director take actions to ensure appointments are scheduled using clinically indicated or preferred appointment dates, all veterans eligible for the Veterans Choice Program are added to the VCL in a timely manner, and scheduling staff timely act on consults and appointment requests. The acting director of the ECHCS concurred in principle with our recommendations. ECHCS executed a number of corrective actions to become compliant with current VHA scheduling guidance. Based on actions already implemented, we consider Recommendation 1 closed. We will follow up on the implementation of the remaining recommendations until all proposed actions are completed.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended the Eastern Colorado Health Care System Director ensure that scheduling staff use the clinically indicated or preferred appointment dates when scheduling primary care patient appointments.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended the Eastern Colorado Health Care System Director ensure that scheduling staff use the earliest appropriate date when scheduling new patient appointments.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended the Eastern Colorado Health Care System Director ensure that staff place all veterans with appointments occurring over 30 days after the clinically indicated or preferred appointment date on the Veterans Choice List within 1 day of scheduling the appointment.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended the Eastern Colorado Health Care System Director ensure that resources are sufficient for scheduling staff to act on consults within 7 days and appointment requests for newly enrolled veterans within 1 day of the approved appointment request.