Report Summary

Title: Healthcare Inspection – Follow-Up Review of Management of Mental Health Consults and Other Access to Care Concerns, VA Maine Healthcare System, Augusta, Maine
Report Number: 16-00354-201
Issue Date: 4/20/2017
City/State: Augusta, ME
VA Office: Veterans Health Administration (VHA)
Report Author: Office of Healthcare Inspections
Report Type: Healthcare Inspections
Release Type: Unrestricted
Summary: OIG conducted a healthcare inspection at the request of Senators Susan M. Collins and Angus S. King, Jr., and Representatives Chellie Pingree and Bruce Poliquin to follow up on recommendations made in our original report, Healthcare Inspection—Mismanagement of Mental Health Consults and Other Access to Care Concerns, VA Maine Healthcare System, Augusta, Maine (Report No. 14-05158-377, June 17, 2015). The purpose of the follow-up inspection was to evaluate the progress VA Maine Healthcare System made implementing the action plans created in response to the report’s recommendations to ensure that the consult package is used when referring patient for Mental Health (MH) care, MH consults are reviewed and closed in accordance with VHA policy, and VHA appointment schedule guidance is followed, including the use of the electronic wait list.

We found the system implemented and sustained corrective actions to improve consult package use for patients referred for MH services, and the consult review and closure processes were consistent with VHA policy. We found the system was noncompliant with the requirement to make direct contact with patients when scheduling MH appointments. At the time of our follow-up review in 2016, system staff were able to schedule MH appointments for service connected veterans timely and no longer needed to use the electronic wait list, therefore we were unable to determine if staff responsible for scheduling MH appointments utilized the electronic wait list correctly. Although not part of the original recommendations we were evaluating, we found documentation of initial and annual scheduling competencies for medical support assistants responsible for scheduling was missing or incomplete. We recommended the System Director ensure (1) that MH schedulers consistently make direct contact with patients prior to scheduling appointments and that compliance is monitored for a minimum of three months and (2) training and competencies are documented, complete, and up to date for all staff responsible for scheduling Mental Health appointments.