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Intimate Partner Violence Assistance Program Implementation Status and Barriers to Compliance

Report Information

Issue Date
Report Number
21-00797-248
VA Office
Veterans Health Administration (VHA)
Report Author
Office of Healthcare Inspections
Report Type
National Healthcare Review
Report Topic
Patient Safety
Major Management Challenges
Healthcare Services
Leadership and Governance
Recommendations
7
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
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.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Open Recommendation Image, Square
to Veterans Health Administration (VHA)
The Under Secretary for Health ensures that Intimate Partner Violence Assistance Program protocols are developed at all medical centers consistent with the national requirement.
No. 2
Open Recommendation Image, Square
to Veterans Health Administration (VHA)
The Under Secretary for Health evaluates the sufficiency of current guidance and operational status regarding Intimate Partner Violence Assistance Program coordinators’ dedicated time and population needs, and takes action as warranted.
No. 3
Open Recommendation Image, Square
to Veterans Health Administration (VHA)
The Under Secretary for Health determines the appropriate guidance for dedicated administrative staff support in consideration of the Intimate Partner Violence Assistance Program coordinators’ responsibilities, and takes action as warranted.
No. 4
Open Recommendation Image, Square
to Veterans Health Administration (VHA)
The Under Secretary for Health considers the establishment of standardized Intimate Partner Violence staff training content and format as well as the evaluation of training efficacy, and takes action as warranted.
No. 5
Open Recommendation Image, Square
to Veterans Health Administration (VHA)
The Under Secretary for Health develops intimate partner violence screening requirements based on the current guidance and patient population needs, and takes action as warranted.
No. 6
Open Recommendation Image, Square
to Veterans Health Administration (VHA)
The Under Secretary for Health expedites standardized program evaluation processes with oversight and reporting responsibilities to ensure identification of implementation and program deficiencies and monitoring of corrective action and performance improvement plans.
No. 7
Open Recommendation Image, Square
to Veterans Health Administration (VHA)
The Under Secretary for Health evaluates the current guidance and operational status related to the roles and oversight functions of the Veterans Integrated Service Network Intimate Partner Violence Assistance Program champions and lead coordinators and clarifies expectations and requirements.