VA Health Care: Spending for Mental Health Strategic Plan Initiatives Was Substantially Less Than Planned Page: 2 of 39
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aAccountabiity Integrity Reliability
Highlights of GAO-07-66, a report to
Why GAO Did This Study
The Department of Veterans
Affairs (VA) provides mental
health services to veterans with
conditions such as post-traumatic
stress disorder (PTSD) and
substance abuse disorders. To
address gaps in services needed
by veterans, VA approved a
mental health strategic plan in
2004. VA planned to increase its
fiscal year 2005 allocations for
plan initiatives by $100 million
above fiscal year 2004 levels and
its fiscal year 2006 allocations for
plan initiatives by $200 million
above fiscal year 2004 levels.
GAO was asked to provide
information on VA's allocation
and use of funding for mental
health strategic plan initiatives in
fiscal years 2005 and 2006, and to
examine the adequacy of how VA
tracked spending and the extent
of spending for plan initiatives.
GAO reviewed VA reports and
documents on plan initiatives and
conducted interviews with VA
officials at headquarters, 4 of 21
health care networks, and seven
medical centers. VA networks
provide oversight of medical
center operations and most
medical center resources.
GAO recommends that VA track
the extent to which the resources
allocated for strategic plan
initiatives are spent for these
initiatives. VA did not comment
on the content of this report.
To view the full product, including the scope
and methodology, click on the link above.
For more information, contact Laurie E.
Ekstrand at (202) 512-7101 or
ekstrandl @ gao.gov.
VA HEALTH CARE
Spending for Mental Health Strategic Plan
Initiatives Was Substantially Less Than
What GAO Found
In fiscal year 2005, VA headquarters allocated about $88 million of the
$100 million above fiscal year 2004 levels that VA officials intended for
mental health strategic plan initiatives. VA allocated about $53 million
directly to medical centers and certain offices based on proposals submitted
for funding and other approaches targeted to specific initiatives. VA solicited
proposals from networks for initiatives to be carried out at medical centers
through requests for proposals (RFP). In addition, VA headquarters officials
said that VA allocated $35 million for plan initiatives through VA's general
resource allocation system to its 21 health care networks on a retrospective
basis, several months after resources had been provided to the networks
though the general resource allocation system. VA did not notify network
and medical center officials that these funds were to be used for plan
initiatives. Network and medical center officials interviewed told GAO that
they were not aware these allocations had been made. As a result, it is likely
that some of these funds were not used for plan initiatives. VA did not
allocate the approximately $12 million remaining of the $100 million for
fiscal year 2005 because, according to VA officials, there was not enough
time during the fiscal year to do so. Medical center officials said they used
funds allocated for plan initiatives for new services and for enhancement of
existing services. For example, two medical centers increased the number of
mental health providers at community-based outpatient clinics. However,
some medical center officials reported they did not use all funds allocated by
the end of the fiscal year, due in part to the time it took to hire staff.
In fiscal year 2006, VA headquarters allocated about $158 million of the
$200 million above fiscal year 2004 levels intended for mental health
strategic plan initiatives directly to medical centers and certain offices. VA
allocated about $92 million of these funds to support new initiatives, using
RFPs and other targeted funding approaches. VA also allocated about
$66 million to support recurring costs of continuing initiatives from the prior
fiscal year. About $42 million of the $200 million for fiscal year 2006 was not
allocated. Officials from seven medical centers GAO interviewed reported
they had used funds for plan initiatives, such as the creation of a new case
management program. Officials at some medical centers reported they did
not anticipate problems using all of the funds allocated within the fiscal year;
however, officials at other medical centers were less certain they would be
able to do so.
VA tracking of spending for plan initiatives was inadequate. In fiscal year
2005, VA did not track such spending. In fiscal year 2006, VA tracked aspects
of plan initiatives but not dollars spent. However, available information
indicates that VA spending for plan initiatives was substantially less than
planned. In fiscal year 2006, VA medical centers returned to headquarters
about $46 million of about $158 million allocated for plan initiatives because
they could not spend the funds that year. However, VA cannot determine to
what extent the approximately $112 million remaining was spent on plan
initiatives because it did not track specifically how these funds were spent.
United States Government Accountability Office
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United States. Government Accountability Office. VA Health Care: Spending for Mental Health Strategic Plan Initiatives Was Substantially Less Than Planned, report, November 21, 2006; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc302162/m1/2/: accessed April 18, 2019), University of North Texas Libraries, Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.