Medical and benefits information systems at the Departments of Defense and Veterans Affairs do not classify service members and veterans as severely wounded, ill or injured. That's hindering ensuring that all individuals eligible for a special wounded warrior care management program are being identified and enrolled, according to the Government Accountability Office.

The departments in 2007, following reports of poor case management for outpatients at Walter Reed Army Medical Center, created the Federal Recovery Coordination Program (FRCP) to better share coordination of clinical and nonclinical care after wounded warriors are discharged.

The VA manages FRCP, but its pertinent information systems, along with applicable systems in DOD and the five military services' wounded warrior programs can't exchange data on affected individuals. That means eligible individuals aren't being automatically identified; enrollment in the program is dependent on referrals.

And linking those systems isn't a high priority. The project "is a grassroots effort and that work on the initiative has been performed by DOD and VA employees in addition to their normal duties, making a completion date difficult to estimate," according to a new report from GAO, a congressional investigatory agency.

Some case managers, called Federal Recovery Coordinators (FRC), told GAO they are frustrated with delays in obtaining appropriate computer and communications equipment when initially reporting to their facilities.

"For example, one FRC said she waited more than six weeks at the facility to receive a DOD computer and landline telephone," according to GAO. "Another FRC reported that he has found that e-mail is an effective mode of communication with enrollees with traumatic brain injuries because he can provide detailed instructions to them, but when he was hired he did not receive a DOD computer and a landline telephone with long-distance calling capabilities for eight months. Consequently, he had to resort to mailing letters and brochures to current and potential enrollees."

Even if the information systems were made available to case workers and properly linked, the Federal Recovery Coordination Program would still struggle to ensure those needing continued services get it, the GAO asserts. Care coordinators, or FRCs, evaluate individuals identified as eligible for continued services, "a process that involves considerable judgment by FRCs because of broad criteria," the report states. "However, FRCP leadership does not systematically review FRCs' enrollment decisions, and as a result, program officials cannot ensure that referred individuals who could benefit from the program are enrolled and, conversely, that the individuals who are not enrolled are referred to other programs."

GAO's new report, "Federal Recovery Coordination Program Continues to Expand by Faces Significant Challenges," is available here.

--Joseph Goedert


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