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Readjustment Counseling Service Vet Center Report

We identified areas that required improvement. The documentation in client records was

not

always

complete.

Although

RCS

had

procedures

that

detailed

required

documentation in the client record, professionals along with annual clinical was not consistently occurring. RCS’ demonstrated deficiencies in various

record reviews by supervisory and clinical

review review areas.

by RCS regional managers disclosed this of the psychological counseling records The deficiencies included inadequate

documentation

of

treatment

plans,

military

histories,

missing

closing

summaries,

and

progress notes. Another problem identified was the lack of record leader. Our review of 136 client records disclosed similar findings.

review

by

the

team

Nine percent of Vet Centers did not have an External Clinical Consultant; therefore, routine clinical assessment and consultation was not occurring at these Vet Centers. Since External Clinical Consultants are required to perform at least 4 hours of monthly clinical consultation and help counselors to manage complex treatment issues, the need for an External Clinical Consultant is essential. The RCS regional office managers reported that some positions had been recently vacated and others were difficult to fill due to the site location.

The relationship between the Vet Centers and support facilities needs to be strengthened.

The high percentage of Vet Centers that did not and the reported lack of feedback of suicide process between Vet Centers and VAMCs. medical centers did not extend an invitation

have a seat on the support facility’s MHC analysis are examples of a fragmented Regional managers reported that some to the MHC due to the content of the

meeting; while travel time of

others 3 to

reported the distance to the

4

hours).

A

seat

on

the

medical center as an impediment (a MHC could establish collaborative

relationships and cohesive working to meet the needs

encourage mutual referrals and consults. Regardless of the reason, a relationship between the Vet Center and the support facility is essential of the veterans.

We also found several RCS and VHA policies that were not consistently followed. These policies include but are not limited to:

  • Having a seat on the support facility’s MHC.

  • Privileging Vet Center professional staffs.

  • Completing a M&M review in cases of homicides and/or suicides and providing a

copy of the M&M review to the OMI. The RCS Chief Officer stated they were in the process of updating many of their policies.

VA Office of Inspector General

19

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