VA Organization That Provides Assistance to Veterans Essay Example

in fulfilling responsibilities, and to be conscientious stewards of institutional and community resources essential to our mission,” (James A. Haley Veterans’ Hospital, n.d.).

Programs

Comprehensive health care through James A. Haley includes primary and tertiary care, as well as long term care in medicine, surgery, psychiatry, rehabilitation, spinal cord injury, neurology, oncology, geriatrics, and extended care (Veterans Affairs, 2019). Social workers can be seen on various teams throughout each of these hospital departments. In addition to the extensive health care provided, the VA offers programs such as homeless veteran services, post-deployment and re-integration support, women veteran services, LGBTQ specific veteran care, and supportive services for caregivers. For the purpose of this evaluation, the primary focus will be on the homeless veteran services offered through James A. Haley, with special attention on one specific program.

The homeless veteran area holds the largest section of social workers within the agency, ensuring needs are met thoroughly and efficiently. Specific services provided in this section include HUD-VASH (Housing and Urban Development – VA Supportive Housing), SSVF (Supportive Services for Veteran Families), GPD (Grant and Per Diem), DCHV (Domiciliary Care for Homeless Veterans), CWT (Compensated Work Therapy), and VJO (Veteran Justice Outreach).

The HUD-VASH program works closely with the Tampa Housing Authority, combining rental vouchers with intensive case management through the VA to assist veterans and their families in finding and maintaining permanent housing. The program prioritizes chronically homeless veterans, veterans with families and minor children, and other vulnerable veteran populations. According to data released from Veterans Affairs (2019), HUD-VASH services the largest number and percentage of Veterans who have experienced enduring or repeated homelessness.

Effectiveness of Services

It is not uncommon for many veterans enrolled

in HUD-VASH to remain in the program long-term, as disability and other circumstances make employment unfeasible. However, it is possible for veterans to be successfully discharged from case management services as a result of their accomplishments while in the program and their abilities to maintain their housing and keep up with their payments. A successful discharge from case management is regarded as a positive discharge and is an overall goal for all enrolled in the program.

Veterans that do find employment may remain in the program should they still meet the income requirements, but often those veterans find themselves desiring to rent or buy a home without the assistance of HUD-VASH, which is also considered a positive discharge. The VA analyzes data pertaining to the rate of veterans exiting housing programs as employed individuals. According to data from the 2017 fiscal year, “7,000 veterans exited residential programs with employment, with the employment rates of HUD-VASH specific veterans exceeding the national target by four percent,” (Veterans Affairs, 2019). These numbers support the consistency of an upward trend for the last four year. A table indicating percentage outcomes from 2014-2017 can be found in Table 1 for a visual reference.

Use of Information

The James A. Haley HUD-VASH program is currently implementing the analysis of positive versus negative discharges against the total amount for each fiscal year to gain further understanding of why veterans are being discharged from the program and what can be done to prevent negative discharges. According to the current available numbers, the total amount of discharges from the program appear to be increasing. The themes surrounding the discharges must be considered to determine effectiveness and future

direction.

Additionally, data pertaining to individual client progress is collected via individual service plans and the PHQ9 inventory, which is a ten-item depression-anxiety scale. Individual service plans are reviewed annually to determine if veterans are meeting the outlined goals and PHQ9 inventories are given every six to twelve months. The PHQ9 is given to every veteran in HUD-VASH, despite the program not being primarily clinical in nature, due to common mental health diagnoses seen among this population. Such diagnoses include depression, anxiety, adjustment disorder, and post-traumatic stress disorder. The leadership team uses both assessments as success indicators reported to the board monthly to assess program effectiveness. The board and James A. Haley believe that when a veteran is successfully houses, they can accomplish goals in other areas of their life.

Monthly reports are pulled by the section chief to assess units of services for employee productivity and reimbursement services and are reviewed by the board. Ensuring all applicable ICD-10 codes and billing procedures are properly applied enables the department to receive adequate funding to keep the program functioning. The rate of clinic notes indicating face-to-face home visits are also pulled monthly to ensure case managers are meeting the number of visits required by the program for each level of care. For example, a veteran flagged at level 1 must be seen face-to-face once a week, a level 2 twice a month, a level 3 once a month, a level 4 quarterly, and a level 5 twice a year. The level noted also provides some insight into how well a veteran is progressing in the program which impacts a potential increase in funding and the approval for hiring

more staff.

Program Goals & Critique/Suggestions

Currently, the only measure taken to determine program goals are being met is the tracking of how many veterans are presently housed under the HUD-VASH program. The number of veterans currently housed under the program is not available at this time. Additional treatment goals specific to individual veterans are not monitored, only the primary goal of maintaining stable housing. It can be argued that individual treatment goals can be considered met if a veteran is successfully discharged from case management, however, these goals vary widely across caseloads and there is currently no process in place to monitor this. It is unknown if any prior evaluation efforts have been made regarding individual treatment goals.

The process of evaluation could be made more accurate by recruiting a team to pull data from various areas, rather than just the section chief, as this individual is solely responsible for the multiple reports being compiled. Sporadic chart reviews would also be beneficial and would facilitate cohesiveness in terms of documentation and coding. It appears there has been confusion surrounding what codes can be used with certain notes. A telephonic clinical note, for example, cannot be coded with a suicide risk assessment code even if one was performed by the clinician. Coding guidelines come directly from the board and, unfortunately, changes with the coding procedures. However, offering training refreshers and proper education for newer employees would combat these errors.