VA rebuffs IG criticisms of crisis hotline

The Department of Veterans Affairs second in command is pushing back against  an oversight report criticizing the agency’s suicide hotline program for not adequately training staff and using a backup call center that relied on voicemail to handle some calls.

VA Deputy Secretary Sloan Gibson said changes in business practices, the hiring of additional staff and investments in technology and work space have dramatically improved the environment of the Veterans Crisis Line in Canandaigua, New York, where a VA Office of Inspector General investigation found quality assurance concerns.

“The operation at the Veterans Crisis Line today does not bear any resemblance to what was described in the IG report or in some of the ensuing coverage,” Gibson said during a Feb. 26 call with reporters. “The fact of the matter is the reports of calls going to voicemail were reports from 2014. In fact, there was a very rigorous process put in place back then to ensure that our third party fallback, rollover call center was not under any circumstance utilizing voicemail. And where it was identified that voicemail was used (about 20 calls) every one of those veterans was followed up with to make sure we took care of them.”

“I’m not saying that there aren’t things we’ve got to do better, there clearly are,” Gibson said. “But these people need our recognition for the great work that they do every single day.”

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Hughes said that in response to the investigation, which was conducted from fiscal 2014 through the first quarter of fiscal 2015, the call center brought on additional staff, and those people are going through a six-week training program to help ensure “they are ready to take calls before they get on the phone.”

“In addition to that we are enhancing the space that responders work in so it’s more consistent with call centers of today and ideal call center operations,” said Greg Hughes, director of the Veterans Crisis Line, who’s been on the job for two months, during the call. “We’re increasing the supervisors to staff ratio so that we know that we have sufficient supervisors in place to not just monitor staff but to support staff, so as they take these difficult calls they can decompress and brief with supervisors so that they’re ready to go back on the phones.”

Matthew Eitutis, acting director of member services for the Veterans Health Administration, said the VA puts additional importance on readiness and resiliency training for its staff to ensure that they’re not only ready to help callers, but they are able to leave their shift and be “ready to engage back in their normal, personal lives.”

“We’re taking a look at the core competency areas of contact center management, that includes analytics and informatics, forecasting and scheduling, workforce management software, replacement telephony equipment, as well as a proper design of the organization that we began and have been addressing for the last year,” Eitutis said.

VA’s Office of Inspector General Office of Healthcare Inspections conducted the investigation based on complaints that calls to the crisis line went unanswered or were sent to voicemail, assistance was not always immediate and that staff were not properly trained.

The OIG found evidence to support the complaints that some calls were routed to voicemail at a backup center, as well as found gaps in quality assurance and in some training and orientation for social service assistants.

“The VCL program does not provide or monitor backup centers’ staff training; therefore, we could not substantiate that backup center staff, including volunteers, did not receive adequate training,” the report stated. “However, we did find evidence that raised concerns regarding backup center training adequacy.”

The American Association of Suicidology, which accredits the VLC, allows the use of voicemail or putting callers on hold, but requires that “most callers reach a trained crisis worker (VCL responder) within one minute of placing a call.”

At the time of the investigation VA contracted with Link2Health Solutions, Inc., (L2HS) to work as a backup center for the VCL. L2HS is a part of the non-profit Mental Health Association of New York City. A request for comment from L2HS was not immediately returned.

Despite the progress that’s been made in the past two years, congressional watchdogs were critical of the report.

Sen. John McCain (R-Ariz.), chairman of the Armed Services Committee, called the investigation’s findings “shameful” and “unacceptable.”

House Veterans Affairs Committee Chairman Jeff Miller (R-Fla.), meanwhile, cited the report as a sign that the Veterans Health Administration, which oversees the hotline, needs immediate attention.

“In order to prevent problems like this from occurring in the future, those responsible must be held accountable and VA should be completely transparent with the public regarding the status of the veterans whose calls went unanswered as well as the steps the department took to get them the help they needed,” he said in a statement.

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