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HEHS-95-172R 1 (1995-06-02)

handle is hein.gao/gaobackvq0001 and id is 1 raw text is: GAO United States General Accounting Office Washington, D.C. 20548 Health, Education and Human Services Division B-260591 June 2, 1995 Senator John D. Rockefeller IV Ranking Minority Member Committee on Veterans' Affairs United States Senate Dear Senator Rockefeller: More than 240,000 veterans receive inpatient and/or outpatient substance abuse services at 165 Department of Veterans Affairs' medical centers (VAMC) and freestanding clinics at an annual cost to the government of over $500 million. The high incidence of substance abuse in the veteran population and the significant cost to VA of treating this problem led your staff to ask us to obtain information on (1) the types of services that are being provided to veterans and (2) how the veterans are utilizing these services. We began our review by examining the Brockton VAMC located in Brockton, Massachusetts. We did not select the center because of any preconceptions about the services being provided. Instead, our plan was to review a city-based program, discuss with your staff what we learned from this review, and determine whether further work at other locations was warranted. Brockton has an extensive substance abuse program that consists of inpatient and outpatient detoxification and rehabilitation services; counseling; training for psychiatrists, psychologists, and social workers; and research activities. In fiscal year 1994, the Brockton VAMC spent approximately $4.5 million on its substance abuse program. The program, which was revised and expanded in 1994, served over 1,200 veterans in the inpatient and outpatient settings in the first half of fiscal year 1994. This letter focuses on (1) the center's detoxification and rehabilitation services, (2) the need for better utilization data at this facility, and (3) efforts made by Brockton personnel since June 1994 to restructure its substance abuse program. To develop this information, we interviewed program officials; examined program documentation, including policies, procedures, goals and objectives; reviewed randomly selected medical files of 30 veterans enrolled in the inpatient and 30 enrolled in the outpatient programs between October 1, 1993, and March 31, 1994; and developed and analyzed utilization information on inpatient program participants who received GAO/HEHS-95-172R Brockton Substance Abuse

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