Additional Controls Are Needed to Improve the Reliability of Grant and Per Diem Program Data

Report Information

Issue Date
Report Number
23-02610-226
VA Office
Veterans Health Administration (VHA)
Report Author
Office of Audits and Evaluations
Report Type
Review
Report Topic
Clinical Care Services Operations
Major Management Challenges
Healthcare Services
Recommendations
3
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary

The Grant and Per Diem (GPD) Program is VA’s largest program for transitional housing. It awards grants to community partners that provide veterans experiencing homelessness with temporary housing and supportive services, such as mental health and substance use disorder treatment and assistance in obtaining permanent housing. With a budget of over $275 million, the GPD program served almost 24,000 veterans in fiscal year 2022. Given the importance of the GPD program and VA’s reliance on data from the program’s Homeless Operations, Management, and Evaluation System (HOMES), the OIG conducted this review to determine whether VHA has reliable data to monitor grantee performance, veteran outcomes, and progress in preventing the recurrence of veteran homelessness.

The review team estimated that HOMES outcome data were unreliable for about 888 (21 percent) of the 4,151 veterans recorded as having exited the program for permanent housing. In these cases, HOMES data did not match VA medical records, did not match the grantee’s files, or lacked supporting documentation. Additionally, HOMES data did not accurately capture all negative exits—case outcomes where veterans are discharged from the GPD program under negative circumstances. Reasons for the inaccuracies included GPD liaisons not verifying grantee-reported information, liaisons not following the HOMES data definitions guide when they recorded veterans’ housing arrangements, and medical facilities not validating data that the liaisons entered.

Although VHA took steps to improve data reliability, additional controls would improve leaders’ ability to make informed decisions on the services unhoused veterans need and allow VA to hold grantees accountable for improving their services for veterans.

The OIG recommended policies and procedures for GPD liaisons to obtain reliable discharge information from grantees, controls to ensure HOMES data are consistent with grantee files and VA medical records, and quality reviews to check for accuracy.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Open Recommendation Image, Square
to Veterans Health Administration (VHA)

Establish policies and procedures for Grant and Per Diem liaisons to obtain reliable discharge information from grantees when veterans exit from the Grant and Per Diem Program.

No. 2
Open Recommendation Image, Square
to Veterans Health Administration (VHA)

Implement controls, including enhanced medical facility and grantee guidance and training, to ensure grantee files and VA medical record documentation of veteran housing outcomes are consistent with Homeless Operations, Management, and Evaluation System data definitions and support the data in the Homeless Operations, Management, and Evaluation System.

No. 3
Open Recommendation Image, Square
to Veterans Health Administration (VHA)

Implement controls, such as quality reviews, to ensure Homeless Operations, Management, and Evaluation System outcome data are supported by and consistent with veteran medical records and grantee files.