Review of Suicide Prevention Program Staff Duties at the Atlanta VA Health Care System in Decatur, Georgia

The VA Office of Inspector General (OIG) conducted an inspection in response to an allegation that assigning psychotherapy duties to Suicide Prevention Program staff at the Atlanta VA Healthcare System in Decatur, Georgia, limited staff’s ability to fulfill program requirements. The OIG did not substantiate the allegation. System leaders and staff indicated that core Suicide Prevention Program responsibilities continued without disruption following the assignment of psychotherapy duties. Additionally, the OIG reviewed program metrics and found no evidence these duties affected completion of program requirements.

The OIG found that all 18 Suicide Prevention Program staff members were licensed clinical social workers whose assigned duties included performing advanced practice procedures, such as psychotherapy, mental health assessments, and diagnosis. However, a review of staff scopes of practice, which define the clinical services providers are authorized to perform at a facility, found five social workers were not authorized through their scopes of practice to perform advanced practice procedures.

The OIG also identified a concern related to credentialing social workers under the medical staff structure. Although Veterans Health Administration (VHA) policy recognizes social workers as licensed independent practitioners, system leaders blended privileging and scope-of-practice processes, which unintentionally limited their ability to practice independently. Rather than being recognized as licensed independent practitioners in the medical staff bylaws, the system categorized them as practitioners requiring “supervision and/or collaboration.”

The OIG issued three recommendations to the System Director to align scopes of practice with licensure and assigned duties, ensure proper integration of social workers into the medical staff structure, and recognize licensed clinical social workers as licensed independent practitioners. The Veterans Integrated Service Network and System Directors concurred with the recommendations and will consult with VHA national program offices in modifying scopes of practice, amending medical staff bylaws, and ensuring social workers are identified as licensed independent practitioners.