VA Vet Centers: Opportunities to Improve Survey of Counselor Productivity Expectations

Fast Facts

The Department of Veterans Affairs runs 300 Vet Centers nationwide that provide counseling services to military veterans and servicemembers.

We previously reported on how VA assesses Vet Center counselors’ productivity. In this Q&A, we looked at VA’s staff survey on how productivity expectations may have affected care.

We found that some parts of the survey were unclear, such as a question that didn’t specify whether Vet Center directors were supposed to answer based on their own productivity expectations or those of the counselors they supervised.

We recommended ways to help VA improve the survey.

Veterans at a Vet Center group counseling session

Veterans at a Vet Center group counseling session

Highlights

What GAO Found

Vet Centers play an important role in helping veterans and service members readjust to civilian life or to continued military service. Within the Department of Veterans Affairs (VA), the Veterans Health Administration’s Readjustment Counseling Service (RCS) operated 300 Vet Centers nationwide in fiscal year 2024. Counselors provided nearly 1.3 million counseling sessions across Vet Centers in fiscal year 2024, according to RCS.

Each Vet Center has a director, who is responsible for overseeing that Vet Center’s staff, including one or more counselors. RCS has established expectations for counselors’ productivity. (See figure.)

In December 2023, RCS administered its first annual Counselor and Client Engagement Survey to all Vet Center counselors and directors to solicit feedback on how productivity expectations affect client care and counselor welfare. RCS officials said they administered the survey to directors as well because they would have feedback about counselors’ productivity expectations. Directors also provide counseling to clients and have their own productivity expectations.

RCS obtained an overall response rate of 37 percent for the survey. Lower survey response rates raise the risk of survey responses being less representative of experiences of all counselors and directors. The degree to which counselors and directors who responded to the survey differ from those who did not on key characteristics (nonresponse bias) undermines the confidence with which RCS can use survey findings to draw conclusions about the experiences of counselors and directors overall. Federal standards for statistical surveys call for agencies to conduct a nonresponse bias analysis for any survey with a response rate of less than 80 percent.

RCS officials did not conduct an analysis of potential nonresponse bias for its survey. Thus, RCS does not know the degree to which the feedback is representative of all counselors and directors. Officials said they did not conduct the nonresponse bias analysis because they could not ascertain the exact nonresponse rate given the anonymous web address RCS used to administer the survey. However, there are other ways to address the risk of nonresponse bias, such as by comparing characteristics of respondents to those of the total population eligible to be surveyed.

GAO also identified issues with the clarity of the survey, which limit RCS’s ability to use the feedback collected to understand respondents’ perspectives on counselors’ productivity expectations. For example, it was unclear whether respondents were to provide feedback on the time management expectation, the encounters expectation, or both. This has led to RCS collecting information of limited quality for the questions on the positive and negative effects of productivity expectations on client care and counselor welfare. Thus, this information could be prone to misinterpretation, including a lack of understanding of which expectations respondents assessed in their feedback.

Why GAO Did This Study

The James M. Inhofe National Defense Authorization Act for Fiscal Year 2023 includes a provision requiring VA to evaluate productivity expectations of Vet Center counselors annually by obtaining systematic feedback from counselors and to implement any needed changes to the expectations. In response to this provision, RCS administered a survey in December 2023.

The act also includes a provision for GAO to audit the feedback. This report examines the feedback RCS obtained.

GAO reviewed documentation and interviewed RCS officials about the design and administration of the survey, analysis of survey responses, and RCS’s plans for administering additional surveys. GAO assessed RCS’s December 2023 survey against federal statistical policies, the James M. Inhofe National Defense Authorization Act for Fiscal Year 2023 provision that VA obtain feedback from counselors on productivity expectations, and the federal standard for internal control for information and communication.

Recommendations

GAO is recommending that the Veterans Health Administration (1) analyze the potential for nonresponse bias in the Counselor and Client Engagement Survey and, as appropriate, develop strategies to increase the likelihood of representative survey findings; and (2) modify the survey to clarify that counselors and directors should provide feedback on both the time management and the encounters productivity expectations for counselors. The agency concurred with GAO's recommendations and identified steps it plans to take to implement them.

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Recommendations

GAO is recommending that the Veterans Health Administration (1) analyze the potential for nonresponse bias in the Counselor and Client Engagement Survey and, as appropriate, develop strategies to increase the likelihood of representative survey findings; and (2) modify the survey to clarify that counselors and directors should provide feedback on both the time management and the encounters productivity expectations for counselors. The agency concurred with GAO's recommendations and identified steps it plans to take to implement them.