“The Office of Inspector General (OIG) is conducting a series of reviews focusing on the Veterans Health Administration’s (VHA) management of key clinical areas during the COVID-19 pandemic that are crucial to the well-being of veterans.1 This review focused on select Veterans Crisis Line (VCL) operations ranging from contingency planning to quality metrics and lessons learned. The VCL is organizationally aligned under the VHA Office of Mental Health and Suicide Prevention and operates 24 hours per day and 7 days per week, with call centers in Canandaigua, New York; Atlanta, Georgia; and Topeka, Kansas. Callers can access VCL by telephone, chat, or text through either the Suicide Prevention Lifeline (Lifeline: 1-800-273-TALK) and pressing 1 or when calling any VA medical facility, VA outpatient clinic, or community-based outpatient clinic by pressing 7. For veterans at risk of self-directed violence, VCL staff submit a consult to the suicide prevention coordinator (SPC) at a VA medical facility, and the SPC is responsible for ensuring the veteran receives evaluation and treatment from appropriate VA or other services…”
“The VCL call centers were not conducive to staff health and safety during the pandemic because staff generally worked in close proximity to one another and shared cubicles, computers, and telephones. Telework-based operations, however, had previously been considered “too much of a risk,” primarily due to concerns about the quality and dependability of employees’ residential internet connections and the potential for poor call quality and lost calls. Nevertheless, VCL leaders started planning for a phased telework deployment, and as the pandemic spread quickly in the United States, the VHA Office of Mental Health and Suicide Prevention leaders directed the rapid deployment of telework for VCL staff on March 21, 2020. At this point, VCL leaders’ primary challenge was to transition nearly 800 VCL workers to telework-based operations as quickly as possible, while also ensuring that functional equipment, staff training, and supervision and oversight were in place. The VA Office of Information and Technology (OIT) coordinated the acquisition of 300 computers (including a keyboard and mouse for each computer), 600 monitors, and 300 iPhones with licenses. Regional OIT staff formatted and installed the related software and ensured that VCL employees had the necessary tools to perform their duties prior to being sent home to telework. By the last week of April 2020, all 738 of VCL call center employees who wanted to telework were teleworking. VCL survey respondents who teleworked overwhelmingly reported having the necessary equipment and technical support to enable them to perform their duties at their telework location. The OIG found that to ensure continued operations, OIT prioritized VCL’s equipment and other needs to rapidly deploy staff to telework. To support the VCL mission, and in the context of telework uncertainties, VCL leaders developed a comprehensive “extreme scenarios” strategic and contingency plan that broadly included telework planning, standard operating procedure changes, call center management, and technical and clinical partner engagement. The OIG found that the VCL provided employees with training, guidance, and resources related to telework, new VCL processes, and COVID-19- specific concerns. Because the transition to telework took time to organize and was conducted in phases, some VCL staff remained in the call centers until telework was fully accomplished for those who desired it. To promote staff safety, VCL leaders and call center managers implemented a screening process and plans for telework, supplies, personal protective equipment (PPE), and cleaning. However, VCL survey respondents had mixed opinions about VCL leaders’ responsiveness to the emerging pandemic, with slightly less than half stating that VCL leadership was prepared for and responded timely to the evolving COVID-19 pandemic…”
Read the full 40-page report here.
Source: Veterans Crisis Line Challenges, Contingency Plans, and Successes During the COVID-19 Pandemic – October 28, 2020. VA OIG.
