FECA Eligibility

The FECA program provides health benefits—reimbursement for medical  expenses related to illnesses or injuries that DOL determines are service  connected—as well as other benefits, such as wage-loss (death and  disability) compensation. From 2009 through 2011, DOL Provided about $36 Million in Health Care and Other Benefits for Volunteers

From 2009 through 2011, DOL provided a total of about $36 million in  FECA benefits for volunteers, providing about $22 million in health care  benefits—reimbursements for medical expenses to treat service- connected injuries and illnesses for Peace Corps volunteers—and   $13.8 million in other benefits. During this period, almost 1,400 volunteers  each year received health care benefits. The most-common medical conditions for which DOL  provided health care benefits—reimbursements for medical services— were mental, emotional, and nervous conditions; dental;  other/nonclassified diseases; and infectious or parasitic diseases.These four medical conditions represented about 40 percent of all  medical conditions and accounted for about $5.9 million—or more than a  quarter—of all medical reimbursements for volunteers under FECA  between 2009 and 2011. According to Peace Corps  officials, these health care and other expenses represent a growing  portion of its annual budget. The Peace Corps Uses Information on Volunteers’ Awareness of FECA, but Neither DOL Nor the Peace Corps Use Other Available Information to Monitor Access and Quality

The Peace Corps uses information it has to monitor volunteers’  awareness of the FECA program; however, in general, neither DOL nor  the Peace Corps use information in the remaining three areas in our  review to monitor the accessibility and quality of FECA benefits for  volunteers. These areas are (1) information on volunteers’ knowledge of  FECA program and application requirements, such as medical  documentation that is required to be submitted with an application;   (2) information on DOL’s timeliness in reviewing FECA applications and  reimbursing medical expenses, and on the level of customer satisfaction  with the FECA program; and (3) information on the availability of FECA-  Table 2 summarizes the extent to which  registered medical providers.DOL and the Peace Corps use information available in the four key areas  to monitor the accessibility and quality of FECA benefits for volunteers. While the Peace Corps uses information on volunteer awareness, neither  DOL nor the Peace Corps use available information related to the  remaining three areas of our review to monitor the accessibility and  quality of FECA benefits for volunteers. However, by not using this available information to review volunteers’  level of knowledge of the FECA requirements, DOL and the Peace Corps  may be unaware, for example, of the extent to which volunteers  experience difficulties accessing FECA benefits because of limited  understanding of certain application requirements, such as in (a)  providing appropriate and sufficient medical evidence and (b) establishing  a service connection for the illness or injury for which the volunteer is  seeking FECA benefits. geographic areas and for certain medical specialties.information DOL has on the geographic location and medical specialty of  FECA-registered providers, DOL and the Peace Corps cannot determine  the extent to which there are limitations in the availability of FECA- registered providers in certain geographic areas and for certain medical  specialties. From DOL’s perspective, volunteers do not represent a large  proportion of the overall FECA population. However, FECA is a relatively  larger issue from the Peace Corps’ perspective. The volunteers are a  unique population compared to others who receive benefits under  FECA—for example, they are more likely to have mental, emotional, or  nervous conditions that are service-connected—and, according to Peace  Corps officials, the amount the Peace Corps pays DOL for FECA  reimbursements represents an increasing portion of the Peace Corps’  annual budget. Because both of the agencies have certain responsibilities  related to the provision of FECA benefits for eligible volunteers who return  from service abroad, it is especially important that the Peace Corps and  DOL jointly monitor the accessibility and quality of the FECA program to  ensure that the FECA program is achieving its intended objectives— including ensuring that eligible volunteers receive needed FECA health  care benefits. While information is available to DOL and the Peace Corps that could be  used for monitoring, the agencies are generally not working together to  use the available information to monitor the accessibility and quality of  FECA benefits for volunteers. Unless the two agencies work together on monitoring, they will miss the  opportunity to make use of the available information to help ensure the  accessibility and quality of FECA benefits for volunteers. Recommendation for Executive Action

We recommend that the Secretary of Labor and the Director of the Peace  Corps jointly develop and implement an approach for working together to  use available information to monitor the access to and quality of FECA  benefits provided to returned volunteers. Agency Comments and Our Evaluation

We provided a draft of this report to the Department of Labor (DOL) and  the Peace Corps for review. Neither DOL nor the Peace Corps indicated  whether or not they agreed with our recommendation.
Why GAO Did This Study

Peace Corps volunteers who suffer a service-connected illness or injury are eligible to receive certain health care and other benefits under FECA--a workers' compensation program administered by DOL. FECA provides health care benefits--reimbursements for medical expenses--to federal employees and volunteers for illnesses or injuries that DOL determines are service-connected.
GAO was mandated to report on the access and quality of health care benefits for Peace Corps volunteers. This report (1) identifies the health care and other benefits provided to volunteers from 2009 through 2011 under the FECA program, and (2) examines the extent to which DOL and the Peace Corps use available agency information to monitor the accessibility and quality of FECA health care benefits provided to volunteers. GAO reviewed agency documents, interviewed agency officials, and analyzed DOL data. GAO developed a framework with four areas to define access and quality and examined available information in these areas that could be used for monitoring.

What GAO Found

From 2009 through 2011, the Department of Labor (DOL) provided a total of about $36 million in Federal Employees' Compensation Act (FECA) benefits--health and other benefits--for Peace Corps volunteers who have returned from service abroad (volunteers). Specifically, DOL provided about $22 million in health care benefits for these volunteers in the form of reimbursements for medical expenses related to service-connected injuries and illnesses, and $13.8 million in other benefits, such as reimbursement for travel expenses incurred when seeking medical care. During this period, approximately 1,400 volunteers each year received these health care benefits under the FECA program. The most common types of medical conditions for which DOL provided reimbursements were mental, emotional, and nervous conditions; dental; other/nonclassified diseases; and infectious or parasitic diseases. These four medical conditions accounted for more than a quarter of all medical reimbursements for volunteers under FECA from 2009 through 2011.
In general, neither DOL nor the Peace Corps use all available information in the four areas GAO reviewed to monitor access and quality of FECA benefits for volunteers. GAO found that the Peace Corps uses information in just one of the areas--volunteers' awareness of the FECA program; however, in general, neither agency uses information in the remaining three areas. These areas are (1) information on volunteers' knowledge of FECA program and application requirements, such as required medical documentation; (2) information on DOL's timeliness in reviewing FECA applications and reimbursing medical expenses, and on the level of customer satisfaction; and (3) availability of FECA-registered medical providers. By not using information available to the agencies, DOL and the Peace Corps are missing an opportunity to determine whether, or to what extent, volunteers face access and quality issues in the FECA program. For example, DOL and the Peace Corps may not be able to determine the extent to which there are limitations in the availability of FECA-registered providers for certain medical specialties.
DOL and the Peace Corps each have certain responsibilities related to the provision of FECA benefits for eligible volunteers, and each has information that could be used for monitoring. From DOL's perspective, volunteers do not represent a large proportion of the overall FECA population. However, FECA is a relatively larger issue from the Peace Corps' perspective. The volunteers are a unique population compared to others who receive benefits under FECA, and the FECA costs associated with volunteers represent a growing portion of the Peace Corps' annual budget. Neither agency has all the information GAO reviewed, and the agencies generally do not work together to use available information to monitor the accessibility and quality of FECA benefits for volunteers. As a result, DOL and the Peace Corps are missing an opportunity to make use of the available information to help ensure the accessibility and quality of FECA benefits for volunteers. GAO recommends that the Secretary of Labor and the Director of the Peace Corps jointly develop and implement an approach for working together to use available agency information to monitor the access to and quality of FECA benefits provided to volunteers. Neither DOL nor the Peace Corps indicated whether or not they agreed with GAO's recommendation. Instead, the agencies provided additional context related to the provision of FECA benefits.

What GAO Recommends

GAO recommends that the Secretary of Labor and the Director of the Peace Corps jointly develop and implement an approach for working together to use available agency information to monitor the access to and quality of FECA benefits provided to volunteers.
Neither DOL nor the Peace Corps indicated whether or not they agreed with GAOs recommendation. Instead, the agencies provided additional context related to the provision of FECA benefits.