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OIG Determination of VHA Occupational Staffing Shortages

Report Information

Issue Date
Report Number
16-00351-453
VA Office
Veterans Health Administration (VHA)
Report Author
Office of Healthcare Inspections
Report Type
National Healthcare Review
Recommendations
4
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
OIG conducted its third determination of Veterans Health Administration (VHA) occupations with the largest staffing shortages as required by Section 301 of the Veterans Access, Choice, and Accountability Act of 2014. We analyzed VHA facility rankings of critical occupations, to interpret “largest staffing shortages.” This is a broader deliberation than simply the number needed to replace or backfill vacant positions. We performed a rules-based analysis on VHA data to identify these occupations, analyzed data on gains and losses for occupations with the largest staffing shortages, and assessed VHA’s progress with implementing staffing models. We determined that the largest critical need occupations were Medical Officer, Nurse, Psychologist, Physician Assistant, Physical Therapist, and Medical Technologist. Because of a tie for 5th place, we had six occupations in our determination. Our analysis of the staffing gains and losses for the first full year after implementation of the Veterans Access, Choice, and Accountability Act of 2014 shows that for critical need occupations, a significant percentage of the total gains continues to be offset by staff losses. We also determined that the percentage of regrettable losses to total onboard staff in many critical need occupations was high relative to net increases in onboard staff. While VHA has made progress in developing and implementing staffing models, we did not identify a plan that included a set of milestones and timelines for further staffing model development to achieve full implementation. VHA has a draft report on staffing models which is pending presentation to senior leadership. We made four recommendations, two of which are repeat recommendations.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We restated our previous recommendation that the Under Secretary for Health ensure that the Veterans Health Administration develops staffing models for critical need occupations, and we further recommend that the Veterans Health Administration sets forth milestones and a timetable for further critical need occupations’ staffing model development, piloting, and implementation.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We restated our previous recommendation that the Under Secretary for Health review data on regrettable losses and consider implementing measures to reduce such losses.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended that the Under Secretary for Health consider incorporating data that predicts changes in veteran demand for health care into its staffing model.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended that the Under Secretary for Health assess the Veterans Health Administration’s resources and expertise in developing staffing models and determine whether exploration of external options to develop the above staffing model is necessary.