OIG Determination of Veterans Health Administration’s Occupational Staffing Shortages FY 2018

The VA Office of Inspector General (OIG) conducted a review in response to newly established requirements in the VA Choice and Quality Employment Act of 2017. The law requires the OIG to report a minimum of five clinical and five nonclinical VA occupations that have the largest staffing shortages at each medical facility. This is in contrast to the prior mandate to report the five largest staffing shortages throughout VHA. This is OIG’s fifth annual determination of staffing shortages in VHA. In light of the changes in law, the OIG adjusted its approach to this year’s iteration of the mandated staffing report and conducted a facility-specific survey to determine current staffing levels and identify staffing shortages at the facility level. The most frequently cited shortages were in the Medical Officer and Nurse occupations. The OIG also found that several nonclinical occupations were frequently designated by VHA facilities as a shortage. Ultimately, the number of facility staffing shortage designations ranged from 1 to 89 shortages, including both clinical and nonclinical occupations. Facility responses to reasons why there was a shortage varied significantly. The most commonly cited challenges to staffing fell into three categories: lack of qualified applicants, non competitive salary, and high staff turnover. The reasons provided by facilities in response to the 2018 survey were consistent with many of the barriers noted in OIG’s 2017 staffing survey. The 2018 survey highlights the need for a staffing model that identifies and prioritizes staffing needs at the national level while allowing flexibility at the facility level.