OIG Determination of Veterans Health Administration’s Occupational Staffing Shortages, FY 2019

Pursuant to the VA Choice and Quality Employment Act of 2017, the OIG conducted a review to identify clinical and non-clinical Veterans Health Administration (VHA) occupations experiencing the largest staffing shortages at each VA medical facility. In this sixth staffing report, the OIG team evaluated facility leader-identified severe occupational staffing shortages and compared them to last year's data. The team also explored the impact of medical center director vacancies on VHA facilities. The OIG found that 96 percent of VHA facilities identified at least one severe occupational staffing shortage. The most frequently cited shortages were in the Medical Officer and Nurse occupations. The lack of qualified applicants and non-competitive salary were the two most frequently noted reasons for severe occupational staffing shortages. As with last year’s report, Psychiatry was the most commonly reported medical specialty in the Medical Officer occupational series. Human Resources Management was the most commonly reported non-clinical occupation with severe staffing shortages. Effective and stable leadership at VA medical centers is critical to the overall success of the facilities. The OIG found more than 46 facilities annually experienced at least one change in medical center directors since 2015. Both VISN and medical center directors expressed the view that vacancies in the medical center director position negatively affected facility operations. Directors also shared concerns about the non-competitive salary and career risks associated with that position. The OIG made two recommendations to the Under Secretary for Health to ensure completion of all open action plans related to recommendations from previous staffing reports and to identify a plan of action that will address the underlying causes of severe occupational staffing shortages as discussed in this review.