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Program of Comprehensive Assistance for Family Caregivers: IT System Development Challenges Affect Expansion

Report Information

Issue Date
Report Number
20-00178-24
VA Office
Veterans Health Administration (VHA)
Report Author
Office of Audits and Evaluations
Report Type
Audit
Report Topic
System Development and Implementation
Recommendations
4
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
VA’s Program of Comprehensive Assistance for Family Caregivers provides benefits such as monthly stipends to approved caregivers of eligible veterans. The VA MISSION Act of 2018 expanded eligibility for the program from veterans injured on or after 9/11 to include veterans injured in any conflict. The prerequisites to expansion include an information technology (IT) system that fully supports the program. The OIG assessed VA’s efforts to implement this IT system and compliance with schedule and system performance requirements, as well as the development costs. The OIG recognizes VA’s significant efforts and the challenges involved. Millions of veterans, if determined eligible, may be considered for participation in the program. However, the OIG found that VA did not meet the MISSION Act’s October 1, 2018, deadline for implementing an IT system, nor the October 1, 2019, reporting requirement. This was due in part to governance issues and lack of continuity in leadership when upgrading and replacing the legacy system. The new IT system, the Caregiver Record Management Application (CARMA), was implemented on October 1, 2020, two years after the MISSION Act’s requirement. VA informed the OIG on January 22, 2021, that CARMA now includes functionalities that meet MISSION Act requirements. However, the OIG found VA did not establish the appropriate security risk category and fully assess the system’s privacy vulnerabilities. The OIG made four recommendations: (1) establish policies and procedures for joint governance on all IT projects to ensure efforts provide an adequate return on investment and achieve program objectives; (2) enforce an existing process to help IT projects deliver and sustain the intended outcomes, ensuring the Program and Acquisition Review Council evaluates underperforming projects; (3) reevaluate elevating the system’s risk category to better protect health information and other sensitive data; and (4) establish agency-wide policies and responsibilities for managing IT projects.

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 Information and Technology (OIT)
The OIG recommended the acting assistant secretary for information and technology, in conjunction with the acting under secretary for health, establish policies and procedures for joint governance by OIT and program offices on all information.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Information and Technology (OIT)
The OIG recommended the acting assistant secretary for information and technology require the Office of Information and Technology to develop controls for making certain the program management review process is consistently enforced for future information technology projects to deliver and sustain the intended outcomes and to ensure underperforming projects are identified for evaluation by the Program and Acquisition Review Council.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Information and Technology (OIT)
The OIG recommended the acting assistant secretary for information and technology, in conjunction with the acting under secretary for health, reevaluate the risk determination for the Caregiver Record Management Application and determine if the system should be set to a security categorization level of high based on the personal health information and other sensitive data maintained therein.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Information and Technology (OIT)
The OIG recommended the acting assistant secretary for information and technology establish VA wide policies and responsibilities for managing VA information technology projects under the Development Operations process.