VA still on government ‘high risk’ list

Jonathan Kaupanger
April 16, 2018 - 2:01 pm

Roberto Koltun/Miami Herald/TNS/Sipa USA

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Veterans Affairs is still on the high risk list of government agencies and programs that have problems with fraud, waste and mismanagement. 

Every two years, coinciding with the new Congress, the Government Accountability Office, they reviews government agencies and programs to find vulnerabilities.  VA was added to this list in 2015 due to five major areas of concern: ambiguous policies and inconsistent processes; inadequate oversight and accountability; IT challenges; inadequate training for VA staff; and unclear resource needs and allocation priorities. 

This is an off year, meaning the full report isn’t redone, but programs can be removed if they meet the criteria for removal, VA has not met these requirements. On the positive side, the GAO report says VA does meet the leadership commitment criteria and now has an action plan to address the five areas of concern.  It hasn’t shown a capacity to address the areas of concern, a way to monitor the implementation of the corrective actions or just show simple progress. 

“We thank GAO for its review and for highlighting practices that VA needs to improve,” said VA Acting Secretary Robert Wilkie, in an announcement today meant to highlight the steps VA is taking to come off this list.  “We are serious about doing business differently to improve veterans care and we are holding ourselves accountable to the nation’s veterans and to American taxpayers who entrust them t to our care.”

VA states that it delivered an action plan to GAO that included crucial steps that have already been taken to address VA health care risk areas. They included purging more than 235 expired directives and about 85 percent of all outdated manuals which should help with the “ambiguous policies and inconsistent processes” part of the five major areas list. 

To help with oversight and accountability, VA has a new VHA Office of Integrity but it’s too early to tell if this is working just yet. Through this office, VA should be able to consolidate compliance, ethics and oversight programs. It has been effective with rapid internal audits which gives the Under Secretary for Health with a way to track operations.

IT challenges continue to be a thorn in the side of VA.  It’s on track to become the top agency for IT spending in the next five years.  VA says there’s a plan.  The new Electronic Health Record (HER) modernization program is going to give “seamless care” and “full Interoperability.”  According to the VA, the EHR will even make veteran health data interchangeable with community health partners. There’s just no signed contract for this yet. 

Since originally adding VA to the high risk list, GAO has made 66 new recommendations related to VA healthcare. There can be anywhere between 80 and 100 open recommendations at any given time. In the last decade, VA has successfully addressed a little under 400 recommendations, but GAO has four that should be addressed immediately:

·         Improve oversight of access to timely medical appointments. Include the development of wait-time measures that are more reliable and not prone to user error or manipulation.

·         Improved oversight of VA community care – specifically timely payment to community providers.

·         Improved planning, deployment and oversight of IT systems.

·         Ensure that recommendations from both internal and external reviews are evaluated for implementation. 

 

The next GAO high risk list report is due in early 2019.