A report from VA OIG shows VA is still failing to hire enough doctors and nurses despite record taxpayer funding and heightened focus on increasing hiring in those vital categories.
A survey conducted in January 2018 of VA medical center directors revealed continued staffing shortages in key roles without the agency. At the top of the list were doctors and nurses. Human resources professional and police were also on the list of shortages.
The top reasons cited for the shortages were:
- Lack of qualified applicants
- Non-competitive salary
- High staff turnover
DOWNLOAD: IG Hiring Shortage Report
Basically, the list reveals widespread corruption in the agency and well-known whistleblower retaliation has damaged hiring capabilities in key occupations. The damage is so bad that record funds and increased spending in propaganda to deflate negative news still is not working to increase the applicant pool.
And who would want to take that risk with their career?
Think about it. As a medical doctor, the individual spent over ten years in training and invested over $200,000 to become a doctor. If that doctor, while at VA, reports malpractice or some other wrongdoing, the agency immediately retaliates by revoking the doctor’s privileges and destroying their reputation.
10 years and $200,000 down the drain. And let’s not forget the massive emotional damage that comes with being retaliated against. Plus the lost earnings once they are fired and unable to locate work elsewhere.
Who would not want to sign up after seeing that the agency’s leadership still refuses to relinquish its well-documented ability to destroy its doctors?
After four years and countless millions on propaganda to polish its image in the public, the White House should take notice of the bigger looming problems. The reality is the Accountability Act is not creating a culture of competence but instead fueling greater retaliation and hostility against whistleblowers.
Not a doctor.
VA OIG Executive Summary
In italics is the executive summary excerpt:
The VA Office of Inspector General (OIG) conducted this review in response to newly established requirements in the VA Choice and Quality Employment Act of 2017 (VCQEA). 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.
VCQEA outlines ways in which VHA may use the information presented in this report, including the recruitment and direct appointment of qualified applicants for the identified occupations. The direct hire authority outlined in the Act resides with 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 (local) level. The OIG relied on VHA facilities to produce accurate assessments of occupational shortages as of December 31, 2017. The OIG did not independently validate the information provided by the facilities. It is important to note that this was a general survey and not a compliance tool. This review and survey was designed to gather information and not assess facility adherence to VHA guidance on staffing.
The survey included a list of occupations developed from (1) Office of Personnel Management (OPM) occupational series codes and (2) VA assignment codes in order to provide further refinement to the physician (Medical Officer) and nursing occupations. Facility directors were asked questions specific to their facility for each occupation:
- What was the number of staff within the occupation as of December 31, 2017?
- Do you consider the occupation “clinical” or “nonclinical”?
- Do you consider there to be a shortage in the occupation?
- If yes to #3, why do you consider there to be a shortage?
- How would you rank the designated shortages in priority order?
While the facility directors were free to delegate the task of populating the survey, they were ultimately responsible for sending the survey back to the OIG indicating their review and agreement with their submission.
The OIG found significant variation in the number and types of shortages reported, as well as the reasons why.
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. For example, Human Resources Management had the second highest frequency, and Police had the seventh highest frequency. While this information captures the number of times a particular occupation was designated as a shortage by facilities at the local level, it does not consider other dimensions that would be needed in order to make a national ranking determination.
Ultimately, the number of facility staffing shortage designations ranged from one to 89 shortages, including both clinical and nonclinical occupations. Facilities designated between one to 76 clinical shortages and zero (no designated shortage) to 26 nonclinical shortages. Currently, VHA does not have a standardized list of which occupations are considered clinical and which are considered nonclinical beyond the appointing authority (Title 38, Hybrid Title 38, and Title 5). Due to the absence of a consistent standard, and in an effort to most accurately represent what is occurring at the local level, the OIG requested each facility director provide the clinical and nonclinical information for each of the designated shortages. As a result of the guidance provided to facilities regarding how to complete the survey, facilities might identify occupations differently based upon the skills and experience of the individual who holds the position and specific facility needs.
Facility responses to reasons why there was a shortage varied significantly. In addition, not all facilities chose to provide a reason for each designated shortage, and the level of detail and specificity differed among facilities. The OIG did not make a judgment with respect to the accuracy or strength of each reason provided. However, due to the difference in how facilities responded, the OIG used a thematic analysis approach in order to review the information.
The most commonly cited challenges to staffing fell into three categories:
- Lack of qualified applicants
- Non-competitive salary
- 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. The OIG has made recommendations related to the development and implementation of a staffing model in each of its previous staffing determination reports. The OIG does not repeat its recommendations for a staffing model in this report as expected due dates for implementation of all recommendations published in the 2017 report are after the completion of data analysis for this report. However, the OIG re-emphasizes the need for VHA to develop and implement a robust and targeted staffing model and will continue to follow VHA’s progress related to previous recommendations through its normal follow-up process.
The OIG recommended that the Under Secretary for Health refine and formalize VHA’s position categorization of individuals (clinical and nonclinical) who are necessary to VHA’s mission of delivering health care by looking at various dimensions of each occupation, including staff skill set and function, enabling identification of positions based on the specific role a person would fill. The OIG also recommended that the Under Secretary for Health ensure the consistent implementation and use of the position categorization approach across all facilities.