Archive
New From the GAO
New GAO Reports and Testimonies
Source: Government Accountability Office
Reports
1. VA Education Benefits: VA Needs to Improve Program Management and Provide More Timely Information to Students. GAO-13-338, May 22.
http://www.gao.gov/products/GAO-13-338
Highlights – http://www.gao.gov/assets/660/654793.pdf
2. Spectrum Management: Federal Relocation Costs and Auction Revenues. GAO-13-472, May 22.
http://www.gao.gov/products/GAO-13-472
Highlights – http://www.gao.gov/assets/660/654795.pdf
Testimonies
1. Government Efficiency and Effectiveness: Opportunities to Reduce Fragmentation, Overlap, and Duplication through Enhanced Performance Management and Oversight, by Gene L. Dodaro, Comptroller General of the United States, before the Senate Committee on Homeland Security and Governmental Affairs.
GAO-13-590T, May 22.
http://www.gao.gov/products/GAO-13-590T
Highlights – http://www.gao.gov/assets/660/654610.pdf
2. Hazardous Waste Cleanup: Observations on States’ Role, Liabilities at DOD and Hardrock Mining Sites, and Litigation Issues, by David Trimble, director, natural resources and environment, before the Subcommittee on Environment and the Economy, House Committee on Energy and Commerce. GAO-13-633T, May 22.
http://www.gao.gov/products/GAO-13-633T
Highlights – http://www.gao.gov/assets/660/654791.pdf
Tentative Eligibility Determinations; Presumptive Eligibility for Psychosis and Other Mental Illness
Tentative Eligibility Determinations; Presumptive Eligibility for Psychosis and Other Mental Illness
Source: U.S. Department of Veterans Affairs (via Federal Register)
This document amends the Department of Veterans Affairs (VA) regulation authorizing tentative eligibility determinations to comply with amended statutory authority concerning minimum active-duty service requirements. This document also codifies in regulation statutory presumptions of medical care eligibility for veterans of certain wars and conflicts who developed psychosis within specified time periods and for Persian Gulf War veterans who developed a mental illness other than psychosis within 2 years after service and within 2 years after the end of the Persian Gulf War period.
New From the GAO
New GAO Report and Press Release
Source: Government Accountability Office
Report
1. Prescription Drugs: Comparison of DOD and VA Direct Purchase Prices. GAO-13-358, April 19.
http://www.gao.gov/products/GAO-13-358
Highlights – http://www.gao.gov/assets/660/654020.pdf
Press Release
1. GAO Fills Vacancy on Health Information Technology Policy Committee May 20.
http://www.gao.gov/press/gao_fills_vacancy_hit_committee.htm
New From the GAO
New GAO Reports
Source: Government Accountability Office
CAPITAL PURCHASE PROGRAM
Status of the Program and Financial Health of Remaining Participants
GAO-13-458, May 7, 2013
PAKISTAN
Reporting on Visa Delays That Disrupt U.S. Assistance Could Be Improved
GAO-13-427, May 7, 2013
VA CONSTRUCTION
Additional Actions Needed to Decrease Delays and Lower Costs of Major Medical-Facility Projects
GAO-13-556T, May 7, 2013
New From the GAO
New GAO Reports
Source: Government Accountability Office
1. Federal Employees’ Compensation Act: Case Examples Illustrate Vulnerabilities That Could Result in Improper Payments or Overlapping Benefits. GAO-13-386, April 3.
http://www.gao.gov/products/GAO-13-386
Highlights – http://www.gao.gov/assets/660/653523.pdf
2. VA Construction: Additional Actions Needed to Decrease Delays and Lower Costs of Major Medical-Facility Projects. GAO-13-302, April 4.
http://www.gao.gov/products/GAO-13-302
Highlights – http://www.gao.gov/assets/660/653586.pdf
New From the GAO
New GAO Reports and Testimonies
Source: Government Accountability Office
Reports
1. Federal Courthouses: Recommended Construction Projects Should Be Evaluated under New Capital- Planning Process. GAO-13-263, April 11.
http://www.gao.gov/products/GAO-13-263
Highlights – http://www.gao.gov/assets/660/653747.pdf
2. NASA: Assessments of Selected Large-Scale Projects. GAO-13-276SP, April 17.
http://www.gao.gov/products/GAO-13-276SP
Highlights – http://www.gao.gov/assets/660/653867.pdf
3. Veterans Health Care: VHA Has Taken Steps to Address Deficiencies in Its Logistics Program, but Significant Concerns Remain. GAO-13-336, April 17.
http://www.gao.gov/products/GAO-13-336
Highlights – http://www.gao.gov/assets/660/653887.pdf
4. Information Technology: Consistently Applying Best Practices Could Help IRS Improve the Reliability of Reported Cost and Schedule Information. GAO-13-401, April 17.
http://www.gao.gov/products/GAO-13-401
Highlights – http://www.gao.gov/assets/660/653845.pdf
Testimonies
1. U.S. Postal Service: Urgent Action Needed to Achieve Financial Sustainability, by Gene L. Dodaro, Comptroller General of the United States, before the House Committee on Oversight and Government Reform. GAO-13-562T, April 17.
http://www.gao.gov/products/GAO-13-562T
Highlights – http://www.gao.gov/assets/660/653840.pdf
2. Federal Courthouses: Most Recommended New Construction Projects Do Not Qualify Under Improved Capital-Planning Process, by Mark L. Goldstein, director, physical infrastructure issues, before the House Committee on Transportation and Infrastructure. GAO-13-523T, April 17.
http://www.gao.gov/products/GAO-13-523T
3. F-35 Joint Strike Fighter: Program Has Improved in Some Areas, but Affordability Challenges and Other Risks Remain, by Michael J. Sullivan, director, acquisition and sourcing management, before the Subcommittee on Tactical Air and Land Forces, House Committee on Armed Services. GAO-13-500T, April 17.
http://www.gao.gov/products/GAO-13-500T
Highlights – http://www.gao.gov/assets/660/653858.pdf
4. Foreclosure Review: Lessons Learned Could Enhance Continuing Reviews and Activities under Amended Consent Orders, by Lawrance L. Evans, Jr., director, financial markets and community investment, before the Subcommittee on Housing, Transportation, and Community Development, Senate Committee on Banking, Housing, and Urban Affairs. GAO-13-550T, April 17.
http://www.gao.gov/products/GAO-13-550T
CRS — Departments of Defense and Veterans Affairs: Status of the Integrated Electronic Health Record (iEHR)
Source: Congressional Research Service (via Federation of American Scientists)
Electronic health records (EHRs) play an important role in optimizing the health care provided to active duty servicemembers and veterans. When a servicemember leaves military service by way of discharge, separation, or retirement he or she may become eligible for VA benefits and services including VA health care. Transitioning their health care information from one large health care system (Department of Defense; DOD) to the other (Department of Veterans Affairs; VA) involves coordination of data and information between DOD and VA. Longstanding concern that this exchange be effective has been expressed in many quarters, including Congress.
The DOD and the VA have been working to exchange patient health information since 1998. To date, both Departments’ initiatives include (1) the Federal Health Information Exchange (FHIE), which enables the one-way transfer of servicemembers’ electronic health information from DOD to VA for all separated servicemembers; (2) the Bidirectional Health Information Exchange (BHIE), which allows health care providers from both Departments viewable access to records of shared patients; (3) the Clinical Data Repository/Veterans Affairs Health Data Repository (CHDR),which enables the DOD and VA to exchange computable outpatient pharmacy and drug allergy information for shared patients; and (4) the Laboratory Data Sharing Interphase (LDSI), which allows DOD and VA facilities to share laboratory information.
Congressional committees with oversight over veterans matters have devoted attention to health information sharing between the DOD and VA. In 2008, they included relevant provisions in the National Defense Authorization Act for FY2008 (P.L. 110-181). The law mandated DOD and VA to jointly develop and implement electronic health record systems or capabilities to allow for full interoperability of personal health care information, and to accelerate the exchange of health care information between DOD and VA by September 2009. To this end, the law also established an interagency program office (IPO) to act as a single point of accountability.
In December 2010, the Deputy Secretaries of DOD and VA directed the development of an integrated Electronic Health Record (iEHR), which would provide both Departments an opportunity to reduce costs and improve interoperability and connectivity. On March 17, 2011, the Secretaries of DOD and VA reached an agreement to work cooperatively on the development of a common electronic health record and to transition to the new iEHR by 2017.
On February 5, 2013, the Secretary of Defense and the Secretary of Veterans Affairs announced that instead of building a single integrated electronic health record (iEHR), both DOD and VA will concentrate on integrating VA and DOD health data by focusing on interoperability and using existing technological solutions. This announcement was a departure from the previous commitments that both Departments had made to design and build a new single iEHR, rather than upgrading their current electronic health records and trying to develop interoperability solutions.
New From the GAO
New GAO Reports
Source: Government Accountability Office
ELECTRONIC HEALTH RECORDS
Long History of Management Challenges Raises Concerns about VA’s and DOD’s New Approach to Sharing Health Information
GAO-13-413T, Feb 27, 2013
GAO’S 2013 HIGH-RISK UPDATE
Medicare and Medicaid
GAO-13-433T, Feb 27, 2013
INDIAN AFFAIRS
Management Challenges Continue to Hinder Efforts to Improve Indian Education
GAO-13-342T, Feb 27, 2013
STRATEGIC SOURCING
Improved and Expanded Use Could Provide Procurement Savings for Federal Information Technology
GAO-13-408T, Feb 27, 2013
New From the GAO
New GAO Reports
Source: Government Accountability Office
INFLUENZA
Progress Made in Responding to Seasonal and Pandemic Outbreaks
GAO-13-374T, Feb 13, 2013
U.S. POSTAL SERVICE
Urgent Action Needed to Achieve Financial Sustainability
GAO-13-347T, Feb 13, 2013
VA HEALTH CARE
Reported Outpatient Medical Appointment Wait Times Are Unreliable
GAO-13-363T, Feb 13, 2013
VA — Suicide Data Report, 2012
Suicide Data Report, 2012 (PDF)
Source: U.S. Department of Veterans Affairs
Major findings of the report include:
- While the percentage of all suicides reported as Veterans has decreased, the number of suicides has increased.
- A majority of Veteran suicides are among those age 50 years and older. Male Veterans who die by suicide are older than non-Veteran males who die by suicide.
- The age distribution of Veteran and non-Veteran women who have died from suicide is similar. The demographic characteristics of Veterans who have died from suicide are similar among those with and without a history of VHA service use.
- Among those at risk, the first 4 weeks following service require intensive monitoring and case management (which verifies the importance of the Enhanced Care Package for those at high risk).
- There is preliminary evidence in 2012 indicating a decrease in the rate of non-fatal suicide events for VHA utilizing Veterans.
- Decreasing rates of non-fatal suicide events are associated with increasing age. The data show a decrease in the 12 month re-event prevalence in fiscal year (FY) 2012.
- The majority of Veterans who have a suicide event were last seen in an outpatient setting. A high prevalence of non-fatal suicide events result from overdose or other intentional poisoning.
- Continued increases in calls to the Veterans Crisis Line may be associated with efforts to enhance awareness of VHA services through public education campaigns.
- The majority of callers to the Veterans Crisis Line are male and between the ages of 50-59.
- Differences in the age composition of callers to the Veterans Crisis Line are associated with gender.
- A large percentage of callers to the Veterans Crisis Line are identified as Veterans.
- Approximately 19 percent of callers to the Veterans Crisis Line call more than once each month.
- The percentage of callers to the Veterans Crisis Line who are currently thinking of suicide has decreased.
- The percentage of all calls resulting in a rescue has decreased, indicating that the calls are less emergent and callers are using the Crisis Line earlier. The percentage of callers receiving a referral for follow-up care is increasing.
- Approximately 93 percent of all Veterans Crisis Line referrals are made to callers with a history of VHA service use in the past 12 months. Service use continues to increase following a referral for care.
- Between FY 2009 – FY 2011, use of inpatient and outpatient services increased following a rescue.
- The 12 month re-event prevalence has decreased among those who have been rescued or received a referral for follow-up care.
Administrative Investigation of the FY 2011 Human Resources Conferences in Orlando, Florida
Administrative Investigation of the FY 2011 Human Resources Conferences in Orlando, Florida
Source: U.S. Department of Veterans Affairs, Office of Inspector General
VA OIG opened an administrative investigation upon receiving allegations of wasteful expenditures related to HR conferences held in Orlando, FL, in July and August 2011. While VA reported lower estimates of conference costs to Congress, we reconstructed the costs of the two conference events to be approximately $6.1 million, but could not gain reasonable assurance that this figure represents a complete accounting for these conferences. In our opinion, VA held these conferences to fulfill valid training needs. However, VA’s processes and the oversight were too weak, ineffective, and in some instances, nonexistent. Thus, many conference costs were not sufficiently documented, which made them difficult to clearly justify, or identify whether they were accurate, appropriate, necessary, or even reasonably priced. In fact, we questioned about $762,000 as unauthorized, unnecessary, and/or wasteful expenses. Further, we found that eleven VA employees, tasked with conference management responsibilities, improperly accepted gifts from contractors seeking to do business or already doing business with VA. The VA Secretary agreed to take action on our findings and OIG will monitor the Department’s progress on implementing all proposed corrective actions.
Review of Veterans’ Access to Mental Health Care
Review of Veterans’ Access to Mental Health Care
Source: U.S. Department of Veterans Affairs, Office of Inspector General
Congress and the VA Secretary requested the OIG determine how accurately the Veterans Health Administration records wait times for mental health services for both new patients and established patients visits and if the wait time data VA collects is an accurate depiction of the veteran’s ability to access those services. VHA policy requires all first-time patients referred to or requesting mental health services receive an initial evaluation within 24 hours and a more comprehensive diagnostic and treatment planning evaluation within 14 days. The primary goal of the initial 24-hour evaluation is to identify patients with urgent care needs and to trigger hospitalization or the immediate initiation of outpatient care when needed.
One method VHA uses to monitor access to mental health services is to calculate patients’ waiting times by measuring the elapsed days from the desired dates of care to the dates of the treatment appointments. Medical facility schedulers must enter the correct desired dates of care in the system to ensure the accuracy of this measurement. VHA’s goal is to see patients within 14 days of the desired dates of care.
VHA does not have a reliable and accurate method of determining whether they are providing patients timely access to mental health care services. VHA did not provide first-time patients with timely mental health evaluations and existing patients often waited more than 14 days past their desired date of care for their treatment appointment. As a result, performance measures used to report patient’s access to mental health care do not depict the true picture of a patient’s waiting time to see a mental health provider.
The Under Secretary for Health concurred with the OIG’s findings and recommendations and stated VHA is unequivocally committed to providing Veterans the best care possible.
+ Full Report (PDF)
Audit of VHA’s Homeless Providers Grant and Per Diem Program
Audit of VHA’s Homeless Providers Grant and Per Diem Program (PDF)
Source: U.S. Department of Veterans Affairs, Office of Inspector General
We conducted this audit to determine whether community agencies receiving funds from the Grant and Per Diem Program (GPDP) are providing services to homeless veterans as agreed upon in their grant agreements or authorized changes of scope. We also examined whether program funding is effectively aligned with program priorities. We found the VHA GPDP provided services to homeless veterans and had successfully assisted veterans to live independently in safe and affordable permanent housing. However, an incomplete grant application evaluation process; a lack of program safety, security, health, and welfare standards; and an inconsistent monitoring program impacted the program’s effectiveness. As a result, VHA did not ensure homeless veterans consistently received the supportive services agreed to in approved grants. In addition, funding was not effectively aligned with program goals. We recommended strengthening the grant application and evaluation process by publishing policies and standards, updating the inspection checklists, and implementing procedures to ensure grant providers had the capability to deliver services. The Under Secretary for Health concurred with our findings and recommendations and provided appropriate action plans.
+ Full Report (PDF)
America’s Women Veterans: Military Service History and VA Benefit Utilization Statistics
America’s Women Veterans: Military Service History and VA Benefit Utilization Statistics (PDF)
This comprehensive report chronicles the history of women in the military and as Veterans, profiles the characteristics of women Veterans in 2009, illustrates how women Veterans in 2009 utilized some of the major benefits and services offered by the Department of Veterans Affairs (VA), and discusses the future of women Veterans in relation to VA. The goal of this report is to gain an understanding of who our women Veterans are, how their military service affects their post-military lives, and how they can be better served based on these insights.
Message from the Secretary of Veterans Affairs on Veterans Day 2011
Message from the Secretary of Veterans Affairs on Veterans Day 2011
Source: U.S. Department of Veterans Affairs (Eric K. Shinseki)
Generation after generation—from Bunker Hill and Bennington to Baghdad and Abbottabad—protected, defended, and preserved the principles and ideals that define our democracy. Across that remarkable sweep of history, today’s America was shaped at Lexington and Concord, Antietam and Gettysburg, in the skies over Midway, on the beaches of Normandy, in winter’s grip at Chosin Reservoir, in the heat of Ia Drang Valley, from the Persian Gulf into Afghanistan and Iraq by those who wore our Nation’s uniforms. Over twenty-two million living Veterans today embody our exceptional character and values as a people—each a line in our Nation’s history, but together many chapters towards today’s future.
The Department of Veterans Affairs fulfills its obligation to serve Veterans, their families, and survivors of the fallen by living a set of core values defining who we are as an organization: Integrity, Commitment, Advocacy, Respect, and Excellence—I CARE. Veterans trust that we will live these values, every day, in our medical facilities, our benefits offices, and our national cemeteries. And VA is committed to serving them. We are privileged to provide the very best in compassionate and quality care and services, delivered by our more than 300,000 employees.
VA Posts Online List of Ships Associated with Presumptive Agent Orange Exposure
VA Posts Online List of Ships Associated with Presumptive Agent Orange Exposure
Source: U.S. Department of Veterans Affairs
Veterans who served aboard U.S. Navy and Coast Guard ships operating on the waters of Vietnam between January 9, 1962, and May 7, 1975, may be eligible to receive Department of Veterans Affairs (VA) disability compensation for 14 medical conditions associated with presumptive exposure to Agent Orange.
An updated list of U.S. Navy and Coast Guard ships confirmed to have operated on Vietnam’s inland waterways, docked on shore, or had crewmembers sent ashore, has been posted at http://www.publichealth.va.gov/exposures/agentorange/ to assist Vietnam Veterans in determining potential eligibility for compensation benefits.“Posting of the ships list is an important recognition of the sacrifices U.S. Navy and Coast Guard Veterans made for this Nation,” said Secretary of Veterans Affairs Eric K. Shinseki. “It provides an easier path for Veterans who served in Vietnam to get the benefits and services they are entitled to under the law.”
VA presumes herbicide exposure for any Veteran with duty or visitation within the country of Vietnam or on its inland waterways during the Vietnam era. Comprehensive information about the 14 recognized illnesses under VA’s “presumption” rule for Agent Orange is also located on the webpage.In practical terms, Veterans with qualifying Vietnam service who develop a disease associated with Agent Orange exposure need not prove a medical link between their illnesses and their military service. This presumption simplifies and speeds up the application process for benefits.
VA Publishes Social Media Policy
VA Publishes Social Media Policy
Source: U.S. Department of Veterans Affairs
The Department of Veterans Affairs (VA) announced today the release of a policy directive regarding the secure use of Web-based collaboration and social media tools. The policy allows the Department and its employees to leverage emerging platforms that enhance communication, stakeholder outreach, and information exchange as the Department transforms itself into a 21st Century organization attuned to the needs of Veterans of all generations.
“Veterans should have consistent and convenient access to reliable VA information real time using social media —whether on a smartphone or a computer,” said Secretary of Veterans Affairs Eric K. Shinseki. “They also should be able to communicate directly with appropriate VA employees electronically.”
The policy, “VA Directive 6515: Use of Web-Based Collaboration Technologies,” encourages the adoption and use of social media by VA employees. It provides workplace boundaries and establishes the Department’s philosophy for communication: VA is open and transparent, and VA is willing and able to engage and collaborate with its many stakeholders online.
“This isn’t about using social media because it’s cool or because it’s a fad,” said VA Director of Online Communications Brandon Friedman. “It’s about getting the right information to the right Veteran at the right time. This policy sets us on a path toward changing how we talk—and listen—to Vets.”
VA began launching social media sites in 2009 and the Department has over 100 Facebook pages, more than 50 Twitter feeds, two blogs, a YouTube channel, and a Flickr page. VA’s Facebook pages have a combined subscribership of over 293,000 fans—with the Department’s main page reaching over 138,000. On Twitter, VA has a combined followership of over 53,000—with the Department’s main feed reaching over 22,000. VA has posted over 300 videos on YouTube and over 9,000 photos on Flickr, which have been viewed over a combined 1.1 million times. In November 2010, VA launched its first blog, VAntage Point, which distinguishes itself from other government blogs by actively soliciting guest pieces from both employees and the public. By the end of the year, the Department expects to have an active Facebook page and Twitter feed for all 152 VA Medical Centers.
+ VA Directive 6515 (Social Media Policy) (PDF)
+ Directory of VA Social Media Sites
Review of Alleged Unauthorized Access to VA Systems
Review of Alleged Unauthorized Access to VA Systems (PDF)
Source: U.S. Department of Veterans Affairs, Office of Inspector General
The Office of Inspector General evaluated the allegations that certain contractors, without proper security clearances, gained unauthorized access to VA systems and networks and whether VA was providing adequate oversight to ensure the contractor is meeting VA information security requirements. We substantiated the allegations that the contractor did not comply with VA information security policies for accessing mission critical systems and networks. Specifically, contractor personnel: improperly shared user accounts when accessing VA networks and systems; did not readily initiate actions to terminate accounts of separated employees; and did not obtain appropriate security clearances or complete security training for access to VA systems and networks. Also, VA has not implemented oversight to ensure the contractor complies with VA information security policies and procedures, making sensitive data at risk of inappropriate disclosure or misuse. We recommend the Assistant Secretary for Information and Technology monitor contractor user accounts and terminate those for separated employees; ensure contractor personnel are vetted and trained prior to accessing VA systems; request a modification the contract to reflect higher level personnel security requirements; and review the contractor’s current system security controls and practices to ensure compliance with VA requirements. The Department agreed with our findings and recommendations.
Audit of Veteran-Owned and Service Disabled Veteran-Owned Small Business Programs
Audit of Veteran-Owned and Service Disabled Veteran-Owned Small Business Programs (PDF)
Source: U.S. Department of Veterans Affairs, Office of Inspector General
We audited VA’s Veteran-Owned Small Business (VOSB) and Service-Disabled Veteran-Owned Small Business (SDVOSB) programs to assess whether businesses met program and contract eligibility requirements and VA provided effective management oversight. We found that VA awards ineligible businesses at least 1,400 VOSB and SDVOSB contracts valued at $500 million, annually. Moreover, VA will award $2.5 billion to ineligible businesses over the next 5 years if it does not strengthen contracting officer oversight and business verification procedures. Seventy-six percent of the reviewed businesses were ineligible to participate in the programs or to receive the contracts. They received $46.5 million in awards, including $26.7 million in Recovery Act contracts. VA’s FY 2010 socioeconomic goal accomplishment data may also be overstated by 3 to 17 percent due to awards made to ineligible businesses. We recommended VA implement comprehensive program controls to ensure awards are not made to ineligible businesses and improve adherence to Federal and VA regulations. The Under Secretary for Health, the Office of Small and Disadvantaged Business Utilization, and the Office of Acquisition, Logistics, and Construction agreed with our findings. The planned actions are acceptable, and we will follow up on their implementation.
Healthcare Inspection Review of Facility Capabilities Where Veterans Received Complex Surgical Care
Healthcare Inspection Review of Facility Capabilities Where Veterans Received Complex Surgical Care (PDF)
Source: U.S. Department of Veterans Affairs, Office of Inspector General
OIG conducted a retrospective review to characterize where seven complex and intermediate surgical procedures were performed at VHA facilities and at non-VHA facilities through fee basis arrangements prior to VHA’s release of Directive 2010-018, Facility Infrastructure Requirements To Perform Standard, Intermediate, Or Complex Surgical Procedures, on May 6, 2010. We found that VHA facilities had appropriate infrastructure to support surgeries performed. Although some surgeries were performed at VHA facilities with designations of lower complexity than required by the Directive, these surgeries were performed prior to the publication of the Directive, and we identified no adverse patient outcomes clearly attributable to facility infrastructure. We also found that VHA referred complex surgeries to non-VHA facilities with sufficient capabilities to support the surgeries performed. OIG made no recommendations.
