OIG Determination of VHA Occupational Staffing Shortages

OIG conducted its third determination of Veterans Health Administration (VHA) occupations with the largest staffing shortages as required by Section 301 of the Veterans Access, Choice, and Accountability Act of 2014. We analyzed VHA facility rankings of critical occupations, to interpret “largest staffing shortages.” This is a broader deliberation than simply the number needed to replace or backfill vacant positions. We performed a rules-based analysis on VHA data to identify these occupations, analyzed data on gains and losses for occupations with the largest staffing shortages, and assessed VHA’s progress with implementing staffing models. We determined that the largest critical need occupations were Medical Officer, Nurse, Psychologist, Physician Assistant, Physical Therapist, and Medical Technologist. Because of a tie for 5th place, we had six occupations in our determination. Our analysis of the staffing gains and losses for the first full year after implementation of the Veterans Access, Choice, and Accountability Act of 2014 shows that for critical need occupations, a significant percentage of the total gains continues to be offset by staff losses. We also determined that the percentage of regrettable losses to total onboard staff in many critical need occupations was high relative to net increases in onboard staff. While VHA has made progress in developing and implementing staffing models, we did not identify a plan that included a set of milestones and timelines for further staffing model development to achieve full implementation. VHA has a draft report on staffing models which is pending presentation to senior leadership. We made four recommendations, two of which are repeat recommendations.