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GAO-16-666R 1 (2016-07-29)

handle is hein.gao/gaobaakcm0001 and id is 1 raw text is: G A U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 July 29, 2016 The Honorable Richard Blumenthal Ranking Member Committee on Veterans' Affairs United States Senate Veterans Health Administration: Personnel Data Show Losses Increased for Clinical Occupations from Fiscal Year 2011 through 2015, Driven by Voluntary Resignations and Retirements Dear Senator Blumenthal: The Department of Veterans Affairs' (VA) Veterans Health Administration (VHA) provided health care to about 6.7 million veterans through its 167 VA medical centers (VAMC) and more than 1,000 outpatient facilities in fiscal year 2015.1 VHA has faced a growing demand by veterans for its health care services, a trend that is expected to continue. For example, the total number of annual outpatient medical appointments VHA provided increased by 17.1 million visits (or about 20 percent) from fiscal year 2011 through 2015. In 2015, VHA had about 195,900 clinical employees in 45 types of occupations.2 To meet the growing demand for care, VHA has implemented a number of targeted hiring initiatives, such as a mental health hiring initiative, which brought on about 5,300 staff nationwide from 2012 to 2013. Despite its hiring efforts, we and others have expressed concerns about VHA's ability to ensure that it has the appropriate clinical workforce to meet the current and future needs of veterans, due to factors such as national shortages and increased competition for clinical employees in hard-to-fill occupations.3 VHA officials also have expressed concern with its own hiring 1Outpatient facilities include community-based outpatient clinics and health care centers. Community-based outpatient clinics are located in areas surrounding VAMCs and provide primary care and some specialty care services that do not require a hospital stay. Health care centers are large multi-specialty outpatient clinics that provide surgical services. 2The 195,000 clinical employees are employed specifically in the VHA occupations covered by 38 U.S.C § 7401-a specific section of law that provides VHA with the authority to hire clinical employees. This number does not include employees of the veteran canteen service, or the VHA central office, health care providers who provided services through contracts, or medical residents or trainees that were intermittently employed or in non-pay status. This number does include some types of trainees, such as interns and post-doctoral fellows. 3See Government Accountability Office (GAO), VA Primary Care: Improved Oversight Needed to Better Ensure Timely Access and Efficient Delivery of Care, GAO-i 6-83 (Washington, D.C.: October 8,2015); VA Mental Health: Clearer Guidance on Access Policies and Wait-Time Data Needed, GAO-1 6-24 (Washington, D.C.: October 28, 2015); VA Health Care: Oversight Improvements Needed for Nurse Recruitment and Retention Initiatives, GAO-15- 794 (Washington, D.C.: September 30, 2015); VA Health Care: Actions Needed to Ensure Adequate and Qualified Nurse Staffing, GAO-1 5-61 (Washington, D.C.: October 16, 2014); VA Office of the Inspector General, Veterans Health Administration: Audit of Physician Staffing Levels for Specialty Care Services, 11-01827-36 (Washington, GAO-16-666R VHA Clinical Employee Retention Page 1

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