At a House Veterans’ Affairs Health Subcommittee hearing in June, representatives were told of continued staffing issues at Department of Veterans Affairs (VA) medical centers and with high-level positions at the VA. Here is an update of what has happened since; click here to see the original story.
WASHINGTON — Oh, what a difference 6 months makes — or not.
Back in June, the House Veterans’ Affairs Health Subcommittee held a hearing to discuss staffing problems at medical centers run by the VA. Witness Max Stier, president and CEO of the Partnership for Public Service, testified that recruiting medical center directors was difficult because “You’re paying medical center directors less than individual physicians in a marketplace where those folks can make four, five, or six times that amount” in the private sector, he said. “[If you] change that… those folks are going to figure out a lot of answers [to the VA’s problems].”
High turnover is another problem, he added. “Over the past 6 years, the VA has seen nearly one-third of its personnel leave.”
In addition, the agency had vacancies at the very top, noted Rep. Julia Brownley (D-Calif.), the subcommittee’s ranking member. “It’s been 16 months since the VA had a permanent undersecretary of health, and no less than nine deputy undersecretary and assistant deputy undersecretary positions are without permanent appointees,” she said.
Since that hearing, not much appears to have happened, Stier said in a phone interview. “It’s certainly the case that the big issues have not been addressed. The medical directors — the 160-to-170 people that are, in my view, the fundamental group in making the health side work right — they are capped out at the pay level that general senior executives across the government can make, despite the fact that they can make up to five times as much in the private sector. My argument is that we ought to have a more market-sensitive system; it may not pay as much as the private sector, but we have to have some reasonable relationship to get the best class of talent willing to stay for a period of time. That has to be fixed.”
Part of the problem with staffing at the VA “is that the human resources (HR) function is overwhelmed and there’s a very high turnover there,” he continued. “One way to make it much better is to create a single [HR] system for the VA, rather than the three that operate today.” Each one of the three systems — which includes a general one for government employees, another one just for medical personnel, and a third one that’s a combination of both — “any one of them is overly complicated, but to have three complicated systems is a nightmare.”
In the partnership’s most recent ranking of best places to work within the federal government, the Veterans Health Administration (VHA) tied with three other government sub-agencies to come in at 199th out of 415 slots. Rankings were determined by surveying employees and asking them how satisfied they were with their job and with their organization, and whether they would recommend their organization as a good place to work.
The full House Veterans’ Affairs Committee has heard a little bit of good news, according to a committee spokesperson. “The most recent information we got about a week or so ago shows the [VHA] is doing better than the industry standard as far as hires and losses and onboarding goes,” she said. “As far as onboarding FTEs, [full-time employees], the VHA has increased in the past year, so the most recent number for fiscal year 2018 is 329,515 [employees], and in 2017 it was 318,320. And from 2013, that’s steadily increased.”
The agency also has increased its number of new hires each year, going from 36,830 in 2017 to 41,913 in 2018, she continued. “The loss rate did decrease a little bit — by only 0.2% — in the last fiscal year, but otherwise it’s been holding steady in the 9.0-9.4% range,” which compares favorably with the 20-30% turnover rate in healthcare generally.
The House will continue looking at the issue when it returns under Democratic leadership in 2019. “It is a top priority for the House Committee on Veterans’ Affairs in this next Congress to work with the VA to quickly fill the more than 40,000 employee vacancies within VHA,” Rep. Mark Takano (D-Calif.), who will chair the full committee, said in an email to MedPage Today. “When jobs are not being filled at the VA, the ones who suffer most are our veterans — through longer wait times, quality of care, and access. As chairman, I will work with my colleagues to help the VA attract the talent it needs to fill these vacancies and ensure that every veteran receives the high quality care that they have earned and rightly deserve.”
The VA did not respond to requests for comment on this story.