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    Subject Term: "Veterans' long-term care"

    1 publication with a total of 2 open recommendations
    Director: Debra Draper
    Phone: (202) 512-7114

    2 open recommendations
    Recommendation: The Secretary of Veterans Affairs should direct the Under Secretary for Health to conduct an evaluation of the implementation of the VISN realignment to determine whether deficiencies exist that need corrective actions, and apply lessons learned from the evaluation to future organizational structure changes, such as possible changes to VISN staffing models or actions to implement Commission on Care recommendations.

    Agency: Department of Veterans Affairs
    Status: Open

    Comments: VHA concurred with this recommendation and has provided regular updates on its progress in implementing it. In July 2017, VHA told us that a Rapid Design and Implementation functional assessment of VHA Central Office and VISN organizations had been completed, which included a survey, interviews with central office and VISN officials, and other meetings. In November 2017, VHA reported that in October it awarded a contract to conduct an independent assessment of the VISN consolidation experience and to make recommendations for future actions. The independent assessment is expected to be completed in January 2018. VHA also reported in November 2017 that the Rapid Design and Implementation functional assessment process yielded a high-level organizational concept that is being used by teams to develop recommendations for consolidations within VHA, and that these recommendations will be submitted to VHA leadership in January 2018. In our recommendation, we stated that lessons learned from evaluating the VISN realignment need to be applied to future organizational structure changes. It is difficult to determine at this time how lessons learned from the VISN realignment's evaluation can be incorporated into new organizational structure changes if such changes are being drafted for VHA leadership approval at the same time that the evaluation is underway. As of December 2017, this recommendation remains open pending further updates from VHA.
    Recommendation: The Secretary of Veterans Affairs should direct the Under Secretary for Health to develop a process to ensure that organizational structure recommendations resulting from internal and external reviews of VHA are evaluated for implementation. This process should include the documentation of decisions and assigning officials or offices responsibility for ensuring that approved recommendations are implemented.

    Agency: Department of Veterans Affairs
    Status: Open

    Comments: VHA concurred with this recommendation and has provided regular updates on its progress in implementing it. Earlier in 2017, VHA reported that its initial work on this recommendation was paused to allow the Agency to respond to President Trump's Executive Order dated March 13, 2017, on "Comprehensive Plan for Reorganizing the Executive Branch." VHA resumed work on this recommendation once the VA Modernization Initiative evaluated and approved the results of a VHA Rapid Design and Implementation that generated a revised VHA functional chart. In November 2017, VHA reported that the Acting Under Secretary for Health approved a new procedure for documenting and implementing organizational changes on July 12, 2017, and provided a copy. The standard operating procedure contains specific instructions and mechanisms for evaluating, recording, promulgating and implementing proposed organizational changes. VHA further reported that the procedure will be applied to implementing organizational structure changes proposed as part of operationalizing the revised VHA functional chart. VHA anticipated that the first proposal using the new organizational changes procedure will be submitted to senior VHA leadership for approval in January 2018. As of December 2017, this recommendation remains open pending further updates from VHA.