Recommendation: The Secretary of Defense should ensure that the CMO, with input from the human resources management team, requires that all DOD human resources providers adopt consistent time-to-hire measures, as one process for assessing performance. (Recommendation 2)

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation and noted planned actions. DOD's Human Resources Reform Team has 3 objectives as part of its reform agenda, including civilian hiring improvements. DOD issued its initial plan for business operations reform in April 2019, which includes detailed information and timelines for actions carried out and planned for this reform team. It stated that the team would conduct an annual review of components' time-to-hire plans and work towards establishment of common DOD process and metrics for civilian hiring and establishing baselines and goals for quality metrics through the end of fiscal year 2019. Further, quarterly assessment of survey data using baseline quality metrics is planned to begin in early fiscal year 2020. DOD officials stated that a departmentwide Time-to-Hire Workgroup was established in March 2019 and conducted six workshops to develop a reengineered process map for civilian hiring and an associated implementation plan. Implementation is to occur along with a new IT system for civilian human resources that is expected to be deployed in fiscal year 2021, but we have not received documentation of the specific requirements for implementation.

Recommendation: The Secretary of Defense should ensure that the CMO, through the human resources management reform team, identifies time frames and deliverables for identifying and adopting optimal IT solutions for human resources and fully assessing, identifying, and implementing the most effective and efficient means of human resources service delivery. (Recommendation 3)

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation and noted planned actions. In its written comments, DOD stated the department is on track to achieve substantial savings through its reform team efforts and CMO emphasis on strong management practices, integrated processes, and best value business investments. DOD issued its initial plan for business operations reform in April 2019, which included detailed information regarding the department's plans for reforming its human resources service delivery. Subsequently, DOD identified 3 human resources management IT system reform projects aimed as identifying and adopting optimal IT systems for its overall civilian human resource management, the defense travel program, and overall training and learning. The reform management group has overseen these reform projects. DOD officials stated that it expects these optimal IT systems to be fully operational later in fiscal year 2020 and 2021. Further, DOD has identified timeframes throughout fiscal year 2023 for identifying and implementing an effective and efficient shared service delivery model for human resources. DOD has made considerable progress in identifying optimal IT systems and service delivery model for its human resources services, and we will continue to monitor the assessment and implementation of these systems and delivery models.

Recommendation: The Secretary of Defense should ensure that the CMO, through the human resources management reform team, collects information on the overhead costs charged by all DOD human resources service providers to assist in determining the most effective, economical, and efficient model of human resources service delivery within the department. (Recommendation 4)

Agency: Department of Defense
Status: Open

Comments: DOD concurred with this recommendation and noted planned actions. In its written comments, DOD stated the department is on track to achieve substantial savings through its reform team efforts and CMO emphasis on strong management practices, integrated processes, and best value business investments. DOD issued its initial plan for business operations reform in April 2019, which included detailed information regarding the department's plans for reforming its human resources service delivery. As part of this effort, DOD officials stated that the department has collected data and information on services, performance, and pricing to provide basis for common definitions and standards as they determine the most effective, economical, and efficient model of human resources service delivery. Further, efforts are continuing to develop a standardized costing model for human resources service delivery, which officials estimate will be approved for use by early fiscal year 2021.

Recommendation: The Secretary of Defense should ensure that the CMO routinely and comprehensively monitors and evaluates ongoing efficiency initiatives within the department, including those related to the reform teams. This monitoring should include establishing baselines from which to measure progress, periodically reviewing progress made, and evaluating results. (Recommendation 5)

Agency: Department of Defense
Status: Open
Priority recommendation

Comments: DOD concurred with this recommendation. In April 2019, DOD submitted to Congress its initial plan for business operations reform. It included an initial plan, schedule, and cost estimate for conducting these reforms. The plan states that a reform initiative framework was implemented to track and report progress of initiatives, and that financial savings will be monitored by a validation process. In December 2019, DOD issued a follow-up report providing additional baseline estimates related to the four areas. DOD officials stated that a reform initiative framework has been implemented to track and report progress of initiatives and that financial savings will be monitored by a validation process. The charter for the Reform Management Group, issued February 2019, directs the governance body to reform and align business functions of the department as well as tracking the progress of those reform efforts. Further, DOD reported on baselines in its January 2020 report to Congress to fulfill the requirements of Section 921 from the FY2019 National Defense Authorization Act. As of June 2020, DOD provided a corrective action plan that details plans to further evaluate results and financial savings associated with its efficiency initiatives. We will continue to review DOD's efforts throughout the year to ensure this monitoring and evaluation is occurring.

Recommendation: The Undersecretary for Health should take additional steps to ensure that VA's website reports health care quality measures that cover a broad range of health care services, highlights key differences in the clinical quality of care, and presents this information in an easily accessible and understandable way (Recommendation 1).

Agency: Department of Veterans Affairs
Status: Open

Comments: As of January 2020, VA provided information that they had updated information on its website to include more quality measures, particularly as they relate to outpatient care. While VA has made progress in reporting on additional measures, we reviewed VA's website-specifically, their Access and Quality webpage which is the primary webpage for veterans to access information on quality-as of February 2020 and found that VA has still yet to report on a broad range of quality measures that would assist veterans in making health care decisions for inpatient care. For example, VA does not report any quality measures related to readmissions and mortality; length-of-stay; or efficiency. VA also continues to report only one timely and effective care measure for inpatient care. With regards to presentation of its quality measures, VA no longer links its Access and Quality webpage to the homepage of VA's website, making it more difficult to find. Additionally, for the new outpatient measures that VA has added to its website, VA has not presented these measures in an easily understandable way as there is little explanation of what they are measuring and how veterans can use these measures to make healthcare decisions. We will keep this recommendation open until VA has made further updates to its website.

Recommendation: The Undersecretary for Health should direct VA Central Office to conduct a systematic assessment of the completeness and accuracy of patient clinical information across VAMCs that is used to calculate the health care quality measures VA reports and address any deficiencies that affect the accuracy of these measures (Recommendation 2).

Agency: Department of Veterans Affairs
Status: Open

Comments: As of January 2020, VA has said they have focused on three main efforts as it relates to documenting information on VA quality of care, including: timeliness of access information (e.g., wait times) to health care within VA facilities; timeliness and accuracy of payments to community care providers; and accuracy of coding and documentation within VA and from community providers. In particular, VA has conducted several efforts to improve education and training on clinical documentation and coding, particularly for providers. VA has also said it has made efforts in requiring programs across regional networks aimed at improving clinical documentation and coding. While these efforts can help with improving documentation of care to veterans, it is unclear how VA Central Office has assessed whether these efforts have actually achieved its goals and improved the accuracy of its quality measures. As we stated in our report, VA Central Office has not conducted a systematic assessment of the completeness and accuracy of the clinical data recorded in VA patient medical records across all VAMCs. The results of such a systematic analysis could help identify the deficiencies, if any, in the recording of patient clinical information and what steps, if any, VA Central Office may need to take to address them. We will keep this recommendation open until VA provides information on a systematic assessment of clinical documentation.

Recommendation: FSOC and OFR should clarify responsibility for implementing requirements to monitor threats to financial stability across FSOC and OFR, including FSOC members and member agencies, to better ensure that the monitoring and analysis of the financial system are comprehensive and not unnecessarily duplicative.

Agency: Department of the Treasury: Financial Stability Oversight Council
Status: Open

Comments: In October 2019, Treasury staff said that steps continue to be taken to clarify roles and responsibilities across FSOC and OFR for monitoring threats to financial stability. Treasury staff said that they are working with OFR to reorganize and restructure the organization to better fulfill its mission and support FSOC. That work is still underway and will include additional clarification of roles and responsibilities. In June 2019, the Senate confirmed a new OFR Director. Treasury published a report in response to the President's executive order (13772) on Core Principles for Regulating the United States Financial System that recommended the structure and mission of the Office of Financial Research should be reformed to improve its effectiveness and to ensure greater accountability. We will continue to monitor progress in implementing these steps.

Recommendation: FSOC and OFR should clarify responsibility for implementing requirements to monitor threats to financial stability across FSOC and OFR, including FSOC members and member agencies, to better ensure that the monitoring and analysis of the financial system are comprehensive and not unnecessarily duplicative.

Agency: Department of the Treasury: Financial Stability Oversight Council: Office of Financial Research
Status: Open

Comments: In October 2019 Treasury staff said that steps are being taken to clarify roles and responsibilities across FSOC and OFR for monitoring threats to financial stability. Treasury staff said that they are working with OFR to reorganize and restructure the organization to better fulfill its mission and support FSOC. That work is still underway as staff from both entities meet on a weekly basis and will include additional clarification of roles and responsibilities. The Senate confirmed a new OFR director in June 2019. In June 2017, Treasury published a report in response to the President's executive order (13772) on Core Principles for Regulating the United States Financial System that recommended the structure and mission of the Office of Financial Research should be reformed to improve its effectiveness and to ensure greater accountability. We continue to monitor FSOC and OFR actions that would be responsive to clarifying responsibilities for monitoring threats to financial stability.

Recommendation: To help ensure that Congress is fully apprised of efforts to resolve a case, Congress may wish to consider amending USERRA to require DOJ and OSC to report on additional time taken to resolve a matter after they decline representation.

Agency: Congress
Status: Open

Comments: As of February 4, 2020, this matter has not yet been considered by Congress.

Recommendation: To help ensure that that servicemembers who file complaints are adequately being informed of their USERRA complaint process rights in accordance with VBIA 2008, Congress may wish to consider amending USERRA to require DOL to report on the extent to which it is notifying complainants of their USERRA complaint process rights within 5 days of filing a complaint.

Agency: Congress
Status: Open

Comments: As of February 4, 2020, this matter has not yet been considered by Congress.

Recommendation: To help ensure that DOJ handles state cases as expediently as private employer cases, Congress may wish to consider amending USERRA to specifically require DOJ to adhere to the same 60-day deadline for state employer matters that they must adhere to for matters against private employers.

Agency: Congress
Status: Open

Comments: As of February 4, 2020, this matter has not yet been considered by Congress.

Recommendation: To help ensure that servicemembers in state employer cases are kept apprised of the status of DOJ's decision making without potentially compromising DOJ's ability to successfully bring suit against state employers, Congress may wish to consider amending USERRA to require DOJ to notify these servicemembers of the status of DOJ's efforts.

Agency: Congress
Status: Open

Comments: As of February 4, 2020, this matter has not yet been considered by Congress.