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Open Recommendations

VA Health Care: Office of Rural Health Would Benefit from Improved Communication and Developing Performance Goals
GAO-23-105855
May 04, 2023
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2 Open Recommendations
Agency Affected Recommendation Status
Department of Veterans Affairs The Director of the Office of Rural Health should develop a policy requiring resource centers to communicate their available research funding opportunities across VA. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Director of the Office of Rural Health should develop performance goals that reflect leading practices, such as being objective, measurable, quantifiable, and linked to other strategic plan components. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

VA Health Care: Improved Data, Planning, and Communication Needed for Infrastructure Modernization and Realignment
GAO-23-106001
Mar 20, 2023
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3 Open Recommendations
Agency Affected Recommendation Status
Department of Veterans Affairs The Secretary of Veterans Affairs should develop specific actions that address the data gaps identified by GAO and others and identify time frames for completing such actions to help ensure that future market assessments fully account for the department's key considerations. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Secretary of Veterans Affairs should direct VA's leadership team to develop a formal, documented plan that identifies its structure and an implementation strategy for its efforts to modernize and realign the department's infrastructure to help ensure the efficiency and effectiveness of these efforts. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Secretary of Veterans Affairs should direct its leadership team to finalize its communication approach, such as by developing, documenting, and disseminating how it will increase communication and transparency with internal and external stakeholders, including specifying how and when communication should occur. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Veterans Health Care: VA Actions Needed to Ensure Timely Scheduling of Specialty Care Appointments
GAO-23-105617
Jan 04, 2023
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3 Open Recommendations
1 Priority
Agency Affected Recommendation Status
Department of Veterans Affairs
Priority Rec.
This is a priority recommendation.
The Undersecretary for Health should develop a timeliness standard for the number of days within which veterans' appointments with VHA facility providers should occur. (Recommendation 1)
Open
VA agreed with our recommendation. In February 2023, VA said that it is developing metrics for the timeliness of care that will align with the access standards that the Veterans Health Administration (VHA) has for community care of 20 days for primary care and mental health and 28 days for specialty care. Officials indicated that these metrics will serve as a source of additional information used in VHA's efforts to improve access, but that they do not plan to use them as standards to assess VA medical centers' performance on appointment timeliness. Officials stated that VHA will continue to assess the feasibility of developing a timeliness standard with stakeholders. To implement this recommendation, VHA needs to develop a standard, which could be informed by available data on specialty care appointment timeliness.
Department of Veterans Affairs The Undersecretary of Health should conduct a comprehensive analysis of appointment scheduling data from all VAMCs to determine whether the community care timeliness standards are achievable and revise them as necessary. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Undersecretary of Health should require referring providers and RCT clinical reviewers to complete the role-based Referral Coordination Initiative training that VHA developed and track completion of the training to ensure familiarity with its updated scheduling process for VHA facility and community care appointments. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Veterans Health Care: Staffing Challenges Persist for Fully Integrating Mental Health and Primary Care Services
GAO-23-105372
Dec 15, 2022
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1 Open Recommendations
Agency Affected Recommendation Status
Veterans Health Administration The Under Secretary for Health should ensure that the Office of Mental Health and Suicide Prevention monitors VISNs' development and implementation of corrective action plans for any VHA facilities that do not fully adhere to VHA's Primary Care Mental Health Integration program requirements. (Recommendation 1)
Open
In May 2023, VA stated that cognizant VHA offices are exploring next steps for addressing this recommendation. VA anticipates addressing the recommendation by December 2023.
Veterans Health Administration The Under Secretary for Health should ensure that the Office of Mental Health and Suicide Prevention comprehensively evaluate and implement strategies to help mitigate staffing challenges that affect VHA facilities' abilities to integrate mental health care within primary care settings. (Recommendation 2)
Open – Partially Addressed
VA has taken some steps but has not yet fully implemented our recommendation. In May 2023, VA stated that the Office of Mental Health and Suicide Prevention evaluated its current strategies to help mitigate staffing challenges that affect VHA facilities' abilities to integrate mental health care within primary care settings and established an action plan to consider further implementation of those strategies. In its plan, VHA assessed ten factors based on a review of the Office of Mental Health and Suicide Prevention's current strategies, the strategies documented in our December 2022 report, and other sources. VHA then assessed those factors to determine whether further action should be taken. Of the ten factors in its plan, VHA stated that it had completed an assessment of eight factors and identified a number of strategies with further actions to implement. VHA noted that it is making progress on meeting the plan's objectives and anticipates completing remaining actions outlined in its plan by December 2024.
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