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Sunday, June 01, 2014

A VETERAN CONNECTS THE DOTS IN THE MILITARY AND VETERANS HEALTH CARE SYSTEMS MAZE


The Massive backlog recently highlighted in the press and in Congress  reveals a dire necessity for simplification, communication and  efficiency in processes, systems and government service contracting in DOD and the Veterans Administration as well as better management of federal government contractors. 

The news media, the auditors and the average American are pointing the finger at the President and the Head of the VA.  One cannot ignore the accountability aspects of these individuals.  

However, the real root causes lie in the massive volume of war veterans returning from our pointless incursions in the Middle East over the last decade, coupled with the historically poor process and systems work conducted between the Department of Defense and the VA and poorly managed military contractors taking home millions on systems specifications that change like the wind blows.  

It is not unlike the Obama Care fiasco.

After returning from two combat tours in Vietnam, I worked in the government contracting environment for 36 years then went through the VA system as a Veteran getting treatment at retirement in 2006

In 2006 I found the VA had a magnificent system capable of handling medical records and treatment anywhere in the world once a veteran was in the system; a key point.  Please contrast the below Time Magazine Story with current events and ask yourself : Why have we had such deterioration?  

http://content.time.com/time/magazine/article/0,9171,1376238,00.html

ANSWER:   We have not experienced deterioration - within the VA itself, except  from pressures due to millions returning from war and from human beings who look for excuses when systems fail.

We have had 10 years of Middle East incursions, a sudden discharge of veterans and poor systems management from the DOD to the VA, from the systems contractors to the state veterans homes.  

Veterans fall through the cracks as a result.

 This is an F-35 aircraft, cost plus scenario, revisited in the form of veterans care systems mismanagement and it will cost billions to fix.  THAT IS THE COST OF WAR.

Unlike the F-35 we must have veterans health care or our volunteer army will disappear.

THE TOTAL SPECTRUM MUST BE VIEWED TO MANAGE THE ISSUES. 


BACKGROUND

A recent 3 part special in Time Magazine addresses the serious gaps between treatment,  benefits and services processes and systems between the military  services and the Veterans Administration:
"While awaiting  processing, "the veteran’s claim sits stagnant for up to 175 days as VA  awaits transfer of complete (service treatment records) from DoD,":

After years of work to move toward integrated electronic records that would eliminate this sort of delay, Defense Secretary Chuck Hagel recently  conceded that the Defense Department is not holding up its end of the bargain to improve the disability process.

"I didn’t think, we knew what the hell we were doing.":
 

http://www.federalnewsradio.com/394/3288748/Hagel-orders-DoD-to-restructure-path-toward-integrated-health-record 
 

HISTORICAL SIMILARITIES

The above scenario is not unlike the Walter Reed Army Hospital care  fiasco a few years ago, before the facility was shut down and consolidated with the Bethesda Naval facility.

OTHER SYMPTOMS

The VA decided to have those who would  actually use the system (claims processors) work with software  developers. This process took longer but will create a system more  likely to meet the needs of those who actually use it. VA also worked  closely with major Congressional-chartered veterans’ service  organizations.

2013 was the year in which regional offices were to be being transitioned to the new electronic system.  It obviously has not occurred as planned.


ROOT CAUSE

Both DOD and the Veterans  Administration use service contractors to perform this type of systems development.  Government Computer News (GCN)  carried a story on the  difficulties experienced with, "Performance-Based Contracting", which  has been made part of the Federal Acquisition Regulation (FAR) in an  attempt to pre-establish at contract award those discrete outcomes that determine if and when a contractor will be paid.


http://gcn.com/articles/2006/12/01/performancebased-contracting-still-baffles-agencies.aspx 

Interestingly enough, the article splits the blame for the difficulties  right down the middle, stating the government typically has problems  defining what it wants as an end product or outcome and looks to  contractors to define it for them. More than willing to do so, the contractors detail specific end products or outcomes, set schedule  milestones and submit competitive proposals.

The winner is selected based on what the government thinks it needs at  the time to fulfill its requirement and a contract is negotiated. Once underway, the government decides it wants something else (usually a  management-by-government committee phenomena with a contractor growing  his product or service by offering lots of options). The resulting  change of contract scope invalidates the original price and schedule, so  a whole new round of proposals and negotiations must occur with the  winner while the losers watch something totally different evolve than  that for which they competed. The clock keeps ticking and the winner  keeps getting his monthly bill paid based on incurred cost or progress  payments.


CONCLUSION

The present state of the economy and the needs of our servicemen will not allow the aforementioned to  continue. Government agencies are now hard pressed to insure the most  "Bang for the Buck". It is in the long term interests of the politician, the DOD, the VA and astute contractors to assist in that endeavor. 


(1)The only way to achieve such an objective is through sound technical, cost and schedule contract definition via an iterative process of baseline management and control.

http://www.smalltofeds.com/2009/08/contract-baseline-management-in-small.html

(2)  Government civil servants must be trained to report systemic poor service up the line in lieu of hiding bad news from superiors or developing workarounds.  This must be an expectation built into their job description and they must be rewarded and promoted for meeting that requirement just as they are for the other requirements of their jobs. 

The first whistle to be blown must be to the boss when the service issue occurs, not to the press a year from the occurrence. 

Our returning soldiers and those who have served before deserve better"





2 comments:

Steve Mattison ABR e-Pro said...

Really pitiful how our heroes get treated after they serve. Hasn't changed much in the 40 some years I have been a vet.

Remo Pollastri said...

The system certainly seems to need major streamlining. Treatment of returning servicemen is unacceptable.