THE VA - AN UPDATE BY A SERVICE VETERAN ON DEPARTMENT PROGRESS AND PROCLIVITIES

                                                                        Records Backlog at a VA Center

HISTORY

In September of 2012 this site published an article on the VA and its efforts to improve services to veterans as well as support small business. It was noted from personal experience that excellent care was being received by those in the system but that there was a growing backlog of cases and lack of an effective process to support getting a faster rate of entrance by those returning from the battlefield. 

 

Also noted were disturbing trends in outlandishly expensive conferences and ridiculous video productions, wasting funds earmarked for veteran care. Red flags were going up in the Inspector General office regarding mismanagement of small business set aside programs as well. 

2012 Article on the Veterans Administration Services

UPDATE 

 

Much as occurred since September of 2012. 

 

Last month (January 2015) I visited the VA in Minneapolis for a blood analysis in connection with my annual physical. I marveled at the hundreds of personnel who were going through the blood draw process at 8AM that morning. Polite technicians handled everyone carefully and courteously. My test results were on my doctor's computer for my 11 AM appointment that day.

 

In 2012 I used the VA hospital courtesy center computers for veterans, finding them hopelessly out of date, security-bound and barely functioning. During my January 2015 visit I found beautifully functioning high speed computers and a courteous attendant serving many veterans at the the center

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On my most recent visit I also went to the department that handles I.D. Cards and applied for a new one, having been informed my card was out of date. I was attended by a sharp technician who checked my credentials, transferred by data, took my picture and processed my application inside of 20 minutes and I was behind several others. 

 

We who are in the system are still receiving fine service. 

 

But the massive number of returning veterans has strained the VA Health Care System to the point where the Department Secretary has been fired. A corporate executive from outside the system has been placed in charge. The department has been massively reorganized into 5 regions across the country to deal with a scandalous scenario of wait times and neglect in services for incoming veterans. 

When All Else Fails - Reorganize 

 

We forecast the above situation.  It is principally due to the fact that the 5 armed forces medical records systems are not connected to the VA Health Care System and the government contractors who have attempted to develop a system to connect them have failed miserably. 

"Next Gov"

" Defense and VA Scrap New Electronic Health Record after estimated costs ballooned to $28 billion. By Congress’ count, the doomed effort – a result of the 2008 Defense Authorization Act – already cost taxpayers more than $1 billion. "
 

A Veteran Connects the Dots

THE FUTURE

Congress is focusing on firing personnel as a remedy. In our view that is symptom-like remedy, not a solution. 

Recent VA Firings 

 

We now have a corporate bureaucrat in charge of the department who is running it like a corporation, reorganizing and establishing a 5-headed bureau under him. There will no doubt be 5 separate fiefdoms to manage. Who knows what will happen to requirements for IT as existing IT system designs get split 5 ways? 

Government contracting services companies are continuing to have a field day, growing rich and failing in the classic fashion we saw with the Obama Care roll out.  Success is not a money-making proposition for these firms.  They get their monthly bills paid as they march hundreds of service workers into government buildings to catch the latest whim of the civil service program managers as they change specifications depending on which way the wind is blowing in the massive bureaucracy.

We believe those who are lucky enough to have entered the system will continue to receive good care. 

We pity those younger or seasoned injured and ill who are knocking on the door and waiting to get in.

A Failing Veterans Health Care Handoff

ISSUE

Massive backlog reveals the dire necessity for simplification, communication and efficiency in processes, systems and government service contracting in DOD and the Veterans Administration. 

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:

http://nation.time.com/2013/04/22/what-the-hell-is-going-on-with-va/#ixzz2RnspoSM4

"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,":


http://veterans.house.gov/sites/republicans.veterans.house.gov/files/2013%2004%2016%20HVAC%20to%20Sec%20Hagel.pdf

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 congressionally-chartered veterans’ service organizations.

This year, 2013, is the year in which regional offices are being transitioned to the new electronic system.

ROOT CAUSE

Both the services 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.

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. The link to the GCN article is below:

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

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 astute contractors to assist in that endeavor. 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.

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