VA struggles to fill hospital jobs; it has 49,000 openings across the country
By JOE DAVIDSON | The Washington Post | Published: November 5, 2019
WASHINGTON — Three numbers indicate just how bad staffing shortages are at the Department of Veterans Affairs — even as the problem in some ways is getting better.
The number of vacant positions across the department: 49,000.
"That is an astounding number," said Rep. Mark Takano, D-Calif., chairman of the House Veterans' Affairs Committee.
The percentage of VA facilities that reported at least one "severe occupational shortage," according to a report by the department's Office of Inspector General: 96.
The decline in severe staffing shortages from 2018 to 2019: 12%. That's good news from the inspector general's survey of all 140 facilities, but it highlights just how bad staffing is at VA.
Staffing shortages amid the 386,000 VA employees are "a root cause for many of the problems in veterans' care," said Inspector General Michael Missal.
There are two main reasons for the shortages — low salaries and a lack of qualified applicants, with the former leading to the latter.
Consider this item from the report: VA "medical center directors make approximately 25% of a private sector hospital chief executive officer salary yet have a greater scope of responsibility." Top pay for a VA medical center director is $201,900.
And this from Daniel Sitterly, a VA assistant secretary: Highly specialized surgeons in San Francisco earn about $800,000, while VA can only pay about half that, tops.
Because the law caps how much federal employees can be paid, "this leaves federal agencies at a disadvantage when competing for talented employees," he said in a statement.
Highly skilled individuals work for the federal government when they could make more elsewhere because of their public service drive and the sense of purpose their agencies provide. VA attracts many employees, including a high percentage of veterans, who appreciate that role and the sacrifice those in uniform have displayed for the nation.
But that only goes so far.
"While VA has employees and applicants who are willing to accept a lower salary to be part of an organization with such an important mission," Sitterly said, VA "faces increasing challenges in its ability to attract or retain quality health care professionals when the salary gap continues to increase."
Money isn't the only problem. Punitive, political policies also play a role.
After the 2014 scandal over the coverup of long patient wait times for veterans' medical care, Congress weakened civil service protections for VA senior executives.
Then in 2017, "the VA Accountability and Whistleblower Protection Act made medical center director positions unappealing, leaving current directors feeling vulnerable and disincentivizing applicants," the report said. "Medical center directors recognized the potential of being removed without appeal."
The congressional action "undoubtedly had a negative effect" on VA recruitment and retention, said Jason Briefel, executive director of the Senior Executives Association. Who would want to work at a place where "you had a target on your back from day one," he asked.
That fuels turnover at the top of VA hospitals. About one-third of VA facilities, the inspectors reported, "annually experienced at least one change in medical center directors."
This led one director to tell inspectors that long-term vacancies in the top slot can result in "a workforce that feels abandoned and that nobody cares enough for them to get stable leadership."
Among other indications of VA staffing shortages, the inspector general found:
— About 39% of the 140 facilities had severe shortages in at least 20 occupations.
— Psychiatry was identified by 85 facilities, more than any other, as a specialty with severe shortages.
— Human resource management was second, cited by 72 facilities.
— Medical officers and nursing shortages were commonly cited across the system.
— Twenty-seven occupations have severe shortages in at least 20% of the facilities.
Despite these difficulties, Sitterly said VA's overall workforce has grown by 2% to 5% annually over the last five years.
That's not good enough for Takano.
"We need to know what actions VA is taking to address long-standing staffing challenges and the extent to which VA has made full use of numerous new [hiring] authorities Congress has authorized in recent years.," he said. " . . . We need to understand why VA is struggling to use this and other tools Congress has provided."
Sitterly said his department is now developing a comprehensive legislative package to help recruit and retain the talent it requires to serve veterans.
VA "needs the ability to offer competitive salaries to recruit and retain employees in various occupations that have much higher rates of pay in the private sector," he said, "particularly in larger cities and rural areas."