The Department of Veterans Affairs (VA) Community Care program is designed to offer eligible veterans the option to receive healthcare services from community providers instead of VA medical facilities. This program has experienced significant expansion in recent years, representing almost 40 percent of the VA’s total contract obligations in fiscal year 2023. Managing contracts for this program is complex, with oversight responsibilities distributed across various sections within the Office of Integrated Veteran Care (IVC). Established in 2022, IVC is still in the process of refining certain roles, including those of Contracting Officer’s Representatives (CORs), who are crucial for keeping contracting officers informed and offering technical guidance to contractors.
Community Care Obligations between Fiscal Years 2018 and 2023 (in billions)
While the VA Community Care program aims to provide timely and accessible healthcare to veterans, the Government Accountability Office (GAO) has identified areas needing improvement, particularly in contract oversight. A key finding is the lack of comprehensive documentation to guide this oversight. The IVC has developed desk procedures, but these are limited to specific administrative tasks and are not complete. For instance, these procedures do not detail how to evaluate contract performance when data is incomplete or unreliable. This gap can impede CORs in effectively monitoring contracts and ensuring veterans receive the quality care they deserve.
Another challenge highlighted by the GAO is the elimination of a program manager position that was initially part of the contract oversight framework. Although VA officials have mentioned alternative processes to cover some of the program manager’s duties, there has been no formal assessment to confirm if these processes adequately fulfill all necessary functions. Furthermore, VA has not updated its oversight plans to reflect these changes, potentially increasing risks in contract management.
The VA is currently working on setting up the next set of contracts for the Community Care program. To avoid repeating past challenges, the GAO emphasizes the importance of establishing a formal system for documenting lessons learned from current contracting efforts. Without a structured approach to collect, analyze, and validate these lessons, the VA risks encountering similar contract oversight issues in the future, potentially affecting the program’s efficiency and the quality of care received by veterans.
In conclusion, the VA Community Care Program is a vital service for veterans, offering access to community-based healthcare. However, effective contract oversight is essential to ensure the program operates efficiently and delivers high-quality care. Addressing the identified gaps in guidance, roles, and lessons learned processes will be crucial for the VA to optimize the Community Care Program and best serve the needs of veterans.
