The Results Act: Observations on VA's June 1997 Draft Strategic Plan
(Correspondence, 07/11/97, GAO/HEHS-97-174R).
Pursuant to a congressional request, GAO reviewed the draft strategic
plan submitted by the Department of Veterans Affairs (VA) as required by
the Government Performance and Results Act, focusing on: (1) VA's
compliance with the Results Act's requirements and the draft plan's
overall quality; (2) how well the draft plan addresses VA's statutory
responsibilities; (3) how well the plan identifies crosscutting
functions and plans for coordination with other departments and
agencies; (4) the extent to which the plan addresses major VA management
challenges GAO has identified in its reviews of VA programs; and (5)
VA's capacity to provide reliable performance and cost information to
support its strategic plan.
GAO noted that: (1) GAO found VA's June 9 draft strategic plan to be
incomplete in terms of the elements of a strategic plan as required
under the Results Act; (2) the plan generally lacks a focus on the
results of VA programs; (3) also, the draft plan is somewhat confusing
and difficult to follow, mainly because it has several different levels
of goals, objectives, and strategies; (4) VA officials and congressional
staff have consulted extensively about VA's June 9 draft, and VA
officials have acknowledged that their plan needs improvement; (5) VA
has indicated that it intends to make significant changes to its draft
strategic plan by mid-July to ensure that it is more results oriented
and complete, and less confusing; (6) VA's draft plan represents an
inconsistent and incomplete application of the six key components of a
strategic plan under the Results Act; (7) while VA's draft strategic
plan is generally based on VA's statutory responsibilities, GAO noted
that VA states part of its mission as serving as "principal advocate"
for veterans; (8) the mission is not stated in VA's statutory authority
and may not be an accurate characterization of VA's role under the law;
(9) the plan acknowledges that VA needs to systematically identify areas
where coordination is required; (10) the plan includes a strategic goal
to improve the coordination of veterans' services among multiple
agencies, because some veterans receive services from agencies other
than VA; (11) on the other hand, VA's draft strategic plan either does
not address major management challenges for VA that GAO has previously
identified or address them in little detail; (12) while VA has made
progress in developing the financial and information systems needed to
provide accurate and timely cost and performance data to support its
strategic planning, much work remains to be done; (13) VA's draft plan
reflects VA's need to develop both cost accounting systems and an
information technology infrastructure that will provide the data VA
needs to develop results-oriented goals and objectives, measure
progress, and manage its programs; (14) however, the plan does not
address such issues as correcting internal control weaknesses in VA's
financial systems and developing an information technology framework
based on "best practices" of leading public and private organizations;
(15) strategic planning under the Results Act is a long-term challenge
for federal agencies; and (16) GAO recently reported that, while
agencies are likely to meet the September 30, 1997, deadline for
producing initial strategic plans, these plans will not be as useful for
congressional and agency decision-making as they could have been.
--------------------------- Indexing Terms -----------------------------
REPORTNUM: HEHS-97-174R
TITLE: The Results Act: Observations on VA's June 1997 Draft
Strategic Plan
DATE: 07/11/97
SUBJECT: Strategic planning
Internal controls
Agency missions
Veterans benefits
Program evaluation
Financial management systems
Interagency relations
Intergovernmental relations
Congressional/executive relations
Reporting requirements
IDENTIFIER: VA Decision Support System
VA Activity Based Costing System
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Cover
================================================================ COVER
September 1997
GAO/HEHS-97-174R
VA's Draft Strategic Plan
(105754)
Abbreviations
=============================================================== ABBREV
BOP - Federal Bureau of Prisons
CFO - Chief Financial Officers
DEA - Drug Enforcement Administration
DOJ - Department of Justice
FBI - Federal Bureau of Investigation
GPRA - x
INS - Immigration and Naturalization Service
NPR - National Performance Review
OMB - Office of Management and Budget
VA - x
VBA - x
Letter
=============================================================== LETTER
B-277393
July 11, 1997
The Honorable Richard K. Armey
Majority Leader
House of Representatives
The Honorable John Kasich
Chairman, Committee on the Budget
House of Representatives
The Honorable Dan Burton
Chairman, Committee on Government
Reform and Oversight
House of Representatives
The Honorable Bob Livingston
Chairman, Committee on Appropriations
House of Representatives
Subject: The Results Act: Observations on VA's June 1997 Draft
Strategic Plan
On June 12, 1997, you asked us to review the draft strategic plans
submitted by federal agencies to facilitate the consultations between
the Congress and the agencies required by the Government Performance
and Results Act of 1993 (the Results Act). This letter provides our
observations on the draft plan the Department of Veterans Affairs
(VA) submitted to the Congress on June 9, 1997. Under the Results
Act, VA and other departments and agencies are required to submit
strategic plans by September 30, 1997.
OBJECTIVES, SCOPE, AND
METHODOLOGY
------------------------------------------------------------ Letter :1
On the basis of the guidance provided in your June 12, 1997, letter,
we focused our review of VA's June 9, 1997, draft strategic plan on
-- VA's compliance with the Results Act's requirements and the
draft plan's overall quality,
-- how well the draft plan addresses VA's statutory
responsibilities,
-- how well the draft plan identifies crosscutting functions and
plans for coordination with other departments and agencies,
-- the extent to which the plan addresses major VA management
challenges we have identified in our reviews of VA programs, and
-- VA's capacity to provide reliable performance and cost
information to support its strategic plan.
To evaluate VA's draft plan, we used our May 1997 guidance for
congressional review of strategic plans;\1 Office of Management and
Budget (OMB) guidance on strategic planning (Circular A-11, part 2);
and our numerous reports and testimonies on VA programs and
departmental management. (See Related GAO Products at the end of
this correspondence.) In addition, we have participated in
consultations between VA officials and the staffs of the House and
Senate Committees on Veterans' Affairs. Some of our preliminary
comments on VA's draft strategic plan were discussed at these
meetings.
In passing the Results Act, the Congress anticipated that several
planning cycles might be needed to perfect the process of developing
a strategic plan and that the plan would be continually refined.
Thus, our comments reflect a "snapshot" of the status of the plan at
a particular point. We recognize that developing a strategic plan is
a dynamic process and that VA is continuing to work to revise the
draft with input from OMB, congressional staff, and other
stakeholders.
--------------------
\1 Agencies' Strategic Plans Under GPRA: Key Questions to Facilitate
Congressional Review (GAO/GGD-10.1.16, Version 1, May 1997).
BACKGROUND
------------------------------------------------------------ Letter :2
In fiscal year 1996, VA spent over $38 billion to provide a wide
array of benefits and services to its customers--veterans and their
families. VA's programs are administered by three major components:
-- The Veterans Health Administration (VHA) administers VA's health
care system, including its 173 hospitals.
-- The Veterans Benefits Administration (VBA) administers
nonmedical benefits for veterans, such as compensation for
disabled veterans; Montgomery G.I. Bill educational assistance;
home loan guarantees; vocational rehabilitation and counseling;
and life insurance for veterans.
-- The National Cemetery System (NCS) operates VA's system of
national cemeteries, provides headstones and markers for the
graves of eligible veterans, and provides certificates to the
families of deceased veterans recognizing the veterans' service
to the nation.
VA began its strategic planning process about 2 years ago. VA
established a Strategic Management Group, consisting of senior VA
officials, to develop a departmentwide strategic planning process,
and to coordinate planning among VA's components.
VA incorporated the strategic planning documents of VHA, VBA, and NCS
into its fiscal year 1998 budget, which was submitted to the Congress
in February 1997. NCS and the loan guaranty "business line" in VBA
are Results Act pilot programs.\2
--------------------
\2 The Results Act required OMB to select at least 10 agencies to
pilot the act's performance planning and reporting requirements for
one or more of each agency's major functions, during fiscal years
1994 through 1996. VBA's New York Regional Office also participated
in this pilot phase.
RESULTS IN BRIEF
------------------------------------------------------------ Letter :3
Overall, we found VA's June 9 draft strategic plan to be incomplete
in terms of the elements of a strategic plan as required under the
Results Act. In addition, the plan generally lacks a focus on the
results of VA programs. Also, the draft plan is somewhat confusing
and difficult to follow, mainly because it has several different
levels of goals, objectives, and strategies. VA officials and
congressional staff have consulted extensively about VA's June 9
draft, and VA officials have acknowledged that their plan needs
improvement. VA has indicated that it intends to make significant
changes to its draft strategic plan by mid-July to ensure that it is
more results oriented and complete, and less confusing.
More specifically, we found that VA's draft plan represents an
inconsistent and incomplete application of the six key components of
a strategic plan under the Results Act. One of the six--a
comprehensive agency mission statement--is present. Other elements
are not consistently represented in the plan. For example:
-- Most of VA's goals are focused on the process of providing
benefits and services, but not on the results of VA programs for
veterans and their families, such as assisting veterans in their
readjustment to civilian life.
-- Some major strategic goals are unsupported by objectives and
strategies for achieving them. The draft plan includes
placeholders indicating that these elements will be added later.
The most significant gap is in the discussion of goals and
objectives for most of VBA's programs.
-- Discussions of external factors beyond the control of VA that
could affect achievement of goals are limited and omit some
important external factors, such as trends in the demographics
of the veteran population.
-- VA's draft plan is not based on formal program evaluations.
Although the draft plan includes a schedule of program
evaluations, these evaluations will not be complete for several
years.
While we found that VA's draft strategic plan is generally based on
VA's statutory responsibilities, we noted that VA states part of its
mission as serving as "principal advocate" for veterans. This
mission is not stated in VA's statutory authority and may not be an
accurate characterization of VA's role under the law. VA does not
necessarily speak for all veterans at all times and may on occasion
take positions that veterans may regard as not in their best
interests.
The plan acknowledges that VA needs to systematically identify areas
where coordination is required. The plan includes a strategic goal
to improve the coordination of veterans' services among multiple
agencies, because some veterans receive services from agencies other
than VA. For example, some veterans receive employment training
services from the Department of Labor. Also, VA sometimes relies on
other agencies for the information it needs to administer
programs--for example, military service records from the Department
of Defense (DOD). On the other hand, VA's draft strategic plan
either does not address major management challenges for VA that we
have previously identified or addresses them in little detail.
Examples of such challenges are major delays in resolving
compensation and pension claims, challenges created by the
"year-2000" computer problem, and recent legislation expanding
eligibility for VA medical care and expanding VA's authority to
contract with non-VA providers for medical services.
Finally, while VA has made progress in developing the financial and
information systems needed to provide accurate and timely cost and
performance data to support its strategic planning, much work remains
to be done. VA's draft plan reflects VA's need to develop both cost
accounting systems and an information technology infrastructure that
will provide the data VA needs to develop results-oriented goals and
objectives, measure progress, and manage its programs. However, the
plan does not address such issues as correcting internal control
weaknesses in VA's financial systems and developing an information
technology framework based on "best practices" of leading public and
private organizations.
Strategic planning under the Results Act is a long-term challenge for
federal agencies. We recently reported that, while agencies are
likely to meet the September 30, 1997, deadline for producing initial
strategic plans, these plans will not be as useful for congressional
and agency decision-making as they could have been.\3 This conclusion
applies to VA. The draft strategic plan acknowledges many of its own
deficiencies and recognizes that much work remains to be done before
VA can produce a strategic plan meeting the Results Act's
requirements. VA also recognizes that it will not overcome all of
the deficiencies in its draft strategic plan by the Results Act's
deadline.
--------------------
\3 The Government Performance and Results Act: 1997 Governmentwide
Implementation Will Be Uneven (GAO/GGD-97-109, June 2, 1997).
VA'S DRAFT STRATEGIC PLAN DOES
NOT FULLY ADDRESS KEY RESULTS
ACT ELEMENTS
------------------------------------------------------------ Letter :4
The Results Act requires that agency strategic plans contain the
following key elements: (1) a comprehensive mission statement; (2)
general goals and objectives, including outcome-related goals and
objectives; (3) a description of how the goals and objectives are to
be achieved; (4) a description of how performance goals in annual
agency performance plans will be related to the general goals and
objectives; (5) identification of key external factors that could
affect achievement of the general goals and objectives; and (6) a
description of program evaluations used in establishing or revising
the general goals and objectives, as well as a schedule for future
program evaluations. VA's draft strategic plan contains a
comprehensive mission statement but is deficient in addressing the
other five key elements. For two of the key elements (development of
results-oriented goals and use of program evaluations), the draft
plan contains plans to help correct the deficiencies.
VA'S MISSION STATEMENT
---------------------------------------------------------- Letter :4.1
VA's draft strategic plan contains a basic mission statement,
followed by a more detailed discussion of the purposes of its major
program areas. A mission statement should focus on an agency's
purpose and how it will achieve that purpose. VA's mission statement
does this by stating that part of its mission is to help promote the
health, welfare, and dignity of veterans, in recognition of their
service to the nation. The more detailed discussions of VA's major
program areas support the basic mission statement by describing how
each major program assists veterans and their families. For example,
the plan states that
-- through NCS, VA ensures that veterans' service is honored by
providing dignified burials and lasting memorials, as well as by
maintaining veterans' cemeteries as national shrines, and
-- VBA's educational assistance program has several purposes, such
as assisting service members in readjusting to civilian life;
extending opportunities for higher education to people who might
not otherwise be able to afford it; and aiding in the
recruitment and retention of members of the Armed Forces,
Selected Reserve, and National Guard.
CORPORATE AND STRATEGIC
GOALS, OBJECTIVES, AND
STRATEGIES AND PERFORMANCE
GOALS
---------------------------------------------------------- Letter :4.2
VA's draft strategic plan contains multiple layers of goals, along
with objectives, strategies, and performance goals to support them.
This is a major source of confusion in attempting to evaluate the
plan. Most of the plan's strategic goals are accompanied by
objectives, strategies, and measurable performance goals. However,
some corporate and strategic goals are not explained at all; instead,
the plan states that explanations will be provided at a later date.
Also, most of the plan's goals are oriented toward VA's operations
and processes, rather than toward the results of VA's programs for
veterans and their families. VA officials agree that their goals
need to be more results oriented and focused and told us they intend
to make such changes in their mid-July revision of the draft
strategic plan.
VA's draft strategic plan is organized around two levels of goals:
four corporate goals, which are subdivided into 34 strategic goals.
A complete list of these goals appears in enclosure I. The four
corporate goals are to
-- honor, compensate, and care for veterans in recognition of their
sacrifices for America;
-- provide "One-VA" world class customer service;
-- create and maintain a high performing workforce to serve
veterans; and
-- provide the taxpayer maximum return on investment.
Under the first corporate goal, which reflects program purposes set
forth in various VA statutes, VA lists strategic goals for all of its
major programs. The other three corporate goals are not based on
specific requirements in VA's statutes but reflect the need to
provide quality, efficient service to veterans. In addition, the
last three corporate goals lack a focus on the results of VA programs
for veterans and their families; instead, they focus on VA's
processes for providing benefits and services.
Each corporate goal has up to 10 strategic goals. This additional
layer of goals is one of the factors that makes the plan confusing
and difficult to evaluate. Also, almost all of the strategic goals
are process oriented, rather than results oriented. For example, two
strategic goals are geared toward the implementation of the Results
Act:
-- A strategic goal stating that "VA programs are effective in
meeting the needs of veterans and their beneficiaries" is very
broad. However, the explanation of this goal describes a
process for meeting some of the key requirements of the Results
Act. Under this strategic goal, VA plans to identify the
purpose of each program, establish results-oriented performance
measures, identify the data needed for strategic planning
purposes, and initiate formal program evaluations.
-- The strategic goal to "improve the continuity and coordination
of delivery of veteran services and benefits from multiple
federal agencies" describes VA's intention to establish a
process for identifying overlaps and linkages between VA and
other agencies, enhancing and improving communications links
with other agencies, and improving communications with state
veterans' offices and other state officials.
Wide differences also exist in the scopes of strategic goals. For
example, compare the strategic goal to "improve the overall health
care of veterans" with the strategic goal to "establish an ongoing
process of collecting employee information about the workforce and
integrate priority concerns into the strategic management process."
The former goal is very broad, covering VHA's statutory
responsibility to provide health care to veterans; the latter appears
to be an objective or strategy for achieving a larger strategic goal.
In general, VA's strategic goals are supported by statements of
objectives, strategies to implement the objectives, and performance
goals against which VA's progress in meeting strategic goals can be
measured. However, not all of the strategic goals are supported by
objectives, strategies, and performance goals. The most significant
gap is in the strategic goal to "improve benefit programs." This goal
covers all five of VBA's business lines, but supporting details are
provided for only one business line: loan guaranty. Thus, the plan
lacks any discussion of objectives, strategies, or performance goals
for several major VBA program areas, including compensation and
pension--one of VA's two largest program areas (the other being
medical care). VBA has done strategic planning for these programs,
as reflected in its fiscal year 1998 budget submission. However, VA
is still working to incorporate VBA's strategic planning into the
Department's strategic plan, including the development of
results-oriented goals and objectives. Other gaps in VA's draft
strategic plan are in the strategic goals related to VHA's medical
education and emergency medical back-up functions.
One of the necessary features of a strategic plan is a discussion of
how an agency plans to ensure accountability for achieving strategic
goals. VA's draft plan contains such a discussion, in the form of a
strategic goal to ensure that VA employees are accountable for their
performance in achieving VA's goals. VA's strategy is to establish a
performance management system to emphasize achievement by individual
employees, or groups of employees, of specific organizational goals;
emphasize accountability for outcomes; and promote innovation.
Executive rewards are to be made consistent with this new performance
management system.
Some of the statements of strategies do not address how they will
contribute to achieving strategic goals, or how the strategies will
be implemented. For example, under the strategic goal to "improve
the overall health care of veterans," one of the strategies is to
increase the proportion of VA residents trained in primary care to 50
percent. The strategy does not explain how increasing the proportion
of residents trained in primary care will help improve veterans'
health care, nor does it describe how VA will increase the proportion
of medical residents trained in primary care.
Most of the plan's strategic goals are accompanied by measurable
performance goals. Many of VA's performance goals meet the
definition of an annual performance goal because they have (1) a
performance measure used to track progress in achieving the
performance goal (for example, the average number of days required to
process a claim for educational assistance) and (2) a target level to
be achieved during a given fiscal year (for example, reducing the
average number of days to process an educational assistance claim to
23 days by fiscal year 2002).
The strategic goal to provide "prompt delivery of services and
benefits" is accompanied by 15 measurable performance goals covering
promptness of service for most of VA's major program areas, such as
to
-- provide veterans with decisions on vocational rehabilitation
claims within 60 days, by fiscal year 2002;
-- set headstones and grave markers in national cemeteries within
60 days of interment, by fiscal year 2002; and
-- schedule primary care appointments for VA patients within 7 days
of their contacting VA, by fiscal year 2003.
REFLECTION OF EXTERNAL
FACTORS
---------------------------------------------------------- Letter :4.3
Most of the strategic goals in VA's draft plan are accompanied by
discussions of external factors affecting achievement of the
strategic goal. External factors can be economic, demographic,
social, technological, or environmental. Assessments of such
external factors can be valuable to agencies in setting goals and can
assist the Congress and agencies in determining the likelihood of
achieving strategic goals. Further, such assessments can explain why
agencies did not meet their strategic goals.
In many cases, the draft plan's discussion of external factors
supporting strategic goals is limited to whether the Congress will
appropriate sufficient funds, or make substantive legislative
changes, to allow VA to meet its goals. This is particularly true
for VA's discretionary programs, such as health care and NCS. Also,
discussions omit external factors that are beyond the control of both
VA and the Congress. For example, while the plan includes some data
on demographic trends in the veteran population, it does not explain
how these were used in setting strategic goals, or how they will be
used to measure progress in achieving these goals. Also, larger
trends, such as in the overall workforce and health care system, are
not tied to strategic goals.
One of the major strategic goals of NCS is to ensure that a burial
option is available to all eligible veterans. The plan defines a
burial option as burial in a VA national cemetery or a state
veterans' cemetery within 75 miles of the veteran's place of
residence. NCS' performance goals, in turn, are geared toward
constructing new VA national cemeteries; expanding existing VA
cemeteries; and assisting, through the State Cemetery Grants Program,
the construction of new state veterans' cemeteries. The plan lists
specific VA cemeteries to be constructed or expanded, with specific
target fiscal years for each. The plan's discussion of external
factors consists of a statement that resource constraints could delay
achievement of the plan's performance goals. However, the plan does
not tie the strategic and performance goals to external factors, such
as the mortality rate for veterans and veterans' relative preferences
for VA, state, and private cemeteries, which will affect the need for
additional VA and state cemetery capacity.
The first strategic goal specific to VHA--to improve the overall
health care of veterans--is defined, in part, in terms of increasing
the number of users of VA's health care system. The plan's
discussion of external factors indicates that its objective to
increase VA health care system users is dependent on enactment of
legislation to allow VA to keep reimbursements from third-party
insurers, and to obtain Medicare reimbursements, for some of the
medical care VA provides.\4
However, the plan does not address the effects of major external
factors on future use of VA's health care system, notably, changes in
the overall health care market (such as the trend toward managed care
in the private sector) and veterans' demographics (such as the
decline in numbers and aging of the veteran population). These
factors could potentially limit the increase in health care that VA
is attempting to achieve.
--------------------
\4 In general, VA can collect the costs of providing care not related
to veterans' service-connected disabilities from private insurers but
cannot collect from Medicare. Third-party collections not needed to
cover VA's collection costs are deposited in the Treasury.
PROGRAM EVALUATIONS
---------------------------------------------------------- Letter :4.4
The goals in VA's draft strategic plan are not supported by formal
program evaluations. Program evaluations are objective, formal
assessments of the results, impact, or effects of a program or
policy. Program evaluations can be an important source of
information in helping the Congress and others ensure that agency
goals and strategies are valid and reasonable, providing baselines
for agencies to use in developing performance measures and developing
performance goals, and identifying factors likely to affect agency
performance.
VA's plan acknowledges that VA has not performed such evaluations.
To prepare for evaluations, VA programs are conducting "strategic
program scans." These are general reviews of VA's current programs,
including identification of each program's purpose, outcomes,
existing performance measures, and data needed to measure program
outcomes and impact.
VA's draft strategic plan includes a plan for beginning a formal
evaluation process for its programs. VA's strategy is to identify
and prioritize, in consultation with congressional oversight
committees and stakeholders, programs to be evaluated. VA plans to
establish its prioritization in fiscal year 1998 and begin conducting
evaluations in fiscal year 1999. VA also plans to begin performing
more focused reevaluations of the first programs evaluated, starting
in fiscal year 2001.
OMB guidance suggests that agencies include a schedule for program
evaluations in their strategic plans. These schedules should
communicate the general scope and methodology of evaluations, key
issues to be addressed, and when evaluations will occur. VA's
strategic plan does not contain this information; its schedule is
general, stating that two evaluations will be initiated in fiscal
year 1999, and four will be initiated every fiscal year thereafter
until all VA programs have been evaluated.
KEY STATUTORY RESPONSIBILITIES
ARE ADDRESSED IN VA'S STRATEGIC
PLAN
------------------------------------------------------------ Letter :5
VA's draft plan addresses its major statutory responsibilities and is
generally consistent with them. The mission statement includes a
reference to VA's general authority to administer laws providing
benefits to veterans and their beneficiaries. The basic mission
statement is supported by more specific references to the statutory
authorities for VA's major programs. VA's major statutory
responsibilities are to provide
-- health care (38 U.S.C. 1701);
-- burial services (38 U.S.C. 2400);
-- vocational rehabilitation (38 U.S.C. 3100);
-- educational assistance (38 U.S.C. 3001, 3201, and 3451);
-- compensation for disabilities (38 U.S.C. 1101 and 1301);
-- pensions (38 U.S.C. 1501);
-- insurance (38 U.S.C. 1901); and
-- home loan guarantees (38 U.S.C. 3701).
The mission statement also includes an element that is not dictated
by law. In particular, VA describes part of its basic mission as
serving as the �principal advocate� for veterans and their families
in "ensuring that they receive medical care, benefits, social
support, and lasting memorials promoting the health, welfare, and
dignity of all veterans." This role is not directly linked to
anything in the laws governing VA and may not be an accurate
characterization of its role under the law. A senior VA official
stated that VA has a responsibility to determine whether its programs
are adequate to meet the needs of veterans and, from time to time, to
recommend changes in statutory authority to the Congress. While it
is reasonable for VA to review its programs and recommend changes,
serving as a principal advocate for veterans and their families is
not an accurate description of that role. VA does not necessarily
speak for all veterans at all times and--because of factors such as
its statutory duties, the policies of the executive branch, and the
availability of funds--may on occasion take positions that veterans
may regard as not in their best interests.
VA HAS NOT FULLY IDENTIFIED AND
COORDINATED CROSSCUTTING
FUNCTIONS
------------------------------------------------------------ Letter :6
VA has not clearly identified the areas where its programs overlap
with those of other federal agencies, nor has it coordinated its
strategic planning efforts with those agencies. Instead, one of VA's
strategic goals is to identify areas of overlap and coordinate with
other federal agencies. According to the draft plan, this will
involve (1) identifying programmatic overlaps and linkages with other
federal agencies, (2) enhancing and improving communication links
with other federal agencies, and (3) keeping state directors of
veterans affairs and other state officials apprised of VA benefits
and programs and of opportunities for collaboration and coordination.
In some areas, VA provides benefits and services to veterans that are
similar to those provided by other federal agencies to nonveterans or
exclusively to veterans. Examples of areas where VA needs to
coordinate with other departments and agencies follow.
EMPLOYMENT TRAINING
---------------------------------------------------------- Letter :6.1
We have identified 163 separate employment training programs in the
federal government.\5 VA administers 11 of these programs, including
its largest education program--the Montgomery G.I. Bill--and VA's
vocational rehabilitation program.
--------------------
\5 Multiple Employment Training Programs: Information Crosswalk on
163 Employment Training Programs (GAO/HEHS-95-85FS, Feb. 14, 1995).
SUBSTANCE ABUSE
---------------------------------------------------------- Letter :6.2
In October 1996, we reported that VA was one of 16 federal agencies
providing substance abuse treatment and prevention programs.\6 VA's
focus is on treatment programs for veterans, provided through VHA's
medical centers, outpatient clinics, and domiciliaries. Treatment
services can include diagnostic assessment; detoxification; and
medical, psychiatric, and psychological counseling. VA's draft
strategic plan does not indicate whether VA plans to coordinate with
other agencies providing substance abuse treatment and prevention
services, notably the Departments of Health and Human Services,
Education, and Housing and Urban Development.
--------------------
\6 Drug and Alcohol Abuse: Billions Spent Annually for Treatment and
Prevention Activities (GAO/HEHS-97-12, Oct. 8, 1996).
TELEMEDICINE
---------------------------------------------------------- Letter :6.3
VA is one of nine federal agencies developing telemedicine systems.
Telemedicine, in its broadest sense, refers to the use of
communications technology to help deliver medical care without regard
to the distance separating the participants. VA examples include the
following:
-- The Baltimore VA Medical Center stores X rays and magnetic
resonance images electronically, rather than on film. This
provides better images and allows several users at distant sites
to view them at the same time.
-- The Washington and San Francisco Medical Centers routinely
review, via telephone lines, the status of cardiac pacemakers
worn by VA patients. This reduces the number of unnecessary
operations to replace pacemakers.
-- The Atlanta Medical Center uses its telemedicine system to
provide continuing medical education and training to residents,
including classes conducted by the Centers for Disease Control
and Prevention.
VA participates in the Joint Working Group on Telemedicine (JWGT),
which was established in 1995 to coordinate federal agencies'
telemedicine efforts. We reported in February 1997 that JWGT is
having difficulty developing an inventory of telemedicine programs
and that agencies do not have strategic plans to guide their
telemedicine investments.\7 VA's draft strategic plan addresses VA's
efforts to implement telemedicine systems under the strategic goal of
reducing medical care costs and improving VHA's revenue stream. VA's
main performance goals include developing a telemedicine strategic
plan in fiscal year 1998 and developing and implementing standards
for such projects. The plan does not, however, mention JWGT or any
efforts to coordinate telemedicine development with other
agencies--for example, with the DOD health care system.
Also, VA relies on other agencies for information and must coordinate
with these agencies. VA relies heavily on DOD to provide records of
veterans' military service. For example, VA needs military records
-- as part of the evidence required to determine whether veterans
have service-connected disabilities, which affects veterans'
eligibility and entitlement for many VA programs, including
disability compensation and medical care, and
-- to determine whether veterans and Selected Reserve and National
Guard members meet the military service requirements for
eligibility for Montgomery G.I. Bill educational assistance.
--------------------
\7 Telemedicine: Federal Strategy Is Needed to Guide Investments
(GAO/NSIAD/HEHS-97-67, Feb. 14, 1997).
VA'S STRATEGIC PLAN DOES NOT
ADDRESS SOME MAJOR MANAGEMENT
CHALLENGES
------------------------------------------------------------ Letter :7
Our work at VA has identified a number of major management challenges
that VA faces, some of which are not addressed in VA's draft
strategic plan.
We have reported that VA's vocational rehabilitation program should
be more focused on whether it helps disabled veterans find jobs than
on whether veterans complete the program.\8 As we have noted above,
VA's draft strategic plan is silent on the goals and objectives of
most of its programs, including the vocational rehabilitation
program. A results-oriented goal for this program would focus on
issues such as how well it assisted disabled veterans in overcoming
their employment handicaps to obtain and maintain employment
consistent with their abilities, aptitudes, and interests.
Veterans face major delays in the resolution of their compensation
and pension claims by the time the appeals process has been
completed. VA's draft plan includes a strategic goal to �do it right
the first time.� This strategic goal includes performance goals
related to reducing delays in claims processing, including (1)
providing correct entitlement decisions on claims 97 percent of the
time by fiscal year 2002 and (2) reducing the proportion of veterans'
appeals that are remanded by the Board of Veterans Appeals back to
VBA benefits offices from 43.7 percent to 20 percent by fiscal year
2002. Also, under the strategic goal of �prompt delivery of services
and benefits,� VA has set a performance goal to reduce appeal
processing time by 64 percent (from 1,000 days to 365 days) or more
by fiscal year 2003.
VBA may not be able to make accurate and timely benefit payments to
veterans at the beginning of the year 2000 unless it is able to
reprogram its computers to recognize the next century. Most computer
software in use today is limited to a two-digit date field, such as
"97" for 1997. Thus, this software will not be able to distinguish
between the years 1900 and 2000 because both will be designated "00."
We recently reported and testified that VBA could do more to address
its year-2000 problems and recommended a number of actions VBA should
take to address the serious risks associated with its year-2000
activities.\9
The discussion in VA's draft strategic plan on developing a
departmentwide information technology infrastructure addresses the
year-2000 issue. The plan states that VA's objective is to ensure
that its information systems will provide uninterrupted service to
support VA benefits delivery and medical care in the year 2000. The
plan also includes a performance goal that full implementation and
testing of compliant software (that is, software capable of
processing dates beyond 1999) will be completed by December 1999.
VBA also needs to strengthen its ability to prevent overpayments of
compensation and pension benefits. At the end of 1996, VA's
outstanding overpayments exceeded $500 million. VA has the
capability to prevent millions of dollars in overpayments but has not
done so because it has not focused on this area. VA's draft
strategic plan states that, through efforts within VA and with other
agencies, VA will work to ensure that data used in making decisions
are correct and up to date. Among the decisions that should be
improved with better data are VBA's determinations of compensation
and pension payment amounts. However, the plan does not establish a
strategy or performance goal for reducing overpayments.
VHA faces challenges in implementing the Veterans' Health Care
Eligibility Reform Act of 1996 (P.L. 104-262). This law expanded
eligibility for VA health care services and required VHA to establish
an enrollment system for veterans using VA's health care system.
VHA's challenge is to develop an enrollment system that accurately
reflects the law's priorities. The Eligibility Reform Act also
expanded VHA's authority to procure health care services from other
providers and sell its services to other providers. VHA's challenge
is to determine when it should provide services in its own facilities
and when it should contract for services. VA's draft strategic plan
sets out a performance goal to increase the number of enrolled
veterans that is based on VA's objective to preserve its existing
health care system for all veterans by increasing the number of
veterans using the system. The plan does not address how the
enrollment system will be developed to support its strategic goal of
improving veterans' health care, nor does it address contracting out
care as an option for meeting the health care needs of veterans.
--------------------
\8 Vocational Rehabilitation: VA Continues to Place Few Disabled
Veterans in Jobs (GAO/HEHS-96-155, Sept. 3, 1996).
\9 Veterans Benefits Computer Systems: Risks of VBA's Year-2000
Efforts (GAO/AIMD-97-79, May 30, 1997) and Veterans Benefits Computer
Systems: Uninterrupted Delivery of Benefits Depends on Timely
Correction of Year-2000 Problems (GAO/T-AIMD-97-114, June 26, 1997).
VA'S CAPACITY TO PROVIDE
RELIABLE INFORMATION ON
ACHIEVEMENT OF STRATEGIC GOALS
IS STILL LIMITED
------------------------------------------------------------ Letter :8
In addition to the Results Act, the Congress in recent years has
enacted other legislation designed to help federal agencies meet
their needs for accurate and reliable information to support
executive branch and congressional decision-making.
-- The Chief Financial Officers' (CFO) Act of 1990, as expanded by
the Government Management Reform Act of 1994 and the Federal
Financial Management Improvement Act of 1996, was designed to
improve the timeliness, reliability, usefulness, and consistency
of agencies' financial information and requires, among other
things, cost accounting.
-- The Paperwork Reduction Act of 1995 and the Clinger-Cohen Act of
1996 are intended to improve agencies' ability to use
information technology to support their mission and improve
performance.
VA has begun to implement these acts and has made progress in
financial management and information technology. But VA still has
financial management and information technology issues that it needs
to address before it can be assured that it has the performance and
cost information needed to measure its progress in achieving
results-oriented goals.
VA has established a sound financial management structure, a goal of
the CFO Act of 1990. The Assistant Secretary for Management serves
as VA's Chief Financial Officer, and CFO positions have been
established in VHA, VBA, and NCS. Also, VHA plans to establish a CFO
position in each of its 22 veterans integrated service networks.
Further, VA participated in a pilot for annual accountability reports
beginning with fiscal year 1995. Accountability reports are designed
to consolidate reporting of performance and financial data under
various laws and provide a comprehensive picture of an agency's
program performance and financial condition.
A good financial management system is important to help VA ensure
that it has reliable and timely information on the costs of its
programs. For example, VHA needs accurate and timely information on
its costs for providing medical care in order to determine whether
providing health care in a VA facility is more or less costly than
contracting it out. The installation of its Financial Management
System gives VA, for the first time, an integrated financial
management system. This system has led to improvements in reporting
of receivables and property management, which resulted in the first
issuance by VA's Inspector General of an unqualified opinion on VA's
Statement of Financial Position for the fiscal year ending September
30, 1996.\10
However, the Inspector General identified six areas where VA still
needs to correct internal control weaknesses:
-- continuing efforts are needed to refine property, plant, and
equipment records;
-- continuing action is needed to improve estimates used in valuing
accounts receivable;
-- aggressive efforts are needed to cancel unneeded obligations;
-- continuing progress is needed in correcting problems of the
antiquated VA Life Insurance system;
-- information system security controls need improvement; and
-- the Housing Credit Assistance program financial accounting
process needs strengthening.
In addition, VA's fiscal year 1996 Accountability Report mentioned 12
material weaknesses, reported under the Federal Managers' Financial
Integrity Act (FMFIA), dealing with such issues as compliance with
credit reform requirements, loan sale program management, controls
over prescription drugs, and antiquated computer hardware and
software. The strategic plan does not discuss any planned corrective
actions with regard to the six reportable conditions or the 12 FMFIA
material weaknesses.
VA's draft strategic plan includes a strategic goal to establish an
effective departmentwide cost accounting system. According to the
plan, this system would include two cost accounting systems already
in development: VHA's Decision Support System (DSS) and VBA's
Activity Based Costing (ABC) system.
Using DSS to combine clinical and financial information, VA can
compare the costs of surgery performed by different physicians at
different medical facilities; evaluate patient outcomes; and analyze
ways to increase service quality, reduce costs, and appropriately
price excess services for sale to the private sector or other federal
agencies. We previously reported, however, that some of the clinical
and cost data DSS requires are incomplete, inaccurate, or
inconsistent.\11 VHA plans to achieve universal usage of DSS for its
management and budgeting by fiscal year 2000.
In general, the ABC model involves (1) developing cost information,
(2) identifying specific program activities to be costed, and (3)
allocating costs to the specific activities. The ABC model has been
pilot tested at VBA's St. Louis and Philadelphia Regional Offices to
capture these offices' costs that were attributable to VBA's
educational assistance and insurance business lines, respectively.
Three other pilots were completed in May 1997--at VBA's St. Paul
Debt Management Center; its Benefits Delivery Center and Finance
Office in Hines, Illinois; and VBA's Central Office operations.
The Paperwork Reduction Act of 1995 provides basic guidance to
federal agencies on acquiring and managing information resources.
Based on the concept that information resources should support agency
missions and performance, the act requires that information resources
management plans (1) delineate the resources that are needed and (2)
explain how the agency plans to minimize the paperwork burden on the
public and the cost to the government of collecting information. The
Clinger-Cohen Act of 1996 reinforces this guidance and adds
requirements designed to promote the use of information technology to
better support agencies' missions and performance. This act is
primarily concerned with ensuring that agencies have systems to
prioritize information technology investments.
VBA's information technology efforts have yielded some improvements
in its hardware and software capabilities. Our work on VA's
information technology development, focusing on VBA, identified areas
where improvements are needed before VBA can provide accurate
performance data to support its strategic planning and program
management.
One such problem is the need for VBA to develop credible strategic
business and information resources management plans. VBA has
undertaken several initiatives to improve claims processing
efficiency and reduce its large backlog of unprocessed claims. But
it has done so without an overall business strategy clearly setting
forth how it would achieve its goals. Instead, VBA has used stopgap
measures to deal with its claims processing problems. While these
measures have improved processing times and reduced the claims
backlog, VA needs to find other solutions. VBA plans to use business
process reengineering (BPR) methods to develop new strategic goals
and resource requirements for each of its business lines. Three of
these business lines, including compensation and pension, have begun
BPR projects, but only the compensation and pension BPR project has
progressed sufficiently to produce formal goals and detailed plans.
Another challenge for VBA is to do a better job of managing its
information technology development projects as investments. Our
reviews of VBA's information technology initiatives show that VBA
lacks the critical cost, benefit, and risk information it needs to
determine whether it has made worthwhile investments--a first step in
determining what it needs to meet its information resource management
priorities.\12 For example, VBA's January 1997 information resource
management support plan identified the year-2000 problem discussed
earlier as VBA's top priority, but neither these plans nor VBA's
year-2000 plan adequately discusses the resources required to deal
with the problem. VBA needs to develop the tools needed to follow a
three-phased management approach for selecting, controlling, and
evaluating information technology-related projects. It also needs to
develop a process to rank and prioritize information technology
investments as a consolidated portfolio.
A third challenge for VBA is to improve its software development
capability. Once agencies have identified their top priority
information technology projects, they must be able to determine
whether the projects should be developed in house or contracted out.
Our review of VBA's software development capabilities found that, on
a scale of software development maturity, VBA was in the "least
mature" category.\13 Thus, VBA cannot reliably develop and maintain
high-quality software within existing cost and schedule constraints.
This, in turn, places VBA's information technology modernization
efforts at significant risk. We made several recommendations to the
Secretary of Veterans Affairs. These recommendations and VBA's
responses follow:
-- Obtain expert advice on developing high-quality software. VBA
is working with the Air Force, under an interagency agreement,
to implement this recommendation.
-- Develop a plan to achieve a higher level of software development
maturity. VBA has developed such a plan and has taken other
actions to improve software development maturity.
-- Require that future software development contracts specify that
services be obtained from contractors with at least a level 2
(on a scale of 1 to 5, with 5 being the highest level) rating.
According to VBA, it has awarded a general software contract
that requires contractors to have knowledge of the software
capability evaluation methodology and use it where applicable.
VA's draft strategic plan identifies several actions it will take to
address VA-wide information technology planning, including the
following:
-- Development of a VA-wide Capital Asset Plan and establishment of
a VA Capital Investment Board to generate policies for capital
investments, including investments in information technology,
and review proposed capital investments.
-- Development of a VA-wide information technology strategic plan
and a portfolio of information technology capital investments.
The draft plan's discussion of information technology does not
address VA's need to address its information security weaknesses--an
issue we have identified as high-risk throughout the federal
government.\14 Also, the Paperwork Reduction Act of 1995 and the
Clinger-Cohen Act of 1996 call for agencies to implement a framework
of modern technology management based on the "best practices"
followed by leading private- and public-sector organizations that
have successfully used technology to dramatically improve performance
and meet strategic goals. VA's draft plan does not include these
"best practices."
--------------------
\10 VA has been preparing audited annual financial statements since
fiscal year 1986.
\11 VA Health Care Delivery: Top Management Leadership Critical to
Success of Decision Support System (GAO/AIMD-95-182, Sept. 29,
1995).
\12 VBA Information Technology Investment (GAO/AIMD-97-10R, Oct. 18,
1996).
\13 Software Capability Evaluation: VA's Software Development
Process Is Immature (GAO/AIMD-96-90, June 19, 1996).
\14 Information Management and Technology (GAO/HR-97-9, Feb. 1997).
AGENCY COMMENTS
------------------------------------------------------------ Letter :9
We met with VA officials on July 9, 1997, to discuss their comments
on a draft of this letter. At that time, the Assistant Secretary for
Policy and Planning provided a letter stating VA's general comments
(see enc. II).
VA officials agreed that VA's strategic plan needs to focus more on
results but noted that congressional oversight of VA has focused on
program delivery (such as expanding benefits to more veterans and
increasing benefit amounts) and not, for the most part, on program
outcomes or results.
In addition, VA officials said that VA will continue to place
"appropriate emphasis" on customer service, workforce development,
and management issues. They noted that VA is in the business of
providing services and benefits; thus, they believe that VA's
processes are important to serving its customers. Also, these
officials believe that the Results Act does not preclude focusing on
VA's processes. We agree that process-oriented goals and measures
are important and can support results-oriented goals and measures.
VA officials also believe that our letter should reflect the
"extensive and constructive" consultations that have already taken
place on VA's draft strategic plan. As we have noted, we
participated in the consultations between VA officials and staffs of
the House and Senate Committees on Veterans' Affairs and discussed
many of the observations in this letter at these meetings.
---------------------------------------------------------- Letter :9.1
As arranged with your offices, unless you publicly announce its
contents earlier, we plan no further distribution of this
correspondence until 30 days after its issue date. At that time, we
will send copies to the Minority Leader of the House of
Representatives; the Ranking Minority Members of the House Committees
on Budget, Government Reform and Oversight, and Appropriations; the
Chairmen and Ranking Minority Members of the Senate Committees on
Budget, Government Reform and Oversight, and Appropriations; the
Chairmen and Ranking Minority Members of the House and Senate
Committees on Veterans' Affairs; the Secretary of Veterans Affairs;
and the Director, Office of Management and Budget. We will also send
copies to others on request.
Please contact me on (202) 512-7202 if you have any questions. Greg
Whitney also contributed to this correspondence.
Cynthia M. Fagnoni
Acting Associate Director
Veterans' Affairs and
Military Health Care Issues
Enclosures - 2
CORPORATE AND STRATEGIC GOALS IN
THE DEPARTMENT OF VETERANS
AFFAIRS' DRAFT STRATEGIC PLAN
=========================================================== Appendix I
Corporate goal Strategic goals
---------------------------- --------------------------------------------------
1. Honor, compensate, and 1.1: VA programs are effective in meeting the
care for veterans in needs of veterans and their beneficiaries and
recognition of their contribute to improving the quality of their
sacrifices for America. lives.
1.2: Improve the overall health care of veterans.
1.3: 100 percent of the VA medical research
projects are demonstrably related to the health
care of veterans or to other departmental
missions.
1.4: VA will collaborate with the Department of
Health and Human Services and affiliated medical
schools to regulate the number of physicians
trained to ensure there are a sufficient number in
each subspecialty and avoid creating a surplus in
particular subspecialties.
1.5: Provide back-up medical care for the
Department of Defense in times of emergency.
1.6: Improve benefit programs.
1.7: Ensure that a burial option is available to
all eligible veterans.
1.8: Improve minority veterans' awareness and
utilization of VA programs, services, and
benefits.
1.9: Improve women veterans' utilization of VA
programs, services, and benefits.
1.10: Improve the continuity and coordination of
delivery of veteran services and benefits from
multiple federal agencies.
2. Provide "One-VA" world 2.1: Ease of access: A veteran, beneficiary, or
class customer service. representative will be able and encouraged to
access VA in the fastest possible time; by the
easiest possible means; and, where possible,
receive one-stop assistance.
2.2: Customer satisfaction: Service will meet or
exceed customer expectations.
2.3: Courtesy: Service will be delivered with
respect, dignity, and compassion.
2.4: Do it right the first time: Accurate and
complete benefits and services will be delivered
with zero defects. If it is not done right the
first time, there will be candid acknowledgment of
mistakes and priority assignment to correction of
mistakes.
2.5: Prompt delivery of services and benefits:
Timeliness of service delivery will meet or exceed
customer expectations and will be analyzed against
the best-in-business.
2.6: Effective outreach: Veterans, dependents, and
beneficiaries will know and understand the
available benefits and services.
3. Create and maintain a 3.1: Establish an ongoing process of collecting
high-performing workforce to employee information about the workplace and
serve veterans. integrate priority concerns into the strategic
management process.
3.2: Support VA's ability to create and maintain a
high-performing workforce to serve veterans today
and tomorrow.
3.3: Promote VA's mission to train future health
care providers in service to veterans and all
Americans.
3.4: Ensure that VA's future workforce is well
prepared to carry out its responsibilities.
3.5: Ensure that VA employees are accountable for
their performance.
3.6: Promote efforts to ensure that VA's workforce
reflects the diversity of the customers we serve:
the nation's veterans and their dependents.
3.7: VA's work environment is recognized by
employees as conducive to productivity,
achievement, and fostering respect among all.
3.8: Advance innovative work and employment
practices.
4. Provide the taxpayer 4.1: Establish an effective departmental cost
maximum return on accounting system.
investment.
4.2: Reduce costs and improve the revenue stream
for the health care system.
4.3: Reduce benefit delivery costs and improve
productivity.
4.4: Manage the national cemeteries in the most
efficient and effective manner.
4.5: Develop and implement a departmental Capital
Asset Plan that addresses the construction and
information technology needs of medical
facilities, cemeteries, and veterans' benefits
offices.
4.6: Implement an overarching departmental
information technology infrastructure to integrate
information resources management within the
Department.
4.7: Enhance the departmental Procurement System.
4.8: Ensure that corporate data and information
are timely maintained; accurate; used consistently
throughout VA; and readily available within the
Department, to external stakeholders, and to the
general public, as appropriate.
4.9: Provide fast, efficient, and cost-
competitive delivery of human resource and payroll
services.
4.10: Increase the use of alternate dispute
resolution to conserve time, money, and resources.
--------------------------------------------------------------------------------
Note: Not all of the strategic goals are numbered in VA's draft
plan; we added numbering for ease of identification.
Source: VA draft strategic plan dated June 9, 1997.
(See figure in printed edition.)Enclosure II
COMMENTS FROM THE DEPARTMENT OF
VETERANS AFFAIRS
=========================================================== Appendix I
(See figure in printed edition.)
============================================================ Chapter 0
============================================================ Chapter 1
RELATED GAO PRODUCTS
============================================================ Chapter 2
Veterans Benefits Administration: Focusing on Results in Vocational
Rehabilitation and Education Programs (GAO/T-HEHS-97-148, June 5,
1997).
The Government Performance and Results Act: 1997 Governmentwide
Implementation Will Be Uneven (GAO/GGD-97-109, June 2, 1997).
Veterans Benefits Computer Systems: Risks of VBA's Year-2000 Efforts
(GAO/AIMD-97-79, May 30, 1997).
Veterans' Affairs: Veterans Benefits Administration's Progress and
Challenges in Implementing GPRA (GAO/T-HEHS-97-131, May 14, 1997).
Veterans' Employment and Training Service: Focusing on Program
Results to Improve Agency Performance (GAO/T-HEHS-97-129, May 7,
1997).
Agencies' Strategic Plans Under GPRA: Key Questions to Facilitate
Congressional Review (GAO/GGD-10.1.16, Version 1, May 1997).
Department of Veterans Affairs: Programmatic and Management
Challenges Facing the Department (GAO/T-HEHS-97-97, Mar. 18, 1997).
Managing for Results: Using GPRA to Assist Congressional and
Executive Branch Decisionmaking (GAO/T-GGD-97-43, Feb. 12, 1997).
VA Disability Compensation: Disability Ratings May Not Reflect
Veterans' Economic Losses (GAO/HEHS-97-9, Jan. 7, 1997).
VA Health Care: Improving Veterans' Access Poses Financial and
Mission-Related Challenges (GAO/HEHS-97-7, Oct. 25, 1996).
Vocational Rehabilitation: VA Continues to Place Few Disabled
Veterans in Jobs (GAO/HEHS-96-155, Sept. 3, 1996).
VA Health Care: Opportunities for Service Delivery Efficiencies
Within Existing Resources (GAO/HEHS-96-121, July 25, 1996).
*** End of document. ***