The Veterans Health Administration already had a lot of job vacancies before the pandemic. But the COVID crisis made the vacancies more acute. So VHA went to expedited hiring, with the goal of getting people on board within three days of an offer. That strategy get ’em in, but it does some with risks. For more on the possible downside, the VA’s deputy assistant inspector general Leigh Ann Searight joined Federal Drive with Tom Temin.
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Tom Temin: Ms. Searight, good to have you on.
Leigh Ann Searight: Thank you, Tom.
Tom Temin: So you looked at the expedited hiring as a result of the COVID? Or were you looking at this before this all hit?
Leigh Ann Searight: Actually, I had a team that was doing an audit looking at the Section 505 reporting in relation to the MISSION Act. And while they were doing that work, they came across, you know, the expedited hiring authorities that VHA was implementing, and we were looking at the risks within COVID, you know, cross COVID issues in terms of areas that we could look at in the VHA cohort. And so they identified this as a potential risk. Plus their history and working in human capital brought this to their attention as well, with the personal suitability issues we’ve identified in the past.
Tom Temin: Yes, because they did have a big hiring shortfall. They needed about 40,000 people they didn’t have after the Mission Act was passed, but before the COVID came in.
Leigh Ann Searight: Right. Probably in March 2020, they were showing about 47,000 vacancies within VHA alone.
Tom Temin: Wow. And so what are the risks in expedited hiring? You could hire a criminal I guess.
Leigh Ann Searight: You could. But with expedited hiring really what it allowed them to do is push some of the requirements such as fingerprinting, background investigations, credentialing, and some of the drug testing requirements post hiring, versus pre hiring. So our concern was that you know, specifically with the fingerprinting, the fingerprinting process is important because they pull those fingerprints and then FBI uses that information to do those background checks. And so if you don’t have those fingerprints, then those checks, while you can do a name check, that you know, if you’ve changed your name, or if your name is a little bit unique, or like Tom Jones, right, there’s a lot of Tom Jones, so ensuring that you identify the appropriate Tom Jones and find the appropriate background on those individuals, so things could slide through the cracks.
Tom Temin: And is there any evidence that something might have slipped through the cracks with any employees so far? Do we know?
Leigh Ann Searight: No, we haven’t found any evidence of that. And this management advisory memo really was to highlight the risk to VHA not because we found the problem necessarily, but because we wanted to ensure they’ve remained aware of the problem.
Tom Temin: And one of the other risks that you identified as other deferred onboarding tasks may not be centrally monitored to ensure completion. Translate that for us.
Leigh Ann Searight: So the human resources staff uses a USA Staffing onboarding manager system. And so the guidance was a little unclear to that human resource staff in terms of how to track those tasks. So when we looked at it, the way they were interpreting the guidance is that they wouldn’t annotate any dates of completion of those tasks, until all the tasks were completed. Well, when you’re hiring 50,000 people, it’s really hard to manage, you know, where those tasks are, what’s completed, what’s not completed, if you are annotating those dates appropriately. So as part of our work and highlighting this issue to VHA, they updated their guidance. And so they will track those tasks as they complete them versus waiting until every task is completed for our hiring.
Tom Temin: Yes. And you mentioned as part of that prechecking is the example as tuberculosis, I guess you wouldn’t want to have someone come on and be breathing all over sick patients with tuberculosis. Did the COVID come into that is also something that needs to be screened right away before people are onboarded?
Leigh Ann Searight: I can’t answer that for certain, we did not look at that COVID screening. But I would think, you know, knowing the access points to VHA and whether people had a COVID test or hadn’t had a COVID test before they come into the facility, I would think that would be part of the process.
Tom Temin: We’re speaking with Leigh Ann Searight, she’s deputy assistant inspector general at the Veterans Affairs Department. And what were your recommendations then here?
Leigh Ann Searight: So in a management advisory memo, we don’t make recommendations, we make what we call suggested actions. So like I mentioned earlier, we didn’t actually identify that these things were or were not happening, we just wanted to ensure VHA maintained visibility of those processes as they move through this, you know, with the hiring of 50,000 plus people in a given year. That’s a lot, right? So we wanted them to put more definition into the timeliness of doing the fingerprinting, ensuring that they add more specificity as to when you know kind of what the left and right bounds of that are. And then also as we discussed earlier, the adding the requirements or being more clear in their requirements in terms of traffic those tasks. And with the fingerprints, you know, the longer they wait to do that the more backlog there is on that suitability check. So we wanted to ensure that they were getting that moving into the process.
Tom Temin: And is one of the things they normally do, I guess this is maybe outside the scope of this specific report, but when they hire someone for the medical staff, a physician and MD of some type, do they also check records to make sure there’s no judgments or malpractice or that kind of thing against that particular practitioner?
Leigh Ann Searight: So our report didn’t focus on that fitness of those hires. But VA does have a responsibility to perform those checks before hiring. So those would be tasks that VA would have done in advance of that.
Tom Temin: Got it. So that wouldn’t be part of that three day onboarding process, they would already have vetted the person medically by them.
Leigh Ann Searight: Right. So they would do a preliminary credentialing prior to onboarding them. And then they have 120 days to do the full credentialing when they are on board.
Tom Temin: And by the way, do they still have that 50,000 person gap or have they closed it somewhat with all this expediting and so on?
Leigh Ann Searight: No, they haven’t closed it. I mean, they are hiring, they have hired quite a few people. But you know, VA has an attrition rate as well. So, while they continue to hire, they still pretty much are maintaining the gap that they have. It’s just that they’re hiring the housekeepers, the nurse practitioners, the physicians that they needed to offset those needs within COVID.
Tom Temin: Yeah, it’s hard to fill a bucket when there’s a hole on the bottom, I guess, even for Veterans Affairs and reading this report, it strikes me that although you’re talking in terms of VAs particular situation, the risks of expedited hiring, it seems like this is a report you could almost share with the CIGIE group and the other inspectors general because lots of agencies have had expedited hiring partly because of the pandemic.
Leigh Ann Searight: Right. And a lot of those agencies have the same requirements in terms of background investigations, fingerprinting, credentialing for whatever those requirements might be.
Tom Temin: And does this give rise to any future investigations you might look at just to follow up on on the people they’ve hired and the way they’ve done it?
Leigh Ann Searight: The credentialing and suitability has always been a focus that we’ve looked at within OIG, so I’m sure that we will continue to keep our focus on those areas moving forward.
Tom Temin: Leigh Ann Searight is deputy assistant inspector general at the Veterans Affairs Department. Thanks so much for joining me.
Leigh Ann Searight: Thank you.