VAOIG Report $Millions Mis-Managed, VA Rural Health Program

Specifically, we found ORH did not adequately manage the use of fee funds and the proposal selection process. Additionally, ORH did not monitor project obligations and performance measures. This occurred because of a lack of financial controls, the absence of policies and procedures to ensure staff followed management directives, and inadequate communication with key stakeholders. Also, ORH lacked a project monitoring system, procedures to monitor performance measures, and a process to assess rural health needs. As a result, ORH lacked reasonable assurance that its use of $273.3 million (51 percent) of the $533 million in funding received during FYs 2009 and 2010 improved access and quality of care for veterans residing in rural areas.
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Link to full report here: Audit of the VHA’s Office of Rural Health, Report Number 10-02461-154, 4/29/2011

Audit of the VHA’s Office of Rural Health
Report Number 10-02461-154, 4/29/2011 | Full Report (PDF)

The Office of Inspector General (OIG) conducted this audit to assess whether the Veterans Health Administration’s Office of Rural Health (ORH) effectively planned and managed $533 million allocated to improve access and quality of care for veterans residing in rural areas during FYs 2009 and 2010. The Veterans Health Administration needs to strengthen the management of rural health care funding to ensure that rural health projects meet ORH’s mission of improving access and quality of care for rural veterans. Specifically, we found ORH did not adequately manage the use of fee funds and the proposal selection process. Additionally, ORH did not monitor project obligations and performance measures. This occurred because of a lack of financial controls, the absence of policies and procedures to ensure staff followed management directives, and inadequate communication with key stakeholders. Also, ORH lacked a project monitoring system, procedures to monitor performance measures, and a process to assess rural health needs. As a result, ORH lacked reasonable assurance that its use of $273.3 million (51 percent) of the $533 million in funding received during FYs 2009 and 2010 improved access and quality of care for veterans residing in rural areas. We recommended the Under Secretary for Health implement financial controls, establish management policies and procedures, and implement an effective communication plan. We also recommended the Under Secretary establish a project monitoring system, establish procedures to monitor performance measures, and reassess the FY 2012 budget for ORH to align planned use of resources to their greatest rural health needs. The Under Secretary for Health agreed with our finding and recommendations. We consider these planned actions acceptable, and will follow up on their implementation.”