Virginia’s health care workforce shortage is widening again after years of progress

The Veterans Health Administration is seeing severe staffing shortages on the rise again after years of making progress on that front.

The Department of Veterans Affairs inspector general in a report released Thursday found that all 139 VHA facilities surveyed this year reported at least one critical shortage of professional staff.

Overall, the VA IG report found 2,622 critical staffing shortages for 285 VHA occupations nationwide.

The total number of current VHA staffing shortages…

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The Veterans Health Administration is seeing severe staffing shortages on the rise again after years of making progress on that front.

The Department of Veterans Affairs inspector general in a report released Thursday found that all 139 VHA facilities surveyed this year reported at least one critical shortage of professional staff.

Overall, the VA IG report found 2,622 critical staffing shortages for 285 VHA occupations nationwide.

The total number of current VHA staffing shortages remains lower than what the agency reported in 2018. But it also marks the first report in recent years in which the VHA did not continue to reduce the total number of occupations with staffing shortages.

“For the first time since reporting at the facility level, there was a net increase in the critical shortage of professional staff, suggesting that it has been more difficult to fill VHA positions,” the report states.

Fiscal year 2022 marks the first report in years that VHA did not continue to reduce the total number of occupations with shortages (Source: VA OIG)

The report found that VHA experienced a 22 percent increase in severe staffing shortages in FY22 compared to the previous year. In 2019, 2020 and 2021, the agency saw a decrease in staff shortages compared to the previous year.

Deputy Health Secretary Steven Lieberman told the IG’s office that the impact of the COVID-19 pandemic on the health care workforce and shortages of doctors and nurses across the labor market “has led to and continues to lead to the health care shortage , as documented by the Bureau of Labor Statistics.”

Virginia has seen record high turnover in its health care workforce since the start of the COVID-19 pandemic. The agency urged Congress to pass legislation that would raise the caps for health care jobs and make permanent some pandemic-era hiring authorities.

The VA is also preparing to transform its workforce and health care facilities in anticipation of legislation that would provide a historic expansion of health care for veterans.

Last month, the Senate passed the Sergeant First Class Heath Robinson Act, which keeps our promise to address pervasive toxics (keeping up with our PACT). The bill is now back in the House of Representatives awaiting the final floor before heading to President Joe Biden’s desk.

Virginia Secretary of State Dennis McDonough told a Virginia Senate committee in June that the PACT Act would give Virginia much-needed authority to set higher pay caps for certain health care positions and that Virginia’s ability to get veterans to care under -quickly is “obviously affected by the tightness of the labor market.”

Critical Demand for Medical Officers, Nurses

VHA continues to face long-standing challenges in retaining sufficient medical staff and nurses.

The report found that 87 percent of facilities had a critical shortage of professional nursing staff, and 91 percent reported a critical shortage of nurses. The VA IG has noted severe shortages in these positions every year since 2014.

This year’s report marks the first in which the IG’s office found more than 90 occupations facing severe shortages.

“FY2022 saw more severe shortages of professional staff from more facilities than in recent financial years. Although VHA has experienced a net increase in board staffing levels for certain occupations, there continues to be a severe shortage of professional staff. The OIG recognizes that the COVID-19 pandemic has impacted VHA’s delivery of health care and their staffing needs,” the report states.

The Grand Junction VA Medical Center in Colorado and the Palo Alto VA Medical Center in California reported 89 staffing shortages in this year’s report — the most shortages reported by any VA facility.

The report found seven occupations that remained in the top 10 most frequently reported severe shortages annually: police, psychiatry, primary care, practical nurse, general engineering psychology and medical technologist.

However, the IG found that VHA as a whole has seen a net increase in staffing levels for each of these seven occupations each year since FY 2017.

“Therefore, although these occupations have been identified as having severe professional staff shortages, VHA is increasing the number of staff in these occupations,” the report states.

The IG also identified five occupations that saw the largest increase in facilities reporting severe shortages between FY 2022 and FY 2021. These include custodial workers, practical nurses, nursing assistants, nursing assistants and registered nurses sisters.

“OIG believes this comparison gives VHA insight into which occupations may benefit from additional workforce planning strategies,” the report states.

The IG found that 63% of VA facilities reported severe shortages of medical care assistants, the more critical staffing shortage among Title 38 occupations VHA is able to non-competitively select individuals using direct hire authority for Title 38 positions .

The VA IG’s office, under the Employment Choices and Quality Act of 2017, is required to identify staffing shortages in the agency’s clinical and nonclinical positions.

Senators press VA, OPM for timeline for new federal occupational series

Meanwhile, the VA faces a 23 percent vacancy rate for licensed professional mental health counselors (LPMHCs) as well as marriage and family therapists (MFTs).

Virginia Senate Committee Chairman John Tester (D-Mont.) and Ranking Member Jerry Moran (R-Kan.) are seeking an update from the VA and the Office of Personnel Management on steps to bring in more of these personnel.

The senators, in a letter to Virginia Secretary Dennis McDonough and OPM Director Kiran Ahuja, are seeking an update under the John Scott Hannon Veterans Mental Health Improvement Act of 2020, which requires agencies to create a new federal occupational series for these professionals .

“Establishing a professional series for LPMHCs and MFTs is integral to ensuring the streamlined hiring of these mental health professionals and the delivery of timely mental health care to Veterans. The lack of a professional streak for these two positions may add difficulty to the hiring process for human resources staff trying to fill open positions and candidates researching and applying for positions in Virginia,” the senators wrote.

VA officials briefed lawmakers on implementation of the Hannon Act last November. Tester and Moran said OPM last October agreed to create an Integrated Project Team (IPT) to create a professional series for LPMHC and MFT.

“That briefing did not provide a timetable on the IPT’s course of action and now, almost seven months later, we have not received an update on the IPT’s performance or a forecast for completion of the professional series for LPMHC and MFT. This is also troubling given that we have been asking VA and OPM since 2017 to establish a professional series for these mental health professionals,” the senators wrote.

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