The Veterans Affairs Departments long-term strategic planning and budgeting need improvement, the Government Accountability Office said in a new report. In fiscal 2007, the VA spent about $4.1 billion, or about 12% of its total healthcare spending, on long-term care for veterans, which it provides through institutional care in nursing homes and noninstitutional care in veterans homes and communities. But according to a letter from the GAO to Rep. Bob Filner (D-Calif.), chairman of the House Committee on Veterans Affairs, the departments long-term planning methods have been scrutinized by Congress and others.
VAs long-term strategic planning needs improvement: GAO
The increased scrutiny has occurred, in part, because, as we have reported, VA underestimated its long-term-care spending for fiscal years 2005 and 2006 due to unrealistic assumptions and projections, the letter said. The underestimation was a key factor that led to the president requesting additional funding during those years.
GAO also said that the VAs 2007 long-term strategic plan reported expected increases for some of its long-term-care workload, but that the workload information the VA provided for both nursing home and noninstitutional care was incomplete. In addition, in its budget justification for 2009, the VA may have underestimated its nursing-home spending because it assumed nursing home costs would increase about 2.5%, an amount that appears unrealistically low compared to VAs recent experience and other indicators.
Currently, the VA is developing its next long-term strategic plan. The GAO said the department should include three types of workload information in that new projection: planned total nursing home workload, including care provided to veterans on a discretionary basis; estimated demand for noninstitutional services and the departments timeframe for meeting that demand; and a comparison of planned noninstitutional workload with recent noninstitutional workload to show the effect of the expected change. The VA did not comment on the recommendations, but said it will provide an action plan in response to the final report, the GAO report said.
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