A Hiring Initiative to Expand Substance Use Disorder Treatment Needed Stronger Coordination, Planning, and Oversight

In fiscal year (FY) 2022, the Veterans Health Administration (VHA) launched a multiyear hiring initiative to expand veterans’ access to substance use disorder treatment. The VA Office of Inspector General (OIG) conducted this review to assess how well medical centers met the FY 2022 goal of hiring for 90 percent of the approved positions for the initiative. The OIG found that medical centers only hired about 26 percent of approved staff by the end of FY 2022 and spent approximately $8 million of the $96 million available in specific purpose funds for medical centers to hire behavioral health staff. In addition to external factors, the medical centers failed to meet this goal because VHA did not clearly communicate hiring priorities, define and assign responsibilities for implementation and oversight, and generally ensure accountability for achieving the initiative’s goals. The OIG also examined FY 2023 hiring and determined the initiative’s challenges persisted. By the end of FY 2023, medical centers only hired a two-year total of 837 people (65 percent rather than the 90-percent goal established for the first year) and spent $97 million of the two-year total of $267 million in specific purpose funds for the initiative. The remaining funds were spent on other nonhiring substance use disorder purposes, retained by medical centers for other unspecified purposes, or were returned to the finance office. VHA concurred with the OIG’s three recommendations to ensure the $14 million in funds retained by medical centers for other purposes have been properly spent, and to take other corrective actions to address the deficiencies identified in the report.