Open Recommendations

We recommend the Vice President, Power Operations, take steps to conduct all inspections and testing of fire-protection subsystems as required.

We recommend the Vice President, Power Operations, take steps to resolve fire-protection system issues in a timely manner.

We recommend the Vice President, Power Operations, take steps to assign a priority level to each impairment as required by Power Operations Standard Programs and Processes 18.119.

We recommend the Vice President, Power Operations, take steps to emphasize the importance of including all impairment information in the Fire Impairment Database.

We recommend the Vice President, Power Operations, take steps to review the differences between Power Operations Standard Programs and Processes 18.121 and the site-specific job plans and make changes as necessary to clarify the requirements.

The under secretary for benefits ensure all erroneous scenarios in the Veterans Benefits Management System for Rating special monthly compensation calculator identified in this review are corrected and certify the results to the VA Office of Inspector General.

The under secretary for benefits establish a plan to conduct additional testing of the Veterans Benefits Management System for Rating special monthly compensation calculator to ensure its accuracy.

Develop and provide training on updated Fiduciary Program Manual procedures on flagging barred individuals or entities as Do Not Appoint and include a mechanism to ensure that fiduciary hub staff have taken and understand the training.

Finalize and approve procedures and standards included in the Draft COVID EIDL Servicing Manual.

Publish and communicate written overall CESC performance goals for effective monitoring of its operations in coordination with SBA’s Office of Financial Program Operations.

Ensure the program clarifies and defines requirements for pain management teams in the new Veterans Health Administration Directive 1151, Pain Management and Opioid Safety.

Establish means to periodically validate the status information of facilities pain management teams.

Require the program and the chief operating officer to assess and ensure corrective actions are taken to address each medical facilitys lack of progress in achieving compliance with the requirement to have a pain management team as mandated by the Jason Simcakoski Memorial and Promise Act.

Facility leaders ensure all veterans and visitors, including those who require mobility assistance, have safe and accessible pathways to clinical areas during elevator repairs.

Facility leaders ensure staff complete and document preventive maintenance for medical equipment.

We recommend that the OGP Associate Administrator strengthen the PMRD’s policies and procedures to: more clearly define the PMR scoring system and its relevance to the PMR report findings and recommendations; clearly identify the findings and recommendations in the PMR report, including whether corrective action is required to address each finding; and ensure all required corrective actions are included in a CAP and implemented.

We recommend that the OGP Associate Administrator perform training and oversight to ensure proper administration and closeout of CAPs.

District leaders and the Evanston, La Crosse, and Milwaukee Vet Center Directors collaborate with the support VA medical facility to determine reasons for noncompliance with staff participation on the mental health executive council, take action as indicated, and monitor compliance.

District leaders and the Evanston, Gary Area, La Crosse, and Milwaukee Vet Center Directors determine reasons for noncompliance with completing four hours of external clinical
consultation for clinically complex cases per month, ensure a process is implemented, and monitor compliance.

District leaders and the Gary Area Vet Center Director determine reasons for noncompliance with Vet Center Director review of 10 percent of active client records monthly for each counselors caseload, ensure completion, and monitor compliance.

District leaders and the Gary Area, La Crosse, and Milwaukee Vet Center Directors determine reasons for noncompliance with employees completing select trainings in the required time frame, ensure completion, and monitor compliance.

District leaders and the Evanston, Gary Area, and Milwaukee Vet Center Directors determine reasons for noncompliance with completion of an outreach plan with all required strategic
components, ensure completion, and monitor compliance.

District leaders and the La Crosse Vet Center Director determine reasons for noncompliance with monthly automated external defibrillator inspections, ensure completion, and monitor compliance.

District leaders determine reasons why the closing of the Milwaukee Vet Center resulted in multiple communication failures, and ensure all clients are notified of the new location, the Vet Center Call Center has accurate information, and websites include correct location and phone number information.

The Readjustment Counseling Service Chief Officer considers developing written guidance for vet center closure and temporary relocation processes including oversight responsibilities.