Among actions the VA took in response to the high-risk listing was to create an Office of Internal audit. Image: Mark Van Scyoc/Shutterstock.com
Nearly a decade after GAO put VA health care on its high-risk list the department still is working on identifying and addressing risks across that system, the GAO has said.
GAO said that among actions the department took in response to the high-risk listing was to create an Office of Internal audit “to provide objective information to VHA leadership on how well particular aspects of its health care system are working;” and to establish an “Audit, Risk, and Compliance Committee as the governance body that is to guide its oversight and, in turn, make recommendations for system-wide improvements.”
The former is under the Office of Integrity and Compliance, which more broadly is “responsible for managing risks (threats to achieving VHA’s mission), by implementing an agencywide approach to understanding the combined impact of risks.”
It said the integrity and compliance office has taken steps such as training employees on its risk management approach through new courses but has not fully met leading practices for risk management, such as by comprehensively identifying risks across its health care system. The office of internal audit meanwhile has “encountered challenges due to its unclear reporting structure and oversight role. VHA did not define a clear purpose for its internal audit function and had not updated its policy directive in light of its 2024 reorganization.”
And the audit, risk and compliance committee, made up of senior officials from across VA organizations, “did not review relevant oversight findings, such as those from its medical investigations, and did not provide recommendations for potential system-wide improvements,” said GAO.
VA management agreed with recommendations to address those findings.
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