More Employees Hired So Far in FY2023 Than Ever Before

The VA Under Secretary of Health Shereef Elnahal, MD, visited the Western New York VA Healthcare System in August. Photo from the Western New York VA Healthcare System’s Facebook page.

WASHINGTON, DC — The 1-year anniversary occurred last month of the signing of the PACT Act—the sweeping legislation that expanded healthcare and benefits to veterans exposed to toxic substances during their service. The bill also included provisions allowing VA to expand its staff to handle the expected increase in both new patients and benefits claims.

While the Veterans Benefits Administration (VBA) has been successful in meeting expected goals for new claims examiners, filling vacancies has been more difficult. VA officials blame antiquated hiring systems, which have resulted in new hires waiting five months or more to be onboarded.

“Hiring faster and more competitively is my most important, foundational priority,” VA Under Secretary for Health Shereef Elnahal, MD, told the Senate VA Committee last month. “We have to execute this legislation to its fullest. We cannot do that without enough people.”

The Office of Personnel Management (OPM) has a governmentwide goal for agencies to onboard new hires within 80 days. While VBA hits that mark 85% of the time, VHA’s median onboarding time is 165 days. That delay can result in VA losing potential hires to private sector competitors.

“We can lose significant numbers of good people, especially talented healthcare folks,” Elnahal said. “Part of [the reason for the bottleneck] is some government specific rules that OPM asks us to do for Title 5 employees. But a lot of it is just our process, which needs to be made more lean and more efficient.”

According to Elnahal, VA released a “much more streamlined hiring process” in July, and VA’s human resource officers are currently undergoing new training to implement it.

“We hope in the next few months that time will go down,” he said. “We need to get much closer to what VBA is performing in onboarding.”

Source: VA

Legislators pointed out that there is a recent precedent for VA bringing new employees in much more quickly. In 2020, VA was granted temporary hiring authority to shore up facilities struggling under the weight of COVID-19 patients. During that time, new hires were onboarded in a matter of days or weeks rather than months.

Asked if VA had experienced any ill effects of working so quickly, Elnahal admitted that it was a mixed bag.

“It definitely worked in bringing folks on,” he said. “But at the back end, we had to do all of the credentialing, privileging and quality checks to determine suitability. Our overseers have called out some issues with suitability in the past. So it’s always a tough balance … between getting the number of folks on board as fast as we can, with getting the right quality of individuals. Those that don’t have state licensing board citations or tort claims—things that would surface during the normal process.”

According to Elnahal, the hiring authorities provided in the PACT Act have helped encourage potential hires to endure the long onboarding process, particularly the piece of the legislation expanding VA’s ability to offer lump sum recruitment incentives up front.

“This has encouraged people to wait it out in order to that incentive,” Elnahal said.

Other hiring tools, however, are going mostly unused. The legislation included a provision that allows VA to buy out the non-VA service contract of certain healthcare professionals in exchange for that individual agreeing to be employed at a rural VA facility for at least four years.

“The [provision] has been implemented. We’re providing it to the field. But the uptake is not nearly as much as I’d hoped,” Elnahal told legislators. “We have less than 10 providers whose contracts we’ve bought out at this point. … I do think this should be more robust.”

Despite these difficulties, VHA hired more people in the first nine months of FY2023 than at any time in the agency’s history and is experiencing its highest total employee onboard growth rate in more than 15 years.

“We’re on pace to exceed 400,000 VA healthcare employees for the first time,” Elnahal boasted. “We’re able to retain employees at much higher levels than in the last several years, especially in the context of the pandemic. We’re not taking our foot off the gas. We still have a goal of hiring 52,000 external hires this fiscal year, and we’re already at 43,000. So we’re on pace to beat it.”