Report 2012-119 All Recommendation Responses

Report 2012-119: California Department of Veterans Affairs: It Has Initiated Plans to Serve Veterans Better and More Cost-Efficiently, but Further Improvements Are Needed (Release Date: May 2013)

Recommendation #1 To: Veterans Affairs, Department of

To ensure that it maximizes its ability to generate revenue at all the veterans homes and better cover the costs of providing care to its members, CalVet should continue to implement standardized policies and procedures throughout the veterans homes to increase revenue, including its policies and procedures for identifying and enrolling eligible members into federal, state, and private insurance programs, such as the Medicare and Medi-Cal programs.

1-Year Agency Response

1. CalVet Homes Division led an effort at all eight veterans homes during Medicare Open Enrollment period in 2013. Residents who did not have Medicare coverage were identified and educated on the benefits they are eligible for. As a result 3 new residents were enrolled in Part B. Also, there were 583 residents enrolled in Medicare Part D and an additional 659 residents were enrolled this year taking it to a total of 1,242. CalVet's program to educate residents regarding plans for which they are eligible, as well as its tracking of new enrollees, are ongoing. 2. CalVet reached out to the Department of Health Care Services (DHCS) on the implementation of the Coordinated Care Initiative (CalMedi Connect) which caused residents to be passively enrolled in managed care. As a result, there are monthly data transmissions between CalVet and DHCS to ensure residents are not dis-enrolled from Medi-Cal. 3. CalVet Homes Division reached out to the Medi-Cal Benefits Division on the potential cost recovery of residents who are dual eligible under Medi-Cal and Medicare. As a result, CalVet confirmed that it can participate in the crossover claim process and recover more revenue from Medicare Part B, and the Department is doing this. 4. New revenue sources were identified in the areas of Respiratory, Pulmonary, Behavioral, Mental health, Audiology, and Optometry. CalVet will identify the top CPT/HCPS codes for those services and monitor the matrix of the increased revenue. 5. In order to maximize the revenue from the USDVA, CalVet has secured funding and position authority for all the homes to have Veteran Claim Representatives. The positions were approved on July 1, 2014, and the vacancies were posted. Those who already have civil service positions participated in a statewide County Veteran Service Officers four day conference for the first time where they will learn about claims process and getting additional revenue for residents.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

6-Month Agency Response

HQ Homes Division Staff provided training on revenue types and insurance coverage to Fresno (June11th and 12th and Fresno July 18th and 19th). Remaining homes will be provided revenue training in the first quarter of calendar year 2014. Expanded pay source training in the new electronic health record system was provided to Yountville, Redding and Fresno staff on October 2nd. As a result of the upated charge master, CalVet was able to bill for 21 additional types of services. CalVet initiated a Medicare Open Enrollment campaign and letters were sent to residents who do not currently have Medicare Part B and D on November 1, 2013.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

Within 60 days, CalVet will develop additional policies and procedures which specifically address identifying and enrolling eligible members into all insurance programs for which they are eligible. CalVet will use the expanded functionality of the new electronic health record system to maximizing the department's ability to recover its cost from multiple payers through coordination of benefits.

1) In June provided training to Fresno staff on health insurance plans. Redding Training scheduled for July. Remainder of homes will receive training by December.

2) Implemented a revised Charge Masters in Barstow as pilot home to capture more services in medical billing process. This will increase revenue and will be rolled out to all homes by December 2013.

3) Created policies on Corporate Compliance.

4) Amendments proposed to Insurance Coverage Policy to include post admissions insurance coverage. Will be finalized by December 2013.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Recommendation #2 To: Veterans Affairs, Department of

To ensure that it maximizes its ability to generate revenue at all the veterans homes and better cover the costs of providing care to its members, CalVet should analyze its cost-recovery model, including an evaluation of the state laws that limit the amount of revenue that CalVet can collect for the care it provides to its members at the veterans homes.

Annual Follow-Up Agency Response From November 2016

In the last three years, CalVet conducted multiple surveys of other states to analyze their Veterans Homes' cost-recovery models. Survey results revealed that California differs from other states in terms of the type of veteran admitted, services offered and the fees charged to recover the cost of care. CalVet has educated external stakeholder about the differences in California law on tours of the Veterans Homes and in policy meetings for the last three years. Legislation was introduced in 2016 that captured many of the cost recovery model changes that were needed. CalVet worked with the author and sponsors of this legislation, SB 980. The amendments included in the bill would have defined a fee schedule enabling the CalVet to create a benefit plan, institute penalties for non-payment of fees, require participation in insurance plans, give priority to those with service-connected disabilities, and clarify several other areas of the law which would have improved revenue and cost recovery. The bill was approved in the house of origin and in the Veterans Affairs Committee of the second house. However, it was held in the Appropriations Committee at the end of the legislation session. Other significant CalVet accomplishments impacting cost recovery are the successful implementation of the ICD-10 codes for medical billing, which were required across the nation. CalVet is in the process of conducting a post-implementation audit to ensure that the best coding and documentation practices are being utilized. Finally, CalVet has successfully obtained CMS certification in two of the three newest Homes. This will result in Medicare and Medi-Cal revenue to offset the General Fund.

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

CalVet conducted multiple studies to analyze how its revenue and cost-recovery models compare to other states. CalVet then used that analysis to help propose legislation in 2016 (SB 980) that would strengthen its ability to generate revenue and bring its cost-recovery model more in line with the models of other states' veteran homes systems. However, SB 980 did not pass, and CalVet's Chief Financial Officer told us that the department plans to resubmit a similar bill for 2017. Further, in June 2016 it entered into a collections contract with a third party to provide debt collection services for delinquent member fee accounts. Moreover, as reported in Recommendation #1, in 2013 CalVet Homes Division revised its procedures to increase veteran resident enrollment in Medicare to help reduce medical costs at the homes, among other cost saving and revenue increasing practices.

Annual Follow-Up Agency Response From September 2015

CalVet entered into a partnership with the California Research Bureau to conduct a study on the cost-recovery models used by veterans homes systems throughout the country. CalVet is evaluating the data in the Research Bureau's report and determining next steps. Additionally, CalVet has entered into a collections contract to assist in the pursuit of unpaid fees.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From October 2014

CalVet has entered into a partnership with the State Library to gather data from veterans homes across the nation on their cost recovery models, to help CalVet determine best practices. Results are expected by December 1, 2014. Also, CalVet has started the process to establish income verification through the Social Security Administration to ensure the correct fees are being assessed. Finally, CalVet has entered into a collections contract to assist in the pursuit of unpaid fees.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

1-Year Agency Response

1. CalVet will implement the recommendation in the January 31, 2014 management Letter from the Department of Finance. 2. CalVet will work with its stakeholders to make legislative changes as needed.

California State Auditor's Assessment of 1-Year Status: Pending

6-Month Agency Response

We are currently examining different fee models and will determine the impact they would have on residents. Based on most recent BSA Investigation we are amending our action plan related to MWR and will be reporting our corrective action and changes to MWR usage. We are currently examining the fee structure and the impact changes would have on residents.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

CalVet will analyze the impact a revised fee structure would have on veterans, and develop legislative recommendations after collaboration with the CalVet Board and veteran stakeholders. In addition, CalVet will examine the laws creating the Morale, Welfare, and Recreation Fund at each of the veterans homes as recommended to determine if each of these funds could sustain themselves.

1) Implemented new room and board rate based on level of care by home as of July 1, 2013. This will enable CalVet to recover a more accurate unreimbursed cost of care from the deceased residents estate.

2) Working on updating Military and Veterans Code and Regulations on Fee structure.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Recommendation #3 To: Veterans Affairs, Department of

To better ensure that the veterans homes are providing quality care as cost-efficiently as possible, CalVet should continue monitoring the nurse-to-member ratios in the homes and work with the homes as necessary to help them meet the targeted ratios.

60-Day Agency Response

CalVet has implemented standard 'Hours Per Resident Day' (HPRD) guidelines based on Title 22 regulations and guidance from the Undersecretary of Veterans Homes. Based on the regulations and guidance, CalVet has implemented a policy that requires each Veteran Home to report HPRD on a weekly basis. The reports are reviewed each week by the Director, Health Care Services and looks at variances from the guidelines. The Director, Health Care Services assesses any variances with the Nursing Administration of that Home and assesses the cause of the variance. If any of the Homes are consistently out of compliance, the Director, Health Care Services reports it to the Undersecretary of Veterans Homes. The HPRD are also included in the monthly QM Report as part of its routine monitoring.

California State Auditor's Assessment of 60-Day Status: Fully Implemented

Recommendation #4 To: Veterans Affairs, Department of

CalVet should provide similar oversight to the veterans homes in implementing the standardized staffing model, once it is finalized.

1-Year Agency Response

1. A Budget Change Proposal was approved as part of the January 2014 Governors Budget to convert contracted positions to civil services to implement the staffing standards. This enables all the homes to be staffed the same in the areas of food service, security and veteran claim representative. 2. On May 20 and May 22, 2014, the Legislature approved CalVet's proposal to convert contracted landscapers to civil service in the Chula Vista home. They are the only home that was dependent on contracted services in this area. As a result the homes will all be consistent with the staffing standards in this area. 3. All vacancies are filled through the completion of a form called M-80. Since the implementation of the staffing standards, all M-80s are signed by an executive manager in the Homes Division to ensure compliance with the staffing Standards. Those that do not meet the staffing standards are rejected. Attached you will find the policy samples of M-80s from all homes with the new required approval from Homes Division.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

6-Month Agency Response

CalVet continues to monitor 'Hours Per Resident Day' reports weekly and has demonstrated that this is an ongoing task that it has done routinely therefore this item is complete.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Although it has provided evidence that it continues to monitor nurse-to-member ratios, CalVet has not provided evidence that it is providing similar oversight of its other staff classifications based on the standardized staffing model.

60-Day Agency Response

CalVet plans on developing a standardized staffing model for the Veterans homes:

1) Veterans Homes Redding and Fresno BCP in Governor's May Revision with the staffing standard approved for July 1, 2013 included staffing standards.

2) Hours Per Patient Day Policy Developed.

3) Application of Title 22 related to staffing was clarified with CDPH for ICF level of care.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Recommendation #5 To: Veterans Affairs, Department of

To better utilize unused space at the veterans homes, and to serve more veterans within legal restrictions, CalVet should use the information in the Yountville veterans home master plan to develop a plan for using unused space at that home to generate revenue and/or serve more veterans.

Annual Follow-Up Agency Response From October 2019

CalVet is completing a master planning effort for the state's eight Veterans Homes. Among other topics, the Legislature directed the Department to evaluate uses of the Veterans Home properties. The project will be complete by December 31, 2019, in accordance with a legislative deadline for a report on the project. The final report will contain substantial discussion of opportunities and limitations. While the Veterans Homes must remain focused on their mission of providing long-term care, the master plan research may identify other ways in which the Department may appropriately provide services to veterans. The plan may in the future lead to the development of proposals related to CalVet programming, levels of care, bed allocations, or property use.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From October 2018

CalVet has taken significant steps to pursue the priorities in the Yountville Facilities Master Plan, primarily a new skilled nursing building for the Yountville Home. The Legislature allocated funding through the 2018-19 state budget process for CalVet to pursue certain refined planning steps for a new 240-bed facility on the property. The Department is in the process of developing performance criteria and working with a master architect. CalVet also has taken the necessary formal steps to obtain federal funding for the building.

Simultaneously, CalVet is undergoing a legislatively requested audit of the Department's leases related to Veterans Home properties, primarily in Yountville. CalVet is awaiting the results of the audit and is conducting its own internal evaluation, including defining future parameters, expectations, and improved policies for leasing space in manners that complement the long-term care services offered on the properties.

Also, CalVet obtained legislative authority with the 2018-19 budget to relocate Domiciliary residents in Yountville to private rooms in order to approve quality of life, and has been completing this effort over the past few months.

Finally, CalVet has embarked on a comprehensive needs assessment research project that will lead to identification of additional ideas, proposals, and opportunities for the future of the Veterans Home properties. The project will be complete by December 31, 2019, in accordance with a legislative deadline for a report on the project. The final report will contain substantial discussion of opportunities and limitations, and may in the future lead to the development of proposals related to CalVet programming, levels of care, bed allocations, or property use.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From November 2017

CalVet continues to make efforts towards the long term planning and future use of the Yountville Veterans Home. Over the past twelve-month period CalVet has accomplished the following:

- Completed a full budget package for the construction of a 420-bed skilled nursing building. The proposed building would provide space for the residents of Yountville's existing skilled nursing program, including memory care, and the intermediate care program. The budget package was completed March 31, 2017.

- Submitted a request within the state's normal budget cycle for the funding of the skilled nursing building.

- Extended the U.S. Department of Veterans Affairs pre application grant for the funding of the skilled nursing building.

- Relocating domiciliary residents to single bedrooms within existing resources.

- Evaluated the potential opportunities for public-private partnerships and the long term use of the facility.

- Implementation of an ESCO state supported energy project that reduces the need for energy and improves the reliability of energy related system within the Yountville Veterans Home.

Continue with an ongoing review of the Master plan as the Department continues to evaluate opportunities that are feasible as well as consistent with the long term mission.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From October 2016

Due to the age of the campus, its infrastructure and significant real estate at Yountville, CalVet contracted with HOK Architects for the development a comprehensive Facility Master Plan Evaluation at the Yountville Home. The master plan evaluation was to identify potential ongoing facility needs, efficient long term planning, and options for potential revenue generating. The effort was to utilize evaluation techniques and processes commonly used in local government regional planning or urban planning processes.

To date the following actions have been taken in regards to the recommendations:

- Within current resources permit Domiciliary residents an opportunity for single bedroom occupancy.

- Identify additional opportunities for single bedroom occupancy that do not significantly impact the general fund.

- Continued revision of lease agreements to reflect current fair market value and return revenue generated by these leases to the general fund.

- Approved funding for the renovation of the Main kitchen within the FY 16/17 budget

- Budget package for a new SNF Building approved by DOF June 2016.

- Submitted a preapplication grant application with the USDVA for the purpose of funding a new skilled nursing facility on the facility grounds.

- Complete roof repair of the Holderman Building and Main Dining Room

- Requested an energy evaluation to be conducted by DGS at all CalVet homes in regards to energy efficiencies.

- CalVet is currently in the process of performing a campus wide state historical evaluation conducted by the State Historic Preservation Office. This evaluation allows approval for future renovation or construction among the sensitive historic structures on campus.

An ongoing review of the plan continues as CalVet continues to evaluate opportunities that are feasible as well as consistent with the long term mission.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From September 2015

In addition to the measures reported in the previous update, such as including a new skilled nursing building in the Department's five-year capital outlay plan and obtaining a site-wide historic evaluation of the property, CalVet also has begun an assessment of the Yountville Veterans Home McKinley Building. This assessment will aid the Department in defining the future use of this building and planning any capital outlay projects needed prior to its use.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From October 2014

The master plan has been evaluated internally. To date the following actions have been taken; a new SNF building has been included in the Department's five year capital outlay plan. A pre-application for a new SNF Building has been submitted to the USDVA Construction Grant Program. A site-wide historic evaluation has been conducted by the State Historic Preservation Office. The evaluation provides guidance when renovation activities occur to protect the site's historic value. In addition a water management plan is underway for the Rector Dam to include water management strategies as well as an evaluation of any potential new customers that can be accommodated within the current permit. Completion of the water management plan is anticipated for December 31, 2014.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

1-Year Agency Response

The master plan has been evaluated internally. To date the following actions have been taken; a new SNF building has been included in the Department's five year capital outlay plan. A pre-application for a new SNF Building has been submitted to the USDVA Construction Grant Program. A site-wide historic evaluation has been conducted by the State Historic Preservation Office. The evaluation provides guidance when renovation activities occur to protect the site's historic value. In addition a water management plan is underway for the Rector Dam to include water management strategies as well as an evaluation of any potential new customers that can be accommodated within the current permit. Completion of the water management plan is anticipated for December 31, 2014.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

6-Month Agency Response

The master plan remains in the process of internal evaluation, certain recommendations regarding infrastructure and renovation have been incorporated into the Departments capital outlay five year plan. The master plan has also been made available to the public. The plan has been submitted to members of the Veteran Services Committees as well as made available to the Allied Council and residents of the Veterans home. Copies of the master plan have been made available to local legislative leaders as well as the leadership of the Town of Yountville. Preliminary meetings with the Town of Yountville leadership have occurred to understand any relevant concerns regarding implementation of certain components of the plan. Based on a recent Federal ruling the use of any USDVA funded projects shall be evaluated for their appropriateness and compliance with the new ruling will be evaluated within any lease.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

CalVet is currently in the process of evaluating the Yountville Veterans home master plan for opportunities to increase revenue and increase services to veterans. Once an internal evaluation has been completed the Department intends to formally incorporate a specific set of milestones and objectives into the Departments strategic plan by the summer of 2013. Preliminary review of the Yountville master plan is currently underway.

California State Auditor's Assessment of 60-Day Status: Pending

Recommendation #6 To: Veterans Affairs, Department of

To better utilize unused space at the veterans homes, and to serve more veterans within legal restrictions, CalVet should develop and implement procedures for periodically evaluating all of the veterans homes to identify opportunities to enhance use of unused space and increase revenue generation, including documenting the results of its evaluations.

1-Year Agency Response

Capital Outlay Unit Policies and Procedures have been updated to reflect evaluation criteria for the purposes of utilizing unused space. Policies and Procedures were updated in December 2013 to reflect criteria for unused space. CalVet has determined that a focus on identifying opportunities to arrange partnerships to utilized unused space will take away from its focus on long-term care of veterans and has removed this goal from its strategic plan. This shift is reflected in a letter from the Undersecretary to the Secretary that has been provided. The updated Policies and Procedures provide a mechanism through which such arrangements may be made, when needed, but the department will not focus on regular evaluations per the change in its strategic plan.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

6-Month Agency Response

Policies and procedures have been provided to each of the Home administrators to ensure the proper implementation of lease guidelines. Evaluation criteria for unused space and revenue is currently underway. Target date for the revision of those polices and procedures will be completed by December 31, 2013.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

Policies and Procedures for securing leases or agreements for unused space have been developed by the Capital Assets Unit. Further development of those policies shall include periodic evaluation of each veterans home in regards to unused space as well as opportunities for general fund revenue. Policies and procedures have been provided to each of the Home administrators to ensure the proper implementation of lease guidelines. Evaluation criteria for unused space and revenue is currently underway. Target date for the revision of those polices and procedures will be completed by December 31, 2013.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Recommendation #7 To: Veterans Affairs, Department of

To better utilize unused space at the veterans homes, and to serve more veterans within legal restrictions, CalVet should develop a formal process for identifying, securing, and evaluating public-private partnership agreements with other entities that could provide services to more veterans than it currently serves, and update its tracking matrix to include the dates when such efforts were initiated or the date of the most recent status of those efforts.

1-Year Agency Response

1. CalVet has determined that a focus on public-private partnerships will take away focus on long-term care of veterans and has removed this goal from its strategic plan. See letter from Undersecretary to Secretary. 2. CalVet has entered into a sharing agreement with the USDVA to serve homeless veterans on the WLA home as part of the Transitional Housing Program. As part of this partnership, USDVA will evaluate homeless veterans and make a placement at CalVet, Salvation Army Haven or New Directions. Therefore, CalVet will work within this new framework to accept veterans who successfully complete the programs in Salvation Army Haven or New Directions and are placed by USDVA.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

6-Month Agency Response

CalVet is analyzing a formal process for identifying Public, Private, Partnerships and evaluating their value to serving more veterans. For example, CalVet initiated a budget change proposal to convert 84 SNF beds into domiciliary beds targeted towards the neediest veterans. The proposal was approved as part of FY 13-14 May revise. Subsequent to that, CalVet partnered with USDVA to fill the beds through a sharing agreements and an MOU. This new partnership enables CalVet to use what would have been unbudgeted space to serve more veterans.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

Updated matrix developed with recommended fields. Formal process being developed.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Recommendation #8 To: Veterans Affairs, Department of

To better utilize unused space at the veterans homes, and to serve more veterans within legal restrictions, CalVet should identify measures to facilitate monitoring the success of its public-private partnership agreement with the Pathway Home at the Yountville veterans home, as well as its agreements with New Directions and Salvation Army Haven at the West Los Angeles veterans home.

1-Year Agency Response

Monitoring and evaluation criteria has been incorporated into a new lease with the Pathway Home Inc., and the lease was finalized in June 2013. Also, CalVet no longer has agreements with the Salvation Army Haven program or New Directions.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

6-Month Agency Response

The Pathway Home Inc. lease was completed within the first 60 days and closed out. New Memorandum of Understandings with New Directions and Salvation Army Haven are pending signature.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

Evaluation or monitoring criteria has been developed and will be included in the renegotiated lease between the State and the Pathway Home Inc. program. Monitoring criteria will be developed in collaboration with New Directions Inc. and Salvation Army Haven to ensure that the success of each program will be monitored. CalVet included metrics for review and evaluation of program success in the renegotiations with the Pathway Home Inc. and is waiting for response from the program's leadership. Monitoring and evaluation criteria has been incorporated into a new lease with the Pathway Home Inc. The lease was finalized in June 2013.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

CalVet's July 2013 agreement with Pathway Home includes metrics for reviewing and evaluating program success, including required quarterly meetings between Pathway Home and CalVet to review, among other things, the program's status. In addition, the agreement requires Pathway Home to provide CalVet with quarterly reports detailing program participant census, admission rates, graduation rates, and participating rates during outpatient treatment activities. The agreement also permits CalVet to monitor Pathway Home's quality assurance measures and may request reports as needed.

CalVet anticipates that the revised agreements with New Directions Inc. and Salvation Army Haven will be completed by September 2013.

Recommendation #9 To: Veterans Affairs, Department of

To better utilize unused space at the veterans homes, and to serve more veterans within legal restrictions, CalVet should, as part of its 2013 renegotiations with Pathway Home, document its review and evaluation of any legal restrictions that may limit this agreement.

1-Year Agency Response

Legal restrictions for the Pathway Homes lease have been reviewed and documented by the CalVet Legal Unit. The lease was finalized in June 2013.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

6-Month Agency Response

Legal restrictions for the Pathway Homes lease have been reviewed and documented by the CalVet Legal Unit. The new lease was finalized in June 2013.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

60-Day Agency Response

As part of the review process CalVet will review all legal restrictions that may apply to the new Pathway Home Lease.Legal restrictions for the Pathway Homes lease have been reviewed and documented by the CalVet Legal Unit. The lease was finalized in June 2013.

California State Auditor's Assessment of 60-Day Status: Pending

According to CalVet's chief counsel, CalVet has conducted an assessment of legal restrictions. However, CalVet has not yet provided the State Auditor with documentation of the assessment.

Recommendation #10 To: Veterans Affairs, Department of

To better utilize unused space at the veterans homes, and to serve more veterans within legal restrictions, CalVet should, for any future public-private partnership agreements, specify measures in the agreements that will allow it to monitor and assess the success of the agreements, and it should document its review and evaluation of any legal restrictions that may limit its authority to enter into the agreements.

1-Year Agency Response

1) Policy created and in the approval process. 2) Policy was approved and implemented in Policy Tech.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

6-Month Agency Response

Policy was approved and implemented in Policy Tech.

California State Auditor's Assessment of 6-Month Status: Partially Implemented

Although CalVet demonstrated that it has developed a policy that addresses the recommendation, it did not provide evidence that it has yet implemented this policy.

60-Day Agency Response

Monitoring criteria for public private partnerships will be developed by June 30, 2013. All new Public Private Partnerships will have monitoring criteria and reporting included within any new agreement. Policy created and in the approval process.

California State Auditor's Assessment of 60-Day Status: Pending

CalVet drafted policy guidelines for all new Public Private Partnership agreements and Memorandums of Understanding developed on behalf of the veterans' homes to include monitoring criteria within the agreement as a review of any legal restrictions that may impact the authority to enter into the agreement. However, as of July 2013, CalVet has not fully implemented these policies.

Recommendation #11 To: Veterans Affairs, Department of

To ensure it is maximizing its ability to serve veterans in the State's veterans homes, CalVet should follow through with its plan to assess the bed capacity of the homes for veterans' needs after the homes in Fresno and Redding are licensed, to determine the most appropriate number of beds for the different levels of care offered at each home.

Annual Follow-Up Agency Response From October 2019

CalVet is nearly complete with a master plan required by the Legislature. It will be complete by December 31, 2019, and will address among other topics the capacity, demand, and distribution of beds and levels of care throughout the system of Homes.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From October 2018

CalVet continues to pursue the needs assessment/master plans required in the 2017-18 budget. In the subsequent budget process, for the 2018-19 budget, the Legislature extended the report deadline to December 31, 2019, and added language specifying certain requirements in the report. This project is well under way, and CalVet anticipates meeting the December 2019 deadline.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From November 2017

In 2016, CalVet hired two retired annuitants to conduct the first phase of a needs assessment. Initial findings indicated future need will be primarily in skilled nursing and memory care. A requirement was added to the 2017-18 budget to conduct , master plans at each Home, due July 2019. In addition, Assembly Bill (AB) 1365 was recently signed and will require master plans for each Veterans Home every five years. At each five-year interval, these master plans are expected to begin with in-depth research similar to the ongoing needs assessment. The Veterans Homes Division is in the process of hiring staff specifically for this project and will carry out the research as required by the budget bill. The specific requirements of AB 1365 can be found here: https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180AB1365.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From September 2016

In accordance with the State Auditor's recommendation, with the Redding and Fresno Veterans Homes operational and nearly at capacity, the Homes Division has begun this study. The Division hired two retired annuitants, one who specializes in demographics and one who specializes in the development of mental and behavioral health programs. In their respective areas of expertise, these retired annuitants are conducting research into potential future needs and demographic projections. Together, the retired annuitants and Homes Division leadership have created a timeline in which initial findings would be completed in September and a determination of next steps will be complete by November.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From September 2015

CalVet has begun the process of recruiting a consultant to conduct a level of care study. This study will involve an evaluation of the population the Department serves and future need, resulting in recommendations related to the levels of care offered at the Veterans Homes. CalVet acknowledges that the number of individuals using either nursing facilities, alternative residential care, or home care services is expected to increase from 15 million in 2000 to 27 million in 2050. In order to continue to meet the care needs of our residents, CalVet wishes to better understand the projections for future generations of veterans and the ways in which our services may need to be redesigned. CalVet is completing internal work on bid solicitation documents for the level of care study.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From October 2014

The Fresno and Redding homes are still completing their licensing and certification processes. As this occurs, in order to maintain responsiveness to veterans' long-term care needs, CalVet has assessed all eight veterans homes' management of admission applications to ensure that those individuals who apply are apprised of availability at all eight homes in the system. This effort enables CalVet to reduce the amount of time an applicant must wait for space to become available in a particular home, and it ensures the space and resources the homes offer are used most effectively.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

1-Year Agency Response

1. CalVet is still on track to pursue funding in FY 2014-15 for a statewide study on need for beds and level of care by home.

California State Auditor's Assessment of 1-Year Status: No Action Taken

6-Month Agency Response

CalVet is on track to conduct an assessment on the demand for Veterans Homes' beds statewide by level of care paid for within existing resources.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

CalVet will do a formal study after the Redding and Fresno homes are licensed as noted in this audit.

CalVet will contract for a statewide study of long-term care bed needs and levels of care by May 2014.

California State Auditor's Assessment of 60-Day Status: Pending

Recommendation #12 To: Veterans Affairs, Department of

To better reach a larger number of veterans who might not otherwise learn about and take advantage of benefits and services to which they are entitled, CalVet should continue to use technology, including implementing CalVet Connect.

1-Year Agency Response

This project was completed and closed out by the Department of Technology.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

6-Month Agency Response

CalVet Connect is nearing the end of the design phase and beginning testing. A pilot of the system will occur in early December with full implementation occurring in February of 2014.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

CalVet will continue to use technology to reach Veterans by developing CalVet Connect. A vendor has been selected and will be awarded the contract in April 2013. The project is expected to start on May 1, 2013. This is a reportable project to the California Technology Agency and they are providing Project Oversight. We anticipate launching CalVet Connect in February 2014. CalVet Connect Contract Awarded. FSR submitted.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Recommendation #13 To: Veterans Affairs, Department of

To ensure that it is providing the highest quality of services to veterans, CalVet should implement oversight and guidance policies to ensure that its veterans homes are providing adequate and appropriate referral options to veterans who have been placed on the waiting list or denied admission into a home.

1-Year Agency Response

CalVet has developed a consistent process that will be used to refer veterans. Those applicants who are denied admission are referred to a social worker or to other programs that may provide services that meet the applicants' needs. An example of the tracking mechanism for this process has been provided. Additionally, the Homes Division has recently appointed a staff person to the Community Collaborative Partnership with the Department of Health care Services, Long Term care Division. The core objective of the Long Term Support Services Committee is to provide resource services for community based living options for at risk populations including veterans. There are eight Aging and Disability Resource Connection (ADRC) located throughout the state that CalVet will work with in addition to other programs in place.

California State Auditor's Assessment of 1-Year Status: Fully Implemented

6-Month Agency Response

Developed Policy on referral options for veterans not admitted.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

As part of its continuing efforts to improve its programs, prior to the completion of the audit, CalVet developed an audit matrix for monthly review of the Pre-Admission Tracking System. Within 60 days the department will develop an audit schedule to ensure that the system is used consistently by all the veterans homes. Also, within 60 days CalVet will develop policies on referral options provided to veterans who have been placed on the waiting list or denied admissions into a Veterans home. Develop Policy on referral options for veterans not admitted.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

Recommendation #14 To: Veterans Affairs, Department of

To ensure that it is providing the highest quality of services to veterans, CalVet should improve its tracking system policy by developing oversight controls so that the system is used consistently by all of the veterans homes.

Annual Follow-Up Agency Response From September 2016

The Homes Division has implemented and sustained an oversight process for the system-wide admissions program, including its standardized application tracking system. This includes routine internal audits of each Veterans Home's practices to ensure compliance with Department requirements for use of the system and record-keeping. The Homes Division created this audit schedule and process in 2014 and has maintained it over three rounds of reviews. Additionally, having met and sustained the State Auditor's recommendation, the Division expanded the audits in the 2016 calendar year. This expansion increasing the participation of Headquarters analytical staff in the process and adding to the scope of the reviews to better understand operational practices and identify any areas in need of further standardization.

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

According to its policy, CalVet implemented the Pre-Admissions Tracking System (PATS) in each of the veterans' homes to help ensure that a standardized enterprise-wide process is used when managing applications for admissions into the veterans' homes. Further, CalVet developed oversight controls so that PATS is used consistently by all of the veterans homes, including an annual systems review at all the veterans homes. Specifically, in 2015 CalVet performed audits at each of the eight veterans' homes and determined that all the homes were consistently using the PATS tracking system and found no issues. Further, CalVet developed a calendar to evaluate all the homes during 2016.

Annual Follow-Up Agency Response From September 2015

In the spring of 2014, CalVet's Director of Admissions performed audits to ensure the homes were consistently and accurately using the Pre-Admission Tracking System. The review concluded that six of the eight Veterans Homes were in full compliance; two homes showed a need for improvement. These two homes were placed on a quarterly review plan and were required to develop a plan of action to achieve compliance. Since that time, both Homes have achieved compliance. So far this fiscal year, seven of the eight homes have been reviewed for their annual audit and all were 100% compliant, including the two that showed a need to improve last year. The eighth home is scheduled to be reviewed in October.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From October 2014

CalVet has developed an oversight schedule to ensure that each home has implemented the tracking system. As of September 2014, the Homes Division had conducted initial reviews of all eight homes and had begun following up with homes that showed need for improvement. The Homes Division is in the process of implementing a revised policy to reflect its review schedule. The revised policy specifies that, in order to provide ongoing oversight, the Homes Division will conduct annual reviews of those homes that were fully successful in the initial reviews, and quarterly reviews of those homes that initially showed need for improvement, based on the development of correction plans.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

1-Year Agency Response

CalVet has developed an oversight schedule to ensure that each home has implemented the tracking system. As of June 6, 2014, the Homes Division had conducted initial reviews of all eight homes. The Homes Division also is in the process of implementing a schedule for ongoing monitoring and a revised policy to reflect the schedule. The revised policy specifies that, in order to provide ongoing oversight, the Homes Division will conduct annual reviews of those homes that were fully successful in the initial reviews, and quarterly reviews of those homes that initially showed need for improvement, based on the development of correction plans.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

6-Month Agency Response

Audit of Ventura home was completed. A schedule was developed for the audit of the remaining homes.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

Developed oversight schedule to review admissions at all homes.

California State Auditor's Assessment of 60-Day Status: No Action Taken

CalVet did not provide a copy of the oversight schedule to review admissions at all the homes.

Recommendation #15 To: Veterans Affairs, Department of

To allow for public input and to prevent any legal challenges that its policy of capping members' fees, its $165 monthly income-retention policy for members, and its age and admission policy are unenforceable underground regulations, CalVet should adopt these policies as regulations in accordance with the Administrative Procedure Act.

Annual Follow-Up Agency Response From October 2019

The Homes Division is working with the Department's Regulations Unit to develop this regulation. The Division experienced a delay in the completion of this recommendation previously due to personnel and operational changes, and is resuming work on it in conjunction with the Regulations Unit to make it a priority in the coming year.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From October 2018

The Department has continued to form and structure its new Regulations Unit under new leadership. This unit has begun producing new and updated regulations, including some related to the admissions program. The Veterans Homes Division has conducted extensive research into the regulation on the $165 monthly income retention, but due to a change in leadership in the area of financial operations, this regulation preparation work experienced delays. The Division plans to make it a priority for newly assigned personnel with appropriate expertise.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From November 2017

The Veterans Homes Division has conducted extensive research into the two remaining regulation topics, the monthly income-retention program and the admissions regulation, and each is on its way to being incorporated into the Department's published regulations. Research on these regulations became superseded in early 2017 by a need for these staff to conduct research for potential regulations stemming from an omnibus budget trailer bill, in the event the bill passed, which happened. Once this additional pressing workload reached particular milestones, these staff resumed work on the admissions and income-retention program regulations. Proposed text for the admissions regulation has been submitted to the Office of Administrative Law (OAL) for the public review process. Language for a regulation on the monthly income-retention program is in a regulation draft that is being reviewed at CalVet Headquarters and prepared for submission to OAL. Lastly, the form of the Department's Regulations Unit has changed in the past year. The Department has seen a leadership change in its division that addresses legislative affairs and regulations, and the Regulations Unit has expanded in staffing and is under new direction. The enhancement of this program has led to greater structure, planning, and productivity in the updating and creation of regulations Department-wide.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From October 2016

The Secretary of the California Department of Veterans Affairs provided a letter to the California State Auditor in September 2016 indicating the Department had discontinued its practice of capping resident fees. The letter indicated CalVet would couple its change in practice with appropriate notification of residents. Regarding the $165 monthly income retention and the age and admission policy, the Veterans Homes Division has begun work toward formally adopted regulations on both of these topics. The Division provided the State Auditor's Office a timeline indicating it plans to submit these regulation packets to the Office of Administrative Law before the end of October 2016. By law, the regulation process can take up to one year to complete.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From September 2015

The CalVet Homes Division is in communications with the Legal Division regarding the programs related to the $165 and the monthly fee cap, and will have additional information on a resolution of the situation shortly. Regarding the admissions priorities regulation, CalVet staff in the Homes Division and Legal Division have held numerous meetings over a four-month period and are nearing completion of the initial materials that will be submitted to the Office of Administrative Law to begin the public input process. CalVet expects to submit these materials in the coming days, following a final internal legal review. Upon acceptance by OAL, CalVet will host a 45-day public comment period and complete the other steps of the Administrative Procedure Act process.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From October 2014

CalVet Homes Division has reorganized its structure and created a dedicated Chief of Research and Program Review. This position was filled in May 2014. The staff member in the position has been enrolled in a rulemaking class that will be offered by the state Office of Administrative Law.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

1-Year Agency Response

Due to key vacancies, no further action could be taken. However, CalVet Homes Division has reorganized its structure and created a dedicated Chief of Research and Program Review. This position was filled in May of 2014 and will focus on these policy areas.

California State Auditor's Assessment of 1-Year Status: No Action Taken

6-Month Agency Response

In progress.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

CalVet is firmly committed to allowing public input and expects to complete the preliminary rulemaking activities for each of these three proposed regulations by the end of August 2013. After the rulemaking process has been completed, and upon Office of Administrative Law approval, the proposed regulations will be enacted. In progress.

California State Auditor's Assessment of 60-Day Status: Pending

Recommendation #16 To: Veterans Affairs, Department of

To more effectively and efficiently meet state purchasing and procurement requirements, CalVet should analyze its current purchasing model to ensure that it is the most efficient and cost-effective to use when purchasing non-IT goods and services for the veterans homes.

Annual Follow-Up Agency Response From September 2016

CalVet has rewritten its policies and procedures in December of 2015 to address the recommendations suggested in the audit. In January 2016, the Department of General Services (DGS) approved CalVet's new procedures as well as upholding the Department's delegated authority. Additionally, CalVet held a mandatory Contracts and Procurement Training Workshop for the entire Department on August 23-25, 2016.

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

CalVet analyzed and revised its procurement policies and procedures and restructured its contracting unit. According to the chief of business services, CalVet analyzed its business structures as a result of the 2013 audit. Specifically, CalVet revised its non-IT procurement policies and procedures in December 2015. Further, CalVet determined that the hybrid centralized/decentralized method for contract procurements was ineffective, and in 2016 implement a centralized contracting unit where headquarters conducts the contracting for the veterans' homes.

Annual Follow-Up Agency Response From September 2015

CalVet's non-IT Contracts and Procurement staff have been under new leadership since May 2015. With this new leadership, the Department is undergoing an extensive revision of its procurement policies and procedures and generating updates and revisions as needed. CalVet will complete a revised procedure manual by December 31, 2015.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From October 2014

CalVet's analysis of our current purchasing model indicates we follow all purchasing guidelines and procurement laws and regulations. These laws are intended to ensure efficiency and cost effectiveness over all state procurements. CalVet continues to improve our compliance procedures and ensure purchasing and contracting staff at the Veterans Homes receive bi-annual training in all procurement processes. We are also relooking the purchasing model for the Department.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

1-Year Agency Response

CalVets analysis of our current purchasing model indicates we follow all purchasing guidelines and procurement laws and regulations. These laws are intended to ensure efficiency and cost effectiveness over all state procurements. CalVet continues to improve our compliance procedures and ensure purchasing and contracting staff at the Veterans Homes receive bi-annual training in all procurement processes. We are also relooking the purchasing model for the Department.

California State Auditor's Assessment of 1-Year Status: Pending

6-Month Agency Response

Due to key staff retirements and the opening of the Redding and Fresno Veterans Homes no further action was taken on the analysis of current purchasing model. Analysis will resume and recommendations will be developed December 31, 2013.

California State Auditor's Assessment of 6-Month Status: No Action Taken

60-Day Agency Response

CalVet agrees to analyze its purchasing model, and concurs with the December 2013 time period provided in this audit. Review of purchasing at each home completed. Analysis of purchasing model in progress.

California State Auditor's Assessment of 60-Day Status: Pending

Recommendation #17 To: Veterans Affairs, Department of

To more effectively and efficiently meet state purchasing and procurement requirements, CalVet should continue implementing quality assurance policies to strengthen its oversight of its purchasing practices, including conducting on-site reviews of the purchasing practices of the veterans homes.

Annual Follow-Up Agency Response From October 2019

Quarterly reviews will be conducted by the Headquarters Office of Procurement and Contracts (OPC) annually. The purpose of the reviews is to ensure that CalVet maintains or exceeds the standard set by the Department of General Services for the delegated purchasing authority through the Accreditation process. The OPC will notify the Home General Services Administrator (HGSA) of the quarterly purchase order review one month in advance through email by a notification letter. The letter will request a copy of the Home's purchase order log, a list of the Home's buyers, and the California Procurement and Contracting Academy (CALPCA) courses that each buyer is required to complete.

Upon receipt of the purchase order logs, OPC will review the logs for acquisition type, solicitation process, and dollar amount. A sampling of no less than 10% of the purchase orders will be requested from the Homes. The sampling shall include supporting documents in the purchase order file. The assigned HQ analyst will review the purchase order file against the CalVet Purchase Order File Documentation Checklist and the data entered into FI$Cal for completeness and accuracy with the HQ FI$Cal checklist. The HQ analyst will also assess each buyer at the Home by reviewing their CALPCA education against the reviewed purchase orders that the buyer created.

Upon completion of the review findings, a report will be provided to Deputy Secretary, Administrative Services, and the Deputy Secretary, Veterans Homes. A copy of the signed report will be submitted electronically to the Home Administrator and HGSA as attachments to a follow-up meeting to discuss the findings and corrective action plans, if any.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From October 2018

- Monthly meetings with all P-card users to discuss ongoing issues and/or changes.

The California Department of Veterans Affairs (CalVet) Headquarters, Office of Procurement and Contracts, conducts meetings, one-on-one phone conversations, in-person training, and email exchanges with all P-Card users at least once per month, and more frequently as CalVet transitions to FI$Cal.

- Update on current Policy & Procedures

The California Department of Veterans Affairs (CalVet) Policy and Procedures for Non-IT Procurements is currently being further updated to include the Department of General Services (DGS) State Contracting Manual (SCM) Volume F requirements for departments transacting in Fi$CAL and DGS/Procurement Division's Accreditation requirements for retention of DGS's delegated purchasing authority.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From November 2017

Over the past 12-month period, the CalVet Office of Procurements and Contracts has accomplished the following to address the ongoing improvement of quality assurance:

- Provided ongoing training at each of the Veterans Homes to include contract management training and procurement activities;

- Revised the service order (SO) policy for the Department, and relocated the process to Headquarters to ensure the proper use of the service order procedures in procurement activities. Also provided DVBE/Small Business training to each of the Veterans Homes;

- Participated in the state's Fi$Cal implementation process to ensure accurate accounts of procurement activities when the Fi$Cal operation begins 7/01/2018;

- Initiated a bulletin to provide key information on P-Card use to all Veterans Home staff.

Over the next 12-month period, the Office of Procurements and Contracts will implement or initiate the following:

- Update of current procurement policies and procedures;

- Training for the eight Veterans Homes on service order updates and policy and procedure changes;

- Monthly meetings with all P-card users to discuss ongoing issues and/or changes.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From October 2016

Over the past 12-month period, CalVet has internally audited the state Veterans Homes for compliance with Department of General Services (DGS) and State Administrative Manual purchasing requirements. Additionally, the Department's policies and procedures have been rewritten to be more in compliance with the state's expectations. The results of those audit findings were addressed at the Contracts and Procurement Training Workshop for the entire Department, which was held on August 23-25, 2016.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From October 2015

CalVet's non-IT Contracts and Procurement staff have been under new leadership since May 2015. With this new leadership, the Department is undergoing extensive revision of its procurement policies and procedures and generating updates and revisions as needed. CalVet will complete a revised procedure manual by December 31, 2015. Additionally, the CalVet Office of Procurement and Contracts is conducting an internal review and assessment of Purchase Orders, Service Orders and contract management practices. These reviews began in the Veterans Homes in September 2015 and will continue through mid-November 2015. They include all eight Veterans Homes.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

Annual Follow-Up Agency Response From October 2014

CalVet recently conducted four training sessions in person and by video teleconference for staff in headquarters and the Veterans Homes on contracting procedures. CalVet will be providing training on the procurement process the first week of November 2014. In addition, the third Wednesday of each month CalVet has an ongoing training session on contracting issues. CalVet updated its procurement procedures and is in the process of finalizing and revamping its contracting procedures. In addition, headquarters staff is also conducting quarterly visits to the Veterans Homes to provide training and to pull sample contracts and purchase orders for auditing. CalVet is also relooking the purchasing model for the Department. CalVet expects to complete this evaluation by December 2014.

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

1-Year Agency Response

Continued ongoing implementation of quality assurance policies for our Purchasing and Contracting section and those within our Veterans Homes is part of CalVet's leadership intent. As a part of this process, CalVet recently, March 2014, filled a vacant manager position that oversees Procurement and Contracting. CalVet is actively working to update our current Purchasing & Contracting Procedures Manual. The Department of General Services Procurement Division directed CalVet to update our Purchasing & Contracting procedures in order to retain our Purchasing Approval Authority. As a part of this update, CalVet instituted a bi-annual training of the Purchasing & Contracting personnel throughout CalVet. Headquarters staff will visit each home to provide training and pull samples contracts to audit. We will also conduct sample audits of Purchase Orders during veterans home visits. We are also relooking the purchasing model for the Department. CalVet expects that we will complete this evaluation by December 2014.

California State Auditor's Assessment of 1-Year Status: Partially Implemented

6-Month Agency Response

Headquarters staff will provide more oversight and guidance (twice a year) to ensure that its Veterans Homes comply with state purchasing and procurement requirements.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

As part of its continuing efforts to improve that process, CalVet has already implemented a checklist and expects to complete the initial on-site reviews of each of the Veterans homes by June 2013. Joy Hempstead visited each home and conducted a review of the purchasing practices. As a result additional training is being developed for the homes. Provided each purchasing staff a copy of the delegated purchasing acknowledgement form which was signed.

California State Auditor's Assessment of 60-Day Status: Partially Implemented

CalVet has taken steps to implement this recommendation, but will need to provide additional training to its staff to help ensure they will follow appropriate purchasing practices in the future.

All Recommendations in 2012-119

Agency responses received after June 2013 are posted verbatim.