Report 2012-119 Recommendations and Responses in 2015-041

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

Department Number of Years Reported As Not Fully Implemented Total Recommendations to Department Not Implemented After One Year Not Implemented as of 2014-041 Response Not Implemented as of Most Recent Response
California Department of Veterans Affairs 2 17 7 7 7

Recommendation 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.

Response

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 Status: Not Fully Implemented
  • Completion Date: December 2016
  • Response Date: October 2015

Recommendation 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.

Response

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 Status: Not Fully Implemented
  • Completion Date: December 2014
  • Response Date: September 2015

Recommendation 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.

Response

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 Status: Not Fully Implemented
  • Completion Date: December 2016
  • Response Date: September 2015

Recommendation 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.

Response

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 Status: Not Fully Implemented
  • Completion Date: January 2016
  • Response Date: September 2015

Recommendation 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.

Response

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 Status: Not Fully Implemented
  • Completion Date: November 2015
  • Response Date: September 2015

Recommendation 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.

Response

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 Status: Not Fully Implemented
  • Completion Date: October 2016
  • Response Date: September 2015

Recommendation 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.

Response

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 Status: Not Fully Implemented
  • Completion Date: September 2016
  • Response Date: September 2015

Current Status of Recommendations

All Recommendations in 2015-041