In part 1, I wrote of President Barack Obama’s appointment of General Eric Shinseki as Secretary of Veterans Affairs in 2009. General Shinseki’s vision allowed the current RTLS initiative to come to the forefront.
I indicated that federal regulations could hinder the VHA’s approach. Specifically, I stated that guidance may be taken as mandates to ensure that the solicitation is written in accordance with the law.
Before I re-familiarized myself with acquisition law, I examined documents as far back as the mid-80s. The reports reflected investigative findings from Quality Programs and Supply Distribution and Processing inspections by the General Accounting Office and the Veterans Inspector General’s Office.
For example on June 27, 1985, the General Accounting Office published GAO/HRD 85-57, VA Has Not Fully Implemented Its Health Care Quality Assurance Systems. Senators Frank Murkowski, Alan Cranston, and Alan Simpson set the investigations into motion. These 3 Senators were mentioned by name or signed the letters requesting the investigations. The mission was quite clear. Senator Simpson wrote December 21, 1983:
I am writing as Chairman of the Senate Committee on Veterans' Affairs to request that the General Accounting Office review the Office of Medical Inspector and Evaluation which was established July 30, 1981, by the Administrator of Veterans' Affairs to monitor and report on the quality of care within the Department of Medicine and Surgery - Appendix I
The GAO’s mission was further described as to determine if facilities had implemented quality programs that included five mandated quality assurance functions. The GAO team visited 13 facilities that represented a “cross-section” of the VA Medical Facilities. - Page i
The inspectors from the GAO wrote of very methodical approaches in all instances. The inspectors went as far as looking into budgets, those who had external oversight of the quality programs, explanations of how the program should work and who had organizational responsibility. The findings were clear and often very detailed.
There were not many outright recommendations in this reports. The inspectors’ comments are woven into each chapter.
One thing I find particularly interesting, the detail of the 2nd request coming from the Senate Committee. The 1st request, December 21, 1983, shows a very general request. The 2nd request, September 6, 1984, contained very detailed areas in which the GAO was requested to review - 22 bullets, some with multiple questions. Either the Senators understood or a staffer understood what should have been happening. It was probably both. More can be found in The Veterans Administration RTLS, Recommendations for Success
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