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VA Construction: VA Should Enhance the Lessons-Learned Process for Its Real-Property Donation Pilot Program

GAO-21-133 Published: Dec 10, 2020. Publicly Released: Dec 10, 2020.
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Fast Facts

A 2016 law created a pilot program allowing the Department of Veterans Affairs to accept donations of facility construction or improvements. In August 2020, a group of donors—working in consultation with the VA—completed the first facility under this pilot program in Omaha, Nebraska. The VA is anticipating a second facility will be built under the pilot program in Tulsa, Oklahoma, by a different group of donors.

We recommended that the VA improve how it documents and shares lessons learned from the Omaha project. This could help guide additional projects under the pilot program—like the one in Tulsa—and other VA construction efforts.

The new Veterans Affairs' Ambulatory Care Center in Omaha, Nebraska, adjacent to the existing VA hospital

U.S. Department of Veterans Affairs Ambulatory Care Center

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Highlights

What GAO Found

The Department of Veterans Affairs (VA) has received one real property donation through a partnership pilot program authorized by the Communities Helping Invest through Property and Improvements Needed for Veterans Act of 2016 (CHIP-IN Act) and is planning for a second. This Act authorized VA to accept donated real property—such as buildings or facility construction or improvements—and to contribute certain appropriated funds to donors that are entering into donation agreements with VA. Under VA's interpretation, its ability to contribute to such funds is limited to major construction projects (over $20 million). The first CHIP-IN project—an ambulatory care center in Omaha, Nebraska—opened in August 2020. Pending requested appropriations for a second CHIP-IN project, VA intends to partner with another donor group to construct an inpatient medical center in Tulsa, Oklahoma. (See figure.) Other potential donors have approached VA about opportunities that could potentially fit the CHIP-IN pilot, but these project ideas have not proceeded for various reasons, including the large donations required. VA officials told us they have developed a draft legislative proposal that seeks to address a challenge in finding CHIP-IN partnerships. For example, officials anticipate that a modification allowing VA to make funding contributions to smaller projects of $20 million and under would attract additional donors.

Completed Department of Veterans Affairs' (VA) Ambulatory Care Center in Omaha, NE, and Rendering of Proposed Inpatient Facility in Tulsa, OK

Completed Department of Veterans Affairs' (VA) Ambulatory Care Center in Omaha, NE, and Rendering of Proposed Inpatient Facility in Tulsa, OK

VA has discussed and documented some lessons learned from the Omaha project. For example, VA officials and the Omaha donor group identified and documented the benefits of a design review software that helped shorten timeframes and reduce costs compared to VA's typical review process. However, VA has not consistently followed a lessons-learned process, and as a result, other lessons, such as the decision-making that went into developing the Omaha project's donation agreement, have not been documented. Failure to document and disseminate lessons learned puts VA at risk of losing valuable insights from the CHIP-IN pilot that could inform future CHIP-IN projects or other VA construction efforts.

Why GAO Did This Study

VA has pressing infrastructure demands and a backlog of real property projects. VA can accept up to five real property donations through the CHIP-IN pilot program, which is authorized through 2021. GAO previously reported on the CHIP-IN pilot program in 2018.

The CHIP-IN Act includes a provision for GAO to report on donation agreements entered into under the pilot program. This report examines: (1) the status of VA's efforts to execute CHIP-IN partnerships and identify additional potential partners and (2) the extent to which VA has collected lessons learned from the pilot, among other objectives. GAO reviewed VA documents, including project plans and budget information, and interviewed VA officials, donor groups for projects in Omaha and Tulsa, and selected non-profits with experience in fundraising. GAO compared VA's efforts to collect lessons learned with key practices for an overall lessons-learned process.

Recommendations

GAO is making two recommendations to VA to implement a lessons-learned process. Recommendations include documenting and disseminating lessons learned from CHIP-IN pilot projects. VA concurred with GAO's recommendations.

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs The Secretary of VA should ensure that relevant internal stakeholders—such as the CHIP-IN steering committee's members and local and regional VHA staff—complete a lessons-learned process for the Omaha CHIP-IN project that aligns with lessons-learned key practices, including documentation and dissemination of lessons. (Recommendation 1)
Closed – Implemented
In December 2020, we reported that VA had completed its first project under a partnership pilot program authorized by the Communities Helping Invest through Property and Improvements Needed for Veterans Act of 2016 (CHIP-IN Act). This program pilots a new approach to help address VA's infrastructure needs-allowing donation partnerships for construction projects with non-federal entities. The first CHIP-IN project-an ambulatory care center in Omaha, Nebraska-opened in August 2020. To complete this project, several VA offices worked with a donor group, which led design and construction and employed private sector practices, which was allowable under the pilot. In prior work, we identified six individual key practices-collect, analyze, validate, document, disseminate, and apply-that can be used to identify and apply lessons learned. These practices can be combined and considered steps in an overall lessons-learned process. Recently, we found that VA had completed most of these practices for one identified efficiency from the CHIP-IN program. However, VA had not consistently completed these practices for other potential efficiencies from the pilot program. Specifically, VA officials have not consistently followed key practices for lessons learned, such as documenting the information they have discussed and disseminating it with relevant stakeholders such as the CHIP-IN steering committee and local and regional VHA staff. Not consistently collecting lessons learned and following lessons-learned practices puts VA at risk of losing valuable insights from the CHIP-IN pilot that could identify efficiencies for future projects under this pilot or other VA construction efforts. Therefore, we recommended that VA ensure that relevant internal stakeholders complete a lessons-learned process for the Omaha CHIP-IN project that aligns with lessons-learned key practices, including documentation and dissemination of lessons. In September 2021, we confirmed that VA had completed a lessons-learned process for the Omaha CHIP-IN project that aligned with key practices. In doing so, VA collected lessons learned at different project stages from various internal stakeholders, as well as the donor group. VA analyzed the lessons to determine, for example, advantages and disadvantages of certain practices, and validated them to determine applicability for the next CHIP-IN project in Tulsa, Oklahoma. The lessons were documented and disseminated within VA's construction office and shared with stakeholders involved with the second CHIP-IN project, in Tulsa, Oklahoma. By completing the lessons-learned process for the Omaha project, VA will be better positioned to identify efficiencies-including opportunities for cost and time savings-for future CHIP-IN projects or other VA construction projects.
Department of Veterans Affairs The Secretary of VA should ensure that relevant internal stakeholders—such as the CHIP-IN steering committee's members and local and regional VHA staff—implement a lessons-learned process for future CHIP-IN projects that aligns with lessons-learned key practices, including documentation and dissemination of lessons. This process should include a clear plan for timing and execution. (Recommendation 2)
Closed – Implemented
In December 2020, we reported that VA had received one real property donation through a partnership pilot program authorized by the Communities Helping Invest through Property and Improvements Needed for Veterans Act of 2016 (CHIP-IN Act) and was planning for a second. This program pilots a new approach to help address VA's infrastructure needs-allowing donation partnerships for construction projects with non-federal entities. The first CHIP-IN project-an ambulatory care center in Omaha, Nebraska-opened in August 2020. The second CHIP-IN project-a hospital in Tulsa, Oklahoma-is slated for completion in 2024. We also found that, according to VA and the Omaha donor group, the CHIP-IN donation approach had resulted in various efficiencies on the first CHIP-IN project, including time and cost savings compared to a typical VA construction project. VA was seeking to understand how well the lessons from CHIP-IN can be applied to other settings, including other VA construction projects. In prior work, we identified six individual key practices-collect, analyze, validate, document, disseminate, and apply-that can be used to identify and apply lessons learned. These practices can be combined and considered steps in an overall lessons-learned process. Recently, we found that VA had completed most of these practices for one identified efficiency from the CHIP-IN program. However, VA had not consistently completed these practices for other potential efficiencies from the pilot program. Specifically, VA officials have not consistently followed key practices for lessons learned, such as documenting the information they have discussed and disseminating it with relevant stakeholders such as the CHIP-IN steering committee and local and regional VHA staff. Without a lessons-learned process, it is unclear if VA will collect and document lessons from the CHIP-IN projects consistently enough to help it make informed decisions about how to make the CHIP-IN approach as effective as possible. Establishing a lessons-learned process could not only help VA better execute CHIP-IN projects during the pilot, but it could also ensure VA does not lose valuable insights as the program proceeds and that may be applicable to VA projects outside of the pilot program. Therefore, we recommended that VA should ensure that relevant internal stakeholders implement a lessons-learned process for future CHIP-IN projects that aligns with lessons-learned key practices, including documentation and dissemination of lessons, and that the process should include a clear plan for timing and execution. In September 2021, we confirmed that VA had implemented a lessons-learned process for the CHIP-IN pilot program that aligned with key practices. Specifically, VA incorporated a process for collecting, documenting, and disseminating lessons learned into a policy memorandum that guides the CHIP-IN program. The memorandum states that lessons are to be collected and documented throughout the project, and VA told us that this will occur at three stages: the donation agreement, design, and construction. VA also identified the internal and donor group stakeholders who will conduct the lessons learned process at different stages of the projects. VA has begun to implement this lessons-learned process with the second CHIP-IN project, in Tulsa, Oklahoma. By implementing this lessons learned process VA will gain valuable insights from the CHIP-IN pilot that could inform future CHIP-IN projects or other VA construction efforts.

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Best practicesBuildingsConstructionDonationsFacility constructionFacility repairsHealth care centersHealth care facilitiesInfrastructure projectsLessons learnedPolicies and proceduresPrivate sectorProgram evaluationProgram implementationProgram managementPublic and private partnershipsReal propertyVeteransVeterans affairsVeterans' health care