Senate and House Veterans’ Affairs and Veterans’ Affairs Committee Hearing
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Chairmen Sanders and Miller, Ranking Members Burr and Michaud, Members of the
It is my honor to represent more than 1.9 million members of the
Before we discuss the VFW's legislative priorities for 2014, I would like to take a moment to personally thank Ranking Member Michaud for more than a decade of service on the
What concerns the VFW and patriots everywhere is that America has forgotten that OUR NATION IS STILL AT WAR!
We have 38,000 men and women stationed inside
And we have some in
Messrs. Chairmen, I pledge to you that the VFW will fight to preserve the safety and security of
I would like to recognize and thank Senator Sanders for introducing S. 1982, the "
Everything the VFW wants costs money, but everything the VFW wants is for someone else--someone from every city and town in every congressional district, and in every state and territory who swore an oath of allegiance to protect and defend our great country and its Constitution.
The VFW exists to serve veterans, and that includes representing them in
The VA also exists to serve veterans. It should be seen as a privilege and not a right to work at VA. We call on
The VFW looks to these two committees to answer those needs. Much has been done over the past 13 years of war, and still more can be done without breaking the bank. We understand fiscal realities, but we also understand commitment and sacrifice. We see it as a matter of priorities, because a nation that cares about its liberties and security can afford to do both.
VA BUDGET CONCERNS
The VFW remains concerned about the impact spending reductions will have on the VA. Sequestration is still a reality. VA was exempt in the first rounds of cuts, and all Departments are safe for the next two years. But after this two year reprieve, VA will be vulnerable to devastating cuts to its budget.
To care for those who have answered our nation's call, the VFW calls on
* Fully fund all VA accounts
* Place all VA budgetary accounts under advance appropriations
The areas of highest need are medical care, construction, and Information Technology (IT). Within medical services, VA needs to be funded at a level that will allow them to provide sufficient and timely medical services. The Administration's FY 2015 advance appropriations for medical services increased only 2 percent from the FY 2014 appropriated level. This increase was not enough to cover the 1.5 percent increase in utilization and the 3 percent increase in basic medical care inflation.
The Administration has also underfunded VA's construction and non-recurring maintenance budget lines. For years, VA's capital infrastructure has been eroding and efforts to maintain existing structures and build new facilities have fallen far short of what is needed. The VA has projected that to close all capital infrastructure gaps, more than
As VA moves forward with their capital planning, frank and open conversations must be had that will focus on identifying new and innovative ways to close the gaps in existing infrastructure so VA will have the resources it needs to continue to provide the care veterans need, when and where they need it.
To adequately cover all medical care accounts
As VA continues to modernize, it is important to ensure adequate funding for IT. These accounts have seen considerable increases over the past few to meet the demand of developing computer programs which support claims processing, customer service and health care delivery such as electronic health care records, eBenefits and VBMS. It is critical that these accounts continue to receive the funding they need to ensure continued development and success.
The VFW continues to strongly support H.R. 813, the "Putting Veterans Funding First Act of 2013," a bill that places all VA budget accounts under Advance Appropriations. The importance of this bill can be highlighted by the recent government shutdown. Veterans and surviving spouses were days away from not receiving their disability, pension and survivor payments, and veterans and dependents enrolled in school would not have received their living stipends. During the shutdown, veterans couldn't access vocational rehabilitation services and disability claims that were filed during the shutdown were not processed, adding more pressure to the claims backlog. Advance Appropriations for VA medical care accounts is widely viewed as a success. It is time to include all VA budget accounts under this model; to ensure veterans will receive all their care and benefits without interruption.
VA has made vast improvements in its collection of third-party billing, but VA must continue to focus on ways to recover every dollar owed to them for services provided for non-service connected care. VA's lack of proper billing - and the failure to respond to insurance companies leaves millions of dollars on the table that VA could use to provide additional care and services.
The VFW believes that legislation must be introduced that would allow VA to collect funds from
BENEFITS DELIVERY
Over the past 10 years,
Secretary Shinseki is working to tackle the systematic problems which slow claims processing by enabling historic changes in IT modernization, which we believe will enable VA to process claims more quickly and with higher accuracy. The Secretary has set the bold goal to break the backlog in 2015. He has also redefined what constitutes a backlogged claim from 180 days to 125 days, while at the same time setting higher accuracy standards for claim decisions. This is a laudable goal - and the Secretary is making progress on this goal - but achieving that goal should not be the single focus.
As the VBA transforms from paper-based to an all-electronic system, care must be taken to ensure the laws that are in place to protect veterans' rights stay intact. Below are specific areas of concern for the VFW.
VBA TRANSFORMATION
Accountability: One of the most difficult things to do in any large organization is to ensure that employees - both rank and file workers and supervisors - are held accountable for their performance.
In recent years VBA refined training and instituted testing of some positions to gauge job knowledge. While performance appraisals address both production and quality, failure to produce at required levels garners more attention than poor quality. In our view this is exactly backwards.
VBA needs to continue to utilize the data it gathers through its Quality Review Teams to identify employees with weak skills and focus training on improving them. Employees who cannot improve sufficiently should be replaced at the earliest opportunity. Quality should be the first priority; production will improve once an employee knows what to do. Working at VA is not a right, it is a privilege. Employees must understand their mission, and be given the training and equipment to accomplish that mission, and they must be held accountable for their actions. Manages who don't hold employees accountable must be reprimanded and relieved of their duties. Managers must manage.
Quality: VBA is under a lot of pressure to reduce the number of backlogged disability claims. But as we continually state, quality cannot suffer in the effort to move more claims through the system. Claims must be done correctly the first time. Over the past year VA has made claims that the quality of rating decisions has increased substantially. While it appears quality has improved in most Regional Offices (RO), some of the improvements appear to be based on new measurement standards, and others on quality reviews that do not identify all of the errors.
VBA has changed its quality metric from a claim-based error to an issue-based error. Under the old metric, if a claim had a substantive error, the whole claim was found in error, regardless of how many issues were in the claim. Now, under the issue-based metric, if a claim has 10 issues but only one of the 10 issues is in error, then the claim is considered 90 percent accurate. By using the issue-based error rate, VA can inflate its accuracy rate without actually improving accuracy. This new metric does, however, allow VA to more accurately mine data to understand what the most common errors are and what type of training employees need.
Most veterans view problems with their claims in the same manner as they would a problem with their car. If their car doesn't run, they don't care if 10 parts are broken or only one. The problem is that the car doesn't run. With a VA decision, if one part of the decision is wrong then the decision is wrong.
The VFW recently completed a site visit to the VA regional office in
Further, we identified three clear and unmistakable errors in earlier ratings. One of these decisions, when corrected, should provide an award of benefits to a veteran back to 1985.
In addition, we found that raters accepted a number of inadequate VA examinations for rating rather than return them for additional data or correction. Based on this review, it appears that some rating specialists would rather rate a case using inadequate - and often negative - evidence rather than return an examination to be completed correctly. This simply confirms what other service officers have been telling us: that rating personnel are under intense pressure to complete ratings, and that some may take shortcuts to comply.
The VFW plans to make more site visits to audit VA's accuracy claims. It is important that your committees continue to use its oversight role to ensure that quality does not suffer while VA races to eliminate the backlog in disability claims.
The Veterans Benefits Management System (VBMS): VBMS has the potential to allow VA to employees to work efficiently and effectively in an all-electronic environment. If implemented correctly, it will enable VA to obtain and utilize computable data, expand rules-based decision making tools to improve quality in claims decision actions for disabilities evaluated primarily by numeric data, and allow the processing of claims, either in whole or in part, anywhere in the country.
While VA has rapidly moved to develop and deploy VBMS, it continues to suffer from significant processing delays and unpredictable and frequent periods of downtime. Further, VBA has largely neglected to institute improvements in veteran service organization workload management tools. This inattention has caused frustration and exacerbated inefficiencies among service officers who are helping veterans with their benefits claim. VA must be reminded that VSOs relieve a large burden from VA's claims processors. Implementing these improvements will make our service officers more efficient, and in turn, make VA more efficient.
Though VBMS has the potential to bring efficiency to the claims process, VA's automation will only go so far, if VA and
The VFW urges
Proposed Rule AO81: As part of their effort to reduce the claims backlog, VA published a proposed rule in
If the proposed rule goes into effect, an informal communication would no longer serve as the veteran's date of claim, unless the veteran chooses to file their claim electronically. This will cause veterans to lose months' worth of compensation.
While the rule may seem benign to the casual observer, the VFW believes this rule will make it harder for thousands of veterans who do not have access to or the confidence to use a computer to receive the same benefits they have under existing law. The change could result in substantial delays in veterans being able to file a "complete claim," as well as a substantial reduction of benefits because the date of claim is delayed by months while veterans are forced to meet the bureaucratic requirements imposed by VA.
The elimination of the ability to file an informal claim will negate the one incentive veterans have to file a Fully Developed Claim (FDC). Today, veterans can notify the VA that they are filing a claim under the FDC program. VA accepts the written notification but does nothing until the rest of the claim is submitted. If VA awards benefits, it may use the date of receipt of the informal claim as the effective date of the award. However, elimination of informal claims removes the one incentive veterans have to file a FDC claim. Without the ability to file an informal claim, veterans will simply file a claim, leaving it to VA to develop the claim as it did in the past.
VA has touted the rule change as an incentive for filing electronic claims and to reduce the backlog. The VFW considers it a punishment to veterans who either do not have access to computers, or do not wish to send highly sensitive personal information over the internet. Any reduction in the backlog will result from forcing veterans to comply with tedious and complex application requirements before they can file a claim. The VFW urges
Priority of Workload: In response to the public outcry about the number of veterans waiting seemingly forever to receive their benefits, the VA has triaged their case load to focus on the backlog of disability claims, - specifically, the initiative to process all one and two-year-old claims first - neglecting dependent claims and appeals as well as other categories of claims. The VFW knows that since VBA does not consider appeals as part of its total claims backlog, it has consistently diverted appeals staff to work disability claims. Even when Decision Review Officers were allowed to work appeals, they had huge caseloads and insufficient support staff to handle the work. Data shows that appeals have increased from 252,000 to over 272,000 over the past few years. In its annual reports for FY 2012, released in
Some VA officials argue that the unique set of veteran-friendly laws creates obstacles to efficient appeals processing. It is true that
Veteran dependency claims are another area left virtually untouched due to the heavy focus on the disability claims backlog. Veterans with service-connected disabilities, evaluated at 30 percent or more, are entitled to an additional allowance for their dependent spouse and children. Under existing policy, if a veteran submits a claim for compensation and supplies dependency information, VA policy requires that these dependents be added at the same time it awards the veteran basic compensation benefits. In the past three-and-a-half years, dependency claims have increased from about 40,000 to nearly 240,000 - clear evidence that VA's policy isn't being followed. Now they delay adjudicating dependency claims until someone can find the time to do it. The VFW and other VSOs have asked VA to process these dependent claims when it awards compensation and pension to a veteran. Now we urge
Brokering: VBA is increasingly transferring its authority to work on a claim to an office other than the one that has original jurisdiction. This has decreased the time it takes VA to fully adjudicate a claim, which is a good thing, but when claims are brokered it can leave the VSO service officer in the dark on the status of the claim, often times preventing them from being able to comment on decisions prior to promulgation.
VA needs to enhance its system so when claims are brokered three things will occur to give allow VFW service officers and other advocates a chance to comment on the rating prior to promulgation.
First, VA needs to notify the service officer when a claim for disability they hold a power-of-attorney for is brokered. This will let the service officer know the claim is no longer in the Regional Office where they work. Second, the service officer needs to be notified when the claim has been rated. This will provide the service officer the 48-hour window of time to review the case for comment. Lastly, VA needs to provide the service officer with a point of contact, usually the rating officer, so the comments can be returned and taken into consideration before the decision is promulgated.
Fully Developed Claim (FDC): The FDC program is simply the formalization of a local VA regional office practice that has existed for decades. Historically, many of VA's Veteran Service Center Managers agreed to quickly work fully developed claims submitted by VSOs. This program was regularized by VBA in 2009 and rolled out to all VA regional offices in 2010. Since then, VBA has refined the FDC program and increasingly encouraged veterans and VSOs to submit claims which do not require development of non-governmental evidence.
The FDC program shifts much of the burden of collecting the evidence necessary to adjudicate a claim from VA to veterans and other claimants. Essentially, in exchange for a promise to process a claim more quickly, VA requires claimants to locate, obtain and submit all non-government held records necessary to their claim at the time they submit an application to VA.
The FDC program can be a win-win for the veteran and VA. Veterans who successfully provide all necessary evidence to rate his or her claim are often rewarded with a decision frequently within 90-120 days of submission, rather than the more common 240-360 days VA takes to work non-FDCs. With FDC claims, VA is relieved of the need to develop a claim. This reduces the number of employees necessary to perform this work, which allows VA to assign them to other tasks. In addition, because the bulk of the development is done by the claimant and not VA, traditional measures of claims processing timeliness (average days pending, average days to complete) are reduced. This allows VA to assert that it is processing claims more quickly.
This can only be a win if the veteran is focused, knowledgeable and efficient, or has sought the assistance of a trained VSO representative, only then can he or she can accomplish the development more quickly than VA. However, if the claimant lacks full understanding of what is necessary to successfully complete his or her claim, it may take longer to complete the application package.
We believe that for many veterans, the total time to gather evidence, submit a claim to VA and receive a decision, is little different under the FDC program than under the non-FDC model, and if the veteran does not know to submit an informal claim, he or she can lose months of compensation and benefits. In addition to the time factor involved in veteran development, there are also some hidden costs inherent in the pre-filing development undertaken by veterans. For example, many private health care providers are reluctant to provide records directly to the claimant or charge significant fees which must be paid, while those same records may be provided to the VA upon official request without cost. As part of the FDC program, the VA encourages that the veteran submit a completed Disability Benefit Questionnaire (DBQ); however, many VA treatment providers are reluctant to assist the veteran in this regard. Worse still, we have many reports of VA health care providers refusing to complete DBQs despite VA directives to do so. Finally, private health care providers find DBQ instructions to be confusing, and they often charge veterans a fee to have them completed. VA must ensure that all of its health care providers comply with requests to complete DBQs.
The VFW supports the FDC program. As reported by VA for the first quarter of 2014, 30.7 percent of all claims submitted by VFW service officers are fully developed, and we will continue to work with VA to make improvements to the program and increase the number of veterans who file FDCs.
However, as mentioned above, adoption of the regulation changes proposed in AO 81 to eliminate informal claims will eliminate the FDC program because veterans will not be able to submit an informal claim to hold a date of claim while they develop their claim.
Quality Review Teams: The VFW wants to acknowledge VA's Quality Review Teams (QTR). These teams, composed of subject matter experts, are charged with reviewing a sampling of work from all employees each month. The idea is to provide immediate feedback when problems are identified so corrections can be made in near real time. An added bonus, is that data can be quickly gathered, which allows management to identify problems, which can be used to focus training and remediate employees with quality problems as well as identify employees who produce at a high level of quality. Over time it also provides sufficient information to identify error trends at a very granular level. Both sets of data allow VA to really focus training where it is needed. These are good things.
VA MEDICAL CARE
As the nation's largest integrated health care provider, the
VA anticipates veteran enrollment to grow beyond 9 million veterans in this fiscal year, with more than 6.5 million unique veterans receiving some type of care. This number has doubled over the last decade and will continue to rise. The increase is due to both improved access and quality of care that is being provided, as well as specialized care for war-related disabilities. It is predicted that these increases will continue as the current conflict comes to a close, the military begins its aggressive drawdown of troops, our
According to VA statistics from the third quarter of FY 2013, more than 965,000
Accordingly, as part of the IB, the VFW recommends a funding level of
Accountability: Although the vast majority of medical care provided at VA facilities is exemplary, VA must do a better job of holding its employees accountable when negligence is identified. The VFW is concerned that an overall lack of accountability across VHA is directly to blame for incidents of diminished standards at certain facilities, leading to tragic results for veterans.
This year,
WOUNDED WARRIORS
More than 51,800 service members have been wounded in action since the current conflicts began. This does not take into account those service members who are suffering from Traumatic Brain Injury (TBI), Post-Traumatic Stress Disorder (PTSD), or were exposed to harmful environmental toxins, or the invisible psychological wounds of war that may not manifest themselves for years. We must all realize and account for the hundreds of thousands of veterans who never needed a corpsman or medic's assistance on the battlefield, or went to sick call while in garrison, but in the months and years after their service could suffer from the demands that training and fighting wars has on the body and mind.
Mental Health: The most recent data available from VA shows that more than half of all OIF/OEF patients treated by VA have suffered some mental trauma, and about a fourth of them have been specifically diagnosed with PTSD. However, other research indicates that the number could be even higher. These numbers are staggering, and our efforts to address the problem cannot be cost driven.
As we seek to provide the best possible care for our newest war veterans, we cannot forget the men and women who have served in previous conflicts. No matter what era they served, all who are sent in harm's way are forever changed by their experiences. We must fully resolve to bring new advancements to bear in the lives of veterans of previous conflicts that still struggle with PTSD or other mental health challenges, while addressing barriers to quality, accessible care.
Over the past year, VA has hired more than 2,000 new health care providers and administrative staff. Additionally, VA began its peer support program, hiring over 1,000 veterans who act as peer-support specialists. This program has proven to be a success, and should be considered for further expansion. However, there is no indication that this hiring initiative was sufficient to ensure timely and quality mental health care.
VA must continue to improve in scheduling and following up with missed mental health appointments. In the most recent GAO report, appointment scheduling recommendations were provided to VA. VA is working to implement these recommendations, which included improving the way that wait times are measured, consistent enforcement of scheduling policies across VHA, better allocation of scheduling staff resources, and improving telephone service access for veterans.
The VA must continue to promote and expand the use of Vet Centers. There are currently over 300 Vet Centers and 70 Mobile Vet Centers nationwide that provide confidential individual and group, family and bereavement counseling for combat veterans and their families. The Vet Center model of care is a proven success. As
Suicide: Suicide among military personnel and veterans presents the most serious challenge to VA, the
Equally as troubling is the suicide rate in our armed forces, which steadily increased through 2012. Suicides in the U.S. military surged to 349 that year, meaning there were more suicides among active duty service members than there were combat deaths. In response,
The VFW believes the pre- and post-deployment evaluations have been a much-needed tool in detecting mental health issues. As an added measure of protection, and to increase awareness about the importance of early detection,
One VA initiative that has proven effective in combating veterans' suicide is the Veterans Crisis Line. As of
Veterans' suicide is a crisis which communities around the nation are aware of and are admirably working to address, and VA has recognized that community collaboration is an important component to finding effective solutions. In 2013, VA held Mental Health Summits at all 152 VAMCs to build partnerships and connect veterans and their families with local mental health resources unique to their communities. This initiative was a positive first step for VA toward community collaboration, but the VFW has been informed that there are currently no plans to hold similar events in the future.
We believe that Mental Health Summits should be held at each VAMC on an regular basis. The effort to truly build community awareness and partnerships must be ongoing in order to succeed. VA must remain engaged in every community to collaborate with new resources as they emerge. Regular Mental Health Summits would ensure that VA is able to identify mental health and suicide prevention programs that show success in communities around the nation, support them where they already exist and expand them into areas where there is a need.
Traumatic Brain Injuries (TBI): VA must continue to aggressively research the effects of TBI on cognitive and behavioral function. Currently, VA is conducting seven unique areas of research to better understand and treat, and to provide adaptive assistance and family support for veterans who suffer from TBI. In an effort to take the next steps in TBI research, VA held a conference entitled "Research to Improve the Lives of Veterans: Approaches to Traumatic Brain Injury Screening, Treatment, Management, and Rehabilitation." The recommendations from this conference include creating a centralized TBI database, to recruit and hire additional TBI researchers, and to increase the number of clinical trials within
Women Veterans Health Care: The number of women utilizing VA healthcare services has grown steadily over the last decade to coincide with the increasing number of women entering and leaving the military. Of those who have served, VA estimates that in FY 2012, 583,580 women veterans were enrolled in the VHA. The number of women veterans who have received care within VA has more than doubled over the past decade, and the number is expected to continue to grow over the next two to four years.
Because of the significant increase of women veterans turning to VA for services, VA created coordinated models of service delivery with specialized programs developed to meet their unique post deployment needs. This includes Women Veteran Program Managers, who can be found at each VA medical center and Regional Office. With all these new resources available, VA must ensure that women veterans' health programs are enhanced so that access, quality, safety and satisfaction with care become equal between men and women. VA must also continue its aggressive outreach services utilizing TV, radio, print, and social media outlets to remind women veterans that they are eligible and that VA is there to serve them.
Research from the
The VFW wants to ensure that access to care for women veterans is all-inclusive and takes into account their specialized needs. VA has made progress expanding female health care services, but much more needs to be done.
VA Services for Military Sexual Trauma Victims: VA began screening all enrolled patients for MST in 2013, and all veterans who screen positive are offered a referral for MST-related treatment. They have also recently developed a Military Sexual Trauma Support Team and MST program under the
VA is training clinicians in a number of evidence-based practices for mental health treatment. Because PTSD, depression and anxiety are commonly associated with MST, these national initiatives have been significant in expanding access to cutting-edge treatments for those who have experienced MST.
Veterans who experienced MST may also receive assessment counseling and referral services through
Strides have been made in the field of MST health care; however, sexual assault victims still face challenges within the VA claims process.
Currently, rating personnel are instructed to consider evidence showing a sudden change in behavior, a request for transfer from a unit, and correspondence as secondary evidence that could be used to support the assertion of an assault during military service. Unfortunately, in many of these cases, this type of evidence is not available, leading to the claim being denied.
The
Burn Pits: The use of open air burn pits in combat zones has caused invisible, but grave health complications for many service members, past and present. Particulate matter, polycyclic aromatic hydrocarbons, volatile organic compounds and dioxins - the destructive compound found in Agent Orange - and other harmful materials are all present in burn pits, creating clouds of hazardous chemical compounds that are unavoidable to those in close proximity. Burn pit exposure is clearly related to military service, and any resulting negative health effects must be considered for service-connected disability compensation and VA health care eligibility - to include those veterans who report being healthy at discharge, but later develop skin and pulmonary issues.
On
Centers of Excellence: Many of the events causing TBI on the battlefield are also leaving an alarming number of our service members with serious auditory and vision impairments. According to the
DCOE also estimates that around half of those suffering with TBI also experienced some level of vision impairment. Over 46,000 veterans of
The VFW is concerned that congressional intent behind creating the DCOE system is not being realized. A pronounced lack of funding, and a possible lack of cooperation between agencies, is resulting in a lack of progress and a diminished contribution. Exacerbating the problem is the fact that
Caregivers: As of
Another caregiver issue that must be corrected is that caregivers of veterans who were disabled by service-connected illnesses are currently excluded from eligibility for VA caregiver benefits. The
Non-VA Purchased Care: Non-VA purchased care is provided to enrolled veterans when direct care is not readily available to them due lack of available specialists, unreasonably long wait times, or geographic inaccessibility. Although purchased care is necessary in some cases to ensure proper access, the VFW believes that it must be used judiciously so that VA is able to maintain its full range of specialized in and outpatient services in a cost effective manner. In the past, the VFW has been critical of the fragmented fee basis system of purchased care due to its total lack of care coordination and susceptibility to improper payments.
The VFW believes that VA has taken a large step forward in solving the problems associated with the fee basis system with its new Patient-Centered Community Care (PC3) model, a program which is currently being implemented and is scheduled to be fully operational next month. Late last year, VA awarded contracts to
Under PC3, contracted networks will be authorized to provide most specialty care services - to include mental health services and newborn care for female veterans, as well as limited emergency care. Primary care services will remain exclusively with VA, along with nursing home care, dental care and dialysis. On
Although we are hopeful that PC3 will be successful in filling access gaps in a well-coordinated manner, the VFW will be monitoring its effectiveness closely in the coming year and we urge active Congressional oversight of the program. The uniform application of PC3 across different VA Medical Centers and VISNs will be essential to ensure the intent of the program is met, and non-VA care coordination staff must be properly trained. VA must maintain oversight of this program to ensure its use doesn't become fragmented or misused - with particular emphasis on highly rural areas where unreasonable travel times and lack of specialists pose the largest challenges.
Telehealth: VA is the largest and most comprehensive provider of telehealth services in the nation. Telehealth provides opportunities to save money, provide better health outcomes, and improve customer satisfaction by providing many services nearer and in some cases in the home. While the VFW recognizes the limitations of broadband and mobile infrastructure in many rural areas, we strongly believe VA must continue to be the leader in developing practical telehealth options that will benefit veterans and the larger medical community.
Today, many CBOCs are linked to larger VA facilities and their medical experts through teleconferencing, allowing for consultations and diagnostic testing. These services must continue to be expanded. Telehealth also allows for veterans to receive care while at home for mental health follow-ups, diabetes maintenance, post-surgical updates, and many other services. According to VA, the number of enrollees utilizing telehealth services grew from 9 to 11 percent in 2013, with over 600,000 veterans receiving almost 1.8 million telehealth-based episodes of care. VA believes, however, that the percentage of veterans who could potentially benefit from some form of telehealth is far greater and, according to the 2013 VA Performance and Accountability Report, has set a long-term strategic goal of eventually providing telehealth services to 75 percent of all enrolled veterans.
In an effort to make telehealth services even more convenient, VA is also currently piloting 10 mobile apps. These and other new technologies, including telemental health, are improving the lives of veterans in a cost effective way. VA is the national leader in telehealth, and we hope they will keep their finger on the pulse of technological advancements with the intent to roll out new methods of diagnosing and treating veterans wherever possible.
CONSTRUCTION PROGRAMS
The vastness of VA's capital infrastructure is rarely fully visualized or understood. VA currently manages and maintains more than 5,600 buildings on almost 34,000 acres of land with a plant replacement value (PRV) of approximately
With shrinking requests and appropriations from the Administration and
Major Construction Accounts: To finish existing projects and to close current and future gaps, VA will need to invest at least
In the short-term, VA must start requesting and
Minor Construction Accounts: The VFW believes that minor construction accounts can be brought back on track by investing approximately
Nonrecurring Maintenance Accounts: VA is moving further from closing current NRM safety, utilization and access gaps, and continues to fall behind on preventing future gaps from occurring. Just to maintain what they have in its current condition VA's Non-Recurring Maintenance (NRM) account must be funded at
Since the 1990s,
ECONOMIC OPPORTUNITY
Historically, veterans have always performed better than their non-veteran peers in the civilian job market. So where is the disconnect?
The VFW believes that improving skills transferability, skills acquisition, accessibility to higher education, and paths to entrepreneurship, as well as bridging the civilian-military divide will allow our nation to ensure that veterans have the opportunities to contribute to the civilian economy long after military service.
Over the last few years, the VFW has worked very closely with both of these committees and other committees in
We must also always consider the needs of those who came before. Though young veterans are more likely to be unemployed, older veterans are the largest cohort of unemployed veterans. Over the years, industries have evolved and jobs have gone away. This is why services like Vocational Rehabilitation, the
Vocational Rehabilitation and Employment (
Recent figures indicate that the workload for
VA must also increase oversight of
The VFW strongly supports Vocational Rehabilitation for Life now more than ever. The VFW has long believed that any time restrictions on utilizing such an important program prevent independence and an enhanced quality of life for veterans. Recent economic conditions have demonstrated exactly why our disabled veterans must always have access to this critical program. Industries evolve and some jobs go away. The VFW believes that America has an obligation to ensure that service-disabled veterans can secure meaningful careers regardless of how long they have been out of the military. Eliminating the current 12-year delimiting date and offering Vocational Rehabilitation for Life will ensure VA can uphold this obligation.
Unfortunately, the VFW remains concerned about the definition of "mandatory TAP," since TAP only mandates participation in the first week of service-specific counseling, Labor's employment workshop and the VA benefits briefing. It excludes the individualized curriculum for education, entrepreneurship, and vocational/technical employment. The VFW believes that all service members must have access to these individualized tracks to ensure they are prepared for post-military life.
The VFW also believes that curriculum must be continually audited and updated for relevance, and that the pilot program on post-service TAP should be extended to support large military and veterans' communities across the country.
Licensing and Credentialing: When we recruit American men and women to serve in the military, we promise them highly technical skills and experience that employers will value. With this in mind, it seems incomprehensible that our veterans continue to struggle to find comparable civilian careers after leaving the military.
Thankfully,
A recent
Veteran Hiring Priority: The VFW believes we must continually encourage civilian employers to proactively recruit, hire and retain veterans. Through their military service, our veterans have gained leadership and teamwork skills unparalleled in the civilian sector. Veterans have also received world class training and real-world experience that should easily translate into any work environment. Recent reports from both the
Unfortunately, these same reports reiterate that a cultural divide persists between the military and potential civilian employers, leading to misconceptions that prevent companies from recruiting, hiring and retaining skilled veteran employees.
Recently, the
Despite some recent examples of success, the VFW believes that more companies in the private sector must step up to hire veterans. The VFW has long advocated for a national "Hire a Vet" public relations campaign to change the mindset in the private sector, but we must also work to ensure that potential employers fully understand how to reach and recruit quality employees from the veterans' community.
Veterans Small Business: The VFW also recognizes that veterans are more likely to pursue business-ownership than their civilian counterparts. After
The federal government has an obligation to do business with veteran-owned small businesses (VOSBs), service-disabled veteran-owned small businesses (SDVOSBs) and contractors who employ veterans. Unfortunately, many agencies still fail to meet the three-percent acquisitions threshold to contract with SDVOSBs, and tools are not in place to enforce veteran-hiring mandates for contractors. To further exacerbate this shortfall, VA's
Many communities around the country lack sufficient entrepreneurial support for veterans. The VFW advocates for effective outreach to all potential veteran business owners so that they may seek opportunities in establishing and developing businesses. In order to receive the adequate knowledge to pursue their goals in business and entrepreneurship, the VFW encourages
The VFW supports equal benefits for all veterans alike. Today, women veterans are the fastest growing segment within the veterans' population, meaning we must afford our women veterans with mentorship and resources to succeed as business owners. The VFW supports the Veteran Women Igniting the Spirit of Entrepreneurship (V-WISE) program and its objectives to help women veterans start their own businesses. Education will be one of the tools used to assist V-WISE participants in acquiring the basic skills of entrepreneurship, to receive mentoring from currently accomplished entrepreneurs, and to build partnerships within the business community.
The VFW also fully supports business development programs to assist veterans with service-connected disabilities. The Entrepreneurship Bootcamp for Veterans with Disabilities Program (EBV) offers exceptional training to veterans with disabilities. Much like other successful business programs for veterans, EBV provides consistent education, mentorship and training, and exposure to build successful entrepreneurs.
USERRA: Members of the Guard, Reserve and the veterans' community have employment and discrimination protections through the Uniformed Servicemembers Employment and Reemployment Rights Act (USERRA), but enforcement is difficult and the federal government continues to be one of the worst offenders.
The VFW has learned that many service members, veterans and their employers fail to understand their most basic rights and responsibilities under USERRA, which causes many service members to unknowingly waive those rights by signing binding, pre-dispute arbitration agreements upon employment. To change this,
Finally, the VFW has long supported veterans' hiring preferences within the federal workforce. At a time of federal hiring freezes and budget constraints, the VFW believes that
Education: In 2008,
Over the years, some on
Over the past year we have also seen significant improvement in the consumer resources available to college-bound veterans. Last year we applauded
The VFW was proud to support
The VFW urges
Also current Fry-eligible dependent children are excluded from enhanced tuition reimbursement available through the Yellow Ribbon Program, meaning they may incur significant unforeseen out-of-pocket costs for higher education. The VFW believes survivor GI Bill benefits should be comparable to veterans' benefits. A simple legislative fix will provide Fry Scholarship recipients with the same benefits as other Chapter 33-eligible beneficiaries, and the VFW encourages
Finally, the VFW continues to call on
,OTHER BENEFITS
Survivor Benefit Plan-Dependency and Indemnity Compensation: The VFW calls on
SBP is a purchased insurance that pays a percentage of military retiree pay to a surviving spouse, and a benefit conferred in line-of-duty deaths for active duty service members. The amount of SBP paid to the survivor whoever, is offset dollar-for-dollar by any DIC payment received.
Other federal programs do not have an offset of this kind. We believe those who give their lives for their country deserve equal compensation for their surviving spouses and children. Our service members died believing that their sacrifice would enable a decent quality of life for their spouses and children. The elimination of this survivor benefit inequity is a top legislative goal for VFW.
Concurrent Receipt: The VFW continues to supports legislation which calls for full concurrent receipt of military retirement pay and VA disability compensation without offset, and regardless of the rating percentage. Current law will allow military retirees with 20 or more years of service and a disability rating of 50 percent or higher to receive both their military retirement pay and their VA disability compensation without offset by the end of the 2014. Now it is time to include those service-connected disabled military retirees with VA ratings of 40 percent and below, and Chapter 61 retirees, who were medically retired with less than 20 years. No other federal employees are penalized for retiring and having a disability.
The VFW calls on
Veterans Homelessness: Ending homelessness among veterans by 2015 is a top priority for the VFW and the Administration. Encouraging data has been released by VA and the
VA announced the availability of
VA must continue its outreach efforts to help ensure homeless veterans gain access to the necessary health and benefit programs. They must also take the lead in addressing specific needs of homeless veterans by evaluating and improving its strategies of local and government cooperation in order to be successful VFW continues to stress that ending homelessness requires a firm understanding that the problem must be solved at every level of government not just
VA Adaptive Grants: Adaptive grants for eligible service-connected veterans provide independence and allow veterans with severe disabilities to regain confidence and freedom of movement in a challenging environment. Currently, VA provides adapted-housing grants only once regardless of any change in circumstances like locality to employment, family size, or access to medical care. Once the housing grant is used, veterans with service-incurred disabilities must bear the cost of continued accessible living should they move or modify a home. Veterans should not be forced to choose between surrendering their independence by moving into an inaccessible house, or staying in a home that no longer fits their families' needs.
VA Insurance Programs: VA insurance programs are designed to provide coverage to veterans and service members who may have difficulty obtaining affordable coverage in the private sector due to service-connected disabilities.
VFW encourages
DOD RETIREMENT AND QUALITY OF LIFE
Although the following issues fall under the purview of the Armed Services Committees, the VFW must take the time to express our concerns with issues concerning military retirees and service member quality of life.
The most recent attempt to save money through the erosion of retiree medical benefits came in the form of the
Protection of Military Retirement System: There continues to be a push from the
Equity that non-military cohorts earn in home ownership is lost for service members who move every three to four years. Spouses lose career longevity, precluding them from raises and promotions associated with staying with an employer long-term.
Not included in the financial hardships are the years away from family, the physical toll military training and war have on service members, or the internal turmoil caused from uprooting children from schools every few years. Comparing civilian careers to military service in an effort to justify reducing the military retirement plan is disingenuous and an insult to all who wear the uniform. To maintain a high quality, all-volunteer force, it is important to keep personnel benefits, particularly the current retirement system intact.
Military Sexual Trauma (MST): The FY 2014 National Defense Authorization Act (NDAA) and other noted legislation included provisions to strengthen sexual assault prevention and response programs and amend the Uniform Code of Military Justice (UCMJ). We applaud programs like
We urge
POW/MIA FULL ACCOUNTING ISSUE
No organization does more for the POW/MIA mission than the VFW. We have sent senior leaders into
The FY 2010 National Defense Authorization Act requires the Joint POW/MIA Accounting Command (JPAC) to identify at least 200 missing servicemen annually by 2015. The new requirement did not initially come with increases in personnel or funding, and whether or not programmed budget increases through FY 2016 come to fruition remains to be determined, especially since it appears the two largest accounting organizations - JPAC and the
Mission accomplishment is what's important to the VFW, not organizational structure. We are concerned, however, that new mission requirements - such as the resumption of recovery operations in
We urge full mission funding for every organization involved in
America must always live up to her commitment to never leave a fellow service member behind.
Thank you for the opportunity to testify before you today. I am happy to answer any questions the Committees may have.
Read this original document at: http://www.veterans.senate.gov/download/?id=275b2c91-7586-4bb3-8448-48182b114337&download=1
Copyright: | (c) 2010 Federal Information & News Dispatch, Inc. |
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