VFW Commander-in-Chief William Thien's Testimony
March 05, 2014
WILLIAM A. THIEN
VETERANS OF FOREIGN WARS OF THE UNITED
BEFORE THE JOINT HEARING
THE COMMITTEES ON VETERANS AFFAIRS
UNITED STATES SENATE AND UNITED STATES
HOUSE OF REPRESENTATIVES
WEDNESDAY, MARCH 5, 2014
Sanders and Miller, Ranking Members Burr and Michaud, Members of the Senate and
House Veterans Affairs Committees,
is my honor to represent more than 1.9 million members of the Veterans of
Foreign Wars of the United States and our Auxiliaries. It is also my duty to advocate on behalf of
our nation’s 21 million veterans, her 2.3 million military service members, and
all of their families—to give them a voice on Capitol Hill and inside the White
House on issues that concern those who served and continue to serve and
sacrifice for our nation.
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 House Veterans Affairs Committee. You have been a true student
of veterans’ issues, and a strong advocate for the veterans’ community. Your
leadership and bipartisanship has not only had a positive impact on this
Committee’s work, but has also improved the lives of veterans of all
concerns the VFW and patriots everywhere is that America has forgotten that OUR
NATION IS STILL AT WAR!
have 38,000 men and women stationed inside Afghanistan fighting to ensure the
country doesn’t become a terrorist training ground again. We have another 30,000 stationed in South
Korea helping to preserve a 61-year-old ceasefire that is looking more and more
tenuous. We have tens of thousands more service
members stationed abroad helping to bring peace and stability, and humanitarian
assistance when and where it’s needed.
we have some in Washington who have opened up a new war against the very
Quality of Life programs that you and your committees have fought hard to
bestow on our service members, veterans and their families, as seen with the
backroom deal to lower military retiree COLA by 1 percent. Some believe the
cost of war ends when the last troops leave Afghanistan. We know this is not
true, and that is why we need a fully funded state-of-the-art VA health care
system, benefits programs and cemetery system.
Chairmen, I pledge to you that the VFW will fight to preserve the safety and
security of the United States and the continued viability of the All-Volunteer
Military. We will fight attempts to force veterans, service members and their
families to shoulder an unfair share of the nation’s debt, and we will fight
for adequate funding for the Department of Veterans Affairs and for advance
appropriations for all of its accounts.
would like to recognize and thank Senator Sanders for introducing S. 1982, the
“Comprehensive Veterans Health and Benefits Act of 2013.” Your bill has pushed
veterans’ issues to the forefront again. We look forward to working with you
and your colleagues on the Senate Veterans Affairs and House Veterans Affairs
Committees to ensure passage of a comprehensive veterans’ health and benefits
legislation this year.
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.
VFW exists to serve veterans, and that includes representing them in Washington
where the voice of one veteran is often overlooked and the voice of servicemen
and women is prohibited. The VFW exists
to ensure that a nation that creates veterans fulfills its sacred duty to care
for them when they return home.
VA also exists to serve veterans. It should be seen as a privilege and not a
right to work at VA. We call on Congress to continue its oversight role and
hold those accountable who hold management positions, but fail to manage.
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.
continues to constrain budgets, looking in every Department and agency for
savings. The VFW understands Congress must find ways to reduce spending, but
the VA cannot fall victim to underfunding. With ever-growing costs to deliver
health care and the continued increase in usage of VA care and benefits, the
VFW is concerned that a budget with little to no increase will not sustain the
level of care and services our veterans need. Congress must provide a budget
that will allow the Veterans Health Administration, Veterans Benefits
Administration and National Cemetery Administration to fulfill their missions.
As a partner of the Independent Budget,
the VFW is requesting a fiscal year (FY) 2015 discretionary budget of $72.9
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. Congress
must act to repeal the current sequestration law.
care for those who have answered our nation’s call, the VFW calls on Congress
to do two things:
Fully fund all VA accounts
Place all VA budgetary accounts under
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.
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 $60 billion will need to be invested. The
Administration must submit a budget request – and call on Congress to pass a
capital infrastructure budget – that will allow VA to maintain their facilities
so they are safe and efficient. Included in its overall capital planning needs,
Congress must solve its capital leasing issue so VA can continue to enter into
long-term Community-Based Outpatient Clinics (CBOC) and other long-term leases.
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.
adequately cover all medical care accounts Congress will need to appropriate
$61.1 billion, not including VA’s medical care collections. This funding will
cover medical services, medical support and compliance, and medical facilities,
which includes non-recurring maintenance. Congress must also appropriate $3.9
billion to cover VA’s construction programs to close the access and safety gaps
that continue to grow.
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.
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.
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.
VFW believes that legislation must be introduced that would allow VA to collect
funds from Medicare for medical services VA provides to veterans for non-service
connected conditions. Medicare collection will allow VA to collect funds for
the care they provide, while providing that care at a reduced cost to Medicare.
Congress must act now; this is a simple solution that will be a win-win for VA
and the Medicare Trust Fund, as well as allowing Medicare-eligible veterans to
receive their full continuum of care through VA.
the past 10 years, Congress has worked diligently to increase funding to meet
the growing needs of America’s veteran population. While Congress increased
veterans funding, the need for veterans’ services has only increased. Since
1996 The Department of Veterans Affair’s enrolled population has grown three
times faster than appropriations levels for that same period. This resulted in
an overwhelmed Department that could not respond to the needs of veterans.
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.
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.
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
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.
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
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.
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.
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.
VFW recently completed a site visit to the VA regional office in St.
Petersburg, Fla. Our staff reviewed 79
paper and electronic claim files with rating decisions. We found that 21 cases had problems or
errors. That represented 26.6 percent of
the cases reviewed. VA reports that
ratings in St. Petersburg are, on average, wrong 10 percent of the time. While not all of the errors we found involved
ratings, we did find errors in 17.7 percent of the ratings we reviewed. This is significantly higher than what VA
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.
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
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
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.
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 DOD fail to make the change to a single, interchangeable health record. The
lack of progress has exacerbated the claims backlog as VA waits for DOD to scan
and send military treatment records to VA. Congress has provided the funding to
make a single record, but a solution still isn’t in place. The VFW supports the
idea of DOD adopting the VA’s VISTA record system, and we further suggest that
the Appropriations Committee withhold funding of DOD’s IT accounts if a
solution isn’t in place before the beginning of fiscal year 2016.
The VFW urges Congress to continue its
oversight of the development of VBMS and other critical IT programs, to include
the implementation of a single health record system for VA and DOD.
Proposed Rule AO81: As part
of their effort to reduce the claims backlog, VA published a proposed rule in
October 2013 that would require claimants to complete standardized forms before
starting the claims process. Under current law, a veteran can start a claim by
sending any communication – such as a handwritten note – to indicate their
intent to file a claim. Veterans then have up to one year to complete whatever
standard forms VA requires. If VA
approves the claim and awards benefits, the veteran receives back pay to the
date when the veteran first submitted a claim.
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
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.
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.
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 Congress to protect the ability of
claimants to file informal claims, whether electronically or on paper.
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 February 2013, the Board of Veterans Appeals (BVA) said that
it took, on average, 1,040 days for a veteran to receive a BVA decision after
filing a substantive appeal. At least two-thirds of all time is spent awaiting
processing in VA regional offices. The VFW believes that the due process rights
of veterans are threatened by the lack of resources spent on adjudicating
VA officials argue that the unique set of veteran-friendly laws creates
obstacles to efficient appeals processing. It is true that Congress has enacted
a unique set of pro-veteran policies dealing with veterans benefits, uncommon
in other areas of the law. The VFW believes that veterans who have made
uncommon sacrifices for our country should be entitled to unique treatment by
the government. More importantly, while laws may create challenges for the VA,
they are not insurmountable challenges. For example, last year VBA concluded a
one-year appeals pilot at the Houston Regional Office which focused on
eliminating processes inefficiencies, ineffective training, and poor oversight.
VA reports that during this pilot they were able to shave 1,000 days off the
average time it took the Houston staff to process appeals. While the VFW needs
to study the process more closely to ensure that veterans were not harmed
during this project, we are encouraged by the pilot’s results.
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 Congress to hold VA
accountable for the increase of backlogged dependency claims.
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.
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.
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.
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
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.
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.
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.
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.
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.
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
Quality Review Teams:
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
As the nation’s largest
integrated health care provider, the Veterans Health Administration (VHA) has
four primary missions: to provide health care and services to America’s sick
and disabled veterans; to train and educate doctors, nurses and other health
care professionals; to conduct world-class research on medical issues including
prosthetics; and to serve as the nation’s primary health care backup in times
of war or domestic emergency.
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 Vietnam era
veterans begin needing long-term care, and our women veterans continue to
access VA health care at unprecedented levels.
According to VA statistics from
the third quarter of FY 2013, more than 965,000 Iraq and Afghanistan veterans
have sought VA care out of a pool of more than 1.6 million. The VFW and the Independent Budget (IB) expect this
number to continue increasing. The VFW continues to hear of delays in
appointment times, especially for specialty care. We must not fail to provide
the care these heroes have earned in a timely manner.
Accordingly, as part of the IB,
the VFW recommends a funding level of $61.1 billion for total medical care, an
increase of $3.4 billion over the FY 2014 operating budget level. Additionally,
the Administration recommended an advance appropriation for FY 2015 of
approximately $55.6 billion in discretionary funding for VA medical care. When
combined with the $3.2 billion projection for medical care collections, the
total available operating budget recommended for FY 2015 is approximately $58.8
billion. Full funding will be absolutely necessary for VA to successfully
provide care to an increasing number of veterans while continuing to maintain
high quality and access standards.
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, OIG
released a report detailing the improper handling of cases where veterans have
died. The VFW finds it absolutely unacceptable that veterans are dying from
preventable causes at VA facilities while seemingly no one is held accountable.
VA must be more proactive in developing and enforcing a uniform standard of
care in every VISN and at every VAMC to prevent these tragic events before they
happen, and to hold those who are directly responsible accountable. The VFW
strongly believes that the only way to achieve this is through meaningful
accountability of local and regional leadership.
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.
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.
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. Congress and VA must ensure
enough mental health care providers are hired to ensure VA can meet the
established 14-day wait time policy. Proper oversight will be necessary in the
coming year to determine if still more providers and staff are needed and if
so, VA must be prepared to recruit, hire and retain them.
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. Congress must
ensure these policies are fully developed and implemented, staff is trained in
new procedures, and accurate follow-up reporting is done to ensure veterans’
appointment needs are being met in a timely manner.
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 Congress and VA move forward with expanding access to mental
health care service, Vet Centers are a commonsense, cost effective way to reach
veterans in their communities, and must be at the top of the list to receive
increased funding and expansion.
Suicide among military personnel and veterans presents the most serious challenge
to VA, the Department of Defense and the nation. A January 2014 update of
the VA Suicide Data Report provided more detailed and telling demographic data
on which veterans are taking their own lives at the highest rates. Although
suicide rates fell significantly among male veterans aged 35 to 64 from 1999 to
2010, suicide rates among younger male veterans and all female veterans
increased during that time. During this time, suicide rates, have remained
constant at about 22 veterans per day. This data includes veteran who are
receiving care and those who are not receiving care through VA. While this
indicates that VA suicide prevention efforts have produced positive outcomes
for some groups, it also highlights the groups that are at the highest risk. In
light of this new information, VA and DOD must refine their message and
outreach to young veterans to ensure a total decline in veteran suicide.
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, DOD
aggressively expanded its suicide prevention programs, and the most recent data
from the Army indicates that these efforts are having a positive effect. Suicides among active duty soldiers fell from
185 in 2012 to 150 in 2013; a 19-percent drop.
The VFW is relieved to learn of this declining trend, but believes that
the numbers are still far too high, recognizing that even one military death
from suicide is one too many. We must
continue to do everything we can in the coming year to ensure that DOD is
providing adequate behavioral health counseling programs, and is actively
engaged in reversing the negative stigma associated with seeking help to
finally end this horrible epidemic.
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, DOD and VA must continue to educate
family members on how to detect signs of stress. Spousal and parental
involvement and education is absolutely essential to this effort. It is all too
common for veterans to dismiss or delay treatment options, and family members
are often unsure how to respond to an episode or personality change. Educating
those closest to veterans about warning signs is a common-sense way to equip
family and friends with coping skills to assist veterans suffering from PTSD.
One VA initiative that has proven
effective in combating veterans’ suicide is the Veterans Crisis Line. As of January 2014, VA estimates that Veterans
Crisis Line has responded to over 1.1 million calls, resulting in the
prevention of over 35,000 traumatic events.
The VFW believes that it is critical to ensure that VA continues to
maintain an aggressive outreach campaign to veterans and their families of all
eras, with proper funding to expand this effective program as necessary.
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
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 VA Research and Development. VA has a plan to move forward in improving
the lives of veterans who have suffered a TBI. The Administration and Congress
must provide the funding necessary to achieve these goals. In partnership with
the Independent Budget, the VFW calls on Congress to appropriate $611 million
for FY 2015 for VA’s Medical and Prosthetic Research accounts.
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.
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
from the VA Health Services Research & Development Service concluded that
the effects of deployment among OEF/OIF women included higher rates of moderate
to severe pain, higher distress after the first deployment, and when involving
combat exposure, high rates of eating disorders and extreme weight loss. VA
researchers must continue to study the impact of war and gender differences on
medical and mental health post deployment to determine the best models of care,
rehabilitation, and new treatments to address the needs of women veterans.
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. Congress must continue to provide oversight and demand progress
reports from VA, and to gain greater insight from women veterans themselves
about access to VA services and programs, satisfaction with care, and perceived
barriers or gaps in services.
VA Services for Military Sexual Trauma
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 Office of Mental Health Services.
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 VHA’s Readjustment Counseling Service,
and have access to new initiatives that are being used for PTSD-like Cognitive
Processing Therapy and Prolonged Exposure. There are also national training
initiatives for anxiety and depression, Acceptance and Commitment Therapy, and
Cognitive Behavioral Therapy, which are being utilized by clinicians as
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
Senate must pass S. 294, the “Ruth Moore Act,” the companion bill to H.R. 671,
which passed the House in June. If signed into law, the provision will afford
the same relaxed evidentiary burden that is given to soldiers engaged in combat
– that if a veteran states that he or she experienced military sexual trauma,
and a qualified mental health professional confirms that the claimed stressor
is adequate to support the diagnosis of post-traumatic stress disorder, and
that the victims symptoms are related to the claimed stressor, then the
veterans statement alone is sufficient evidence to establish the stressor.
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.
February 4, 2014, VA published the proposed rules for initiating a burn pit
registry with the intent of conducting a longitudinal cohort study of adverse
health effects related to airborne hazards and burn pit exposure in Iraq and
Afghanistan. We ask Congress to provide oversight ensuring that the burn pit
registry becomes operational this year without undue delay so VA can begin
gathering a veteran cohort to produce the longitudinal study.
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 Defense Hearing Center of
Excellence (DCOE), 350,000 veterans of the current conflicts have reported
suffering from Tinnitus, and more than 250,000 veterans from these conflicts
report having hearing loss.
DCOE also estimates that around
half of those suffering with TBI also experienced some level of vision
impairment. Over 46,000 veterans of Iraq and Afghanistan have reported an eye
injury, and VA Polytrauma Centers report that 80 percent of all TBI-injured
patients complain about some level of visual dysfunction. While these
afflictions affecting the visual and auditory systems are obviously pervasive,
they are not getting the attention they deserve.
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 Congress reduced funding for this
research last year, making what were already difficult choices even more
complicated. According to DCOE, many serious opportunities for valuable
research are available to them, but they do not have available resources to
pursue them. DCOE should have adequate funding for research initiatives that
have a high degree of promise. We urge your respective committees will work to
ensure the best possible outcomes for our service members suffering with the
problems these centers were created to address.
Caregivers: As of
May 2013, over 10,000 family caregivers were participating in the program, with
approximately 500 new caregivers being approved for the program each month. One
of the requirements of the Caregiver Act was for VA to submit a report to
Congress examining the feasibility of expanding eligibility for comprehensive
caregiver benefits to those who care for severely injured veterans of previous
eras. That report, issued in September
2013, estimated that between 32,000 and 88,000 pre-9/11 veterans would become
eligible for the program at an estimated cost of $1.8 to $3.8 billion. VA stated that such an expansion would be
operationally feasible, as long as Congress provides the necessary funding to
administer the programs and hire the required additional staff. The VFW strongly encourages Congress to provide
VA with the necessary resources to fully expand the caregiver program to all
eras, because all have borne the cost of caring for their loved ones for many
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 Department of Defense provides support to family
caregivers of members of the armed forces who are catastrophically disabled
through its Special Compensation for Assistance with Activities of Daily Living
(SCAADL) program, which includes disabilities caused by illnesses in its
eligibility requirements. The VFW believes that it is necessary to fully align
VA caregiver benefits with the SCAADL program, to create a more seamless
transition for the most severely disabled veterans, and to ensure that those
who care for them receive the support they need.
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 Health Net
Federals Services and TriWest Healthcare Alliance to develop networks of
providers across the country to deliver non-VA health care. The advantages to
the PC3 contracts include convenience due to required commute time standards,
efficiency due to pre-negotiated payments rates, and care coordination due to
the requirement that medical records are returned to VA before payments are
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 January 1, 2014, TriWest partially stood
up its networks ahead of schedule and began health care delivery in Region 5,
which includes the West Coast, Hawaii, Arizona, New Mexico, and parts of Idaho,
Nevada and Texas. In the first month alone, they
received 1,400 authorizations from 18 different VA Medical Centers in Region 5,
and have already scheduled over 650 appointments.
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
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
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.
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 $45 billion. Although VA has
decreased the number of critical infrastructure gaps, there remain more than
3,900 gaps that will cost between $54 and $66 billion to close, including $10
billion in activation costs.
With shrinking requests and
appropriations from the Administration and Congress, VA is slipping further
behind in closing known safety, utilization and access gaps, and continues to
fail to prevent future gaps from arising. To only maintain VA infrastructure in its current condition, VA’s
Non-Recurring Maintenance (NRM) account would justify $1.35 billion per year,
based on the estimated plant replacement value The Independent Budget veterans service organizations (IBVSOs) have
calculated. The account is currently being funded at $712 million. More funds
will need to be invested to prevent the documented NRM backlog of $19 billion
to $23.3 billion from growing even larger. To close the gaps in safety, access
and utilization, VA will need to invest between $27 and $33 billion dollars in
major and minor construction and leasing. VA capital infrastructure will never
close all its safety and utilization gaps if they continue to conduct business
as usual. It is time to have a serious discussion on what VA infrastructure
will look like in the future. This discussion must be held in the public eye
with a broad scope of voices – especially the voice of veterans. This
discussion must include the idea of a public-private partnership, disposal of
unutilized and underutilized properties, and forecasting of veterans
Construction Accounts: To finish existing projects and to close
current and future gaps, VA will need to invest at least $23.2 billion over the
next 10 years. At current requested funding levels, it will take more than 67
years to complete VA’s 10-year plan.
In the short-term, VA must start
requesting and Congress must start funding major construction at a level that
begins to reduce the backlog. The IBVSOs recommend providing VA with $2.8
billion in major construction funding in FY 2015. This will allow funding to
close the most severe safety gaps and complete funding on the longest standing
projects. VA must also begin presenting long-term proposals that will outline
how the Department will address closing all major construction gaps.
Construction Accounts: The VFW believes that minor construction
accounts can be brought back on track by investing approximately $832 million
per year over the next decade to close existing gaps and to help prevent
unmanageable future gaps.
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 $1.38 billion per year, based on The
Independent Budget veterans service organizations estimated Plant
Replacement Value. It is currently being funded at $712 million per year. More
will need to be invested to prevent the $22.4 billion NRM backlog from growing
fourth cornerstone to VA’s capital planning is leasing. The current lease plan
calls for little more than $2 billion over the next 10 years. VA leases
properties, ranging from CBOC and medical centers to research and warehouse
space. These leases do not fall under the larger construction accounts, but
under each VA agencies and staff office operating accounts.
Since the 1990s, Congress has
helped improve VA health care access and patient satisfaction by authorizing
and funding nearly 900 VA CBOCs. These facilities have provided local,
convenient and cost-effective primary care for millions of veterans. In a 2012
policy shift, the Congressional Budget Office changed its accounting practice
on how major capital leases are to be funded, effectively halting congressional
authorization of future leases. Currently, there are 28 major capital leases,
totaling nearly $247 million, for which VA has requested congressional
authorization. These leases are now in limbo. This backlog of leases will only
grow as existing leases expire. Lack of reauthorization could result in
closures of current clinics, and newly proposed clinics cannot be activated
without authorization. Inaction will lead to increased costs associated with
longer travel times or the need for fee-based care that otherwise would be
provided through CBOCs. Access to care will also decline as veterans will be
forced to travel further and wait longer for the care they need.
deserves recognition for its concerted efforts to reduce veteran unemployment.
Over the last four years we have watched the unemployment rate drop from well
over 12 percent for Iraq and Afghanistan-era veterans to now slightly over 7 percent.
Unfortunately, while the situation has improved, job prospects for our newest
generation of veterans remain grim when compared to their non-veteran
counterparts. Unemployment among post-9/11-era veterans continues to be
unacceptably high. Our troops are already home from Iraq and by the end of this
year, most troops will be brought home from Afghanistan. In a difficult budget
climate, the military has already started to draw down its active duty force,
and the Department of Labor estimates that more than 1 million veterans will
enter the workforce in the next three years. This means that we must remain
ever vigilant in ensuring our veterans have the tools necessary to succeed in
the civilian economy after military service.
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
Congress to commission new programs and improve existing programs to better
serve veterans in the workforce. Whether through veteran hiring tax credits,
small business incentives, public-private hiring partnerships, robust education
benefits, or modernized transitional resources, we have opportunities to better
prepare our newest veterans for what lies ahead.
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 Veterans Retraining Assistance Program,
and veteran priority services at American Jobs Centers remain so critical. Our
nation must have a national strategy to address overall veteran unemployment,
and the VFW is honored to offer our recommendations on how to make this happen.
Vocational Rehabilitation and
Employment (VR&E): VA must conduct a work measurement
study to identify proper staffing levels, and the critical skills and
competency needs that are truly necessary to provide quality assistance for
veterans within the VR&E program. As the wars in Iraq and Afghanistan draw
to a close and more veterans file claims for disabilities incurred in the line
of duty, VR&E will need to adapt to meet this evolving need for
figures indicate that the workload for VR&E counselors is 145 veterans to
every counselor – far in excess of VA’s 125:1 standard. VA has an obligation to
ensure that all veterans who need reemployment services due to their
service-connected disabilities must have the proper guidance and resources to
complete their individualized rehabilitation program. VR&E must focus on
building careers for veterans – not just placement into jobs – and funding for
VR&E must reflect that commitment. The VFW recommends congressional
oversight of VR&E to ensure veterans are receiving the highest level of
must also increase oversight of VR&E service contracts to ensure quality
services are provided, and that reimbursement is at an appropriate level. The
VFW believes that VA should provide a clearer picture of success rates in the
survey and performance data to ensure proper funding and training levels can be
achieved. Currently, veterans who are only using VR&E for employment
services do not receive a monthly living stipend while seeking employment, but
veterans using VR&E more comprehensively receive living stipends for up to
two months past the completion of their rehabilitation plan. The VFW believes
these incentives should be realigned to more fairly assist veterans regardless
of the services they are receiving. It is also important to extend success
tracking from 60 days to the end of the veteran’s probationary period in
employment. This will provide better assurances that veterans are succeeding in
their new careers.
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.
Assistance Program (TAP): The military TAP is the first gateway to
ensuring a veteran can succeed in the civilian workforce after military
service. Unfortunately, for years the curriculum was stale; transitioning
service members chose not to participate; and once the uniform came off, the
information was no longer available. Thanks largely to Chairman Miller and
Senator Murray, and the hard work of these Committees and the VOW to Hire
Heroes Act, all of this has changed over the last few years. TAP is now
mandatory for all transitioning service members, meaning all will have a
quality baseline of information before and after leaving the military.
Moreover, the departments of Defense, Labor, VA and other partner
administrations have completely overhauled the curriculum to make it more
relevant to today’s workforce. Finally, Labor has made all of the new TAP
modules readily available on its website and Congress commissioned pilot
programs to deliver TAP modules to veterans in five communities around the
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.
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, Congress and many
states have taken steps over the last few years to improve the situation. In
federally-licensed fields like aviation, military credentials easily transfer
into federal licenses, and in fields like transportation and health care, the
states are starting to fill in the gaps. More than 27 states recognize military
training and experience when considering veterans for certain professional
recent Department of Defense pilot program on civilian licensing and
credentialing has also succeeded in better training military professionals to
civilian standards. However, the Pentagon acknowledges that this pilot program
needs to be expanded to include other fields, like information technology (IT),
and it needs a sustainability plan. The VFW will continue to work at the state
level to advance the acceptance of military training and experience. The VFW
encourages Congress to look at any and all options to expand and sustain
civilian licensing and credentialing programs for service members while in
uniform, as we work at the state level to advance the recognition of military
training and experience in lieu of civilian recertification. At a time when the
government spends nearly $2 billion each year to finance veteran unemployment
benefits, exposing service members to relevant credentialing opportunities
while in uniform not only creates better trained military professionals, but it
also allows these highly trained professionals to more easily find jobs after
leaving the military.
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 University of Syracuse Institute on
Veterans and Military Families, and the Center for a New American Security,
have confirmed this by talking directly with employers who hire veterans.
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 House Veterans
Affairs Committee hosted a hearing to listen to private industry employers who
have made a concerted effort to bring veterans into their workforce. Each
witness agreed that veterans brought immeasurable skills, but called for
improved public/private partnerships to prepare veterans for new civilian
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.
Small Business: The VFW also recognizes that veterans are more
likely to pursue business-ownership than their civilian counterparts. After
World War II, 49 percent of all small businesses in the United States were
owned by veterans. We must continue to cultivate this entrepreneurial spirit.
We applaud the Small Business Administration for its work to improve
entrepreneurial resources for our veterans, but more can be done to help veterans
access capital to get a business off the ground.
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 Center for Veterans Enterprise continues to put
up roadblocks to veteran entrepreneurs who wish to do business with VA. The
House Veterans Affairs Committee called attention to this issue last session,
and we encourage Congress to hold VA accountable for unreasonable vetting
policies that have prevented some long-established VOSBs and SDVOSBs from doing
business with VA.
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
Congress to pass legislation to sustain and expand Veterans Business Outreach
Centers to provide financial, management and marketing advice, as well as
training and counseling to potential veteran entrepreneurs.
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.
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, Congress must first
create a USERRA exemption for such agreements. We must also better educate
veterans on their rights, and equip both service members and employers to
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 Congress
must ensure the federal government serves as a model employer of veterans,
working proactively to recruit, hire and retain the best possible veteran
2008, Congress passed the Post-9/11 GI Bill offering unprecedented educational
opportunities for our most recent veterans. However, history shows that as a
conflict ends, Congress tends to scale back education benefits. As a result,
the VFW’s top priority is to preserve this benefit at all costs. To do so, we
must have accurate data on student veteran outcomes in higher education.
Over the years, some on Capitol
Hill have pointed to incomplete and largely irrelevant data from the Department
of Education as an indicator that veterans do not succeed in college.
Thankfully, in the last year, veterans’ advocates have stepped up to fill this
void. This is why the VFW applauds the recent collaboration among VA, Student
Veterans of America and the National Student Clearinghouse to compile student
veteran outcome data on nearly 1 million veterans who served after 9/11. We
anticipate this report in the coming months, and we look forward to finally
having reliable data with which we can demonstrate student veteran success. However,
this is just the beginning. We hope this project will serve as a demonstration
for the kinds of information VA and the Department of Education should collect
on student veterans.
Over the past year we have also
seen significant improvement in the consumer resources available to
college-bound veterans. Last year we applauded Congress for passing the Improving Transparency in Education for
Veterans Act of 2013, commissioning a centralized feedback system and
consumer comparison tool for student veterans. The VFW is proud to report that
both of these systems are now up and running. VA can finally process student
veteran complaints in a responsible manner, and college-bound veterans need
only to navigate one website to learn about potential colleges. However, VA and
its partners must have the resources to maintain these tools through IT
collaboration and maintenance of the VA/ED institutional crosswalk.
The Post-9/11 GI Bill was
intended to pay the full cost of in-state tuition at a public institution.
Unfortunately, strict in-state residency requirements at public schools prevent
many veterans from receiving equitable benefits because of past military
service obligations. The VFW believes that no veteran should be disqualified
from in-state tuition because of past military service. For the past year, the
VFW has worked diligently alongside our VSO partners to change the national
discourse on veterans’ in-state tuition with tremendous success. Each day we
learn that more states are extending in-state tuition to their veterans, but we
maintain that the federal government has an obligation to ensure veterans have
a baseline of protection – particularly from states that continually refuse to
properly serve their student veterans. The VFW applauds the House’s
overwhelming passage of the in-state protections included in H.R. 357, and we
encourage the Senate to quickly pass its in-state reform bill as well.
The VFW was proud to support
Congress in its commissioning of the Veterans Retraining Assistance Program, or
VRAP, through the VOW to Hire Heroes Act. We believe that this benefit for
older unemployed veterans provided critical gap education and training to help
make veterans more competitive in the job market. Unfortunately, VRAP is set to
expire this month, and many veterans were precluded from participating because
of administrative hurdles. The VFW encourages Congress to first extend VRAP to
allow all current participants to complete their programs. Next, the VFW wants
Congress extend the program to additional trainees, with relaxed standards
allowing four-year colleges to participate, and allow trainees to drop below
full time status. These changes will allow more eligible veterans to enroll in
training programs and complete any remediation or part-time work necessary to
their program success.
The VFW urges Congress to close
two substantial loopholes for survivors with regard to accessing Post-9/11 GI
Bill benefits. First, surviving spouses must be afforded the opportunity to
receive the Gunnery Sgt. John David Fry Scholarship. Military spouses sacrifice
civilian career growth and professional development due to the rigors of
military family life. As a nation, we have an obligation to provide our
surviving spouses with the tools necessary to rebuild their lives after
suffering such a tragic loss. While the Dependents Education Assistance program
may have been sufficient in the past, today the benefit is largely irrelevant
when compared to the cost of higher education. Opening up the Fry Scholarship
to surviving spouses fixes this inequity.
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 Congress to
quickly pass legislation to close this loophole.
the VFW continues to call on Congress to review the modern role of the State
Approving Agencies (SAAs) through which VA assesses academic programs for GI
Bill eligibility. The VFW believes that SAAs must still play a critical role in
ensuring the academic success of student veterans, but we also believe they are
in need of modernization. We continue to encourage these committees to host
hearings on the SAAs to offer modernization opportunities and clarification of
their evolving role in the 21st century.
Survivor Benefit Plan-Dependency
and Indemnity Compensation: The VFW calls on Congress to repeal the
egregious “Widow’s Tax” survivor penalty. The Survivor’s Benefit
Plan (SBP)/ Dependency and Indemnity Compensation (DIC) offset can be fixed by
passing H.R. 32. This survivor penalty affects over 61,000 military surviving
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.
Congress has recognized the
offset as unfair and has created a Special Survivor Indemnity Allowance (SSIA)
to offset the offset. SSIA is a monthly payment that started at $50 in FY
2008 and will be raised yearly up to $310 through FY 2016. However, SSIA
is only a temporary fix in that it is only authorized through FY 2016.
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 Congress to pass legislation to
allow all military retirees, especially those who are medically retired, to
receive their retirement pay and VA disability without offset.
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 Department of Housing and Urban Development (HUD) showing the
number of homeless veterans declining. A 2013 Annual Homeless Assessment Report, prepared by HUD,
estimates there were 57,849 homeless veterans on a single night in January in
the United States, an 8 percent decline since 2012 and a 24 percent decline
between 2009 and 2013. In 2012, VA provided care and services to more than
240,000 veterans who were homeless or at-risk of homelessness. VA’s homeless
initiatives constitute the largest integrated network of programs in the
country. VA has also increasingly recognized that the problem cannot be fixed
without partnerships with local and state entities. Highly effective programs like VA’s
Supportive Services for Veterans Families (SSVF) and the HUD-VASH program are
critical in finding solutions for veterans transitioning and to prevent at-risk
families from becoming homeless.
VA announced the availability of $600 million in grants
as part of the SSVF program for community organizations – more than double what
was provided in FY 2013. The community
organizations receiving the grants are estimated to serve over 65,000 veterans
and their family members facing homelessness. VFW encourages Congress to continue
providing the sufficient funding for these services. To include 10,000 in new
vouchers in FY 2015 for HUD-VASH, and funding for the necessary case management
services to support this important program.
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 Washington, DC.
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’
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. The Service Disabled
Veterans Insurance (SDVI) program has not been updated to reflect changes in
life expectancy since the program started in 1951. Since that time, reductions in commercial
mortality rates reflect an improved life expectancy as shown in updated mortality
tables. The use of outdated tables
results in rates and premiums that are no longer competitive with private
industry, and; therefore, no longer provide the intended benefit for eligible
veterans. Congress should pass legislation that authorizes VA to revise and
update its premium schedule for SDVI based on current mortality tables.
VFW encourages Congress to pass
legislation that will exempt the cash value of VA life insurance policies and
all dividends and proceeds from being considered as income when determining
eligibility for other government programs like a veterans’ entitlement to
health care under Medicaid.
DOD RETIREMENT AND QUALITY OF LIFE
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.
TRICARE program has afforded active duty military personnel, retirees, and
their families a high quality benefit that we believe keeps faith with the
unique service they have provided to the nation. Unfortunately, this benefit is
continually the target for budget savings.
The most recent attempt to save
money through the erosion of retiree medical benefits came in the form of the
January 2013 announcement by DOD that those who live more than 40 miles away
from a Military Treatment facility or base closure site would be involuntarily
switched from TICARE Prime to the more expensive fee-for-service option,
TRICARE Standard. The VFW vehemently
opposed this change, viewing it as an act of breaking faith with military
retirees, and we are grateful that Congress included a grandfather clause in
the FY 2014 NDAA allowing all those who are currently on TRICARE Prime to
remain so as long as they continue to reside in the same zip code. Although this issue was successfully
resolved, it stands as proof that TRICARE benefits will remain under constant
scrutiny and the VFW will continue to work with Congress to ensure that those
who earned those benefits get to keep them.
Protection of Military Retirement
There continues to be a push from the Pentagon to control costs by reducing pay
and benefits to our service members, retirees and their families. There have
been recent conversations that lead the VFW to believe DOD once again is
looking to suggest fee increases for pharmaceutical co-pays, charging an
enrollment fee for TRICARE for life, reduce basic allowance for housing, and
end the subsidy to the commissary system. These suggestions cannot be acted on.
Congress established a commission to review the military’s pay and benefits
system. Let the commission do its job. The VFW fears any changes will undermine
the incentive to serve 20-plus years in uniform, and fail to recognize the
physical, personal and financial sacrifice service members and their families endure
during a full military career.
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
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 DOD’s Sexual Assault Prevention and Response Office (SAPRO) which
is tasked with ensuring that all military service programs handling sexual assault
complies with DOD policy. VFW is encouraged by the many collaborating
efforts between DOD and VA to ensure proper reporting, screening, treatment and
compensation for conditions resulting from MST.
We urge Congress to
continue holding oversight hearings on the progress DOD is making towards the
reforms and goals of combatting sexual assault. Protecting those who are
victims of military sexual assault by improving policies and practices as well
as providing proper health care and benefits is the key to recovery.
FULL ACCOUNTING ISSUE
organization does more for the POW/MIA mission than the VFW. We have sent
senior leaders into Vietnam every year since 1991, to Russia since 2004, and
now into the People’s Republic of China in an effort to help U.S. researchers
gain deeper access inside foreign military archives and to potential
eyewitnesses. This is because we who have been to war have an unwavering
commitment to those who never returned. This is the most sacred of
missions, and none of our members will truly rest until we know the whereabouts
of everyone who did not return home from war, to include Army Sgt. Bowe
Bergdahl, the only known American service member being held against his will.
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 Defense POW/Missing
Personnel Office (DPMO) – might merge into one organization.
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 North Korea – might become unfunded
mandates. We cannot eliminate or reduce the level of commitment to
recover our missing from other wars and conflicts. Shifting resources
elsewhere will only make current work more complicated. Witnesses will be
harder to find, and acidic soil conditions will continue to destroy the remains
that are left.
urge full mission funding for every organization involved in America’s Full
Accounting Mission, to include the U.S.-Russia Joint Commission on POW/MIAs,
and a waiver be granted for the current hiring freeze that is preventing
additional scientists from being hired to help meet and exceed the 200
identifications a year requirement that Congress mandated.
must always live up to her commitment to never leave a fellow service member
you for the opportunity to testify before you today. I am happy to answer any
questions the Committees may have.
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