U.S. GOVERNMENT PUBLISHING OFFICE

WASHINGTON : 

For sale by the Superintendent of Documents, U.S. Government Publishing Office

Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800

Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001

88–404 PDF 2015

S. HRG. 113–599 

THE FISCAL YEAR 2015 BUDGET FOR 

VETERANS’ PROGRAMS 

HEARING 

BEFORE THE

COMMITTEE ON VETERANS’ AFFAIRS 

UNITED STATES SENATE 

ONE HUNDRED THIRTEENTH CONGRESS 

SECOND SESSION 

MARCH 12, 2014 

Printed for the use of the Committee on Veterans’ Affairs 

( 

Available via the World Wide Web: http://www.fdsys.gov 

(II) 

COMMITTEE ON VETERANS’ AFFAIRS 

BERNARD SANDERS, (I) Vermont, Chairman 

JOHN D. ROCKEFELLER IV, West Virginia 

PATTY MURRAY, Washington 

SHERROD BROWN, Ohio 

JON TESTER, Montana 

MARK BEGICH, Alaska 

RICHARD BLUMENTHAL, Connecticut 

MAZIE HIRONO, Hawaii 

RICHARD BURR, North Carolina, Ranking 

Member 

JOHNNY ISAKSON, Georgia 

MIKE JOHANNS, Nebraska 

JERRY MORAN, Kansas 

JOHN BOOZMAN, Arkansas 

DEAN HELLER, Nevada 

STEVE ROBERTSON, Staff Director 

LUPE WISSEL, Republican Staff Director 

(III) 

C O N T E N T S 

MARCH 12, 2014 

SENATORS 

Page 

Sanders, Hon. Bernard, Chairman, U.S. Senator from Vermont ........................ 1 

Isakson, Hon. Johnny, U.S. Senator from Georgia ............................................... 2 

Brown, Hon. Sherrod, U.S. Senator from Ohio ..................................................... 4 

Johanns, Hon. Mike, U.S. Senator from Nebraska ............................................... 5 

Tester, Hon. Jon, U.S. Senator from Montana ...................................................... 6 

Hirono, Hon. Mazie, U.S. Senator from Hawaii .................................................... 7 

Murray, Hon. Patty, U.S. Senator from Washington ........................................... 183 

Blumenthal, Hon. Richard, U.S. Senator from Connecticut ................................ 190 

Boozman, Hon. John, U.S. Senator from Arkansas .............................................. 194 

Moran, Hon. Jerry, U.S. Senator from Kansas ..................................................... 199 

WITNESSES 

Hon. Eric K. Shinseki, Secretary, U.S. Department of Veterans Affairs; accompanied by Hon. Robert A. Petzel, M.D., Under Secretary for Health; 

Hon. Allison A. Hickey, Under Secretary for Benefits; Hon. Steve L. Muro, 

Under Secretary for Memorial Affairs; Stephen W. Warren, Executive in 

Charge for Information and Technology; and Helen Tierney, Executive in 

Charge for the Office of Management and Acting Chief Financial Officer ..... 8 

Prepared statement .......................................................................................... 10 

Response to posthearing questions submitted by: 

Hon. Bernard Sanders .................................................................................. 20 

Hon. Richard Burr ........................................................................................ 63 

Hon. Jerry Moran ......................................................................................... 159 

Hon. John Boozman ...................................................................................... 166 

Hon. Dean Heller .......................................................................................... 167 

Response to request arising during the hearing by: 

Hon. Johnny Isakson .................................................................................... 182 

Hon. Patty Murray ........................................................................................ 184 

Hon. Jon Tester ............................................................................................. 189 

APPENDIX 

Zumatto, Diane, National Legislative Director, AMVETS; prepared statement 207 

Varela, Paul R., Assistant National Legislative Director, Disabled American 

Veterans; prepared statement ............................................................................. 209 

Paralyzed Veterans of America (PVA); prepared statement ................................ 216 

(1) 

THE FISCAL YEAR 2015 BUDGET FOR 

VETERANS’ PROGRAMS 

WEDNESDAY, MARCH 12, 2014 

U.S. SENATE, 

COMMITTEE ON VETERANS’ AFFAIRS, 

Washington, DC. 

The Committee met, pursuant to notice, at 2:02 p.m., in room 

418, Russell Senate Office Building, Hon. Bernard Sanders, Chairman of the Committee, presiding. 

Present: Senators Sanders, Murray, Brown, Tester, Blumenthal, 

Hirono, Isakson, Johanns, Moran, and Boozman. 

OPENING STATEMENT OF HON. BERNARD SANDERS, 

CHAIRMAN, U.S. SENATOR FROM VERMONT 

Chairman SANDERS. OK, let’s get to work. 

I want to thank all of our guests from VA for being with us today 

to discuss the budget. 

Let me begin by thanking General Shinseki and others for tackling some enormously difficult problems in this enormously difficult 

period facing our veterans. I think if there is anything that I have 

learned in the year and 3 months that I have been Chairman of 

this Committee it is that the cost of war is much, much greater, 

I think, than most Americans perceive. 

We are dealing now with hundreds of thousands of men and 

women who have come home from Iraq and Afghanistan, dealing 

with traumatic brain injury and post traumatic stress disorder. 

Those are tough illnesses to deal with, and the magnitude, the 

numbers, are extraordinary. That is an issue I think we will focus 

on today—the magnitude of that problem—hundreds of thousands 

of men and women dealing with TBI and PTSD is a huge issue. 

We have seen 2,300 individuals suffer wounds in war that make 

it impossible for them to have kids. How do we respond to that? 

We have seen a situation within the VA and throughout our 

country there is a feeling that too many patients are being overmedicated. What kind of alternatives are out there? 

And I think VA, by the way, is doing some cutting-edge work in 

trying to respond to pain and other problems through complementary and alternative medicine. How do we address that? 

We are dealing with an issue that several years ago the U.S. 

Congress passed a very, very important piece of legislation, making 

sure that people who served in Iraq and Afghanistan have the ability to go to college. That has worked, by and large, very, very well. 

Problems remain. How do we address that? 

2 

Going back to the issues of mental health, we are all distressed 

and saddened by the number of suicides that we face, a very difficult issue inside the military, inside the VA, inside the United 

States of America, our general population. How do we deal with 

that? 

We are dealing with the issue that the VA, in the last several 

years, has transformed their claims system—going from paper to 

digital. We think we are making some progress. We want to continue that progress. How do we make sure that we continue that 

progress so that every veteran in this country gets their claim adjudicated in a timely manner? 

The VA has, in my view, over the years done a good job in terms 

of reaching out in primary health care through CBOCs. How do we 

make sure that the proper number of CBOCs continue to be built 

and maintained? 

So, we have a whole lot of issues facing us. These are tough 

times for the veterans’ community, coming out of two wars, dealing 

with older veterans from World War II, Korea, Vietnam, and we 

are not going to turn our backs on those veterans. 

I, again, want to thank the VA. It is very easy to beat up on the 

VA because they are big, they are bureaucratic, and they are public, so that every problem they have, which is many when you run 

151 medical centers—I am sure that there is a problem at every 

one every day, and often they get on the front pages. But sometimes we forget that many millions of veterans are accessing them 

and are very proud and happy with the care that they are getting. 

So, our job is to keep the VA moving forward, address the serious 

problems they have, give them the support they need, and that is 

what this budget hearing is about. 

Senator Isakson. 

STATEMENT OF HON. JOHNNY ISAKSON, 

U.S. SENATOR FROM GEORGIA 

Senator ISAKSON. Well, thank you, Mr. Chairman. 

I appreciate Secretary Shinseki, Dr. Petzel and the rest of you 

for being here today. I appreciate the job that you do. 

Chairman Sanders made a very obvious statement; you all are 

very easy to pick on, but you probably have the hardest job in 

Washington, DC, and the biggest responsibility in the years to 

come. We are grateful for your service and grateful for what you 

do. 

As I understand it, your request calls for $10 billion in an 

increase in VA’s overall budget and $2 billion in discretionary 

spending. 

You know, our responsibilities in Washington are to appropriate 

and to legislate, but we also have another responsibility in our 

committees, and that is oversight. 

Some issues came up this morning that I think I want to address 

in my opening statement so that Secretary Shinseki can possibly 

address them in his responses later in the hearing. 

As we heard from the Wounded Warrior Project this morning, 

one area that needs oversight is the caregiver program. What we 

know about this program so far included inconsistent decisions regarding eligibility, no quality assurance to monitor the quality, conVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00006 Fmt 6633 Sfmt 6633 Z:\113TH HEARINGS PRINTED\88404 PAULIN
3 

sistency, and timeliness of decisions, and no formal process to appeal the decision or eligibility for caregiver assistance. 

I know many, including Chairman Sanders, believe this program 

should be expanded and included to all veterans. Yet, we need to 

ensure its proper implementation before we expand this program. 

We should do this for any program and provide the oversight necessary to do it right. 

Since the beginning of 2013, the Veterans Health Administration 

has been plagued by a series of quality management issues that 

have resulted not only in patient harm but also patient death. 

These issue range from the misuse of a single patient multi-use insulin pen to an outbreak of Legionella to delays in mental health 

care and GI consults. 

You all know what we have experienced in the Atlanta VA, at 

the medical center in Atlanta, with regard to mental health and 

suicide. 

The inspector general has released over 40 health care inspections during the Congress. That is roughly three per month. 

Veterans have sacrificed so much already and deserve worldclass health care, yet our Nation’s veterans are facing long delays 

in scheduling appointments and assessing needed services. 

Another area the veterans face is the longtime backlog in claims, 

which I know you are making progress on. I know by 2015—we 

have goals that are terrific, but we have got to make sure we deal 

not just with statistics but with the actual effect on the lives of 

these veterans and their families. 

So, this work on reducing the claim times and the waste is going 

to be critically important. 1.2 million veterans still wait today for 

a determination. That is a huge number; there are way too many. 

On the issue of suicide, I want to thank Robert Petzel immensely 

for three things—one, his willingness to come to Atlanta in the 

field hearing that we conducted in August including 2-1⁄2 hours of 

emotional, and I am sure painful to a certain extent, information 

about the tragedies we had in the Atlanta VA with three suicide 

deaths and one drug overdose. 

Mr. Secretary, I want to commend you on the replacement of the 

director at the hospital. The new director, Ms. Wiggins, is doing an 

outstanding job. 

Unfortunately, we had another incident about 2 weeks ago. She 

was on the phone to me first when it happened, took immediate action in terms of that incident, and accepted responsibility where responsibility was needed to be accepted. 

That is a great indication of the emphasis you, the Secretary, 

have put—and Robert Petzel has put—on this issue of suicide, 

which we must get our arms around. It is one area where I think 

oversight is going to be critical for us to move the paradigm and 

get best practices in every VA medical center in the country. 

Soft tissue injuries are the toughest to deal with. TBI and PTSD 

are the legacy of the contemporary wars we have been fighting. 

And suicide is the nasty byproduct of a drug overdose and misuse 

of drugs in terms of treating people and not having the right mental health follow-up with those patients. 

I am going to personally dedicate a lot of my time—I know John 

Boozman on our Committee is going to do the same—to delve into 

4 

the issues of suicide, find out where those tragedies are taking 

place, and see if we can find common threads where we can implement best practices in the Veterans Administration so we do not 

lose so many soldiers by taking their own lives. 

Right now, we are losing an average of 22 a day, which is 8,000 

a year, and that is far too many. And it is not just combat veterans 

from Afghanistan and Iraq. In fact, in Atlanta, three of the four 

victims were veterans of the Vietnam-era war. 

It is a pervasive issue in the VA. It is actually a pervasive issue 

in the United States. We owe it to our veterans and to our country 

to see to it that we find every best practice possible and implement 

them. 

One of the things I am going to do, Mr. Chairman, is I am going 

to, as a one-man band or vigilante of one, is have field hearings— 

or, as a Committee representative, have field hearings—and do the 

oversight around the country necessary to bring the best practices 

to light, to try to do what Robert Petzel is doing right now, which 

is meeting with these veterans, getting the right answers, and trying to correct the paradigm, which I am grateful for you to do. 

I yield back the balance of my time. 

Chairman SANDERS. Thank you. 

Senator Brown. 

STATEMENT OF HON. SHERROD BROWN, 

U.S. SENATOR FROM OHIO 

Senator BROWN. Thank you, Mr. Chairman. I appreciate your 

leadership. 

Thank you, Mr. Secretary and all of you who are serving our veterans and serving our country so ably and so selflessly. Thank you 

for that. 

I reiterate the Chairman’s comments about the cost of war. 

I think that Senator Isakson’s aptly pointing out the terrible affliction—and Senator Tester has talked to me about this, too—of 

suicide in the military attests to that, as do unemployment rates, 

as do mental health problems, as do drug addiction, all of those 

costs of war that we should think about in this body more than we 

do. 

A couple of things I wanted to mention—one is VRAP and the 

significant contribution the Veterans Retraining Assistance Program has made to our veterans, to our communities. 

I have one brief story. Everett Chambers in Cleveland used 

VRAP funds to get retrained as an electrical engineering technician 

at Cuyahoga County Community College. He is one of a number of 

people I have met in Youngstown, Cincinnati, and all of over my 

State, who have benefited from VRAP. It is a program that works. 

We should do all we can to make sure that more people have that 

opportunity. 

Obviously, you cannot come in front of us without discussing the 

disability claims backlog and disability ratings—the unevenness of 

the ratings from a bum knee in San Diego being rating differently 

in terms of dollars than a bum knee in Columbus or Cleveland. The 

fixing of both the backlog and the disability ratings together makes 

sense. 

5 

The last issue I would like to mention is I remain concerned with 

the Department’s outsourcing more and more work. First, I believe 

the quality of outsourced work is often subpar. Second, many contractors lack the dedication of career civil servants, especially when 

you realize that places like the VA in Chillicothe, how assiduous 

they have been about hiring veterans, and I know that VA centers 

and CBOCs all over the country strive for that. 

We should not be outsourcing these jobs. Civil servants who decide to pursue a career assisting veterans lead to better services 

compared to services provided by those that are motivated by profit. I think we have seen that in example after example after 

example. 

It does not save taxpayer dollars. It may help politicians, but it 

does not save taxpayer dollars. We saw this at the very basic level 

in places like the Dayton VA medical center where laundry was 

outsourced and now workers say the clothes come back not as clean 

as they were. 

If the VA continues to outsource more and more activities, at 

some point, we are going to reach a point where the VA is a health 

insurance provider and not a health care provider. That does not 

serve veterans. It does not serve taxpayers. It does not serve the 

public. 

So, again, I thank you for your service, all of you. 

Chairman SANDERS. Thank you, Senator Brown. 

Senator Johanns. 

STATEMENT OF HON. MIKE JOHANNS, 

U.S. SENATOR FROM NEBRASKA 

Senator JOHANNS. Mr. Chairman, thank you. 

And to the team that is here today on behalf of the Veterans Administration, let me just say, welcome; we are glad to have you 

here. 

Mr. Secretary, thank you. You stopped by a couple weeks ago, 

and that is always appreciated. So, I want to thank you publicly 

for making that effort. 

In the past years, as we all know, Congress has made the VA a 

priority, and I believe appropriately so. The budget has been provided and there have been personnel increases. In some departments in the Federal Government, that is unheard of, but I think 

it indicates this Committee’s commitment to our veterans and the 

commitment of the Congress to our veterans. 

Quite honestly, I doubt that this year will be any different. I 

think, again, veterans will be a priority, and we will make sure 

that that happens. 

Now, having said that—because I think that is on the good news 

piece of the equation—there are still challenges that we face. I do 

not think anybody in this hearing today is going to make the case 

that we are doing a great job in terms of the list to get disability 

ratings and get people an answer, which is really what we are trying to do, get people information. 

I keep hoping that we find that we are making progress. I hope 

your testimony will deal with that issue, but the claims backlog is 

a concern to all of us. It is not a partisan issue. It is a very, very 

bipartisan concern. 

6 

The other thing that I am hoping there will be some discussion 

about is capital improvements. I scratch my head about this. And, 

Mr. Secretary, no reflection on you, but we have a project in 

Omaha, probably like other places around the United States, that 

is waiting for good news that we are moving up the list. Every time 

I meet with you, we slip further down. 

So, I am not saying there is a correlation. I am just saying, gosh, 

it is frustrating for us. So, I am hoping to hear your thoughts on 

that. 

I just think we are going to have to be creative in this area. I 

think you get near the bottom of the list, and these are still 1940s– 

50s facilities that are outdated. We have great employees trying to 

do the best they can under the circumstances, but at the end of the 

day, some of the folks near the bottom are going to be waiting a 

long time. 

I may not live long enough to see this, but I would like to see 

something creative to try to deal with that backlog. 

Again, thank you for being here. I know you come here with 

hearts that are pure. You want to help the veterans just like we 

do, and maybe we can have a good dialog on how best to do that 

in some of these areas. 

Mr. Chairman, thank you. 

Chairman SANDERS. Thank you. 

Senator Tester. 

STATEMENT OF HON. JON TESTER, 

U.S. SENATOR FROM MONTANA 

Senator TESTER. Thank you, Mr. Chairman. 

I want to welcome everybody from the Veterans Administration 

here today, too. 

I do not have my reading glasses, so all the beautiful notes that 

my staff wrote for me to tell you guys won’t be read. [Laughter.] 

So, you are going to hear what I have to say. OK? 

I think the backlog issue is always a big issue. You know, we 

helped create that in Congress by doing the right thing a few years 

back with the Vietnam Vets. 

General Shinseki, having visited with you several times, I know 

it is a high priority for you. We will keep working on it; and this 

Committee is committed to help you get that backlog down. 

Staffing. I talked with Under Secretary Petzel a day or two ago 

about this issue. It is critically important in rural America. We are 

deficient. I think you guys are on top of it. We just need to make 

sure we get some things done in that area. 

I want to say a special thanks to Steve Muro. Thank you very 

much, Steve, for your work on cemeteries. It is a very, very important issue across the country, and I think you have done some 

great work. 

Mental health. It may be the biggest issue this country faces, 

whether you are in the military or you are out, but it is absolutely 

a critical issue in the military, and we need to figure out how we 

can handle it. 

It is very expensive, but we need to do everything we can do, 

whether it is best practices or whether it is just plain, old experts 

in the field, to be able to develop partnerships, to be able to make 

7 

sure that we give our veterans—as you guys have heard from me 

before, particularly in rural America, that those veterans need 

help. They are isolated anyway. It is a big issue, and we need to 

work together to get that done. 

Construction. I would just say that I understand, and I think 

that you guys have done a great job on the CBOCs and the Vet 

Centers and those things around the country. I think that there is 

opportunity for some advancement there. But I think you are dealing with operations and maintenance issues right now in many of 

your buildings, getting them up to snuff so that the potential for 

things like the veterans’ home in Butte, MT, does not hit the list. 

I appreciate that prioritization, but I certainly would look forward to working together with you guys and through the Appropriations Committee to figure out some way in which we can address some of these senior veterans who served this country so very 

well in the military and in the private sector that need and deserve 

a place to live their later years. 

Next, I say thank you to the VSOs that are in the room—thank 

you guys very, very much for your input to us regarding the VA. 

They are not perfect. There are things that they have to do, but 

I think it is through the leadership of the VSOs that we are able 

to advocate on the issues that you think are important. 

And the one other issue I am going to talk about is advanced appropriations. I think that is a big win for the VA, and it would not 

have had happened without the veterans service organizations all 

being on the same page. 

Thank you, Mr. Chairman. 

Chairman SANDERS. You did very well without your staff notes. 

Senator Hirono. 

STATEMENT OF HON. MAZIE HIRONO, 

U.S. SENATOR FROM HAWAII 

Senator HIRONO. Thank you, Mr. Chairman. 

I want to add my thanks to that of the Members of this Committee. All of us are very much in support of the priorities, Mr. Secretary, that you have articulated. 

Certainly, increasing access to VA benefits, cutting or eliminating the backlog to claims, ending homelessness, the mental 

health issues, the suicide rates—these are all areas that we have 

bipartisan support on the Committee. 

Of course, Hawaiian veterans face many of the same challenges 

that veterans across the country face, and add to that the fact that 

our veterans are—the distance is water, not just land, as they live 

on all of our major islands. 

I think it is really important to focus on the issue of veteran 

homelessness. I recently visited the VET house in Kalihi. I think 

it is an area of our community that, Mr. Secretary, you know. 

But, on the issue of homelessness, the support that we give to 

programs such as the Veterans Engaged in Transition, VET, 

houses, I think really hold promise. 

So, this VET house that I visited is an eight-bedroom home in 

a community in Kalihi. What very much impressed me was that 

this was a situation where the veterans that were homeless are in 

transitional housing. They have places to go after they spend their 

8 

90 days in a stable environment because a lot of the homeless veterans do not have that stability in their lives. So, just to have a 

calm, supportive place for a period of time to enable them to get 

on with their lives is what I saw in this VET house. 

This particular house was created by a non-profit entity in part- nership with money from a grant from the VA of $233,000. They 

worked with the Institute of Human Services, which is a non-profit 

organization in Hawaii that works to provide shelter for the homeless. So, they are in the community. 

The Lions, the Elks Club, other individuals and entities, including Home Depot, by the way, which as a company has made a huge 

commitment, as I am sure you know, to support veterans’ programs, but to supply beds and all of that, and then the bedrooms 

were adopted by these community organizations. 

It was a terrific combination of people coming together, but it 

also would not have happened without the money from the VA 

grant. 

So, these are the kinds of programs that I very much support as 

hands-on. And, yes, it is aid to veterans, but I figure—you know 

what? Each one that we help to get on in a positive way with their 

lives, that is worth doing. 

So, I just wanted to let you know that every time I go home, as 

I am sure my colleagues do, we visit with veterans, which I did 

when I was home a couple weeks ago. 

Thank you very much for your service. 

Of course, I look forward to working with my colleagues to make 

sure that we provide the kind of support that will enable us to 

meet the challenges of our veterans. 

Chairman SANDERS. Thank you very much, Senator Hirono. 

We may have some votes soon. So, we are going to have to juggle 

things, and people will be leaving and coming. 

So, let me begin and request short answers from the panelists. 

Oh, testimony. I knew I forgot something. You probably wanted 

to say something, right? 

Secretary SHINSEKI. I will try to be short in light of the—— 

Chairman SANDERS. Take your time. I am sorry. 

Secretary SHINSEKI [continuing]. Very supportive comments 

made by all the Members here today. 

STATEMENT OF HON. ERIC K. SHINSEKI, SECRETARY, U.S. DEPARTMENT OF VETERANS AFFAIRS; ACCOMPANIED BY HON. 

ROBERT A. PETZEL, M.D., UNDER SECRETARY FOR HEALTH; 

HON. ALLISON A. HICKEY, UNDER SECRETARY FOR BENEFITS; HON. STEVE L. MURO, UNDER SECRETARY FOR MEMORIAL AFFAIRS; STEPHEN W. WARREN, EXECUTIVE IN 

CHARGE FOR INFORMATION AND TECHNOLOGY; AND 

HELEN TIERNEY, EXECUTIVE IN CHARGE FOR THE OFFICE 

OF MANAGEMENT AND ACTING CHIEF FINANCIAL OFFICER 

Secretary SHINSEKI. Chairman Sanders, Senator Isakson, and 

other Members of the Committee, thanks for this opportunity once 

again to present the President’s 2015 budget and 2016 advance appropriations requests for the Department of Veterans Affairs. 

I am working my sixth budget cycle. I find that almost incredible 

to understand, but it is the sixth budget cycle for me. 

9 

Together all of us here have accomplished a lot, and I deeply appreciate—all of us appreciate—your unwavering support of our Nation’s veterans. It does not just occur in testimony. It occurs day 

to day as we engage with you. 

Let me also acknowledge, as others have, the representatives of 

our veterans service organizations who are here today. Their insights and support make us better at our mission, caring for veterans and families and survivors. 

Mr. Chairman, I am going to take a few seconds just to introduce 

the members of my panel here. To my extreme left is Stephen Warren, the Executive in Charge for Information and Technology. Next 

to him is Helen Tierney, VA’s Executive in Charge of the Office of 

Management, and she is also our Acting Chief Financial Officer. To 

my right, Dr. Robert Petzel, Under Secretary for Health, and then 

Allison Hickey, Under Secretary for Benefits, and to her right, 

Steve Muro, Under Secretary for Memorial Affairs. 

Mr. Chairman, I do have a written statement. I ask that it be 

included in the record. 

Chairman SANDERS. Without objection. 

Secretary SHINSEKI. Thank you, Mr. Chairman. 

The fiscal year 2015 budget and fiscal year 2016 advance appropriations requests demonstrate once again President Obama’s 

steadfast commitment to our Nation’s veterans. His leadership, the 

support of the Congress, especially this Committee, have allowed 

us for 5 years now to answer President Lincoln’s charge from 149 

years ago, ‘‘To care for him who shall have borne the battle and 

for his widow and his orphan.’’ 

I thank the Members for your commitment to veterans and seek 

once again your support of these budget requests. 

The President’s vision reflected in these requests is about empowering veterans to help lead the rebuilding of the middle class 

in this country, much as they did after World War II, through access to quality health care, through benefits, through education and 

training, the original GI Bill, and then employment that enabled 

achieving the American dream. The VA’s 2015 budget request seeks $163.9 billion—$68.4 billion 

of that amount is in discretionary funding, including medical care 

collections, an increase of 3 percent above our 2014 enacted funding level, this year’s budget. It also $95.6 billion in mandatory funding. 

This budget also requests $58.7 billion for the fiscal year 2016 advance appropriations for medical care, an increase of $2.7 billion, 

or 4.7 percent, above the fiscal year 2015 request that I am also 

submitting today. 

It is another strong budget, and your support of it is critical to 

providing veterans the care and benefits they have earned through 

their service and sacrifice. 

It enables VA to further the significant progress our Department 

has already made on the top three priorities we outlined years ago 

and have been working at during this intervening time. One is to 

expand veterans’ access to benefits and services; second, eliminate 

the disability claims backlog in 2015, as has been mentioned by a 

number of members; and then, third, end the rescue of homeless 

veterans in 2015. 

10 

Since 2009, we focused the resources you provided to address 

these three key priorities, among other requirements, but these 

three priorities, to best serve veterans. 

I would say, in terms of access, here is what we have accomplished: 

More than two million additional veterans have been enrolled in VA health care. 

We opened our 151st hospital, the first in 17 years, and we 

have increased our community-based outpatient clinics by 55, 

bringing our total to 820 community-based outpatient clinics 

today. 

More than a million veteran family members and students 

have received VA educational assistance and vocational training. 

Nearly 90 percent of all veterans today have a burial option 

within 75 miles of where they live, thanks to Steve Muro’s 

great work. We expect that that will increase out through 

2017. We have plans to do that, at which point we will be at 

the 96th percent mark. 

In terms of disability claims, the backlog has declined 40 

percent in the past 12 months. We are transitioning from 

paper to digital processing, and we are on track to end the 

backlog in 2015. 

In terms of veterans’ homelessness, the estimated number of 

homeless veterans fell by 24 percent between 2010 and 2013, 

and we expect another reduction when this year’s point-in-time 

count is finally tallied up. 

These are some of our key accomplishments. 

I would also report to the Committee that our momentum is up, 

we are making good progress across the board, and, as I have in 

each of my appearances here, assure you that we will continue to 

leverage every resource of the budget—money, time, people—to do 

what is right for veterans. 

As I have for 5 years now, I will assure you that we will use 

these resources that the Congress provides effectively, efficiently, 

and accountably to best care for veterans. 

Again, thank you for this opportunity to appear here today and 

for your continued support of veterans. I look forward to your 

questions. 

Thanks, Mr. Chairman. 

[The prepared statement of Secretary Shinseki follows:] 

PREPARED STATEMENT OF HON. ERIC K. SHINSEKI, SECRETARY, 

U.S. DEPARTMENT OF VETERANS AFFAIRS

Chairman Sanders, Ranking Member Burr, Distinguished Members of the Senate 

Committee on Veterans’ Affairs: Thank you for the opportunity to present the President’s 2015 Budget and 2016 advance appropriations requests for the Department 

of Veterans Affairs (VA). This budget continues the President’s historic initiatives 

and strong budgetary support for Veterans, their families, and survivors. We value 

the sustained support that Congress has demonstrated in providing the resources 

and legislative authorities needed to honor our Nation’s promises to these unique 

and special citizens. Let me acknowledge our partners here today—the Veterans 

Service Organizations—whose insight and support make us better at fulfilling our 

mission. 

After more than a decade of war, many Servicemembers are returning home and 

making the transition to Veteran status. As the war in Afghanistan enters its final 

11 

chapter, our work is more urgent than ever. The current generation of Veterans will 

help to grow our middle class and provide a significant return on the Nation’s investments in them. The President fully supports Veterans and their families, and 

by providing them the care and benefits they have earned, we pay tribute to the 

sacrifices that Veterans have made for this Nation. 

The 2015 Budget for VA requests $163.9 billion—$68.4 billion in discretionary funds, including medical care collections, and $95.6 billion in mandatory funds for 

Veterans benefits programs. The discretionary request reflects an increase of $2.0 

billion (3.0 percent) above the 2014 Budget level. The Budget also requests a 2016 

advance appropriation for Medical Care of $58.7 billion, an increase of $2.7 billion 

(4.7 percent) above the 2015 Budget. The President’s 2015 Budget will allow VA to 

operate the largest integrated healthcare system in the country, including nearly 

1,750 VA points of healthcare and approximately 9.3 million Veterans enrolled to 

receive healthcare; the ninth largest life insurance provider, covering both active 

duty Servicemembers and enrolled Veterans; an education assistance program serving nearly 1.1 million students; a home mortgage program with a portfolio of over 

2 million active loans, guaranteed by the agency; and the largest national cemetery 

system that leads the Nation as a high-performing organization, with projections to 

inter 128,100 Veterans and family members in 2015. 

GROWING DEMAND FOR VA SERVICES AND BENEFITS

Long after conflicts end, VA requirements continue to grow, due to the substantial 

needs of Veterans. VA’s budgetary requirements arise from our Nation’s national security engagements, which are not within our control. As the President said on Veterans Day last November, ‘‘when we talk about fulfilling our promises to our Veterans, we don’t just mean for a few years; we mean now, tomorrow, and forever.’’ 

Over the next decade, the Department of Defense (DOD) predicts that military separations will approach three million. This growing population is demanding more 

services from VA than ever before. Currently, 11 million of the approximately 22 

million Veterans in this country are registered, enrolled, or use at least one VA benefit or service, and this number will undoubtedly continue to grow. 

MEETING VA’S TOP THREE GOALS

In 2015, our challenges are clear and significant. VA must deliver on the ambitious goals we established 5 years ago, which are to: 

• Increase Veterans’ access to VA benefits and services; • Eliminate the disability claims backlog in 2015; and • End Veterans’ homelessness in 2015. 

The 2015 Budget is critical to VA meeting these goals. Without the proper level 

of funding to meet the growing demand for benefits and services, investing in our 

physical and Information Technology (IT) infrastructure to assure reliable access, 

eliminating the disability claims backlog, and completing the rescue phase of ending 

Veterans’ homelessness become even more difficult. VA remains committed to meeting these challenges and appreciates the continued support of the Congress. 

STEWARDSHIP OF RESOURCES

At VA, we are committed to responsible stewardship, using resources effectively 

and efficiently and aggressively identifying budget savings. Over the past three 

years, we have averaged $1.6 billion annually in efficiencies and budget savings, 

and in 2015, that commitment to budget efficiencies and savings is more than $2 

billion. We are attentive to areas in which we need to improve our operations, and 

are committed to taking swift corrective action to eliminate any practices that do 

not deliver value for Veterans. For 15 consecutive years, VA delivered clean financial audits, during which time material weaknesses were reduced from four to one, 

and in 2013, for the first time, we had no significant deficiencies, having eliminated 

16 prior significant financial deficiencies. This is an area of major accomplishment 

in our internal controls and fiscal integrity. 

INFORMATION TECHNOLOGY

To serve Veterans as well as they have served us, we are working to deliver a 

21st century VA that provides medical care, benefits, and services through a secure 

digital infrastructure. IT affects every aspect of what we do at VA. It has a direct 

impact on the quality of healthcare we provide Veterans; our ability to process 

claims efficiently; and our ability to provide Veterans’ benefits and services. In 2013, 

VA IT systems supported nearly 1,750 VA points of healthcare: 151 medical centers, 

135 community living centers, 103 domiciliary rehabilitation treatment programs, 

12 

820 community-based outpatient clinics, 300 Vet Centers, and 70 mobile Vet Centers. The corresponding increase we have seen in the medical care spending for 

these facilities directly translates to new and increased services provided to Veterans. To provide Veterans access and benefits, we must make the necessary investments in IT innovations and deployments. 

Our 2015 Budget requests $3.9 billion for IT, consisting of $531 million for development; $2.3 billion for sustainment; and $1 billion for more than 7,400 staff, most 

of whom serve in VA hospitals and regional offices. The request will sustain our infrastructure while making necessary investments in critical business processes, such 

as modernizing healthcare scheduling, streamlining benefits processing, enhancing 

and modernizing VA’s electronic health record, enhancing data security, and achieving health data interoperability with DOD. 

Information security is a top priority at VA. The 2015 Budget requests $156 million for information protection and cyber security, an increase of $33 million (27 percent) over 2014. VA is constantly strengthening information security and improving 

technology and processes to ensure Veteran data and VA’s network are secure. Like 

any organization, public or private, we must continue to adapt. Our security posture 

is based on a ‘‘defense—in-depth’’ approach, which includes our partners at the Department of Homeland Security who maintain an over watch on our exterior perimeter. Working inward from our firewalls, VA has additional layers and protections 

that are constantly monitoring potential threats. 

Technology is also a critical component for achieving our goal to eliminate the disability claims backlog in 2015. The 2015 Budget requests $137 million in IT funding 

for the Veterans Benefits Management System (VBMS), including $44.5 million for 

development and $92.5 million for sustainment. The 2015 development funds will 

allow VA to electronically process disability compensation claims in VBMS, from establishment to award. Planned enhancements and increased automation will allow 

end-users to focus on more difficult disability compensation claims by reducing the 

time required to process less complex claims. Sustainment funds will support the 

infrastructure behind VBMS as well as the deployment of additional new functionality features. 

The 2015 Budget continues our progress toward evolving VA’s VistA electronic 

health record (EHR) and achieving seamless integration of health data with the 

DOD by 2017. The budget requests $269 million to help achieve our shared goal of 

providing the best possible support for Servicemembers and Veterans. In the near 

term, we are working to create seamless integration of DOD, VA, and private provider health data. In the mid-term, we are working to modernize the software supporting DOD and VA clinicians. Together, these two goals will help to create an environment in which clinicians and patients from both Departments are able to share 

current and future healthcare information for continuity of care and improved treatment. As we strive to build on our successful history of health data sharing and collaboration, we understand our EHR modernization efforts are complicated, dynamic, 

and multi-faceted. 

IMPROVING AND EXPANDING ACCESS TO BENEFITS AND SERVICES

The number of Veterans receiving VA benefits and services has grown steadily 

and will continue to rise as overseas conflicts end and more Servicemembers transition to Veteran status. In 2015, the number of patients treated within VA’s 

healthcare system is projected to reach 6.7 million, an increase of nearly one million 

patients (17.4 percent) since 2009. Within VBA, the number of Veterans and survivors receiving Compensation and Pension benefits will approach 5 million in 2015, 

while the number of Education and Vocational Rehabilitation beneficiaries will exceed 1.1 million. 

We continue to improve access to VA services by opening new, and improving current, facilities closer to where Veterans live. Since January 2009, we have added approximately 55 community-based outpatient clinics (CBOCs), for a total of 820 

CBOCs, and the number of mobile outpatient clinics and Mobile Vet Centers, serving rural Veterans, has increased by 21, to the current level of 78. In addition, while 

opening new and improved facilities is essential for VA to provide world-class 

healthcare to Veterans, so too is enhancing the use of ground breaking new technologies to reach countless other Veterans. We continue to invest in ‘‘taking the facility to the Veteran’’—through expanded access to telehealth, sending Mobile Vet 

Centers to reach Veterans in rural areas where certain services are limited or difficult to reach, and by deploying social media to connect with Veterans to share information on the VA benefits they have earned. 

The Affordable Care Act (ACA) expands access to coverage, provides new ways to 

bring down healthcare costs, improves the Nation’s healthcare delivery system, and 

13 

has important implications for VA. VA is ensuring a coordinated and collaborative 

approach to ACA implementation. We estimate that there are approximately 1.3 

million uninsured Veterans, of which 1 million may be eligible for, but not enrolled 

in VA healthcare. We will continue our education and outreach efforts so Veterans 

know the healthcare law does not affect their VA health benefits or out-of-pocket 

costs, and that Veterans enrolled in VA healthcare do not need to take additional 

steps to meet ACA’s new coverage standards. We will also encourage Veterans’ family members not enrolled in a VA healthcare program to obtain coverage through 

the Health Insurance Marketplaces. 

A large part of our Veteran population hails from the small towns of rural America. Some 3.1 million Veterans enrolled in VA’s healthcare system live in rural or 

highly rural areas, about 36 percent of all enrolled Veterans. In total, more than 

$17.36 billion were obligated in 2013 for the health care needs of rural Veterans. 

As technology advances and broadband access expands across rural America, we 

have been able to extend the availability of VA healthcare through telemedicine, 

web-based networking tools, and the use of mobile devices—all of which help improve access to care and support economic development for people in rural areas. 

Telehealth is a transformative breakthrough in healthcare delivery in 21st century 

medicine, allowing care to reach Veterans who otherwise may not have access, especially those who live in rural and extremely remote areas. The 2015 Budget requests 

$72 million for Rural Health telehealth. 

Changing demographics are driving transformation at VA. Women now comprise 

nearly 15 and 18 percent of today’s active duty military forces and Reserve component, respectively. Women are the fastest growing segment of our Veteran population. Since 2009, the number of women Veterans enrolled in VA healthcare increased by almost 29 percent, to 629,683. The 2015 Budget includes $403 million 

for gender-specific healthcare services for women Veterans. Today, nearly 49 percent 

of our facilities have comprehensive women’s clinics, and every VA healthcare system has designated women’s health primary care providers and a women Veterans’ 

program manager on staff. 

The Caregivers and Veterans Omnibus Health Services Act (Caregivers Act) 

marked a major step forward in America’s commitment to those who provide daily 

care for wounded warriors, who have borne the battle for us all. The sustainment 

phase of the Caregivers program began in 2013, and includes application processing; 

stipends; travel and healthcare coverage; education, training, and competency; and 

IT support. The 2015 Budget includes $306 million for the Caregivers program, including $235 million for caregiver stipends. 

Since VA began implementation of the Honoring America’s Veterans and Caring 

for Camp Lejeune Families Act in August 2012, more than 10,100 Veterans have 

contacted VA concerning Camp Lejeune-related treatment, as of February 27, 2014. 

Of these, roughly 8,300 were already enrolled in VA healthcare. Veterans who are 

eligible for care under the Camp Lejeune authority, regardless of current enrollment 

status with VA, will not be charged a co-payment for healthcare related to the 15 

illnesses or conditions recognized, nor will a third-party insurance company be billed 

for these services. VA continues a robust outreach campaign to these Veterans and 

family members while we press forward with implementing this law. The 2015 

Budget includes $51 million to provide healthcare for Veterans and family members 

who were potentially exposed to contaminated drinking water at Camp Lejeune. 

The 2015 Budget requests $99.6 million in IT funding for the Veterans Relationship Management (VRM) initiative, which is transforming Veterans’ access to VA 

benefits and services by empowering Veterans with new self-service tools. In addition, VRM is essential to achieving our access goals. We are transforming VA’s national call centers into service centers by delivering enhanced, integrated, systemwide telephone capabilities. VBA is also implementing the Client Relationship Management Unified Desktop that provides Veterans or beneficiary contact history and 

a consolidated view of benefit programs for our employees to enhance the customer’s 

experience and provide responsive and complete information. 

As part of this experience, VBA aggressively promoted eBenefits and improved 

Veterans ability to enroll in and access VA benefits and services. The joint VA/DOD 

eBenefits Web portal is a personalized central location for Veterans, Servicemembers, and their families to research, access, and manage their benefits and personal information. More than 3.2 million Servicemembers and Veterans are enrolled 

in eBenefits, and our goal is to expand enrollment to 5 million users in 2015. Over 

50 self-service features, including online filing of claims, online uploading of evidence, and claim status tracking are now available in eBenefits; VA and DOD continue to expand functionality with each quarterly release. 

VA also continues to increase access to burial services for Veterans and their families through the largest expansion of its national cemetery system since the Civil 

14 

War. At present, approximately 90 percent of the Veteran population—about 20 million Veterans—has access to a burial option in a national, state, or tribal Veterans 

cemetery within 75 miles of their homes. In 2004, only 75 percent of Veterans had 

such access. This dramatic increase is the result of a comprehensive strategic planning process that efficiently uses resources to serve the greatest number of 

Veterans. 

IMPROVING ACCESS TO MENTAL HEALTH SERVICES

We have been a Nation at war for more than a decade, and the state of Servicemembers’ and Veterans’ mental health is a National priority. At VA, meeting the 

individual mental health needs of Veterans is more than a system of comprehensive 

treatments and services; it is a philosophy of ensuring that Veterans receive the 

best mental healthcare possible, while focusing on the overall mental well-being of 

each Veteran. VA remains committed to doing all we can to meet this challenge. 

Through the strong leadership of the President and the support of Congress, Veterans’ access to mental healthcare has significantly improved. Some of the stigma 

associated with seeking help has diminished. We proactively screen all Veterans for 

PTSD, depression, TBI, problem drinking, substance abuse, and military sexual 

trauma (MST) to identify issues early and provide treatments and intervention opportunities. We know that when we diagnose and treat people, they get better. 

Rates of suicide among those who use VHA services have not shown increases similar to those observed in all Veterans and the general U.S. population. Since 2006, 

the number of Veterans receiving specialized mental health treatment has risen 

each year from 927,000 to more than 1.3 million in 2013. In addition, Outpatient 

visits and encounters will increase to 12.8 million in 2015, from 12.1 million in 

2013. Vet Centers are another avenue for mental healthcare access, providing services to 195,913 Veterans and their families in 2013. 

While we made significant progress in serving the growing number of Veterans 

seeking mental healthcare, our work is not done. The 2015 Budget includes $7.2 billion for mental healthcare, an increase of $309 million (4.5 percent). VA efforts are 

crucial to dispel the lingering stigma surrounding treatment, and help Veterans regain their dignity and the ability to hold meaningful employment and maintain a 

home, which helps, in turn, strengthen our Nation’s economy. 

In response to the growing demand for mental health services, VA enhanced capacity and improved the system of care so that services are more readily accessible. 

In 2012, VA completed a comprehensive assessment of the mental health program 

at every VA medical center and is using the results of that assessment to improve 

programs and share best practices across VISNs and facilities. VA also held mental 

health summits at each of our 151 medical centers, broadening the community dialog between clinicians and stakeholders. 

We are developing new measures to gauge mental healthcare performance, including timeliness, patient satisfaction, capacity, and availability of evidence-based 

therapies. Evidence-based staffing guidelines are being written for specialty and 

general mental health. In addition, VA is working with the National Academy of 

Sciences to develop and implement measures and corresponding guidelines to improve the quality of mental healthcare. To help VA clinicians better manage Veteran 

patients’ mental health needs, VA is developing innovative electronic tools. For example, Clinical Reminders give clinicians timely information about patient health 

maintenance schedules, and the High-Risk Mental Health National Reminder and 

Flag system allows VA clinicians to flag patients who are at-risk for suicide. When 

an at-risk patient does not keep an appointment, Clinical Reminders prompt the clinician to follow up with the Veteran. 

Since its inception in 2007, the VA’s Veterans’ Crisis Line in Canandaigua, New 

York, answered nearly 1,000,000 and responded to more than 143,000 texts and 

chat sessions from Veterans in need. The Veterans’ Crisis line provides 24/7 crisis 

intervention services and personalized contact between VA staff, peers, and at-risk 

Veterans, which may be the difference between life and death. In the most serious 

calls, approximately 35,000 men and women have been rescued from a suicide in 

progress because of our intervention—the rough equivalent of two Army divisions. 

ELIMINATING THE CLAIMS BACKLOG

VA has no greater responsibility than ensuring Veterans and their survivors receive timely, accurate decisions on their disability compensation and pension claims. 

Too many Veterans have waited too long to receive their benefits—and this has 

never been acceptable to VA, including the employees of VBA, over half of whom 

are Veterans. To attack this longstanding problem, we launched a historic plan to 

transform our people, processes, and technology. Our strategy advances VBA’s tools, 

15 

streamlines claims processes, trains its workforce, improves workload management, 

and meaningfully enhances interaction with Veterans and stakeholders to deliver 

more timely and accurate benefit decisions and services to Veterans and their families. Despite an escalating workload brought about by the correct decisions for Veterans on Agent Orange, Gulf War, and combat PTSD presumptions—and successful 

outreach to Veterans informing them of their benefits—we are making steady 

progress toward our goal of eliminating the disability claims backlog in 2015. 

The 2015 Budget requests $2.5 billion for VBA, an increase of $28.8 million from 

2014. VBA projects a beneficiary caseload of 5.1 million in 2015, with more than 

$78.7 billion in disability compensation and pension benefits obligations. We expect 

to process 1.5 million compensation and pension claims in 2015, up from 1.25 million claims in 2014, an increase of nearly 17 percent over 2014. 

Through our claims transformation initiatives, the use of mandatory overtime, 

and other innovative strategies, we are making real progress in reducing the disability claims backlog. As of March 8, 2014, the backlog stood at 368,829 claims, 

down 242,244 (40 percent) from its highest point on March 25th, 2013. Additionally, 

under its Oldest Claims Initiative that began in April 2013, VA provided decisions 

to over 500,000 Veterans whose claims had been pending the longest. VA continues 

to work closely with DOD, the Internal Revenue Service, the Social Security Administration, and our other Federal partners to identify electronic data-sharing opportunities and process reforms to streamline workflows and limit paper claims filing. 

VBMS is key to VBA’s transformation and success in meeting our 2015 goal. In 

June 2013, VBA completed national deployment of VBMS—six months ahead of 

schedule—providing access to over 25,000 end-users. Approximately 80 percent of 

VA’s pending disability claims are in a digital format for electronic processing in 

VBMS. Moving to a digital environment is critical. VA anticipates there will be approximately 250,000 new Servicemembers transitioning to Veteran status each of 

the next 4 years, for a total of one million new Veterans added during the next four 

years. As a result of our increased efforts to enable more Veterans to access the benefits they have earned and deserved, many of these Veterans are likely to file a 

claim with VBA within the first year of separation. 

The 2015 Budget includes $138.7 million for continued investment in the Veterans Claims Intake Program (VCIP), which converts paper claims into an electronic 

format and enables electronic transfer of medical and personnel records. This electronic transfer is critical to creating the necessary digital environment for 

populating the eFolders and supporting end-to-end electronic claims processing for 

each stage of the claims lifecycle. Although VA continues to accept paper claims 

from Veterans who are not familiar with or cannot access computer technology, VBA 

is working with stakeholders to increase the number of claims submitted electronically. VBA now converts paper claims to electronic format as we receive them, saving time and effort and improving accuracy. As of December 2013, over 25,000 

VBMS users could access 424 million electronic images converted from paper. 

The 2015 Budget includes $94.3 million for the Board of Veterans’ Appeals (the 

Board), which we are requesting as a new appropriation separate from the General 

Administration appropriation. The Board provides direct service to Veterans and 

their families by conducting hearings and issuing final appeals decisions. VA is actively pursuing initiatives to improve the appeals process and reduce wait times for 

Veterans, including a Board-led initiative that pre-screens appeals to ensure that 

the record is fully developed and ready for adjudication. The Board is also streamlining decision writing to increase output and efficiency. Expanded use of VBMS and 

the eventual incorporation of appeals functionality in VBMS will save resources currently spent handling, accessing, storing, and transporting paper claims files between the Board and VBA Regional Offices. The Board completed major technological upgrades to its video teleconference (VTC) equipment and the Board now 

conducts slightly over half of their hearings by video teleconference, a significant increase from 29 percent in 2009. We project appeals will increase to 72,786 cases in 

2015, an increase of 12 percent from 2014’s 64,941 cases. 

ENDING VETERAN HOMELESSNESS

Every Veteran who has served America ought to have a home in America. We 

made great progress toward achieving our goal to end Veteran homelessness in 

2015. VA will use knowledge gained over the past four years to ensure robust prevention programs are in place for future years. The 2015 Budget request is essential 

for VA to successfully achieve an end-to-the-rescue phase, and prevent future homelessness among Veterans at-risk in the years to come. 

Since 2009, VA, together with our Federal, state, and local partners, has reduced 

the estimated number of homeless Veterans by 24 percent. We have conducted over 

16 

six million clinical visits with over 600,000 Veterans who were homeless, at-risk of 

homelessness (including formerly homeless). In 2013 alone, VA served more than 

240,000 Veterans who were homeless or at-risk of becoming homeless—21 percent 

more than the year before. Over the past four years, the Point-in-Time (PIT) count 

of homeless Veterans declined steadily, despite challenging economic times. The PIT 

count estimate of the number of homeless Veterans dropped from 75,609 in January 2009, to 57,849 in January 2013, a 24 percent decrease. 

VA’s programs constitute the largest integrated network of programs with components of homeless assistance in the Nation. They provide homeless Veterans with 

nearly 80,000 beds or units, including permanent supportive housing through the 

Department of Housing and Urban Development-VA Supportive Housing (HUDVASH) program; link Veterans with needed mental health and other medical care; 

and provide supportive services and opportunities to reintegrate Veterans back into 

the community and workforce. VA’s cost-effective, evidence-based homeless programs produce large savings and cost avoidance in budgetary, social, and economic 

terms. Using a Housing First strategy, VA relies on research that shows that placing homeless Veterans into Housing First reduces emergency room visits, other 

forms of intensive hospitalization, and substance overdose. Medical care costs are 

roughly three times as expensive for homeless compared to Veterans who are not 

homeless. 

Despite significant progress and important accomplishments, much work remains. 

We estimate that between 2013 and 2015, approximately 200,000 Veterans will experience homelessness at some point in time. To reach our goal of ending Veteran 

homelessness in 2015, the Budget requests $1.6 billion for VA homeless-related programs, including case management support for the HUD-VASH voucher program, 

the Grant and Per Diem Program, the Supportive Services for Veteran Families 

(SSVF) program, and VA justice programs. This represents an increase of $248 million (17.8 percent) over the 2014 Budget level. This budget supports VA’s long-range 

plan to end Veteran homelessness by emphasizing rescue for those who are homeless today, and prevention for those at risk of homelessness. 

HUD-VASH provides permanent supportive housing to the most vulnerable of our homeless Veterans. The 2015 Budget requests $374 million for HUD-VASH, an increase of $47 million (14 percent) over the 2014 Budget level. This funding will support nearly 3,500 case managers to provide intensive wraparound services to nearly 

80,000 Veterans. These case managers provide an average number of 12 clinical visits per year to these Veterans to ensure that they remain in housing and do not 

become homelessness again. Veterans in HUD-VASH are vulnerable; the majority 

meets criteria for chronic homelessness, and suffers from serious mental illness, 

substance use disorders, and chronic medical conditions. This partnership remains 

the most responsive housing option available to VA and is a critical component of 

our strategy to move homeless Veterans from the streets to a safe and stable home. 

The Grant and Per Diem Program helps fund community agencies providing services to homeless Veterans with the goal of helping them achieve residential stability, 

increase their skill levels and/or income, obtain greater self-determination, independent living, and employment as soon as possible. The 2015 Budget requests $253 

million for the Grant and Per Diem Program, an increase of $3 million (1.1 percent) 

over the 2014 Budget level. In 2015, the program will provide over 15,500 transitional housing beds to Veterans through partnerships with more than 650 projects. 

VA’s SSVF is a critical aspect of our strategy to prevent and end Veteran homelessness. This program provides both prevention and rapid rehousing services to 

Veterans and family members. In 2013, SSVF successfully prevented over 60,000 atrisk Veterans and family members from falling into homelessness, and successfully 

placed over 84 percent of homeless Veterans and family members into permanent 

housing. In the last three years, VA awarded grants totaling $459.6 million to 324 

community agencies in all 50 states, the District of Columbia, Puerto Rico, and the 

Virgin Islands. SSVF grants to private non-profit organizations and consumer cooperatives provide a range of supportive services to include outreach, case management, assistance in obtaining VA benefits, and assistance in obtaining and coordinating other public benefits. In 2015, VA will deploy SSVF grants strategically to 

target resources to communities with concentrations of homeless Veterans. 

In addition, VA’s Justice Programs, which facilitate access to needed VA treatment for Veterans in criminal justice settings such as Veterans Treatment Courts, 

are an important prevention effort for homeless and at-risk Veterans. The goal of 

these Courts is to divert those with mental health issues and homelessness risk 

from the traditional justice system and give them treatment and tools for rehabilitation and readjustment. The first Veterans court was established in 2008 in Buffalo, 

N.Y. By the end of 2013, there were 257 courts nationwide, positively affecting the 

lives of 7,724 Veterans; VA serves Veterans in each of these courts. Many of the 

17 

participating Veterans have avoided incarceration and the cycle of homelessness, 

that often follows incarceration. The 2015 Budget requests $35 million for Veterans 

Justice Programs, an increase of $1.5 million (4 percent) over the 2014 Budget level. 

To increase homeless Veterans’ access to benefits, care, and services, VA established the National Call Center for Homeless Veterans (NCCHV). The NCCHV provides homeless Veterans and Veterans at-risk for homelessness free, 24/7 access to 

trained counselors. The call center is intended to assist homeless Veterans and their 

families; VA medical centers; Federal, state, and local partners; community agencies; service providers; and others in the community. In 2013, the National Call 

Center for Homeless Veterans received 111,096 calls (38 percent increase over 2012) 

and made 78,622 referrals to VA medical centers (55 percent increase over 2012). 

The 2015 Budget requests $5.6 million for NCCHV, an increase of $1.7 million (45 

percent) over the 2014 Budget level. VA has established 28 Community Resource 

and Referral Centers (CRRC) to provide rapid assistance to homeless Veterans. 

MULTI-YEAR BUDGET FOR MEDICAL CARE

Due to Congress’s foresight, under the Veterans Health Care Budget Reform and 

Transparency Act of 2009, VA includes a request for an advance appropriation for 

its medical care budget. The legislation requires VA to plan its medical care budget 

using a multi-year approach, which ensures that VA requirements are reviewed and 

updated based on the most recent data available and actual program experience. 

The 2015 medical care budget of $59.1 billion, including collections, will fund treatment to over 6.7 million unique patients, an increase of 4 percent over the 2013 estimate. Of those unique patients, 4.7 million Veterans are in Priority Groups 1–6, an 

increase of more than 204,836 (4.5 percent). Additionally, VA anticipates treating 

over 757,600 Veterans from the conflicts in Iraq and Afghanistan, an increase of 

over 141,100 patients (23 percent) over the 2013 level. VA also provides medical 

care to non-Veterans through programs such as the Civilian Health and Medical 

Program of the Department of Veterans Affairs (CHAMPVA) and the Spina Bifida 

Health Care Program; we expect this population to increase by over 42,600 patients 

(6.3 percent), during the same period. 

Based on updated 2015 estimates largely derived from the Enrollee Health Care 

Projection Model, the 2015 Budget will allow VA to increase funding for programs 

to end Veteran homelessness; continue implementation of the Caregivers and Veterans Omnibus Health Services Act; fulfill multiple responsibilities under the ACA; 

provide for activation requirements for new or replacement medical facilities; and 

invest in strategic initiatives to improve the quality and accessibility of VA 

healthcare programs. The 2015 appropriations request includes an additional $368 

million above the enacted 2015 advance appropriations level. Our multi-year budget 

plan assumes that VHA will carry over a small percentage of unobligated balances 

from 2014 into 2015 to ensure that funds are available at the beginning of the fiscal 

year to cover any unforeseen costs. 

The 2016 medical care budget of $61.9 billion, including collections, provides for 

healthcare services to treat over 6.8 million unique patients, an increase of 1.5 percent over the 2015 estimate. The 2016 request for medical care advance appropriations is an increase of $2.9 billion, or 4.9 percent, over the 2015 budget request. 

Medical care funding levels for 2016, including funding for activations, non-recurring maintenance, and initiatives, will be revisited during the 2016 budget process, 

and could be revised to reflect updated information on known funding requirements 

and unobligated balances. 

MEDICAL AND PROSTHETIC RESEARCH

VA supports the President’s national action plan to guide mental health research 

across government, industry and academia, and develop more effective ways to prevent, diagnose, and treat mental health conditions like TBI and PTSD. VA’s medical 

research programs demonstrate the creativity and ingenuity of our Nation’s greatest 

minds to help save Veterans’ lives, limit their incapacitation, and build a better 

world for their families. Projects funded in 2015 will focus on identifying or developing new treatments for Gulf War Veterans, improving social reintegration following Traumatic Brain Injury, reducing suicide, evaluating the effectiveness of 

complementary and alternative medicine, developing blood tests to assist in the 

diagnosis of PTSD and mild Traumatic Brain Injury, and advancing genomic 

medicine. 

In 2015, Medical Research will be supported through a $589 million direct appropriation, and an additional $1.3 billion from VA’s medical care program, Federal 

grants, and non-Federal grants. Including Medical Care support, other Federal resources, and private resources, total funding for Medical and Prosthetic Research 

18 

will be nearly $1.9 billion in 2015. VA’s research program benefits Veterans, their 

families, and the Nation. 

INCREASING EMPLOYMENT OPPORTUNITIES FOR VETERANS

Under the President’s leadership, VA, the Department of Labor, DOD, and the entire Federal Government made Veterans’ employment one of their highest priorities. 

At VA, we led by example. We made great strides during the last five years and 

remain committed to meeting our goal of 40 percent of VA employees being Veterans, compared to 32.4 percent currently. During 2013, 33.8 percent of all new 

hires at VA were Veterans, including an impressive 78.5 percent of all new employees in our National Cemetery Administration (NCA). 

We continue to work to ensure that all of America’s Veterans have the support 

they need and deserve when they leave the military, look for a job, and enter the 

civilian workforce. The interagency Employment Initiative Task Force, co-led by VA 

and DOD, developed a new training and services delivery model to help strengthen 

the transition of our Veteran Servicemembers from military to civilian life. Accordingly, the 2015 Budget includes $106 million to meet VA’s responsibilities under the 

President’s Veterans Employment Initiative and the VOW to Hire Heroes Act. In 

addition, the 2015 Budget includes $1 billion in mandatory funding over 5 years to 

develop a Veterans Job Corps conservation program that will put up to 20,000 Veterans back to work over the next 5 years protecting and rebuilding America. Jobs 

will include park maintenance projects, patrolling public lands, rehabilitating natural and recreational areas, and law enforcement-related activities. Additionally, 

Veterans will help make a significant dent in the deferred maintenance of our Federal, state, local, and tribal lands, including jobs that will repair and rehabilitate 

trails, roads, levees, recreation facilities, and other assets. The program will serve 

all Veterans, but have a particular focus on post-9/11 Veterans. 

Since 2009, VA provided over $31.8 billion in Post-9/11 GI Bill benefits in the 

form of tuition and other education-related payments to cover the education and 

training of more than 1 million Servicemembers, Veterans, family members, and 

survivors. As part of this effort VBA launched an online GI Bill Comparison Tool 

to make it easier for Veterans, Servicemembers, and dependents to calculate their 

Post-9/11 GI Bill benefits and learn more about VA’s approved colleges, universities, 

and other education and training programs across the country. The GI Bill Comparison Tool provides key information about college affordability and brings together information from more than 17 online sources and 3 Federal agencies, including the 

number of students receiving VA education benefits at each school. 

VA is also now working with Student Veterans of America to track graduation 

and training completion rates, and we expect a draft report by the end of 2014 to 

quantify program outcomes. The Post-9/11 GI Bill continues to be a focus of VBA 

transformation, as it implements the automated Long-Term Solution (LTS), VA’s 

end-to-end claims processing solution that utilizes rules-based, industry-standard 

technologies for the delivery of education benefits. At the end of January 2014, we 

had 68,215 education claims pending, 21 percent lower than the total claims pending the same time last year. The average days to process Post-9/11 GI Bill supplemental claims decreased by 9.1 days, from 16.1 days in September 2012 to 7 days 

in January 2014. The average time to process initial Post-9/11 GI Bill original education benefit decreased by 15.3 days in the same period, from 32.5 days to 17.2 

days. 

CAPITAL INFRASTRUCTURE

The 2015 Budget requests $1.06 billion for VA’s major and minor construction 

programs, the same as the 2014 Budget level. The capital asset budget demonstrates VA’s commitment to address critical major construction projects that directly impact patient safety and seismic issues and reflects VA’s ongoing promise 

to provide safe, secure, sustainable, and accessible facilities for Veterans. The request also reflects the current fiscal climate and the great challenges VA faces in 

order to close the gaps identified in our Strategic Capital Investment Planning 

(SCIP) process. 

Major Construction 

The major construction request in 2015 is $561.8 million. The request provides 

funding for four on-going major medical facility projects. They include: (1) seismic 

corrections to renovate building 205 for homeless programs at the West Los Angeles, 

CA VA Medical Center; (2) seismic corrections and construction of a new mental 

health facility and parking structure at the Long Beach Healthcare System; (3) construction of a new community living center (CLC), domiciliary and outpatient facilVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00022 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
19 

ity in Canandaigua, NY; and (4) construction of a new spinal cord injury/CLC facility, hospice nursing unit, and upgrades to a high-risk seismic building in San Diego, 

CA. These projects represent VA’s most critical major construction projects and correct critical safety and seismic deficiencies that are currently putting Veterans, VA 

staff, and the public at risk. Once the projects are completed, Veterans seeking care 

will be served in more modern and safer facilities. 

The 2015 Budget also includes $2.5 million for NCA for advance planning activi- ties and $7.5 million for land acquisition to support the establishment of 5 additional national cemeteries in Cape Canaveral and Tallahassee Florida; Omaha, Nebraska; southern Colorado; and western New York to meet the burial access policies 

included in the 2011 budget. 

Minor Construction 

The 2015 Budget includes a minor construction request of $495.2 million. The requested amount would provide funding for ongoing and newly identified projects 

that renovate, expand, and improve VA facilities. This year’s focus is a balance between continuing to fund minor construction projects that we can implement quickly 

to maintain and repair our aging infrastructure, while using major construction 

funding to address life-threatening safety and seismic issues that currently exist at 

multiple VA medical facilities. 

Opportunity, Growth and Security Initiative 

The Budget also includes a separate $56 billion Opportunity, Growth, and Security Initiative to spur economic progress, promote opportunity, and strengthen national security. This Initiative would increase employment, while achieving important economic outcomes in areas from education to research to manufacturing and 

public health and safety. Moreover, the Opportunity, Growth, and Security Initiative is fully paid for with a balanced package of spending cuts and tax loophole 

closers. 

At the Department of Veterans Affairs (VA), the Opportunity, Growth, and Security Initiative will support capital investments essential to expanding and protecting 

Veterans’ access to quality care and benefits. By providing an additional $400 million for the VA capital program, enactment of the Initiative will allow additional 

progress in addressing the Department’s highest priority capital needs, including a 

major construction project to replace a seismically deficient research facility in San 

Francisco, California. 

NATIONAL CEMETERY ADMINISTRATION

The NCA has the solemn duty to honor Veterans and their families with final 

resting places in national shrines and with lasting tributes that commemorate their 

service and sacrifice to our Nation. We honor those individuals’ service through our 

133 national cemeteries, which includes two national cemeteries scheduled to open 

in 2015, 33 Soldiers’ lots and monuments, the Presidential Memorial Certificate program, and through the markers and medallions that we place on the graves of Veterans around the world. The 2015 Budget includes $256.8 million for operations and 

maintenance to uphold NCA’s responsibility for this mission, including funds to 

open two new national cemeteries and to begin preparations for opening two National Veterans Burial Grounds. 

NCA projects its workload will continue to increase. For 2015, we anticipate conducting approximately 128,100 interments of Veterans or their family members, and 

maintaining and providing perpetual care for approximately 3.5 million gravesites. 

NCA will also maintain 8,882 developed acres and process approximately 362,900 

headstone and marker applications. 

NCA maintains a strong commitment to hiring Veterans. Currently, Veterans 

comprise over 74 percent of its workforce. Since 2009, NCA hired over 450 returning 

Iraq and Afghanistan Veterans. In addition, NCA awarded 66.5 percent of contract 

awards in 2013 to Veteran-owned and service-disabled, Veteran-owned small businesses. NCA’s committed, Veteran-centric workforce is the main reason it is able to 

provide a world-class level of customer service. NCA participated for the 5th time 

in the American Customer Satisfaction Index (ACSI), sponsored by the Federal Consulting Group and Claes Fornell International (CFI) Group. In the 2013 review, 

NCA received a score of 96 out of a possible 100, the highest score to date for any 

organization in the public or private sector. 

NCA continues to leverage its partnerships to increase service for Veterans and 

their families. As a complement to the national cemetery system, NCA administers 

the Veterans Cemetery Grant Service (VCGS), which provides grants to establish, 

expand, or improve state and tribal Veterans’ cemeteries. There are currently 90 

operational state and tribal cemeteries in 45 states, Guam, and Saipan, with five 

20 

more under construction. Since 1980, VCGS awarded grants totaling more than 

$566 million to establish, expand, or improve these Veterans’ cemeteries. In 2013, 

these cemeteries conducted over 32,000 burials for Veterans and family members. 

LEGISLATION

In addition to presenting VA’s resource requirements, the 2015 President’s Budget 

also proposes legislative action that will benefit Veterans. These proposals build on 

VA’s legislative agenda transmitted in the First Session of the 113th Congress, as 

part of the 2014 President’s Budget. Let me highlight a few provisions: VA proposes 

a measure that will allow better coordination of care when a Veteran also receives 

other care at a non-VA hospital, by streamlining the exchange of patient information. Additionally, we propose allowing the CHAMPVA to cover children up to age 

26, to make that program consistent with benefits conferred under the ACA. We 

also are submitting a proposal that would modernize our domiciliary care program 

by removing income-based eligibility restrictions. 

To continue our priority to end Veteran homelessness, VA proposes increased 

flexibility in the Grant and Per Diem program to focus on the transition to permanent housing. Also among our proposals is a measure that would allow VA to speed 

payment of Dependency and Indemnity Compensation and other benefits to surviving spouses by eliminating the need for a formal claim when there already is sufficient evidence for VA to act. We greatly appreciate consideration of these and other 

legislative proposals included in the 2015 Budget and look forward to working with 

Congress to enact them. 

SUMMARY

Since the founding of our great Nation, Veterans helped our country meet all challenges; this remains true today as Veterans help rebuild the American middle class. 

At VA, we continue to implement the President’s vision and transform VA into a 

21st century leader of efficiency, effectiveness, and innovation within the Federal 

Government. Our 2015 Budget supports Presidential priorities to always add value 

to the Nation, boost economic growth, strengthen the middle class, and work sideby-side with Federal partners to eliminate unnecessary overlaps or redundancies. 

Given today’s challenging fiscal environment, this Budget focuses VA resources, 

policies, and strategies on the most urgent issues facing Veterans and provides the 

resources critical to expand access, eliminate the disability claims backlog in 2015, 

and end Veteran homelessness in 2015. There is no greater mission than serving 

Veterans. Again, thank you for the opportunity to appear before you today and for 

your unwavering support of Veterans. 

[VA responses to posthearing questions follows:] 

RESPONSE TO POSTHEARING QUESTIONS SUBMITTED BY HON. BERNARD SANDERS TO

HON. ERIC K. SHINSEKI, SECRETARY, U.S. DEPARTMENT OF VETERANS AFFAIRS

BENEFITS PROGRAMS

Question 1. Provide the current performance standards for employees involved 

with the processing of claims. 

Response. Attached are the performance standards for the Veterans Service Representative (VSR) and Rating Veterans Service Representative (RVSR) positions. 

Attachment 1 

NATIONAL PERFORMANCE PLAN 

RATING VETERANS SERVICE REPRESENTATIVE (RVSR) 

(Excludes PMC and IDES RVSRs) 

ELEMENT 1—QUALITY (Critical) 

The RVSR must consistently and conscientiously exercise sound, equitable judgment in applying stated laws, regulations, policies and procedures to ensure accurate information is disseminated to veterans and accurate decisions are provided on 

all benefit claims administered by the Department of Veterans Affairs. 

Fully Successful (Issue Based) 

Experience level defined by time in position: 

6–12 months: The accuracy rate during the evaluation period equals or 

exceeds 80% (cumulative) 

21 

13–18 months: The accuracy rate during the evaluation period equals or 

exceeds 85% (cumulative) 

19–24 months: The accuracy rate during the evaluation period equals or 

exceeds 90% (cumulative) 

Over 24 months: The accuracy rate during the evaluation period equals or 

exceeds 92% (cumulative) 

Indicator 

A random selection will be made of an average of 5 end products per month regardless of number of issues decided. This includes completed cases and partial ratings to determine the accuracy of the originator. The selection of actions, while random, must reflect an appropriate mix of work performed by the employee throughout the month (i.e. not from a single day or single week). 

If a routine review of a RVSR’s work demonstrates the need for quality improvement, an expanded sample of 10 total end products per month will be reviewed for 

quality purposes. 

Once an error is found and recorded concerning a specific issue associated with 

the claim (ex: effective date), no additional errors related to that issue should be 

recorded (consistent with M21–4 under the Quality Review Structure for cascading 

effect). 

ELEMENT 2—TIMELINESS (Critical) 

Timely processing of veterans claims is of paramount importance as it highly correlates with customer satisfaction. The RVSR will operate in an efficient manner 

to accurately finalize claims using all appropriate workload management tools and 

processes. 

RVSRs are responsible for the types of work respective to their assigned duties. 

Extenuating circumstances and notification to the employee’s supervisor will be considered. 

Timeliness of Workload Management (includes rating, non-rating and appeals) 

Fully Successful 

RVSRs must manage their workload in accordance with locally established workload management plans. 

There will be no more than 3 instances of RVSR specific duties not being completed within locally established timeframes, or failure of employee to notify their 

supervisor when cases cannot be worked within established timeframes and reasons 

thereof during the evaluation period. An incident will not be called until after the 

first notification of non-compliance of the above standard. 

Indicators 

1 VETSNET Operations Reports (VOR) 

2 Local Tracking Reports 

3 Supervisory Assignments and Observation 

4 Folder Aging Reports 

5 VACOLS Reports 

ELEMENT 3—OUTPUT (Critical) 

Processes a minimum cumulative average number of weighted actions on rating 

related end products and the following: EP 930 series, statements of the case, supplemental statements of the case, claims certified to BVA, hearing decisions, EP 

290, 600, 095, 070, 172, 165. 

Weighted action credit will be given based on number of issues completed per the 

following: 

1–2 issues completed: .5 weighted action 

3–4 issues completed: 1 weighted action 

5–9 issues completed: 1.5 weighted actions 

Each additional 5 issues completed will be given .5 weight actions (i.e. 10–14 

issues completed: 2 weighted actions; 15–19 issues completed: 2.5 weighted actions; 

20–24 issues completed: 3 weighted actions; et cetera) 

Fully Successful 

Experience level defined by time in position: 

6–12 months: 1.5 weighted actions 

13–18 months: 2 weighted actions 

19–24 months: 2.5 weighted actions 

Over 24 months: 3 weighted actions 

22 

* RVSRs on the Special Operations team will have an additional .25 weighted actions added 

to their output for each claim worked meeting special operations criteria to account for the complexity of these cases. 

Indicators 

VOR 

ASPEN 

VACOLS Reports 

* Duplicate credit will not be allowed for self-correction of an RVSR’s error. 

** Leave, union time, and special projects or assignments pre-approved at the discretion of the 

supervisor are considered deductible time. Unmeasured time, such as informal training, was 

considered in developing the successful level and is not reportable deductible time. 

ELEMENT 4—TRAINING (Critical) 

RVSR will stay abreast of current laws and regulations, work processes, policies 

and procedures and computer applications in order to provide optimum service to 

our veteran population. 

RVSRs are encouraged to actively participate in developmental activities of self 

and others. For example, this may include volunteering to conduct needed training, 

mentoring and second signature reviews. 

The RVSR will complete mandatory Core Technical Training Requirements 

(CTTR) as outlined on a published training schedule and within specified deadlines. 

It is the responsibility of supervisors to provide RVSRs with a training schedule 

in advance so they can complete their training requirements. It is the responsibility 

of the RVSR to complete all required training within established guidelines. 

Performance under this element will be mitigated when the RVSR’s supervisor 

has not allotted sufficient time for RVSR to complete training requirements or if the 

RVSR is not provided a schedule of available training and the deadline they are to 

complete. 

Fully Successful 

Timely completion of nationally mandated training hours to include core requirements and mandated local training during evaluation period. Completes training 

within assigned deadlines with no more than 1 violation during evaluation period. 

Indicators 

TMS 

Supervisory Observation 

ELEMENT 5—Organizational Support (Non-critical) 

Functions as a team member to enhance resolution of claims by work actions. 

Maintains professional, positive, and helpful relationships with internal and external customers (to include fellow employees and all stakeholders) by exercising tact, 

diplomacy, and cooperation. 

Performance demonstrates the ability to adjust to change or work pressures, to 

handle differences of opinion in a businesslike fashion, and to follow instructions 

conscientiously. As a team member, contributes to the group effort by supporting fellow teammates with technical expertise and open communications and by identifying problems and offering solutions. Performance also demonstrates the ability to 

effectively communicate in a courteous manner with internal and external customers (to include fellow employees and all stakeholders). 

The RVSR provides information to veterans and claimants that is accurate, concise, complete and written in a non-adversarial, respectful manner that demonstrates courtesy and compassion. This information may be in the form of rating 

decisions, written correspondence to claimants and other verbal communication with 

claimants such as personal hearings. 

Fully Successful: No more than 3 instances of valid complaints or incidents.* 

* A valid complaint or incident is one where a review by the supervisor, after considering both 

sides of the issue, reveals that the complaint/incident should have been handled more prudently 

and was not unduly aggravated by the complainant. Disagreeing, per se, does not constitute 

‘‘discourtesy.’’ Valid complaints or incidents will be determined by the supervisor and discussed 

with the employee. 

Indicator 

Verbal and/or written feedback from internal and/or external customers. Observations by a supervisor with the complaint documented. 

23 

Attachment 2 

NATIONAL PERFORMANCE PLAN 

VETERANS SERVICE REPRESENTATIVE (VSR) 

(Excludes PMC and PCT VSRs) 

ELEMENT 1—QUALITY (Critical) 

The VSR must consistently and conscientiously exercise sound, equitable judgment in applying stated laws, regulations, policies and procedures to ensure accurate information is disseminated to Veterans and accurate decisions are provided on 

all benefit claims administered by the Department of Veterans Affairs. 

Standard 

Quality of Work 

Successful Level 

GS–7: The accuracy rate during the evaluation period equals or exceeds 80% 

(cumulative) 

GS–9: The accuracy rate during the evaluation period equals or exceeds 85% 

(cumulative) 

GS–10: The accuracy rate during the evaluation period equals or exceeds 92% 

(cumulative) 

GS–11: The accuracy rate for work produced during the evaluation period 

equals or exceeds 93% (cumulative) 

Indicators 

A random selection will be made of an average of 5 actions per month regardless 

of number of contentions claimed. Quality of action taken on each contention will 

be evaluated. The selection of actions, while random, must reflect an appropriate 

mix of work performed by the employee throughout the month (i.e. not from a single 

day or single week). 

If a routine review of a VSR’s work demonstrates the need for quality improvement, an expanded sample of an average of 10 actions per month will be reviewed 

for quality purposes. 

The ASPEN checklist to be used will mirror the STAR worksheet and will include 

a component on systems compliance, which will be considered a substantive error. 

ELEMENT 2—TIMELINESS/WORKLOAD MANAGEMENT (Critical) 

Timely processing of Veterans claims is of paramount importance, as it is highly 

correlated with customer satisfaction. The VSR will operate in an efficient manner 

to accurately finalize claims using all appropriate workload management tools and 

processes. 

VSRs are responsible for the cycles/type of work respective to their assigned duties. If multiple timeliness sub-elements apply to a VSR (e.g. average days awaiting 

award, non-rating, and corrective actions) they must meet the fully successful level 

for all applicable sub-elements to be successful for the element. 

Extenuating circumstances and notification to the employee’s supervisor will be 

considered. An incident will not be called until after the first notification of noncompliance of the above standard. 

Timeliness 

Timeliness of Rating End Products (including EP 930 series) 

Fully Successful: All grade levels must meet locally established timeliness requirements, which are to be derived from end of year station targets. 

The percentage of claims in each cycle pending over the locally established cycle 

goal must align with station goals for percentage of claims greater than 125 days. 

Management for each station sets goals. 

Cycle Times 

a. Average Days Awaiting Development 

b. Average Days Awaiting Evidence 

c. Average Days Awaiting Award 

d. Average Days Awaiting Authorization 

Timeliness of Non-Rating & Control End Products (i.e. EPs 600, writeouts, 800 

series) 

Fully Successful: All grade levels must meet locally established timeliness requirements, which should be derived from station targets. 

24 

Timeliness of Direct Services (i.e. IRIS, Congressional Inquiries, etc.) 

Fully Successful: All grade levels must meet locally established timeliness requirements, which should be derived from station targets. There will be no more than 

5 instances where the VSR fails to meet established timeliness, or failure of employee to notify their supervisor when cases cannot be worked within established 

timeframes and reasons thereof. 

Timeliness of Special Projects & Duties (i.e. Women Veterans Coordinators, 

AEW Project, etc.) 

Fully Successful: There will be no more than 3 instances of tasks not being 

worked within established timeframes, or failure of employee to notify their supervisor when cases cannot be worked within established timeframes and reasons 

thereof. 

Timeliness of Corrective Actions 

Fully Successful: There will be no more than 3 instances of failure to complete 

a returned corrective action, or failure of employee to notify their supervisor when 

cases cannot be worked, within three days of the case being returned to them for 

correction. 

Workload Management 

Fully Successful: All grade levels must manage their workload in accordance with 

locally established workload management plans. There will be no more than 2 instances where the VSR fails to show compliance with established workload management procedures. 

Local management will be responsible for creating and communicating a workload 

management plan that will identify the types of work to be completed. 

Indicators 

• VETSNET Operations Reports • Local Tracking Reports • Supervisory Observation 

ELEMENT 3—OUTPUT (Critical) 

Fully Successful: VSRs process a minimum cumulative average number of outputs 

per day. Outputs will be counted as follows: 

• Development (Initial Development, Subsequent Development, and Ready for Decision including rating Eps, EP 930s, administrative decisions, appeals, non-rating 

Eps, and EP 600s)—.7 • 1–2 contention claim development (Initial Development, Subsequent Development, and Ready for Decision including rating Eps, EP 930s, administrative decisions, appeals, non-rating Eps, and EP 600s)—.5 • Telephone development—.1 • Process award/decision (generate award, clear end product)—.7 • Authorize award—.33 

Note 1: Subsequent development includes any actionable item, which moves the 

claim forward and is subject to quality review. 

Note 2: Telephone development requires contact with claimant, representative, or 

medical facility to further the development of the claim. Credit for telephone development may be taken in addition to development credit. 

Note 3: VSRs performing Post-Determination authorization duties will receive an 

additional .5 weighted action for more complex cases involving out of system payments or retroactive effective dates preceding 1982 (earliest generate line in 

VETSNET). 

Successful Level 

GS–7: 4 

GS–9: 5 

GS–10: 5.5 

GS–11: 6 

Indicators 

• VOR • ASPEN 

There will be no output element expectation for 90 days following the completion 

of challenge training regardless of entry grade. 

Duplicate credit will not be allowed for self-correction of a VSR’s error. 

Leave, union time, and special projects or assignments pre-approved at the discretion of the supervisor are considered deductible time. Unmeasured time, such as inVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00028 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
25 

formal training, was considered in developing the successful level and is not reportable deductible time. 

ELEMENT 4—TRAINING (Critical) 

VSR will stay abreast of current laws and regulations, work processes, policies 

and procedures and computer applications in order to provide optimum service to 

our Veteran population. 

Employees are encouraged to actively participate in self-developmental activities. 

Performance for this standard will be mitigated when the VSR’s supervisor has 

not allotted sufficient time for VSR to complete training requirements or if the VSR 

is not provided a schedule of available training and the deadline they are to 

complete. 

It is the responsibility of supervisors to provide VSRs with a training schedule 

in advance so they can complete their training requirements. 

Successful Level 

GS–7/9/10/11: Timely completion of nationally mandated training hours to include 

core requirements and mandated local training during evaluation period. Completes 

mandatory training within assigned deadlines with no more than 1 violation during 

evaluation period. 

Indicators 

• TMS 

• Supervisory Observation 

ELEMENT 5—Organizational Support (Non-critical) 

Functions as a team member to enhance resolution of claims and customer service 

contacts by work actions. Maintains professional, positive, and helpful relationships 

with customers by exercising tact, diplomacy, and cooperation. 

Performance demonstrates the ability to adjust to change or work pressures, to 

handle differences of opinion in a businesslike fashion, and to follow instructions 

conscientiously. As a team member, contributes to the group effort by supporting fellow teammates with technical expertise and open communications and by identifying problems and offering solutions. Performance also demonstrates the ability to 

effectively communicate in a courteous manner with customers during the personal 

or telephone interview process. 

Successful Level 

GS–7/9/10/11: No more than 3 instances of valid complaints or incidents.* 

* A valid complaint or incident is one where a review by the supervisor, after considering both sides of the 

issue, reveals that the complaint/incident should have been handled more prudently and was not unduly aggravated by the complainant. Disagreeing, per se, does not constitute ‘‘discourtesy.’’ Valid complaints or incidents will be determined by the supervisor and discussed with the employee. 

Indicators 

• Verbal and/or written feedback from internal and/or external customers 

• Observations by a supervisor with the complaint documented 

Question 2. Provide the number of FTE at each VA regional office, separated by 

job title and grade as of March 12, 2014. 

Response. The attached spreadsheet provides full-time equivalent (FTE) employees by regional office (RO), grade, and position. 

26 


312q3SanQ2-1.eps
27 


312q3SanQ2-2.eps
28 


312q3SanQ2-3.eps
29 


312q3SanQ2-4.eps
30 


312q3SanQ2-5.eps
31 


312q3SanQ2-6.eps
32 


312q3SanQ2-7.eps
33 


312q3SanQ2-8.eps
34 


312q3SanQ2-9.eps
35 


312q3SanQ2-10.eps
36 


312q3SanQ2-11.eps
37 


312q3SanQ2-12.eps
38 


312q3SanQ2-13.eps
39 


312q3SanQ2-14.eps
40 


312q3SanQ2-15.eps
41 

Question 3. Provide the methodology utilized to allocate personnel and resources 

to the regional offices and specifically address any refinements made to this methodology in the past fiscal year. 

Response. The Veterans Benefits Administration’s (VBA) Resource Allocation 

Model (RAM) is a systematic approach to distributing field resources each fiscal 

year. The RAM utilizes a weighted model to assign compensation and pension (C&P) 

FTE resources based on RO workload, including rating inventory and rating, nonrating, and appeal receipts. Starting in fiscal year (FY) 2014, the RAM includes additional variables to more closely align with VBA’s transformation to a paperless, 

electronic environment, where receipts can be assigned and managed at the national 

level. These variables include station efficiency, quality, and RO capacity. VBA leaders use the model as a guide, making adjustments for special circumstances or missions performed by individual ROs. Special missions include Day-One Brokering 

Centers, Integrated Disability Evaluation System (IDES) processing sites, Benefits 

Delivery at Discharge sites, Quick Start processing locations, and National Call 

Centers (NCC). Non-payroll and travel resources are allocated to each RO based on 

business need, including the number of FTE, benefit programs administered, and 

other unique factors such as geographic location and jurisdiction. 

Question 4. In 2009, VA began an effort to update the VA Schedule for Rating 

Disabilities. 

a. Provide an itemized list of funding expended in FY 2013 on the rating schedule 

modernization. 

Response. In FY 2013, VBA spent approximately $981,000 to support updates to 

the VA Schedule of Rating Disabilities (VASRD), including $902,000 for personal 

services, $30,000 for travel, and $49,000 for rent, supplies, and other services. 

b. Provide an itemized list of funding expended in FY 2014 on the rating schedule 

modernization. 

Response. In FY 2014, VBA will spend approximately $996,000 to support updates 

to VASRD, including $947,000 for personal services, $3,000 for travel, and $46,000 

for rent, supplies, and other services. 

c. Provide an itemized list of the requested funding in FY 2015 for the rating 

schedule modernization. Also, include the number of FTE assigned to or supporting 

this modernization effort. 

Response. In FY 2015, VBA requested $3.0 million to update the VASRD, including $952,000 for personal services, $30,000 for travel, and $2.0 million for rent, supplies, and other services. The increase in funding in FY 2015 is primarily due to 

a contracted earnings loss studies. Five employees are currently assigned to support 

the VASRD update project. 

d. Provide the Project Management Plan, the VASRD Update Operating Plan and 

project schedule for the rating schedule modernization. 

Response. The Project Management Plan for the VASRD Update Project, which 

contains the operating plan and project schedule, is attached. 

e. Does the FY 2015 request include any funding to support updates that will 

need to be made to IT solutions, including VBMS, disability benefit questionnaires, 


312q3SanQ2-16.eps
42 

rules-based calculators, or other initiatives based on the current VASRD? How much 

funding does VA anticipate these updates will require upon publication of final rules 

for the various body systems? 

Response. The FY 2015 budget request does not include funding to change information technology (IT) systems related to the VASRD modernization project, as 

VBA does not plan to publish the proposed regulations until the fall of 2015. Consequently, any changes necessitated by the new regulations will not be required 

until FY 2016. 

Question 5. Provide the number of FTE assigned to or supporting VA’s accreditation program. Also, provide the following information for calendar years 2012 and 

2013. 

a. The number of individuals per year who have sought recognition to represent 

individuals before VA broken down by representatives of service organizations, attorneys or agents. 

Response. As of April 2014, the Office of General Counsel has approximately 4 

full-time equivalent employees (FTE) dedicated to the accreditation program: 

• 3 FTEs for 3 legal assistants 

• Approximately 0.1 FTE for an Assistant General Counsel 

• Approximately 0.4 FTE for a Deputy Assistant General Counsel 

• Approximately 0.5 FTE total for 10 staff attorneys 

From fiscal years 2009 to 2013, Department of Veterans Affairs has annually received applications from approximately 2,400 individuals seeking accreditation as 

Veterans Service Organization (VSO) representatives; 2,430 individuals seeking accreditation as attorneys; and 355 individuals seeking accreditation as claims agents. 

The estimate for VSO representatives includes requests for cross-accreditation, 

which occur when an individual seeks accreditation through other organizations by 

virtue of his or her membership of and accreditation through another organization. 

(Please note that the data provided in the responses to Question 5 are approximations due to database limitations.) 

b. Of those requests for recognition, how many were granted and how many were 

denied? 

Response. From fiscal years (FY) 2009–2013, Department of Veterans Affairs (VA) 

has annually granted accreditation to approximately 2,390 Veterans Service Organization (VSO) representatives; 2,410 attorneys; and 65 claims agents. Because many 

VSO representatives seek cross-accreditation with other organizations, the estimate 

for VSO representatives does not reflect the total number of individual VSO representatives granted accreditation. 

From FYs 2009- 2013, VA has annually denied accreditation to roughly 10 VSO 

representatives, 20 attorneys, and 290 claims agents. Many claims agent applicants 

are not granted accreditation because they do not take or pass the VA accreditation 

examination or otherwise fail to pursue their application. Also, applicants may have 

been denied because they were Federal employees, who are generally prohibited 

from representing individuals before a Federal agency. 

c. On average, how long does it take VA to process a request for recognition? 

Response. As of April 2014, applications for accreditation of Veterans Service Organization representatives are processed in about 60–90 days; attorney applications 

in about 90–120 days; and claims agent applications in about one year. Claims 

agent applications take considerably longer because claims agent applicants need to 

take and pass a Department of Veterans Affairs accreditation examination, submit 

character references, and undergo a background check. 

d. How many individuals had their recognition suspended or canceled? 

Response. From fiscal years (FY) 2008–2013, Department of Veterans Affairs (VA) 

suspended accreditation for cause for 3 Veterans Service Organization (VSO) representatives, 0 attorneys, and 0 claims agents. 

From FYs 2008–2013, VA canceled accreditation for cause for 18 VSO representatives, 1 attorney, and 1 claims agent. 

Other accredited VSO representatives may have had their accreditation canceled 

by their organizations for various reasons, such as termination of employment, retirement, or failure to comply with the organizations’ training requirements. Other 

accredited attorneys and claims agents may have had their accreditation suspended 

in 2011 for failure to comply with VA’s training requirements. 

e. How many complaints were filed against individuals who are recognized to represent claimants before VA, how many were found to have merit, and how many 

were referred to the Inspector General, a law enforcement agency, or other similar 

enforcement entity and how many of the referred cases resulted in further enforcement, disciplinary or legal action? 

43 

Response. Since January 2012 (Department of Veterans Affairs (VA) does not 

have complete numbers prior to 2012 because the database did not track complaints 

before 2012), VA received approximately 60 complaints—8 complaints regarding accredited Veterans Service Organization (VSO) representatives, 19 complaints regarding accredited attorneys, 10 complaints regarding accredited claims agents, and 

23 complaints regarding non-accredited individuals or organizations. In about 20 of 

these complaints, Office of General Counsel (OGC) found the matter not to have 

merit, or OGC did not receive the necessary disclosure authorizations to follow up 

on the complaints. VA followed up on approximately 40 of the 60 complaints. Currently, there are approximately 30 complaints that are in pending or monitoring 

status. 

In two instances, VA initiated cancellation proceedings against two accredited attorneys for unlawful practices. These two matters are currently awaiting a VA administrative hearing. In two other instances, accredited attorneys refunded to Veterans fees that were allegedly charged unlawfully. In five instances, accredited individuals changed their business policies or practices. 

Since 2009, VA has referred approximately 7 accreditation matters to State Attorney General Offices. In one instance, a State Attorney General’s Office prosecuted 

a non-accredited individual engaged in unlawful activities involving VA benefit 

claims for violation of State consumer protection laws. This matter is currently 

pending with a State administrative hearing judge. 

VA/DOD COLLABORATION

Question 6. According to the FY 2015 budget request, the Integrated Disability 

Evaluation System (IDES) operates at 139 military treatment facilities worldwide 

and is available to all servicemembers who are referred to medical evaluation 

boards for fitness determinations. The FY 2015 budget request noted 31,764 new referrals in 2013. 

a. Has DOD provided VA with information on the anticipated number of referrals 

that VA can expect the program to receive in FY 2015 or future fiscal years? 

Response. Projections were provided by the Department of Defense (DOD). The 

total of 93,868 follows: 

• FY 2015: 27,213 

• FY 2016: 24,194 

• FY 2017: 21,195 

• FY 2018: 21,266 

b. How many referrals has the program received in FY 2014 and how many are 

anticipated in FY15? 

Response. The Department of Veterans Affairs (VA) total for FYs 2014 and 2015 

were 57,803, and below is the breakdown. 

• Projected referrals for FY 2014: 30,590 (Actual referrals through March 2014: 

14,475) 

• Anticipated referrals for FY 2015: 27,213 

c. How many contract disability examinations were used to support IDES in FY 

2013 and to date in FY14? 

Response. VA’s total for FYs 2013 and 2014 were 24,717 and below is the breakdown: 

• Veterans Health Administration (VHA)—VHA provided 2,123 exams in FY 2013 

and 474 in FY 2014. 

• Veterans Benefits Administration (VBA)—In FY 2013, 15,142 VBA contract examinations were completed in support of Integrated Disability Evaluation System 

(IDES). 

• FY 2014 through March 2014: 6,978 VBA contract examinations were completed 

in support of IDES. 

d. What specific actions have been taken to improve intra-agency information exchange processes to ensure VBA meets the benefit notification goal of 30 days? 

Response. VA is taking the following actions to help meet the benefit notification 

goal of 30 days for IDES claims: 

• VA must obtain verified service information before finalizing IDES awards. 

DOD’s Defense Manpower Data Center sends this information to VA via the VA/ 

DOD Identity Repository (VADIR), and VA views the information using the Veterans Tracking Application. In March 2014, separation, severance, and retired pay 

information from VADIR was made available on the Veterans Information Solution, 

an intranet-based application designed to provide a consolidated view of information 

about Veterans and Servicemembers. 

44 

• In coordination with the Providence Disability Rating Activity Site (DRAS), the 

Navy has begun electronically submitting DD Form 214s for IDES participants for 

final processing. This ensures the electronic form is available to VA shortly after 

discharge and eliminates delays associated with untimely submission of DD Form 

214. 

• The Physical Evaluation Boards have agreed to include an indication of the current duty status of members of the National Guard and Reserve along with the request for preliminary IDES ratings. This information allows the DRAS to immediately finalize and deliver benefits to IDES participants who are not in active-duty 

status. 

• In April 2013, VA reviewed disability compensation payments based on disability discharges and disability retired pay. Based on this review, VA issued standard operating procedures for IDES cases in August 2013 that allow disability compensation payments to start without waiting for disability retirement payments to 

begin and that do not result in the creation of an overpayment when retired pay 

does begin. In addition, the Defense Finance and Accounting Service’s Retired Casualty Pay Subsystem completed a programming change in February 2014 that allows VA to more timely process an additional set of claims without incorrectly affecting retired pay. 

e. Provide the amount of funding spent in FY 2013 and how many VA employees 

were dedicated to the IDES process. 

Response. VA’s total for FY 2013 was $93,364,281 and below is the breakdown: 

• Office of Policy and Planning (OPP)—During FY 2013, OPP spent approximately $1,164,281, which is comprised of $570,630 for a program management support contract, $568,651 in salary for 5 FTE, and $25,000 in travel costs. 

• VHA—The FY 2013 IDES Supplemental Budget distributed to the operational 

field sites supporting the IDES Program was $21.5 million. These funds were distributed to VAMCs with a direct IDES mission to assist and defray costs associated 

with the deployment and implementation of the IDES program. Staff located at VA 

medical centers (VAMCs) are not solely dedicated to the IDES process. 

• VBA—During FY 2013, VBA spent approximately $70.7 million for salaries and 

other general operating expenses for 643 FTE dedicated to disability claims processing in the IDES process. Compensation staff and Vocational Rehabilitation and 

Employment counselors are included in this count. Veterans filing claims through 

the IDES sites are captured in the nationwide Veteran caseload count and total 

compensation benefit obligations; therefore, mandatory funding cannot be separated 

for this program. 

f. Provide the amount of funding spent in FY 2014 and how many VA employees 

were dedicated to the IDES process. 

Response. VA’s total for FY 2014 was $73,092,082 and below is the breakdown. 

• OPP—During FY 2014, OPP estimates it will spend $1,192,082, which is comprised of $581,144 for a program management support contract, $585,938 in salary 

for 5 FTEs, and $25,000 in travel costs. 

• VHA—In FY 2014, supplemental funding for IDES was will no longer provided 

to operational sites. IDES Supplemental funding was a VHA initiative inacted to assist facilities having an IDES mission, to assist them defray costs associated with 

the deployment and implementation of the IDES Program. Once the IDES program 

matured and was fully implemented, funding to assist with IDES operational costs 

were included in VHA’s Veterans Equitable Resource Allocation (VERA) model. Staff 

located at VAMCs are not solely dedicated to the IDES process. 

• VBA—During FY 2014, VBA estimates it will spend approximately $71.9 million for salaries and other General Operating Expenses (GOE) to support 648 FTE 

dedicated to disability claims processing in the IDES process. 

g. Provide the amount of funding requested in FY 2015 and how many VA employees will be dedicated to the IDES process. 

Response. VA total for FY 2015 was $75,297,179 and below is the breakdown. 

• OPP—During FY 2015, OPP estimates it will spend $1,197,179 which is comprised of $586,241 for a program management support contract, $585,938 in salary 

for 5 FTEs, and $25,000 in travel costs. 

• VHA—Starting in FY 2014, supplemental funding for IDES was no longer provided to operational sites. IDES Supplemental funding was a VHA initiative inacted 

to assist facilities having an IDES mission, to assist them defray costs associated 

with the deployment and implementation of the IDES Program. Once the IDES program matured and was fully implemented, funding to assist with IDES operational 

costs were included in VHA’s VERA funding as described earlier.Staff located at 

VAMCs are not solely dedicated to the IDES process. 

45 

• VBA—During FY 2015, VBA estimates it will spend approximately $74.1 million for salaries and other GOE to support 648 FTE dedicated to disability claims 

processing in the IDES process. 

Question 7. VA’s Office of Interagency Collaboration and Integration is responsible 

for ‘‘coordinating the implementation of the Integrated Disability Evaluation System 

(IDES) and streamlining the disability evaluation process through continual process 

improvements.’’ 

a. What process improvements were made in FY 2014 to streamline the process? 

Response. 

IDES Process Improvements (FY 2014) 

Improvement Initiatives Impact Current Status 

Disability Benefit Questionnaires (DBQ) in IDES.Decrease rates of inadequate medical exams and allow 

digitalization of IDES med exam information for input 

into Veterans Benefits Management System (VBMS). 

DBQs implemented at all 

IDES sites Oct. 1, 2013 

VHA providers were placed at 

the Regional Offices and 

Disability Rating Activity 

Sites.

• Reduce time and insufficient reports 

• Clarify questions raised regarding the disability exam 

[extra words to cause a runover line] 

• Allow for training points 

Providers are currently located at the Seattle and 

Providence sites. 

VA Pays First ......................... VA will be able to pay separating Servicemembers without waiting 20–25 days for the Defense Finance and 

Accounting Service to complete accounting processes 

for Retired Pay cases with a skeleton record in the 

Recovery Care Program Support System. 

Phase I and II have been 

implemented and Servicemembers are no longer 

waiting to receive pay. 

b. What is the current status of electronic case file transfer capabilities within 

IDES? 

Response. Electronic case file transfer is currently pending the establishment of 

a bi-directional interface between VA’s Data Access Service to VBMS. As an interim 

solution, VA and DOD are exploring alternative methods of sending an electronic 

case file to VA’s scanning vendor for upload into VBMS. 

Question 8. The problem of overmedication and medication management is a national problem, one that both public and private health care systems must address. 

VA has reported the Opioid Safety Initiative (OSI) conducted at eight sites in Minnesota was a success. 

a. Provide the Committee with the results of the OSI conducted at the eight sites 

in Minnesota. 

Response. At the American Academy of Pain Medicine’s annual meeting on 

March 7, 2014, Peter Marshall, M.D., from the Minneapolis VA Health Care System 

presented a summary of methods and outcomes of the Minneapolis VA OSI to the 

Veterans Health Administration (VHA) and DOD pain management leaders. The 

Minneapolis OSI team is submitting a manuscript for publication in Pain Medicine 

describing OSI methods and outcomes. These results include: 

• The number of patients prescribed high-dose (>200 Morphine Equivalent Dose 

or MED) opioids for chronic, non-cancer pain has been reduced by 70 percent. 

• The number of patients prescribed >400MED opioids for chronic, non-cancer 

pain has been reduced by 86 percent. 

• With reduced numbers of patients receiving high-dose opioids, the total 

amounts of opioids supplied to the Minneapolis patient population (in MED) has 

fallen by 50 percent. 

• There has been a 13 percent reduction in total number of unique patients who 

received at least one opioid prescription in the past 30 days, while the total number 

of unique patients went up by 10 percent. This may reflect a change in ‘‘treatment 

culture’’ to use alternatives to opioids for treating chronic, non-cancer pain. 

• Annual urine drug screening (UDS) in patients on opioids for chronic non-cancer pain has increased from 21 percent to 55 percent of patients. For patients on 

high-dose (>200MED), annual UDS has increased from 30 percent to 64 percent of 

patients. 

• All other Veterans Service Integrated Network (VISN) 23 Health Care Systems 

are adapting this model and are at various stages of implementation. Clinical pharmacists and Patient Aligned Care Teams (PACT) are highly engaged in using teambased approaches to support safe and effective care to their patients. 

46 

b. Provide a detailed description of the opioid safety program in which all medical 

centers are now participating. 

Response. OSI is a comprehensive monitoring program to provide safe and effective pain care. Currently, all 21 VISNs and all VA medical centers (VAMC) are able 

to access provider-specific opioid prescribing data through a unique business intelligence tool named the Opioid Safety Dashboard (OSD). OSD enables VISN and 

VAMC subject matter experts trained in the safe use of opioids to assist providers 

in maintaining safe prescribing practices. OSD identifies patients on potential unsafe combinations of medications (such as opioids and benzodiazepines) and those 

who would benefit from closer monitoring of drug treatment through urine screening. This information is available for use by subject matter experts and providers. 

OSD is updated quarterly to reflect new prescriptions and monitor current prescribing. Monitors include: the number of patients monitored using urine drug 

screening, the number of patients on opioids and benzodiazepines, and the total 

number of patients receiving opioids. This data is made available for review by subject matter experts, providers, and VISN and VAMC leadership. VHA Central Office 

also develops trending reports that are reviewed by field-based pharmacy and clinical leadership. 

Additionally, as part of the OSI, VHA Central Office has provided field-based staff 

training materials that encourage the use of non-opioid medications and alternatives, which reinforce the use of complementary and alternative medicine as a 

vital tool to provide safe pain care. 

c. Provide a detailed description of the reasons for having all medical centers participate in an opioid safety program and what plans and procedures VA has to 

measure the success of the program. 

Response. One of the primary goals of VHA is to ensure that the care provided 

to Veterans is safe, high-quality and evidence-based. VHA is implementing OSI system-wide to ensure that Veterans across the Nation have appropriate access to safe 

prescribing of opioids, as this is a treatment modality that is broadly used across 

VHA’s health care system. VHA is utilizing OSD to monitor utilization of urine drug 

screening, provider-specific prescribing of opioids and benzodiazepines, and the total 

number of opioids prescribed. The intent of these monitors is to verify that Veterans 

experiencing chronic pain receive safe, effective care. OSD serves as a tool to assist 

providers and subject matter experts in their clinical practice as they treat Veterans 

experiencing chronic pain. 

d. Similar concerns regarding overmedication and medication management have 

been raised about DOD’s approach to the treatment of wounded warriors. Based on 

the success VA has reported from the OSI conducted at eight sites in Minnesota, 

are there lessons learned that could be shared with DOD? 

Response. The Minneapolis VA OSI team has shared information about the methods and results with the Department of Defense (DOD) and the private sector. At 

the American Academy of Pain Medicine’s annual meeting on March 7, 2014, Peter 

Marshall, M.D., from the Minneapolis VA Health Care System presented a summary of methods and outcomes of the Minneapolis VA OSI to the Veterans Health 

Administration (VHA) and DOD pain management leaders. Dr. Marshall also communicated with Christopher Spevak, M.D., pain specialist at Walter Reed National 

Military Medical Center, and shared Minneapolis OSI data and other OSI and Minneapolis Pain Center program documents. The Minneapolis VA OSI team is also 

available to provide other information and support if requested by DOD. In addition, 

the Minneapolis OSI team is submitting a manuscript for publication in Pain Medicine describing OSI methods and outcomes. 

e. What efforts are VA undertaking to make sure DOD is aware of VA’s work on 

this issue as DOD continues to address similar issues among its wounded warrior 

population? 

Response. VHA regularly presents progress on its various pain management initiatives to the DOD/VA Health Executive Committee’s (HEC) Pain Management 

Work Group (PMWG), where discussion and planning of joint programs in pain 

management take place. PMWG discusses issues related to opioid safety including 

standardizing urine drug testing and the implementation and use of the DOD/VA 

Chronic Opioid Therapy Guidelines. OSI and its pilot results will be presented to 

the HEC PMWG for a discussion of its general implementation in VHA and DOD 

more widely. It is anticipated that the pilot results will be presented at a full HEC 

meeting later in 2014. 

Question 9. Provide a detailed description of how VA intends to ensure the projected amount of money is collected through the Medical Care Collections Fund in 

FY15. 

a. Specifically, what plans does VA have for increasing the collection of accurate 

third-party reimbursement information from both existing and new patients? 

47 

Response. To ensure that VA collects the amount projected in fiscal year (FY) 

2015, VA has deployed seven industry best practice Consolidated Patient Account 

Centers (CPAC) to manage back office collection activities such as billing and accounts receivable follow up. CPACs were deployed in FY 2012, which is 1 year earlier than mandated under Public Law 110–387. CPACs focus on standardized processes and intensive employee training has proven to be successful as evidenced by 

both achievement of expected collection results and performance in key industry 

performance metrics. 

VA also has focused on identifying opportunities to improve front-end revenue 

cycle processes related to collection of accurate insurance information. Toward that 

end, VHA is deploying an Integrated Resources Center (IRC) that provides resources 

to staff to increase their knowledge of approved methods for obtaining and recording 

demographic and health insurance information. The IRC library will include links 

to intake training modules; current policies, procedures and directives; scripts; a 

best practice registry; intake performance tracking; and online training videos made 

in cooperation with VHA’s Employee Education Service. b. How does VA plan to make up for any shortfall if the budget projection of $3 

billion is not met? 

Response. VA does not expect to have a shortfall in the Medical Care Collections 

Fund in 2015. All funding requirements and sources of funds are reviewed periodically throughout the fiscal year. As of May 2014 our aged 3rd Party receivables, 

which are defined as payments from insurers that haven’t been received by 90 days 

after billing, amounted to $114 million. 

Question 10. In its response to my post-hearing questions regarding the FY 2014 

budget request, VA noted it had developed and implemented staffing guidance for 

general outpatient mental health programs. 

a. Has VA developed a staffing model for determining the target number of mental health staff for a whole facility? If no, please explain any progress toward development of a staffing model and when VA’s expects to complete development and implementation. 

Response. VA’s guidance for outpatient staffing levels is developed in the context 

of: (1) data on Veteran access to timely, full-spectrum mental health services at appropriate intensity, and (2) information on the local facility organization (e.g., number and location of Community-Based Outpatient Clinics (CBOC)), the geographical 

area the facility serves, and the availability of inpatient, residential, telehealth, and 

regional specialty mental health services. It is expected that appropriate staffing 

levels will vary somewhat based on: local Veteran needs; whether the patient population resides in a rural area; facility use of contracted or telehealth-based services, 

collaborative service delivery with local residential treatment programs, and other 

factors. As there are strong relationships between mental health staffing levels and 

Veteran access to mental health services, indications of poor access are considered 

a trigger for review of adequacy of clinical staffing and planning for remediation of 

access concerns. 

VA has been developing staffing guidance based on patient demand to assist facilities in ensuring consistent staffing for mental health. For sites with hiring/staffing challenges, VA is expanding the use of contracts and the use of telemental 

health. Methods to estimate future staff needs based on mental health workload 

projections have been drafted and are being reviewed and refined. This modeling 

will provide targets for all mental health staffing needs at a facility. VHA expects 

to conduct internal validation of this modeling over the next 2 fiscal years to determine whether facility adherence to the model is associated with maintenance of Veteran access to mental health services as the mental health patient population 

grows, and adjust within that time as necessary. 

b. In the absence of such a model, describe the methodology VA uses to accurately 

budget for mental health care. 

Response. Please see the response to Question 10a. 

Question 11. What percentage of dental care is provided at VA facilities and what 

percentage is provided through non-VA care? 

Response. For FY 2013, 86 percent of dental workload (measured in Relative 

Value Units) was completed on-site at VA facilities and 14 percent was completed 

through non-VA Care. There were 462,254 total patients, 442,688 received care 

within VA on-site and 54,929 received care in the private sector. Some patients received care in both venues. 

Question 12. Has VA experienced difficulties in recruiting qualified individuals to 

fill open dental vacancies? If so, explain what VA has done to address this issue. 

Response. VA receives sufficient applications to recruit qualified individuals to fill 

open dentist occupational vacancies with the exception of certain scarce specialties 

48 

such as oral surgeons. As of July 15, 2014, there are 20 dentist vacancies and 2 dental hygienist vacancies listed on the USAJobs Web site. The average speed of hire 

(SOH) timeframe to hire these dental occupations is 41.99 days, which is less than 

VA’s SOH goal of 60 days. This data accounts for all hires of the previously mentioned occupations from October 1, 2013, through February 28, 2014. 

Additionally, the following initiatives have been launched to enhance the recruitment of dental hygenists and lab technicians: 

• Hygienists: The qualification standard for dental hygienists is being updated to 

create a career ladder potential for advancement for dental hygienists in VA that 

mirrors the private sector. • Laboratory Technicians: The Central Dental Laboratories maintain a skills development program to advance technicians skills and abilities internally. 

Outsourced laboratory services are also used to fill the gap. 

Question 13. In the medical patient caseload portion of the FY 2015 budget request, VA estimates between FY 2014 and FY 2015, an additional 112,519 Priority 

Groups 1–6 veterans will access VA health care. Yet, it estimates a decrease of 

2,021 veterans in Priority Groups 7 and 8 for the same period of time and a further 

decrease of 9,249 veterans from 2015 to 2016. Given the Affordable Care Act (ACA) 

requires Americans to obtain health care coverage before March 31, 2014, many uninsured veterans will turn to VA for their health care needs. VA estimates it will 

see an increase of 63,000 veterans in 2015 as a result of ACA implementation. 

a. Why does VA estimate a decrease in Priority Groups 7 and 8 veterans in the 

FY 2015 budget? 

Response. VA’s FY 2015 Medical Care budget request does not project a decrease 

in Priority Group 7 and 8 enrolled Veterans, VA projects an increase of 27,987 enrollees (see page 32 of the second volume of the FY 2015 Budget). The 2,021 Veteran 

decline reflects the projected decrease in the number of Priority Group 7 and 8 patients. The VA Enrollee Health Care Projection Model (EHCPM) projects enrollee 

health care services over a 20-year planning period. For each year, the EHCPM 

projects the number of Veterans expected to be enrolled, their priority, age, gender, 

special conflict status, and geographic location. The patient projections model estimates the probability of enrollees becoming patients each fiscal year. Patients are 

projected as a function of enrollee type, priority, age, gender, special conflict status, 

and assumed morbidity and reliance levels. While projections for Priority Group 7 

and 8 enrollees, as reflected in the FY 2015 budget submission, suggest a slight increase in enrollment for this population, since many of these enrollees have some 

other form of public/private health insurance coverage, they tend to be less reliant 

upon VA for care, and therefore do not generate a corresponding increase in patients, as noted by the projected decline of 2,021 Veterans in the chart on page 7 

of the second volume of the FY 2015 Budget. Historical data also shows a decline 

in Priority Group 7 and 8 patients. 

b. Provide the following information regarding priority groups: 

i. The number of such veterans moving from Priority Groups 7 and 8 to Priority Groups 1–6 between FY 2014 and FY 2015; and 

Response. The net number of enrollees that are projected to move from Priorities 7 and 8 into Priorities 1–6 between FY 2014 and FY 2015 is 15,566. 

(**Note: This is the net number of enrollees moving into Priorities 1–6. This 

means that enrollees moving from Priority Groups 7–8 into Priority Groups 1– 

6 are offset by enrollees moving from Priority Groups 1–6 into Priority Groups 

7–8. There are significant movements in both directions, and the net movement 

is close to zero. Movements from Priorities 4–8 into Priorities 1–3 are estimated 

to be 132,325 during the same time period (FY 2014 to FY 2015)). 

ii. The number of veterans currently enrolled in the VA health care system 

that VA expects will become ineligible, in 2015 and 2016, for VA health care 

due to its geographic means test. 

Response. Veterans currently enrolled do not become ineligible based on a geographic means test, if they are already enrolled. 

Question 14. In the performance measure section of the President’s FY 2015 budget request, VA reports an increase of 38 percent, from 2012 to 2013, of targeted 

OEF/OIF veterans with a primary diagnosis of PTSD who receive a minimum of 

eight psychotherapy sessions within a 14-week period. Provide the Committee with 

the criteria utilized in FY 2012 and FY 2013 individually to identify these targeted 

OEF/OIF veterans. 

Response. VA did not report a 38-percent increase in the percentage of Operation 

Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) 

Veterans receiving 8 psychotherapy visits in 14 weeks. We believe that this number 

may have been incorrectly surmised as it looks to be the difference between the 

49 

measure in existence in FY 2012 and the measure in existence for FY 2013. However, these two metrics are not comparable. Below is a description of each measure, 

and a summary of the changes in utilization of psychotherapy across the 2 years. 

In FY 2012, the measure (OEF 4) was a percentage defined by the following numerator and denominator. The denominator (see FY 2012 Presidential Budget Submission, Volume II, page 1G–23) included Veterans who were deployed in OEF/OIF/ 

OND and had two primary diagnoses of Post Traumatic Stress Disorder (PTSD) in 

two outpatient encounters that occur within 90 days of each other. Patients are entered into the denominator once they received a second encounter with a primary 

diagnosis of PTSD. A number of visit types such as telephone contacts and vocational services were excluded when looking for qualifying encounters. In addition, 

any Veteran who had already received at least 8 visits in 14 weeks in the previous 

5 years was excluded from the denominator. The numerator consisted of Veterans 

who are included in the denominator and have encounters with PTSD as the primary or secondary diagnosis for 8 psychotherapy sessions within a 14-week time period after the qualifying encounters. The measure in FY 2012 was reported as a 

straight percentage. At the end of the fiscal year, there were cumulatively 8,155 

Veterans in the numerator and 56,103 Veterans in the denominator, for a percentage of 14.54 percent. 

In FY 2013, the measure reported (OEF 41) was changed (see FY 2013 Presidential Budget Submission Volume II, page 1H–6). Conceptually, the numerator and 

denominator remain the same as OEF 4, although some additional exclusions were 

placed on the denominator such as an expanded set of clinic types that would not 

count toward qualifying encounters and the removal of Veterans who passed away 

after being qualified for the denominator. Most importantly, however, the measure 

was redefined to reflect the fact that not all Veterans will want or be ready for this 

particular type of treatment. Previous VA research had indicated that about 30 percent of Veterans offered these interventions will actually begin the therapies. Therefore, the new measure is calculated as the numerator divided by the denominator 

and then divided by 30 percent. In FY 2013, the numerator was 8,530, the denominator was 53,297. The ratio to be used to compare to FY 2012 was 16.0 percent, 

and the final measure (16 percent/30 percent) is 53.33 percent of all OEF/OIF/OND 

Veterans who could benefit from the treatment and who will want and be ready for 

the treatment. 

It appears that whomever reported the 38-percent change mistakenly subtracted 

the FY 2012 number from the FY 2013 number (a difference of 38.79), not being 

aware that the measures were not comparable. Since the numerator and denominator are roughly comparable, we can say that there was a 1.5 percent increase in 

the proportion of OEF/OIF/OND Veterans receiving 8 visits in 14 weeks. 

Question 15. What is the population size of the targeted population? Has the population size changed since 2012? 

Response. The ‘‘targeted population’’ is Veterans defined by the denominators described in the response to question 14. In FY 2012, it was 56,103 Veterans, while 

in FY 2013 it was 53,297. This number is separate from the number of OEF/OIF/ 

OND Veterans with PTSD served by VA. 

Question 16. In the performance measure section of the President’s FY 2015 budget request, VA reports that 73 percent of veterans answered ‘‘yes’’ to the shared 

decisionmaking question in the Inpatient Surveys of the Health Experience of Patients (SHEP). VA also notes this question will be deleted after Fiscal Year 2014 

and replaced with ‘‘alternative satisfaction measures.’’ 

a. Provide the Committee with the ‘‘alternative satisfaction measures’’ that will 

be used. 

Response. The Self-Management Support measure, found in the Patient Centered 

Medical Home (PCMH) Consumer Assessment of Health Providers and Systems 

(CAHPS) that forms the basis of VHA’s Outpatient SHEP will replace the Inpatient 

Shared Decision Making measure. This new measure has undergone extensive testing for validity and expands the concept of shared decisionmaking into VA’s PACTs, 

which forms the foundation of our Veteran-centered health care efforts. This new 

measure is calculated as the average of the weighted percentage of patients who responded ‘‘Yes’’ to questions 35 and 36, ‘‘in the last 12 months, did anyone in this 

provider’s office talk with you about specific goals for your health,’’ and ‘‘in the last 

12 months, did anyone in this provider’s office ask you if there are things that make 

it hard for you to take care of your health,’’ respectively, in the SHEP survey. 

b. What measures or initiatives is VA currently implementing to increase the percentage of veterans involved in making decisions regarding their health care, including mental health? 

50 

Response. VHA has developed and piloted the Personal Health Inventory as a tool 

for Veterans and teams. This tool allows Veterans and providers to discuss life goals 

and preferences in a personalized plan of care. A number of VHA facilities have deployed an interactive bedside system, which allows the Veteran more direct access 

to their care team. These systems allow the Veteran to provide input on their care 

while at the facility and also provide an opportunity for staff to respond timely to 

issues identified during the stay. Additionally, VHA has developed and deployed 

staff training classes in order to educate staff about involving Veterans in making 

decisions regarding their health care. 

Question 17. What measures and initiatives has VA utilized to achieve a decrease 

in the amount it spends per patient for OEF/OIF/OND veterans of $212 per veteran, 

from 2012 to 2013, while increasing the spending by $45 per patient for all VA patients, during the same time period? Response. The decrease in cost per patient of $212 per Veteran from 2012 to 2013 

was an error and the result of a miscalculation in overhead costs. The correct 2012 

actual is reflected in the table below. On average, the OEF/OIF/OND Veterans population’s medical care is increasing in complexity which translates into an increased 

cost for medical treatment. OEF/OIF/OND is a subset of the total obligations per 

unique patient. This error had no impact on the total budget request, as the correct 

actual data was included in the estimates generated by the VA EHCPM. 

Description 2012 Actual 2013 Actual Difference 

OEF/OIF/OND 

Obligations ($000) ............................................................... $2,745,534 $3,208,682 $463,143 

Unique Patients .................................................................... 544,088 616,487 72,399 

Cost per Patient ................................................................... $5,046 $5,205 $159 

Obligations per Unique Patient 

Obligations ($000) ............................................................... $53,868,410 $55,453,211 $1,584,801 

Unique Patients .................................................................... 6,333,091 6,484,664 151,573 

Cost per Patient ................................................................... $8,506 $8,551 $45 

Question 18. The FY 2015 budget request states that in 2013, the HUD-VASH 

program funded 562 additional positions in various disciplines, including peer support positions, employment specialists, psychiatrists, nurses, and housing specialists. 

a. How many additional positions in each discipline will be funded with the $46.8 

million increase for FY15? 

Response. VA medical centers (VAMCs) receive funding for additional positions to 

support the HUD-VASH Program after each VAMC’s specific allocation of new 

vouchers is determined. Until the FY 2015 specific allocations occur, VA is only able 

to estimate the total number of additional FTE expected to be funded based on previous years’ allocations; accordingly an estimated 500 additional FTE will be funded 

in FY 2015. 

b. Describe the service impact of the $138.5 million anticipated reduction in the 

FY 2016 advanced appropriation request for this program. 

Response. The FY 2015 request of $321 million provides the funding level needed 

to sustain current service levels in the Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH) vouchers as well as support 20,000 additional HUD-VASH vouchers issued in FY 2014 and FY 2015. A decrement of $200 

million in FY 2015 (as reflected in the FY 2015 Advanced Appropriation) or $138.5 

million in the FY 2016 Advanced Appropriation will require significant reductions 

in the level of case management support that can be provided to Veterans. The final 

2016 funding level will be determined during the 2016 budget process when updated 

data and metrics are available; however, if these reductions occur in either year, the 

impact on HUD-VASH operations and on the Veterans served by the program will 

be quite significant. Also, service impacts could include significant reductions in 

level of case mangagment support. Caseloads will increase considerably and process 

times for moving Veterans from the streets to housing will also increase significantly. VHA also anticipates an increase in negative discharges from the program, 

including evictions and unit abandonment, and we can expect additional negative 

outcomes due to the reduction in frequency and intensity of case management support. 

Question 19. The FY 2015 budget submission details that funding for contract residential services (CRS) available through the health care for homeless veterans program has recently ‘‘been prioritized to ensure that every VAMC has the capacity to 

51 

offer ‘‘bridge housing,’’ services that are targeted to and prioritized for homeless Veterans who are transitioning from literal street homelessness.’’ 

a. As of March 12, 2014, which VAMCs currently lack the capacity to offer these 

services? 

Response. VAMCs may request funding from VA Central Office to establish 

Health Care for Homeless Veterans (HCHV) Contract Residential Services (CRS) 

contracts. It is important to note that VAMCs only request funding for HCHV CRS 

when the need for these services is not being met by local community resources or 

by neighboring VA facilities. VA uses HCHV CRS contracts to fill gaps in local continuums of homeless services. 

b. Describe the Department’s efforts to ensure that bridge housing is available to 

veterans, without regard to their gender in each location. 

Response. Each local VAMC that receives VA Central Office funding to establish 

new or expand existing HCHV CRS contracts is expected to include explicit contract 

language to ensure that housing services be available to both male and female 

homeless Veterans. As of March 2014, female Veterans make up 5 percent of the 

total population of homeless Veterans admitted to HCHV CRS programs, representing an increase from 3 percent in FY 2012. 

Question 20. The President’s budget request indicates a transition in the HVSEP 

program, with the provision of funding to hire 160 community employment coordinators. 

a. Are these coordinators intended to supplement, or to replace, the over 400 

homeless or formerly homeless veterans currently staffing this program as Vocational Rehabilitation Specialists? 

Response. The Homeless Veteran Supported Employment Program (HVSEP) hired 

formerly homeless or at-risk-of-homelessness Veterans as Vocational Rehabilitation 

Specialists on term positions for a 4-year period. Funding for these positions will 

end on September 30, 2014. 

As a result of the HVSEP Initiative, 70 percent of HVSEP Vocational Rehabilitation Specialists successfully transitioned into alternative permanent employment, 

358 within VA and 36 with other Federal agencies or in the community. 

In order to continue to provide a full-range of employment services, the new Community Employment Coordinators will augment and coordinate the competitive employment services that are currently available for homeless and chronically homeless Veterans both at VAMCs and in the community. The Community Employment 

Coordinators will oversee the provision of training and guidance to all VA homeless 

programs and staff on resources that result in competitive employment outcomes for 

homeless Veterans. The Community Employment Coordinators will also provide direct assistance in connecting Veterans to the most appropriate and least restrictive 

VA and community-based employment services leading to competitive employment 

with appropriate supports. 

b. How will these coordinators interact with other employment programs this population may be eligible for, such as VBA’s Vocational Rehabilitation program or the 

Department of Labor’s Homeless Veterans Reintegration Program Grantees? 

Response. Partnerships with Federal, state, and community agencies are critical 

in addressing unemployment among homeless Veterans. The Community Employment Coordinators will serve as liaisons and referral sources to VA and non-VA programs that provide community-based employment opportunities and support services to homeless and chronically homeless Veterans including but not limited to: 

Compensated Work Therapy Programs; HCHV and HUD-VASH Employment Specialists; Supportive Services for Veteran Families (SSVF) and Grant and Per Diem 

(GPD) grantees that target employment; Veterans Benefits Administration/Vocational Rehabilitation and Employment; Department of Labor grantees such as the 

Homeless Veteran Reintegration Program; and, state, local, community, and faithbased organizations. 

CONSTRUCTION AND LONG RANGE CAPITAL PLAN

Question 21. Provide a list of priority weights for the major criteria and sub criteria used to inform the FY 2015 Strategic Capital Investment Plan decision plan. 

Response. The diagram below shows the major criteria and sub-criteria priority 

weights that were used to inform the fiscal year (FY) 2015 Strategic Capital Investment Planning (SCIP) process. 

52 

Question 22. The FY 2015 budget request includes a number of funding requests 

to renovate and realign VA Regional Offices. Of these, which are due to decreased 

space requirements as a result of the transition to a paperless claims processing system? 

Response. The RO renovation and realignment projects were approved for the following sites in FY 2015: Boston, Detroit, and New York. These offices will be renovated to meet current size and safety standards and realigned to optimize efficient 

space utilization, taking into account that many paper claims received are being 

converted into an electronic format. Renovation and realignment projects typically 

take 2 to 3 years to complete. The FY 2015 budget request is dedicated to developing the space design and determining the resulting space savings. Funding for 

construction and realignment of the space would then be included in the FY 2016 

and 2017 budget requests. 

a. Provide a list of any location where VBA has leased space for the sole purpose 

of storing paper claims files. For each, also provide an estimated date the lease will 

no longer be needed and the estimated annual savings that would result from not 

leasing this space. 

Response. The chart below shows the locations where separate file storage is 

leased through General Services Administration, contracted through Iron Mountain 

(or another storage vendor), or located on a Veterans Health Administration campus. The ROs listed on the spreadsheet have a project submission for renovation 

and realignment over the next 10 years in VBA’s long-range Strategic Capital Investment Plan submission; however, projects beyond FY 2015 are notional and not 

yet funded. VA will work to find solutions for removal of files from these separately 

leased facilities ahead of the renovation schedule of their respective RO, should 

funding become available. 


312q3San21.eps
53 

Question 23. The FY 2015 budget submission details the department’s efforts to 

conduct onsite surveys of waste streams at 140 facilities in order to assist meeting 

waste diversion goals and save disposal costs. 

a. Share how these 140 facilities were chosen. 

Response. Given the travel time and cost associated with reaching several of our 

facilities, VHA included 140 facilities in the review process. These 140 facilities were 

chosen because they encompass a cross-section of every VISN and complexity level 

of facility in the system. This allows the lessons learned from these reviews to be 

shared with those facilities not included in the review. 

b. Share the results of these surveys. 

Response. VHA continues to work with the vendor to resolve several issues with 

the draft of the waste and recycling assessment summary report. Until these issues 

are addressed, VA will not accept the report as final. Once the report has been accepted, VA will provide the Committee with a complete copy of the individual reports requested. 

c. Share any outcomes that resulted from an analysis of this data. 

Response. Based on the initial review of the survey report data, there are areas 

of opportunity to increase recycling activities throughout VHA, particularly in the 

operating rooms, management of food waste, and composting. The survey also reinforced the need and benefits of the new web-based waste and recycling system, 

which has been implemented throughout VHA for tracking diversion rates in accordance with Executive Order (EO) 13514, Federal Leadership in Environmental, Energy, and Economic Performance. EO 13514 challenges government agencies with diverting up to 50 percent of municipal solid non-hazardous waste from landfills by 

the end of FY 2015. This is generally accomplished through recycling, reuse and 

composting programs. 


312q3San22.eps
54 

Question 24. Describe planned improvements in FY 2015 to the functionality of 

VA’s national utility metering data collection and analysis system. 

Response. In FY 2015, VA will expand the analysis and reporting capabilities of 

its metering data collection and analysis system. These new functionalities will 

build on the progress made in FY 2014 that implemented services for integrating 

electric and non-electric (e.g., gas, water, steam, chilled water) meter data into the 

system. As metering data is added to the system, these new capabilities will allow 

energy managers to access data more easily and in different ways. These expanded 

capabilities will accommodate data from all future as well as existing electric and 

non-electric meters. VA also plans to conduct training for personnel on the use of 

the database system’s analyses and reporting capabilities. 

INFORMATION TECHNOLOGY PROGRAMS

Question 25. The FY 2015 budget request indicates that a portion of the 

cybersecurity funding requested ‘‘will be used to maintain information protection directives and handbooks so VA is compliant with all applicable Federal requirements 

and standards’’ such as FISMA, HIPAA, the E-government Act, FIA, Privacy Act, 

and other requirements. Provide a list of each directive and handbook that is not 

in compliance, as of March 12, 2014. 

Response. All Department of Veterans Affairs’ (VA) security-related directives and 

handbooks are in compliance with Federal regulations and guidelines. VA has drafted a new version of VA Handbook 6500 that includes all the changes from National 

Institutes of Standards and Technology (NIST) 800–53, Revision 4, which was published in May 2013. Federal agencies have one year from the date of publication to 

come into compliance with NIST guidelines. VA expects to publish this version of 

VA Handbook 6500 by the end of fiscal year 2014. In the interim, while the VA 

Handbook 6500 is going through VA’s internal concurrence process, VA is implementing the draft guidelines to secure VA information technology systems, and will 

make any adjustments necessary that are needed to reflect the final guidelines. 

Question 26. How many additional FTE will be required in FY 2015 to fully staff 

the reorganized Network Operations Center and Security Operations Center? Of 

these, how many will be VA employees and how many will be contract employees? 

Response. The Department of Veterans Affairs takes the protection of our Veterans’ and employees’ data seriously. VA has in place strong, multi-layered defense 

to combat evolving cyber security threats. Defenses include monitoring outside our 

network by external partners; active scanning of Web applications and source code; 

and protection of servers, workstations, networks, and gateways, among other security efforts. 

The Department will be reviewing all details of the proposed reorganization of the 

VA Network Security Operations Center to ensure that the continued high level of 

service is maintained should a separate Network Operations Center (NOC) and a 

separate Security Operations Center (SOC) be put in place. The current organizational structure includes network and security staffs at two different locations with 

varying skill sets and the intent of this re-alignment is to improve efficiencies in 

responding to network and security operational requirements. The ongoing review 

will include the development and update of a strategy and concept of operations 

(CONOPS) for the NOC and the SOC, which will be completed in FY 2015. The results of the work to develop the strategy and CONOPS for the SOC and the NOC 

will re-validate the government FTE and contractor current staffing estimates and 

requirements and help guide the reorganization efforts. VA will develop a phased 

approach to establish a recruitment and retention strategy to support the proposed 

number of personnel for each organization, to ensure that we maintain the highly 

technical skills and expertise required to support security and network operations. 

Question 27. Of the additional funding requested for VBMS in FY 2015, how much 

does VA anticipate dedicating to making workload management improvements to 

improve the ability of veterans service organizations and other accredited representatives to assist veterans in managing their claim? 

Response. Veterans Service Organizations (VSO) currently have the ability to perform a number of functions in Veterans Benefits Management System (VBMS), including: 

• Conducting searches 

• Viewing assigned items in the VSO work queue 

• Viewing the Veteran eFolder and annotations 

• Viewing the Veteran Profile and service information 

• Viewing claim contentions and claim detail 

• Viewing rated issues and review ratings decisions 

55 

VBMS is being developed and implemented in a phased approach consisting of incremental software releases. As the system evolves, new functionality is delivered 

to the field and builds upon the foundational architecture available in the latest system release. The scope of each release is prioritized based on business needs as determined by leadership direction, resources, business-line inputs, field enhancement 

requests, and defect reports. Improvements to VBMS workload management is one 

of the main goals for software releases in fiscal year 2015. 

Department of Veterans Affairs (VA) is currently determining the specific capabilities to be delivered in each release. Once the specific capabilities are finalized, 

funding can be allocated. Because workload management capabilities for VSOs are 

not fully defined or scoped, VA is not yet able to provide an estimate of resources 

(personnel or money) required in 2015. VBMS generally deploys a new software release at the end of each fiscal quarter, and the scope of each release is finalized 

approximately 4 to 6 months before the release date. VA would be happy to brief 

the Committee on this issue as soon as the capabilities for VSOs in VBMS become 

fully defined and scoped. 

Question 28. The FY 2015 budget request includes $20 million to rapidly replace 

obsolete telephony equipment and $92 million to provide Voice as a Service solutions 

in order move away from private branch exchanges and into a unified communication strategy. Are these amounts sufficient for an enterprise-wide replacement? If 

not, provide a deployment plan for this initiative, including a list of locations where 

telephony equipment will be switched out in FY15. 

Response. The Voice as a Service initiative will replace over 1,300 voice systems 

across the Department of Veterans Affairs (VA) enterprise, including the voice systems at VA medical centers and Regional Offices, over a period of approximately 10 

years. The number of systems migrated in a given year will be determined primarily 

by funding availability. 

The President’s 2015 budget request of $92 million includes the replacement of 

the first wave of over 200 voice systems and many mandatory dependencies such 

as detailed site surveys, local area network upgrades, wide area network augmentation, and recurring operation and maintenance costs. 

Please see the attached sheet showing the list of facilities planned for fiscal year 

(FY) 2015 migration upon completion of the current pilot project. Procurements supporting site preparation for the locations listed in the attached sheet are funded and 

planned for execution in FY 2014. 

56 


312SanQ28I1.eps
57 


312SanQ28I2.eps
58 


312SanQ28I3.eps
59 


312SanQ28II1.eps
60 


312SanQ28II2.eps
61 


312SanQ28II3.eps
62 

Question 29. Provide a list of the additional 36 VA Health Information Exchange 

partners planned for 2014 and the partners VA plans to add in 2015. 

Response. 

Partner Name City State Status FY 2014/ 

2015 

HealtheConnections NY ..................................................... Syracuse NY In Production FY 2014 

Hawaii Pacific Health ........................................................ Honolulu HI In Production FY 2014 

University of California Davis ........................................... Sacramento CA In Production FY 2014 

Allina Health ...................................................................... Minneapolis MN On-Boarding FY 2014 

Mt Sinai Medical Center Miami ........................................ Miami Beach FL On-Boarding FY 2014 

Sentara Health care .......................................................... Norfolk VA On-Boarding FY 2014 

Dignity Health .................................................................... San Francisco CA On-Boarding FY 2014 

East Tennessee HIN ........................................................... Knoxville TN On-Boarding FY 2014 

HIETexas ............................................................................ Austin TX On-Boarding FY 2014 

Lancaster General Health .................................................. Lancaster PA On-Boarding FY 2014 

Maine HealthInfoNet .......................................................... Portland ME On-Boarding FY 2014 

Medical University of South Carolina ............................... Charleston SC On-Boarding FY 2014 

MetroHealth System ........................................................... Cleveland OH On-Boarding FY 2014 

Michigan HIN ..................................................................... East Lansing MI On-Boarding FY 2014 

Oregon Community Health ................................................ Portland OR On-Boarding FY 2014 

Redwood MedNet HIE ........................................................ Ukiah CA On-Boarding FY 2014 

Yale New Haven Health System ........................................ New Haven CT On-Boarding FY 2014 

Alaska eHealth Network .................................................... Anchorage AK Potential FY 2014 

Cleveland Clinic ................................................................ Cleveland OH Potential FY 2015 

CVS MinuteClinic ............................................................... Woonsocket RI Potential FY 2015 

Geisinger Health Systems ................................................. Danville PA Potential FY 2015 

Georgia HIN ....................................................................... Atlanta GA Potential FY 2015 

Greater Dayton Area Health .............................................. Dayton OH Potential FY 2015 

HealtHIE Nevada ................................................................ Las Vegas NV Potential FY 2015 

Kansas HIN (KHIN) ............................................................ Topeka KS Potential FY 2015 

Social Security Administration .......................................... Baltimore MD Potential FY 2015 

University of Pittsburgh Medical Center (UPMC) .............. Pittsburgh PA Potential FY 2015 

Wisconsin Statewide HIN (WISHIN) ................................... Madison WI Potential FY 2015 

Alabama One Health Record ............................................. Montgomery AL Potential FY 2015 

Bronx RHIO ........................................................................ Bronx NY Potential FY 2015 

Carle Foundation Hospital ................................................. Urbana IL Potential FY 2015 

Central Florida RHIO ......................................................... Orlando FL Potential FY 2015 


312SanQ28II4.eps
63 

Partner Name City State Status FY 2014/ 

2015 

ConnectVirginia ................................................................. Glen Allen VA Potential FY 2015 

EHR Doctors ....................................................................... Pompano Beach FL Potential FY 2015 

Hawaii HIE ......................................................................... Honolulu HI Potential FY 2015 

Health Access San Antonio ............................................... San Antonio TX Potential FY 2015 

RESPONSE TO POSTHEARING QUESTIONS SUBMITTED BY HON. RICHARD BURR TO

U.S. DEPARTMENT OF VETERANS AFFAIRS

GENERAL

Question 30. At the end of fiscal year 2011, the Department of Veterans Affairs (VA) reported $1.2 billion in outstanding delinquent debt owed to VA, of which $732 

million was created in connection with VA benefit payments. In response to questions about VA’s fiscal year 2014 budget request, VA indicated that, at the end of 

fiscal year 2012, there was $3.7 billion in outstanding delinquent debt owed to VA, 

of which $1.6 billion was created in connection with VA benefit payments. VA also 

indicated that, during fiscal year 2012, VA wrote off or waived $201 million of debts 

to VA. 

A. Please explain what factors led to an increase from $1.2 billion to $3.7 billion 

in outstanding delinquent debt between the end of fiscal year 2011 and 2012. Response. According to the Treasury Report on Receivables (TROR), the $3.7 billion amount referenced in this question relates to total Department of Veterans Affairs debt outstanding at the end of fiscal year (FY) 2012. This amount includes debt 

that is ‘‘delinquent’’ (greater than 30 days); debt that is less than 30 days old; and 

debt that is part of an established loan or repayment agreement paid in installments. Delinquent debt at the end of FY 2011 and FY 2012 remained stable at approximately $1.2 billion. B. Please explain what factors led to an increase from $732 million to $1.6 billion 

in outstanding benefit debt between the end of fiscal year 2011 and 2012. 

Response. Department of Veterans Affairs (VA) Treasury Report on Receivables (TROR) records indicate that outstanding benefit debt decreased slightly from $2.4 

billion to $2.2 billion between the end of fiscal years (FY) 2011 and 2012. VA TROR 

records indicate that outstanding delinquent benefit debt decreased slightly from 

$770 million to $730 million between the end of FYs 2011 and 2012. 

C. What was the total amount of outstanding delinquent debt at the end of fiscal 

year 2013? Response. $1,169,280,757. 

D. What portion of that amount was debt created in connection with VA benefit 

payments? Response. $693,453,840 

E. What portion of the delinquent debt was created in connection with the Veterans Health Administration (VHA)? 

Response. $474,551,351 

F. What is the total value of debts for which VA waived recoupment during fiscal 

year 2013 and what is the total value of debts that were written off during fiscal 

year 2013? Response. Fiscal year 2013 Waived and Written Off Debt: $339,324,218 

G. During fiscal year 2014, how much new debt does VA project will be established? 

Response. Based on current trends, Department of Veterans Affairs estimates that it will establish $823,300 new Veterans Benefits Administration debts and 

$379,597 new Veterans Health Administration debts in fiscal year 2014. 

H. During fiscal year 2015, how much new debt does VA project will be established? 

Response. Based on current trends, Department of Veterans Affairs estimates that it will establish $880,900 new Veterans Benefits Administration debts and 

$386,435 new Veterans Health Administration debts in fiscal year 2015. 

Question 31. In response to questions regarding VA’s fiscal year 2014 budget request, VA indicated that approximately $285 million in mandatory funding would 

be used to pay for non-direct benefits, including the salaries for 98 full-time equivalent (FTE) employees. 

A. For fiscal year 2015, please identify how much in mandatory funding will be 

spent on non-direct benefits and how those funds would be spent. 

64 

Response. In FY 2015, VBA expects to spend $296.7 million in mandatory funding 

on non-direct benefits. The $296.7 million in mandatory funding used to pay for 

non-direct benefits includes funding for: Equal Access to Justice Act payments, Medical Examinations payments, and Income Verification Matching (38 United States 

Code (U.S.C.) section 5317) from the C&P account. This also includes: Reporting 

Fees, State Approving Agencies (SAA), reimbursements to the GOE account as authorized under Public Laws (P.L.) 101–237 and 105–368, and reimbursement to the 

Office of Information and Technology (OIT) account as authorized under Public Law 

106–419, 108–454, and 112–56 from the Readjustment Benefits (RB) account. 

Additionally, under section 3674 of title 38 U.S.C., VBA is authorized to reimburse SAAs up to $19 million from the RB account. This funding is authorized for 

the reasonable and necessary personal services, travel, and administrative expenses 

incurred by the employees of SAAs in carrying out contracts for agreements entered 

into with VBA for the purposes of ascertaining the qualifications of educational institutions for furnishing courses of education to eligible persons or Veterans. 

VBA is also authorized under section 3684 of title 38 U.S.C., to pay any educational institution, or the sponsor of a program of apprenticeship furnishing education or training under Chapter 31, 33, 34, 35, or 36, a reporting fee which will 

be in lieu of any other compensation or reimbursement for reports or certifications 

which such educational institution or joint apprenticeship training committee is required to submit to the Secretary by law or regulation. 

Below is a detailed breakdown of the requested funding: 

C&P ($000s) 

Medical Exams ........................................................................... $237,587 

Equal Access to Justice Act ....................................................... $10,554 

Income Verification Matching .................................................... $15,430 

C&P Total .......................................................................... $263,571 

RB ($000s) 

SAAs ............................................................................................ $19,000 

Reporting Fees ............................................................................ $13,574 

Reimbursement to GOE (Outreach) ............................................ $591 

RB Total ...................................................................................... $33,165 

Total ................................................................................... $296,736 

B. For fiscal year 2015, are mandatory funds expected to be used to pay the salary 

of any VA employees? If so, please specify the amount(s) and purpose(s). 

Response. Section 5317 of title 38 U.S.C., directs VBA to pay the expenses of administering certain income verification matching activities with funds from the 

mandatory C&P appropriation. Accordingly, the C&P appropriation reimburses the 

GOE account and OIT account for administrative costs associated with verification 

of eligibility for the C&P programs through income verification matching. The FY 

2015 reimbursement to the GOE account is estimated to be $14.7 million to support 

165 FTE. In FY 2015, the reimbursement to the OIT account is estimated to be 

$112,200 in support of one FTE. 

P.L. 104–275 directs VA to make payments for contracts for the pilot program for 

disability examinations from the C&P appropriation. Accordingly, the C&P appropriation has reimbursed the GOE account for the purposes of this pilot program. 

The FY 2015 reimbursement amount is estimated to be $2.7 million to support 25 

FTE. 

Question 32. This budget would cut VA central office (VACO) funding by $4 million or 1.2 percent; however, the offices that comprise VACO would realize an increase of 38 FTE if this budget were adopted. During last year’s budget rollout on 

April 10, 2013, VA responded to a question about the contradiction of an increase 

in FTE and a funding decrease by stating that the additional staff is paid for out 

of the Supply Fund and Franchise Fund. Additionally, throughout the budget request for the General Administration account, many offices within VACO indicate 

budget allocations and staffing under the heading ‘‘reimbursement.’’ 

A. Of the 2,832 staff requested in the fiscal year 2015 budget request, how many 

are funded through the Supply Fund and Franchise Fund? Please breakout this 

number by individual VACO offices (for example, Office of the Secretary, Office of 

General Counsel, Office of Policy and Planning, etc.). 

65 

Response. The budget reduction of $4 million in the General Administration account is a result of the transfer of rent funds to the Board of Veterans’ Appeals’ 

new appropriation account and is unrelated to pay of personnel or full-time equivalent employees (FTE). In fiscal year (FY) 2015, 74 FTE in the General Administration account (76 FTE in FY 2014) are supported through reimbursements from the 

Supply Fund (60 within the Office of General Counsel, 7 within the Office of Acquisition, Logistics and Construction, and 7 within the Office of Management). No General Administration FTEs are supported by reimbursements from the Franchise 

Fund. 

B. For reimbursable FTE, please provide the Committee with information regarding the office, department, or agency that is being reimbursed, a description of the 

program or service for which they are being reimbursed, and the number of staff 

associated with the reimbursement. Please break this out by individual VACO offices (for example, Office of the Secretary, Office of General Counsel, Office of Policy 

and Planning, etc.). 

Response. In fiscal year 2015, a total 1,096 full-time equivalent employees (FTE) 

in the General Administration account are supported through reimbursements. The 

table below shows the number of FTE for each Staff Office and a brief description 

of the associated program or activity. 

General Administration Staff Office Reimb. 

FTE Description/Activity 

Office of the Secretary .................................................. 24 Office of Employee Discrimination Complaint Adjud. 

Office of General Counsel ............................................. 41 Credit Reform Administration 

63 Medical Care Recovery Act 

60 Contract Law Support (Supply Fund) 

1 Specialized Legal Support 

Office of Management ................................................... 10 Energy/Greening (OAEM) 

24 Business Oversight (A123 & others) 

7 Oversight Reviews of Supply Fund 

Office of Human Resources Admin. .............................. 267 Office of Resolution Management 

321 Human Capital Investment Plan 

20 VACO Campus Administration 

Office of Policy and Planning ....................................... 27 Customer Data Integration 

Office of Operations, Security and Prep. ...................... 30 Identity Credentials and Access Mgt. (HSPD-12) 

Office of Public and Intergov. Affairs ........................... 4 Homeless Veterans Outreach 

Office of Acquisition, Logistics and Const. .................. 140 Resident Engineers Support for Const. Projects 

48 Leasing (Medical Facilities) 

7 Supply Fund Management 

2 Support to NCA 

Total ...................................................................... 1,096 

Question 33. The fiscal year 2015 budget request for VA proposes the creation of 

a $1 billion Veterans Job Corps. This is the third year the proposal has been included in the Department’s budget request. However, even though the Committee 

has previously asked VA to provide more detailed information on the Veterans Job 

Corps proposal, the Committee has not been provided with additional detail. 

A. Historically, employment programs have not been a core mission of the Department. Why has VA been tasked with undertaking the program and not the Department of Labor, which focuses almost entirely on employment? 

Response. VA carries out a robust set of activities related to Veterans’ employment. A few examples include hosting job fairs for Veterans; providing on-the-job 

training and apprenticeship opportunities through the Post-9/11 G.I. Bill program; 

delivering career counseling to Veterans in the VetSuccess on Campus program; administering the Veterans’ Vocational Rehabilitation and Employment program; and 

partnering with the Departments of Defense and Labor in Transition GPS, a program that helps separating Servicemembers transition to the civilian workforce. 

66 

B. Will veterans who participate in this temporary program receive any occupational licenses, certificates, or degrees that can be used in the civilian labor market? 

Response. The goal of the Veterans Job Corps is to enable Veterans to leverage 

the skills developed in the military into jobs on the country’s public lands and in 

its communities, ranging from conservation and infrastructure projects to law enforcement and first responder jobs, such as park rangers, police officers, and firefighters. VA would like to work with the Congress to pass legislation to authorize 

the Veterans Job Corps and address details such as credentialing and the program’s 

linkages to VA’s certificate, licensing, and degree-granting programs, such as the 

Post-9/11 G.I. Bill. 

C. Will there be any guarantee of permanent employment for the veterans who 

participate in this program? 

Response. VA would like to work with the Congress to pass legislation to authorize the Veterans Job Corps and address details such as post-program employment 

opportunities for Veterans who participate in the program. 

READJUSTMENT BENEFITS

Question 34. One item that VA pays for using mandatory funding is reporting fees 

provided to educational institutions. For fiscal year 2013, please provide the number 

of institutions that received reporting fees, the 10 largest payments made to an institution, and the number of institutions that received total payments of $15 or less. 

Response. In FY 2013, VBA paid $10.4 million in reporting fees to 10,578 institutions. Incorporating recoveries from these institutions, net payments were $10.2 million, as shown in the FY 2015 Department of Veterans Affairs’ Budget Submission 

(Volume 3, pg. VBA–32). The chart below shows the ten largest payments made to 

an institution in FY 2013. Additionally, in FY 2013, 1,664 institutions received total 

payments of $15 or less in reporting fees. 

School Name Total Paid 

University of Phoenix (Online) .................................................................. $339,132 

American Public University System (American Military University) ......... $169,596 

Ashford University (Online) ....................................................................... $143,835 

University of Maryland University College ................................................ $91,740 

Liberty University ...................................................................................... $79,119 

Grantham University ................................................................................. $75,600 

Kaplan University ...................................................................................... $72,060 

Columbia Southern University .................................................................. $59,076 

Central Texas College ............................................................................... $55,752 

University of Phoenix (San Diego) ............................................................ $51,372 

Question 35. The authorization for certain work-study activities expired in 

June 2013. Those work-study activities include outreach programs with State approving agencies, working in State homes, and administration of a national cemetery or state veterans’ cemetery. During fiscal year 2013, how many individuals participated in each of those work-study activities? 

Response. The table below provides FY 2013 data related to the number of individuals performing work-study activities at SAAs, state homes, and administration 

of a national cemetery or state Veterans cemetery. 

FY 2013 Work-Study Activities 

Activity/location # of individuals 

SAAs .......................................................................................................... 36 

State homes .............................................................................................. 75 

Administration of a national cemetery ..................................................... 84 

State Veterans cemetery ........................................................................... 19 

Question 36. On March 5, 2014, both the House and Senate Committees on Veterans’ Affairs were informed by VA that the Veterans Retraining Assistance Program (VRAP) would be extended to make payments past the statutory sunset date 

to participating veterans whose training program will not be completed by 

March 31, 2014. Subsection (a)(2) of section 211 of Public Law112–56, the VOW to 

67 

Hire Heroes Act of 2011, which established VRAP, explicitly sets the number of veterans who could participate and limits participation to on or before March 31, 2014. 

A. Subsections (a)(2) and (k) establish March 31, 2014, as the sunset date of the 

program. What statutory authority exists in section 211 to allow for the extension? 

Response. In February 2014, it became apparent that as many as 22,000 Veterans 

might be unable to complete their current term of enrollment in Veterans Retraining Assistance Program (VRAP) courses of study before the authority to issue VRAP 

payments expired on March 31, 2014. Many Veterans receiving retraining assistance 

were enrolled in community colleges or other programs on a typical academic calendar, and while enrollment periods vary from school to school, spring semesters 

and quarters are generally completed by the end of June. Without the assistance 

provided by VRAP, Department of Veterans Affairs (VA) was concerned that many 

of these Veterans would be forced to withdraw from their retraining programs in 

the middle of the academic term. That would be both terribly disruptive and inconsistent with the purpose of ensuring Veterans gain the skills they need. In some 

cases, it might also mean that a Veteran would not obtain the degree or certificate 

they would otherwise receive if allowed to finish their current enrollment period. 

Accordingly, VA’s Office of General Counsel examined the relevant statutes to determine whether it would be possible to make payments prior to March 31, to assist 

those Veterans in finishing their term and thereby maximize the benefits provided 

through this valuable program. OGC’s review concluded that there was no statutory 

bar to issuing payments prior to the March 31, 2014 deadline to cover multiple 

months. OGC further concluded that a policy decision to exercise VA’s discretion 

and make one-time payments to enable completion of ongoing training would further 

Congress’ intent with regard to the program, namely to ensure that Veterans are 

retrained so that they can begin new careers. OGC’s analysis focused on the text 

of the relevant statute, section 211, which does not set a date on which the program 

must end, nor does subsection (a)(2) prohibit participation by veterans after 

March 31, 2014. Instead, subsection (k) of the statute provides that ‘‘[t]he authority 

to make payments under this section shall terminate on March 31, 2014, and subsection (a)(2), which is entitled ‘‘Number of Eligible Veterans,’’ simply places a cap 

on the number of Veterans eligible for the program. 

VA’s action is consistent with the statute because no payments to Veterans will 

be made after March 31, 2014. And read closely, section 211(a)(2)(B) does not prohibit participation after March 31, but rather provides that the number of participants may not exceed 54,000. Similarly, section 211(c), entitled ‘‘Monthly Certification,’’ requires certification to the Secretary of enrollment ‘‘for each month’’ by 

Veterans while participating in the program, but does not specify that those certifications be made monthly, nor does it address frequency of payments. 

B. In order to receive a payment from VA for participating in VRAP, a veteran 

has to certify monthly that he or she is a full-time student in an approved course 

of study. The VA Office of Inspector General has previously found VA had difficulties verifying the attendance status of participating veterans, leading to VA making 

millions in erroneous payments. Given the proposed payment of lump sum payments under the extension, how will VA ensure that millions more will not be 

wasted? 

Response. In order to be approved for the Veterans Retraining Assistance Program (VRAP), a program must be approved for GI Bill benefits under Chapter 36 

of title 38 U.S.C. Consequently, the schools are required to report changes in enrollment (or failure to meet the school’s standards of attendance, or conduct, as applicable) to VBA ‘‘without delay.’’ ‘‘Without delay’’ is defined by regulation as within 30 

days. All approved programs are subject to periodic compliance reviews, which include reviewing records for VRAP participants in order to ensure that the schools 

(and students) are meeting the applicable requirements. In addition, recipients of 

VRAP one-time payments are specifically required, and instructed, to notify VBA 

immediately of changes in enrollment status. This requirement also applies to recipients of one-time payments issued under the various GI Bill programs as well. 

VETERANS BENEFITS ADMINISTRATION

Disability Compensation 

Question 37. The Winston-Salem regional office helps with national missions, such 

as the Benefits Delivery at Discharge program and the Quick Start program, in addition to handling claims from North Carolinians. That office currently has over 

30,000 pending claims. For that workload, how many employees would be appropriate and how many are there currently? 

Response. VBA’s RAM is a systematic approach to distributing field resources 

each fiscal year. The RAM utilizes a weighted model to assign C&P FTE resources 

68 

based on RO workload, including rating inventory and rating, non-rating, and appeal receipts. Starting in FY 2014, the RAM includes additional variables to more 

closely align with VBA’s transformation to a paperless, electronic environment, 

where receipts can be assigned and managed at the national level. These variables 

include station efficiency, quality, and RO capacity. Based on the FY 2014 RAM, the 

Winston-Salem RO FTE allocation for disability compensation claims processing was 

614 FTE. Nine additional FTE were approved in March 2014 due to increased workload. As of March 30, 2014, the number of FTE on board was 615. 

Question 38. The fiscal year 2015 budget request does not include projections for 

how long it will take to complete compensation and pension claims in fiscal years 

2014 and 2015. In fact, the budget books reflect that this performance measure has 

been deleted. 

A. What are VA’s projections for how long it will take to complete disability claims 

in those years? 

Response. In FY 2013, the average days to complete (ADC) rating-related claims 

was 348 days, a reflection of VBA’s emphasis on completing the oldest claims in the 

backlog during the second half of FY 2013. That emphasis continued through the 

first quarter of FY 2014, which ended with an ADC of 277 days for the quarter. 

ADC through the end of the first half of FY 2014 further declined to 253 days. We 

expect this trend to continue through the remainder of FY 2014 and into FY 2015. 

By the second quarter of FY 2015, we expect the downward trend in the monthly 

ADC to begin accelerating, leveling out to approximately 100 days for the last quarter of FY 2015. 

B. Why is this metric being deleted from the budget request? 

Response. VBA’s Agency Priority Goal is to eliminate the backlog and process all 

claims within 125 days in 2015. Both metrics, ADC and Average Days Pending 

(ADP), remain important metrics to track. As we drive toward our goal, VBA implemented an initiative in April 2013, to process oldest claims first, which results in 

the ADC increasing in the short-term, even as we make great progress in eliminating the backlog for Veterans who have waited the longest for a decision. ADP 

is a leading indicator that provides the best measure of the current state of the 

claims inventory, and is the most meaningful way for Veterans to understand how 

long their claim may take to process. The average number of days rating claims are 

pending has been reduced from a peak of 282 days in March 2013, to 161 days as 

of April 5, 2014, which represents a 43-percent reduction. The number of claims in 

the backlog has been reduced from a peak of 611,000 to 337,000 as of April 5, 2014, 

a 45-percent reduction. 

Question 39. The number of dependency adjustments waiting for VA action increased from less than 50,000 in 2010 to nearly 240,000 in March 2014. As of 

March 2014, 75 percent of the dependency adjustments have been pending for longer 

than 125 days. 

A. When does VA consider a dependency adjustment to be ‘‘backlogged?’’ 

Response. There is no defined parameter for a ‘‘backlogged’’ dependency adjustment; however, we do track them against the 125-day goal for all disability claims. 

B. What performance metrics does VA have in place with respect to dependency 

adjustments and how quickly they should be acted on? With on-going efforts to increase the automation for processing these work items, will those performance 

metrics change? 

Response. Each RO has a target for reducing the inventory of pending dependency 

adjustments. VBA is working on several initiatives that streamline the processing 

of dependency claims. Current and upcoming initiatives that will help improve the 

speed and accuracy of dependency claims processing are provided below. 

• Veterans can now request to add dependents using the eBenefits portal. VBA’s 

rules-based processing system (RBPS) automatically processes over 50 percent of the 

dependency requests submitted through eBenefits and automatically adjusts compensation payments based upon the change in dependent status. This new automated system reduces processing time to one day for many of these requests and 

allows VBA to devote more resources to processing other, more complex claims. 

• In the past year, VBA’s Compensation Service (CS) released several dependency-related procedural changes that simplify the decision process and relax evidentiary standards. These include: 

– Liberalizing evidentiary requirements for stepchildren, under which VBA will 

accept a Veteran’s lay statement as sufficient proof to establish a stepchild as 

a dependent, provided that the statement includes basic information about the 

dependency change. VBA will request additional evidence to support the claim 

only when it has a reason to question the validity of the statement. 

69 

– Streamlining procedures when the beneficiary does not provide VBA information sufficient to determine entitlement dates. VBA will attempt to contact the 

Veteran by phone to obtain the date of the dependency change and process the 

change based upon information provided during the call. 

• CS is working to further relax evidentiary requirements and streamline the procedures for processing dependency claims. This initiative includes issuing additional 

procedural guidance to the ROs and evaluating current regulations for the purpose 

of initiating appropriate rulemaking to remove unnecessary processes. 

• New functionality is being developed for VBA’s Customer Relations Management Unified Desktop, which is utilized by VBA’s agents in its National Call Centers (NCC), which will allow the system to send dependency claims that the NCC 

agents receive over the phone to RBPS for automated processing. 

• As automation of dependency claims continues to improve, more of these claims 

will be processed with greater efficiency and improved timeliness. VA will set FY 

2015 performance metric goals that take into consideration inventory levels and the 

level of automation at that time. 

C. Has VA set any timelines, milestones, or goals for when this inventory of dependency adjustments will be reduced to an acceptable level? 

Response. With VBA’s record-breaking production of claims decisions in recent 

years, dependency claims are also rising. To address the rise in claims, VBA built 

a RBPS to automate processing and payment of dependency claims for Veterans 

who file online. Over 50 percent of dependency claims that are filed online are now 

being completed without human intervention. The remaining 50 percent are immediately triaged to make it easier for the claims processor to target the needed evidence for resolution. This new IT capability will enable future claims filed online 

to be completed quickly and accurately, and as a result, our Veterans will receive 

their payments much faster. On April 4, 2014, VBA awarded a contract to provide 

‘‘surge’’ support to complete paper-based dependency claims. Contract personnel will 

enter data from paper claims into RBPS, which will allow a significant portion of 

these claims to be electronically processed and adjudicated—just as if the Veteran 

had input the data. VA also recently trained its call center agents to resolve dependency claims issues over the phone to expedite those claims already in the system. 

ADC for a dependency claim in March 2014 was 207 days, down 75 days from the 

first quarter of FY 2014. 

Question 40. According to the authors of the fiscal year 2015 Independent Budget, 

‘‘the most significant change that has helped reduce the backlog over the past year 

has been [the Veterans Benefits Administration’s] heavy reliance on mandatory 

overtime.’’ 

A. Of the 1.17 million claims completed during fiscal year 2013, what portion was 

completed as a result of overtime? 

Response. VBA spent $71 million on overtime for direct C&P-related claims processing, resulting in a conservatively estimated 91,000–129,000 additional claims 

completed. 

B. So far during fiscal year 2014, how many claims have been completed in total 

and what portion was completed as a result of overtime? 

Response. Through the first two quarters of FY 2014, 631,000 rating-related 

claims have been completed. VBA estimates 65,000–70,000 of the claims completed 

to be attributed to overtime. 

C. What portion of any increase in productivity during fiscal years 2013 and 2014 

has resulted from other initiatives, such as the Veterans Benefits Management System or segmented lanes? At this point, is VA seeing a reasonable return on investment for those other initiatives? 

Response. VBMS is projected to increase productivity in FY 2014; however, it is 

difficult to extract the impact of each transformation initiative from the combined 

people, process, and technology model that are being concurrently implemented to 

determine individual initiative’s contribution to productivity outcomes. 

VBA has seen improvements in performance as a result of its transformation initiatives. As of May 22, 2014, VA has completed 833,000 claims in FY 2014, a 26- 

percent increase over the same time last year and a 32-percent increase over two 

years ago. VBA has also significantly reduced its inventory and backlog. As of 

May 22, 2014, there were 574,000 claims pending in VBA’s inventory, which represents a 34-percent reduction from July 2012 when the inventory peaked at 

884,000 claims. Similar improvements can be seen in the claims acklog (i.e., pending 

over 125 days). As of May 22, 2014, 293 claims were in the backlog—a 52-percent 

reduction since the backlog peaked in March 2013. 

70 

D. What specific initiatives are expected to allow VA to handle more claims in fiscal year 2015 than this year and what statistics or information suggests that a 17 

percent increase in productivity is realistic? 

Response. VA is focused on providing a long-term solution to a decades-old problem. VBA is retraining, reorganizing, streamlining business processes, and building 

and implementing technology solutions based on the newly redesigned processes to 

improve benefits delivery. Several transformation initiatives, as described below, are 

focused on increasing the number of ratings completed per FTE. VBA is also completing a thorough evaluation of its ability to meet the processing demands of incoming workload, through ‘‘demand’’ and ‘‘capacity’’ analyses, which are currently in 

progress. 

VBA’s new organizational model, which incorporates a case-management approach 

to claims processing, has been implemented at all 56 ROs. VBA projects that the 

segmented lanes initiative, part of this new organizational model, will accelerate 

simpler claims, predictably taking less time through the ‘‘express’’ lane, with the remainder of claims flowing through either a ‘‘special operations’’ lane (claims requiring special handling) or ‘‘core’’ lane. This segmented, case-management approach to 

claims processing is creating efficiencies within the workforce. 

VBMS, VBA’s Web-based electronic claims processing system, was deployed to all 

56 ROs 6 months ahead of schedule in June 2013. VBA has also successfully deployed VBMS to the Appeals Management Center (AMC), the Records Management 

Center, the Board of Veterans’ Appeals (Board), all NCCs, and all VA medical centers. VBA is confident in its Transformation Plan. Even during the ‘‘year of change,’’ 

VBA was able to increase production by 12 percent in FY 2013 over 

FY 2012. This is a clear indication that success will continue during FY 2014 and 

culminate in the people, process, and technology improvements that allow for our 

17 percent forecasted increase in FY 2015. 

Throughout 2014 and 2015, VBMS will focus on continuing to improve electronic 

claims processing by providing increased system functionality and more complex automation capabilities for all VBMS end-users. VBMS enhancements will reduce dependency on legacy systems for claims establishment, development, and rating. 

VBMS now has the capability to accept electronic Veterans’ Service Treatment 

Records (STR) from DOD. Additionally, VBMS end-users (to include VA Medical 

Center personnel and VSOs) will be able to leverage enhanced system functionality 

to perform their work more efficiently and accurately. Development of functionality 

will provide end-users with the ability to process claims electronically from receipt 

to payment. The addition of functionality and stabilization of system capabilities, in 

conjunction with business process improvements, will increase production and quality of claim decisions. 

VBA’s partnership with VSOs is crucial to our transformation. VBA is greatly expanding education and collaboration efforts with VSOs that result in the submission 

of more fully developed claims (FDC)—claims that come to VBA ready for final review and decision (http://www.benefits.va.gov/fdc/). 

VBA is also completing the integration with other Federal agencies that enables 

inter-departmental data review and exchange to support pension and disability 

claims processing. This includes Social Security Administration (SSA) and Internal 

Revenue Service (IRS) (income verification), and DOD (military personnel and medical records). 

Question 41. According to information provided in connection with the fiscal year 

2014 budget request, the Veterans Benefits Administration (VBA) planned to expend $40 million in fiscal year 2014 to pay for claims processing staff to work overtime. 

A. During fiscal year 2013, how much in total was actually expended to pay for 

overtime work by claims processing staff? Response. In FY 2013, VBA expended a total of $71 million on overtime for C&P 

rating claims processing. 

B. During fiscal year 2014, how much is now expected to be spent on overtime 

by claims processing staff and what outcomes are expected to be achieved as a result of those overtime hours? 

Response. VBA anticipates using approximately $100 million to fund overtime for 

C&P rating claims processing in FY 2014, and estimates completing approximately 

168,000 claims associated with overtime funding. 

C. For fiscal year 2015, what level of funding is requested to pay for overtime 

hours worked by claims processing staff and what outcomes are expected to be 

achieved as a result of those overtime hours? 

Response. VBA anticipates using approximately $60 million to fund overtime for 

C&P rating claims processing in FY 2015, and estimates completing approximately 

101,000 claims associated with overtime funding. 

71 

Question 42. VA is now projecting that it will complete about 1.25 million disability claims this year. That is about 72,000 less completed claims than VA projected in the budget request last year and 370,000 less than projected in VA’s 2013 

backlog reduction plan. What led to these decreases in the expected productivity for 

fiscal year 2014? Are there initiatives that are not having the expected impact on 

productivity yet? 

Response. The projections of received and completed claims in VBA’s 2014 budget 

and VA’s Strategic Plan to Eliminate the Compensation Claims Backlog were based 

on assumptions made earlier in the budget cycle that included a higher level of 

claims receipts and FTE. Projections are periodically updated based on recent experience, the impact of the transformation initiatives, and enhanced forecasting capabilities. 

Question 43. VA has a number of initiatives underway to reach its goal of a 98 

percent accuracy rate. 

A. In total, how much did VA spend in fiscal year 2013 to carry out all of those 

quality initiatives? 

Response. VBA’s transformation plan is based on over 40 high-impact initiatives 

across people, process, and technology through a systematic and repeatable gap 

analysis process. It is difficult to separate each initiative’s precise impact on quality 

and productivity; however, the FY 2013 funding for four of the initiatives with the 

greatest impact on quality is provided below: 

• VBMS: $51.1 million (VBA GOE program non-pay, non-IT funding for paperless 

initiative) 

• Challenge training: $8.2 million 

• Quality Review Teams (QRT): $52 million 

• Station Enhancement Training (SET): $582,000 

B. In total, how much is VA expecting to spend in fiscal year 2014 to carry out 

all of those quality initiatives, including the quality review teams at each regional 

office? 

Response. As previously noted, several initiatives impact quality. A summary of 

FY 2014 funding for the primary initiatives focused on improving quality is provided 

below: 

• VBMS: $159.9 million (VBA GOE program non-pay, non-IT funding for 

paperless initiative) 

• Challenge training: $13.6 million 

• QRTs: $53 million 

• Training for underperforming claims processors: $10 million 

C. In total, how much is VA requesting for fiscal year 2015 to carry out all of 

those quality initiatives, including the quality review teams at each regional office? 

Response. For FY 2015, VBA has requested the following funding for these initiatives: 

• VBMS: $162.5 million (VBA GOE program non-pay, non-IT funding for 

paperless initiative) 

• Challenge training: $15.5 million 

• QRTs: $57 million 

D. Nation-wide, how many full-time equivalents are currently assigned to these 

quality review teams? 

Response. In April 2014, approximately 650 Quality Review Specialists were assigned to the QRTs nationwide. 

E. If the fiscal year 2015 budget request is adopted, how many individuals Nationwide would be assigned to these teams? 

Response. During the development and piloting of the QRTs, analysis showed an 

appropriate staffing ratio of one Quality Review Specialist to every 15 claims processors. VBA anticipates continuing to utilize this staffing ratio for QRT positions 

during FY 2014 and FY 2015; resulting in consistent staffing levels for both years. 

Question 44. VA’s ‘‘appeals resolution time’’ in fiscal year 2013 was 923 days, an 

increase of 267 days since fiscal year 2010. Also, the number of pending appeals has 

increased by more than 30 percent over the past few years. Although VA recently 

sent the Committee a plan to improve the appeal process, it does not have details 

about when this inventory of appeals will be reduced. 

A. How much in total is expected to be expended by VBA to process appeals during fiscal year 2014? 

Response. In FY 2014, VBA estimates that funding for claims processors to process appeals will total $86.6 million. This includes funding for the approximately 900 

claims processors at the ROs and the AMC. 

72 

B. What level of funding is requested in total for fiscal year 2015 for purposes 

of processing appeals by VBA? 

Response. In FY 2015, VBA estimates that funding for claims processors to process appeals will total $89.3 million. 

C. When does VA expect the inventory of appeals to start to decline and when 

will it reach a level that VA considers acceptable? Please provide any goals, 

timelines, or milestones that VA has set with regard to the reduction in pending 

appeals. 

Response. The rate of appeals (approximately 11 percent) has remained steady 

over last 20 years, regardless of quality or production. As more claims are completed, more appeals are received. VA’s large inventory of pending appeals is due 

in part to the record number of claims VBA has completed over the past four years. 

VA expects to complete well over a million claims again in FY 2014. 

As noted in VA’s Strategic Plan to Transform the Appeal Process, which was provided to the Senate Committee on Veterans’ Affairs on February 26, 2014, the current process provides appellants with multiple reviews in VBA and one or more reviews at the Board, depending upon the submission of new evidence or whether the 

Board determines that it is necessary to remand the matter to VBA. Although VA 

has allocated significant resources to the appeals workload, the multi-step, openrecord appeal process set out in current law precludes the efficient delivery of benefits to all Veterans. The longer an appeal takes, the more likely it is that a claimed 

disability will change, resulting in the need for additional medical and other evidence. VA is implementing a series of initiatives to improve the appeal process and 

continues to work with Congress and other stakeholders to explore long-term solutions that would provide Veterans the timely appeals process they deserve. 

VBA has established the following strategic targets for appeals: 

Veterans Appeals Control Time—7 days 

Veterans Appeals Pending (across all ROs)—174,945 

Veterans Appeals ADP—182 days 

VA Form 9 ADP—320 days 

Question 45. In the fiscal year 2015 budget request, the discretionary request for 

the disability compensation program includes $557 million for Other Services. 

Please provide a detailed itemized list of how that funding would be utilized during 

fiscal year 2015. To the extent any of the funds will be spent on contracts, please 

explain the nature of the contract and the expected outcomes. 

Response. The discretionary request for $557 million contains funding of $440.4 

million for contracts that directly impact or support the delivery of disability compensation claims: 

• Contract Medical Examinations ($250.8 million) 

• Veterans Claims Intake Program (scanning) ($134.4 million) 

• Program management and systems engineering support services for the VBMS 

($32.8 million) 

• Development of instructional methodologies and systems that support the training and skills development of the disability compensation workforce ($8.3 million) 

• Development of the Centralized Mail Processing System ($7.8 million) 

• Program management, scientific, technical, and engineering support for Compensation Service and the VBA Operations Center ($6.3 million). 

The request also includes $32.4 million for studies and analyses that support strategic planning ($16.7 million) and innovation ($15.7 million). 

The remaining $83.8 million is for administrative and management support costs 

associated with VBA-internal support agreements, such as Franchise Fund fees for 

Debt Management Center, Financial Services Center, Computer Data Center Operations services, and for support attained via interagency agreements with the Department of Homeland Security, the Department of the Treasury, and the National 

Archives and Records Administration. 

Question 46. According to the fiscal year 2015 budget request, the disability compensation program expects to spend $33 million on travel during fiscal year 2014, 

which is $15.8 million higher than the amount spent during fiscal year 2013 and 

$10 million higher than the amount originally requested for fiscal year 2014. What 

factors led to this increase in expected travel expenditures? 

Response. The primary factor that led to this increase is the $10 million appropriated for targeted training for claims processors to increase production and help 

eliminate the claims backlog. Additionally, Challenge Training classes were sourced 

at a planned throughput of 220 seats per class. 

Question 47. In response to questions about the fiscal year 2014 budget request, 

VA indicated that VA completed approximately 81 claims per direct full-time equivVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00076 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
73 

alent in fiscal year 2013 and expected to complete at least 90 claims per full-time 

equivalent in fiscal year 2014 and at least 100 claims per full-time employee in 

2015. To date in fiscal year 2014, how many claims have been completed per compensation and pension direct labor full-time equivalent? 

Response. FY 2014 through the end of March, C&P direct FTE completed an average of 47.4 claims per FTE. VBA is on target to reach 90 claims per FTE by the 

end of the fiscal year. 

Question 48. In response to questions about the fiscal year 2014 budget request, 

VA indicated that VA expected to receive more than 200,000 fully-developed claims 

in fiscal year 2014 and expected it to take on average 100 days to process those 

claims. 

A. How many fully-developed claims are now expected to be filed during fiscal 

year 2014 and during fiscal year 2015? 

Response. VBA expects to receive more than 380,000 FDCs in FY 2014 and more 

than 485,000 FDCs in FY 2015. 

B. To date in fiscal year 2014, how many days on average is it taking to complete 

fully-developed claims? 

Response. Through March of FY 2014, FDCs have been completed in an average 

of 144 days. 

C. For fiscal year 2015, how long is it projected to take to complete fully-developed 

claims? 

Response. VA projects to complete FDCs in 125 days or less in 2015, with a September 2015 monthly target of 90 days to complete FDCs. 

D. For fiscal year 2014, how much is expected to be spent on marketing materials 

for the fully-developed claims program and related training? 

Response. VBA expects to spend $1.4 million on materials that promote the FDC 

program. This dollar amount is comprised of expenditures on contracts for: 

Promotional materials 

VBA translation services 

FDC and training support 

FDC eBenefits campaign 

E. For fiscal year 2015, what level of funding is requested for purposes of promoting the fully-developed claims program? 

Response. VBA requested approximately $941,000 in the FY 2015 budget submission. 

Question 49. In response to questions about the fiscal year 2014 budget request, 

VA indicated that it was requesting $10 million in order to contract with private 

entities to retrieve medical records from private medical providers. 

A. In total, how much was spent on that initiative during fiscal year 2013 and 

what was the average time it took the contractors to obtain private medical records 

(or otherwise close out the development action)? 

Response. In FY 2013, VBA obligated $2.1 million to continue the Private Medical 

Records (PMR) initiative. The contractor resolved PMR requests, either by obtaining 

PMRs or otherwise completing development action, in an average of 12 days. 

B. How much is now expected to be spent on this initiative during fiscal year 2014 

and how long on average is it currently taking the contractors to obtain private 

medical records (or otherwise close out the development action)? 

Response. In FY 2014, VA plans to spend $9.3 million on the PMR initiative. In 

FY 2014 through April 3, 2014, the contractor resolved over 114,000 PMR requests 

in an average of 12 days. 

C. Is any funding requested with respect to this initiative for fiscal year 2015? 

If so, please specify the amount. 

Response. For FY 2015, VA is requesting $15.7 million to support the ongoing 

costs of the nationally implemented PMR program. 

Question 50. In response to questions about the fiscal year 2014 budget request, 

VA indicated that it expended $366,139 in fiscal year 2012 for purposes of updating 

the disability rating schedule. The fiscal year 2015 budget request reflects that 

‘‘VBA projects that it will complete its review of the 15 body systems in the rating 

schedule by December 2016.’’ 

A. During fiscal year 2013, how much was spent with respect to efforts to update 

the disability rating schedule? 

Response. In FY 2013, VBA spent approximately $981,000 to support updates to 

the VA Schedule of Rating Disabilities (VASRD), including $902,000 for personal 

services, $30,000 for travel, and $49,000 for rent, supplies, and other services. 

B. During fiscal years 2014 and 2015, how much is expected to be spent with respect to efforts to update the disability rating schedule? 

74 

Response. In FY 2014, VBA will spend approximately $996,000 to support updates to VASRD, including $947,000 for personal services, $3,000 for travel, and $46,000 

for rent, supplies, and other services. In FY 2015, VBA requested $3.0 million to 

update the VASRD, including $952,000 for personal services, $30,000 for travel, and 

$2.0 million for other services. The increased in funding in FY 2015 is primarily due 

to a contracted earnings loss study. 

C. Of those 15 body systems, how many will be addressed by regulations published during the remainder of fiscal year 2014 and how many will be addressed 

by regulations published during fiscal year 2015? 

Response. Under the Project Management Plan, none of the VASRD body systems 

will be addressed by regulations published during FY 2014. VA will address each 

of the 15 body systems with a notice of proposed rulemaking published in the Federal Register by fall 2015, allowing 60 days for public comments. Subsequently, VA 

will review public comments and revise the proposed rules as appropriate before 

publishing them as final. 

Question 51. In response to questions about the fiscal year 2014 budget request, VA estimated that about $663,000 had been spent on earnings loss studies needed 

to complete revisions of the disability rating schedule but that the contract had been 

terminated before the final report had been provided. VA indicated that, through 

this spending, it ‘‘learned that due to statutory limitations, individualized earnings 

data cannot be obtained from the Internal Revenue Service.’’ 

A. Please explain what, if any, information was obtained as a result of that 

$663,000 in expenditures that could be used to complete the revisions to the rating 

schedule? 

Response. VA received six of the nine contract line item numbers outlined in the 

contract with George Washington University for an earnings loss study. VA does not 

expect any more deliverables to be provided under this contract. The six deliverables 

provided to VA are as follows: 

1. Obtained Security Clearance: The contractor completed all paperwork, provided all background information, and completed all training courses necessary 

to secure security clearance and authorization to use VA databases and perform 

tasks on VA property. 

2. Lessons Learned Report: The contractor reviewed VASRD and prior earnings loss studies. The contractor prepared and delivered a written report identifying important lessons learned through previous earnings loss studies and developed a strategy for providing an improved earnings loss study. 

3. Comprehensive Draft Project Management Plan (PMP), Final PMP, and 

Leadership Briefing: The contractor provided VA with a copy of a PMP detailing 

a plan for accomplishing the tasks and subtasks. 

4. Data base of Service-Connected Disabled Veterans: The contractor provided 

a database set, based on a compilation of data gathered from VA, including a 

sample of service-connected disabled Veterans, rating information, and other 

data points such as Social Security numbers, dates of birth, names, and disabilities. The contractor coordinated sampling methodology across the various data 

sets to ensure consistency, representativeness, and confidentiality. 

5. Approach Plan and Briefing: The contractor briefed VA leadership on a 

plan to address each aspect of the contract deliverables, identifying an obstacle 

in receiving required data. IRS and SSA provided the contractor with data 

encrypted into groups, and the contractor was unable to assess the impact of 

earnings losses based on individual service-connected disabilities compared to 

the control group. 

6. Earnings Loss Model: VA requested a systematic analysis of compensation 

payments for disabilities associated with body system profiles and rating criteria identified in VASRD. The contractor delivered a formula with variables to 

evaluate all earnings loss databased on individual service-connected disabilities. 

However, due to the lack of individually identified data from the IRS and SSA, 

the contractor was unable to insert the data into the formula. Without the necessary data, the formula did not provide VA with the requested information. 

B. Was VA’s Office of General Counsel consulted about possible statutory limitations before VA entered into a contract for these earnings loss studies? 

Response. Yes, VA’s Office of General Counsel (OGC) was consulted prior to the 

execution of the contract for the earnings loss study. The contract was tailored to 

meet the specific needs of the earnings loss study and ultimately approved by OGC. 

Upon encountering the statutory limitations regarding the release of individual income data, VA contacted IRS’ OGC. IRS informed VA that the release of individual 

data for the purpose of the study was specifically prohibited by statute. After IRS 

confirmed the statutory prohibition, the period of performance for the initial conVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00078 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
75 

tract expired. A revised statement of work was prepared, stating that George Washington University was only authorized to complete the terms of the contract using 

aggregate data and could not condition the completion of the contract upon receipt 

of individual data. 

C. Does the fiscal year 2015 budget request include any funding for earnings loss 

studies? If so, please specify the amount and the expected deliverables from any 

such studies. 

Response. The FY 2015 budget request includes $2.5 million for external earnings 

loss studies in support of ongoing and future VASRD revisions. Formulation of any 

such studies has not begun; therefore, VA cannot state with any degree of certainty 

what deliverables will be derived from such studies. 

Question 52. VA and the Department of Defense (DOD) have rolled out worldwide 

an Integrated Disability Evaluation System (IDES), through which an injured or ill 

servicemember, before being medically discharged from the military, completes both 

the DOD disability rating system and the VA disability rating process. 

A. During fiscal year 2013, how much in total did VA expend with respect to the 

Integrated Disability Evaluation System and how many VA employees were dedicated to the IDES process? Response. During FY 2013, VBA spent approximately $70.7 million for salaries 

and other GOE for 643 FTE dedicated to disability claims processing in the IDES 

process. Compensation staff and VR&E counselors are included in this count. Veterans filing claims through the IDES sites are captured in the nationwide Veteran 

caseload count and total compensation benefit obligations; therefore, mandatory 

funding cannot be separated for this program. 

B. During fiscal year 2014, how much in total does VA expect to expend with respect to the Integrated Disability Evaluation System and how many VA employees 

will be dedicated to the IDES process? Response. During FY 2014, VBA estimates it will spend approximately $71.9 million for salaries and other GOE to support 648 FTE dedicated to disability claims 

processing in the IDES process. 

C. During fiscal year 2015, how much in total is VA requesting with respect to 

the Integrated Disability Evaluation System and how many VA employees would 

that level of funding support? Response. During FY 2015, VBA estimates it will spend approximately $74.1 million for salaries and other GOE to support 648 FTE dedicated to disability claims 

processing in the IDES process. 

Pension and Fiduciary Service 

Question 53. According to the Monday Morning Workload report for March 8, 

2014, the Pension Management Center in Philadelphia, PA, had over 21,000 pending claims and 52 percent had been pending for longer than 125 days. By comparison, the Pension Management Center in St. Paul had 9,600 pending claims and less 

than 20 percent had been pending for longer than 125 days. 

A. How many full-time equivalent employees are currently assigned to each Pension Management Center and how many are expected to be assigned to each Pension Management Center during fiscal year 2015? 

Response. For FY 2014, the Pension Management Centers (PMC) have a combined 

allocation of 1,145 FTE. The Philadelphia PMC is allocated 430 FTE; Milwaukee 

PMC is allocated 340 FTE; and the St. Paul PMC is allocated 375 FTE. Staffing 

levels are expected to remain the same in FY 2015. The allocations are based on 

VBA’s RAM. The RAM utilizes a weighted model to assign C&P FTE resources 

based on workload. 

B. How many claims are expected to be received by each Pension Management 

Center during fiscal year 2014 and during fiscal year 2015? 

Response. VBA estimates that the three PMCs will receive approximately 

140,000–150,000 claims in the rating-related category during FY 2014 and 150,000– 

160,000 in FY 2015. 

C. How many claims are expected to be completed by each Pension Management 

Center during fiscal year 2014 and fiscal year 2015? 

Response. Expected production from the three PMCs in FY 2014 is 160,000– 

170,000 claims, with a similar amount in FY 2015. 

D. For each Pension Management Center, how many veterans died in fiscal year 

2013 and to date in fiscal year 2014 after a decision on their claim had been rendered but before they received a retroactive award of pension benefits? In how many 

of those cases were the retroactive benefits paid out as accrued benefits? 

Response. During FY 2013, VA PMCs released retroactive benefit payments to 

354 Veterans who had died on or before the date of an award of benefits was processed. As of April 9, 2014, VA has paid these retroactive payments as accrued beneVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00079 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
76 

fits in 41 cases. For FY 2014 through April 9, 2014, the PMCs released retroactive 

payments to 183 Veterans who had died on or before the date of an award of benefits was processed. As of April 9, 2014, VA has paid retroactive payments as accrued 

benefits in 47 cases. A breakdown of this data by pension management center is 

provided below: 

Pension Management Center 

Number of cases where the 

Veteran died prior to receiving 

their retroactive payment 

Number of cases VA paid 

retroactive payment as 

accrued benefit 

FY 2013 FY 2014 thru 

April 9, 2014 FY 2013 FY 2014 thru April 9, 2014 

Milwaukee, WI ................................................................................ 135 60 28 10 

Philadelphia, PA ............................................................................. 116 58 8 11 

St. Paul, MN ................................................................................... 103 65 5 26 

TOTAL ..................................................................................... 354 183 41 47 

E. For each Pension Management Center, how many veterans were declared incompetent during fiscal year 2013 and to date in fiscal year 2014; how long on average did it take for a fiduciary to be assigned to those veterans; and how frequently 

did the veterans die before the assignment of a fiduciary had been completed? 

Response. From October 1, 2012, through March 31, 2014, VA PMCs declared 

42,436 beneficiaries (Veterans and Survivors) incapable of managing their funds. 

The chart below provides the data for each PMC by fiscal year. 

Pension Management Center Incompetency 

Decisions FY 2013 

Incompetency 

Decisions FY 2014 

thru March 31, 

2014 

Philadelphia, PA .................................... 9,913 2,121 

Milwaukee, WI ........................................ 12,115 4,258 

St. Paul, MN .......................................... 10,963 3,066 

Total .............................................. 32,991 9,445 

Nationally, the fiduciary hubs averaged 83 days to complete the appointment of 

a fiduciary for a beneficiary who was rated incompetent in FY 2013. For FY 2014 

through March 31, 2014, it took an average of 51 days to complete a fiduciary appointment. This timeliness data includes all incompetent C&P beneficiaries, both 

Veterans and Survivors. VA systems cannot further categorize this timeliness information for pension only or by PMC. 

Regarding Veterans who died before an initial fiduciary appointment was completed during FY 2013 through March 31, 2014, VA systems cannot categorize this 

information by the PMC that issued the incompetency decision. However, for all 

C&P incompetency decisions issued nationally for both Veterans and Survivors, 

whether issued by a PMC or a RO Veterans Service Center, 376 beneficiaries passed 

away before an initial fiduciary appointment was completed. 

Question 54. In the fiscal year 2015 budget request, the discretionary request for 

the pension, dependency and indemnity compensation, burial, and fiduciary programs includes $17.8 million for Other Services for fiscal year 2015. Please provide 

a detailed itemized list of how that funding would be utilized during fiscal year 

2015. To the extent any of the funds will be spent on contracts, please explain the 

nature of the contract and the expected outcomes. 

Response. The discretionary request for $17.8 million contains funding of $11.8 

million for contracts that directly impact or support the delivery of pension claims: 

• Contract Medical Examinations ($2.3 million) 

• Program management, scientific, technical, and engineering support for Pension 

and Fiduciary Service ($1.2 million) 

• Development of instructional methodologies and systems that support the training and skills development of the Pension and Fiduciary workforce ($8.3 million) 

The remaining $6.0 million is for administrative and management support costs 

associated with VBA-internal support agreements, such as Franchise Fund fees for 

Debt Management Center, Financial Services Center, Computer Data Center Operations services, and for support attained via interagency agreements with the DeVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00080 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
77 

partment of Homeland Security, the Department of the Treasury, and the National 

Archives and Records Administration. 

Question 55. According to VA’s fiscal year 2013 Performance and Accountability 

Report, the average days it took to complete a pension claim increased from 113 

days in 2012 to 140 days in 2013. 

A. During fiscal years 2012 and 2013, how many claims processing personnel were 

dedicated to working on pension claims? 

Response. In FY 2012, an average of 906 employees were dedicated to processing 

claims at the PMCs. In FY 2013, there was an average of 905 employees. In addition to pension claims, these employees also processed dependency and indemnity 

compensation (DIC), parents DIC, accrued, and monetary burial benefit claims, as 

well as all related benefit adjustments. 

B. For fiscal years 2014 and 2015, how many claims processing personnel are expected to be dedicated to working on pension claims? 

Response. As of February 28, 2014, PMCs had 910 employees dedicated to claims 

processing. VA expects this number to increase through FY 2014, as the PMCs bring 

on an additional 35 employees to meet the PMCs’ FY 2014 allocation. VA does not 

anticipate a change in the PMCs’ total staffing allocation in FY 2015. 

Appeals Management Center 

Question 56. Since 2003, certain cases remanded by the Board of Veterans’ Appeals (BVA or Board) have been handled at a centralized entity called the Appeals 

Management Center. 

A. During fiscal year 2013, how much was spent on the Appeals Management 

Center and what level of staffing did that funding support? 

Response. In FY 2013, $21.1 million was spent by the AMC for payroll, non-payroll, and travel. This supported staffing of approximately 228 FTE. 

B. During fiscal year 2014, how much is now expected to be spent on the Appeals 

Management Center and what level of staffing will that funding support? 

Response. In FY 2014, approximately $20.6 million is expected to be spent by the 

AMC for payroll, non-payroll, and travel. This is expected to support staffing of approximately 221 FTE. 

C. In total, how much funding is requested for fiscal year 2015 for the Appeals 

Management Center and what level of staffing would that funding support? 

Response. VBA anticipates that the FY 2015 staffing levels will be consistent with 

FY 2014 levels and therefore funding will also be consistent with FY 2014. 

D. For fiscal year 2014, what are the key performance targets for the Appeals 

Management Center? 

Response. The FY 2014 AMC key performance targets consist of the following 

metrics and corresponding targets: 

• ADP for remands from homeless Veterans—70 days 

• Remand inventory—7,500 

• ADP for remands—75 days 

• ADC remands—140 days 

• Remand production—27,900 

• Accuracy of remand decision—90 percent (3-months rolling) 

Education 

Question 57. According to the fiscal year 2015 budget request, the discretionary 

request for Education programs includes $16 million for Other Services. Please provide a detailed itemized list of how those funds would be utilized during fiscal year 

2015. To the extent any of the funds will be spent on contracts, please explain the 

nature of the contract and the expected outcomes. 

Response. The $15.9 million request contains funding of $5.4 million for contracts 

that support Education Service, including: 

• Program management and systems engineering support services for the Post9/11 GI Bill ($4.4 million); 

• Development of instructional methodologies and systems to support the training 

and skills development of the Education workforce ($608,000); 

• Publication and distribution of outreach pamphlets and letters to satisfy intent 

of Public Law 101–237 and Public Law 105–368 ($242,000); 

• National Student Clearinghouse Contract for degree attainment data ($81,000); 

and 

• SAA Contract to support the development and implementation of a RAM 

($103,000). 

The remaining $10.5 million is for administrative and management support costs 

associated with VBA-internal support agreements, such as Franchise Fund fees for 

78 

Debt Management Center, Financial Services Center, Computer Data Center Operations services, and for support attained via interagency agreements with the Department of Homeland Security, the Department of the Treasury, and the National 

Archives and Records Administration. 

Question 58. According to the fiscal year 2015 budget request, the discretionary request for Education programs includes $3.6 million for printing, compared to 

$522,000 requested for fiscal year 2014. The budget request includes this explanation: ‘‘Printing obligations increase $3.1 million primarily as a result of realigned 

non-IT administrative obligations from the Office of Information and Technology to 

VBA.’’ Please provide a more detailed explanation of how these funds will be spent, 

how they were previously accounted for in the budget, and the need for the change. 

Response. The funding will be used for the centralization and modernization of 

printing associated with Post-9/11 GI Bill claims processing. It will cover expenses 

necessary for the printing of more than 3.6 million letters VA anticipates mailing 

to Veterans and other eligible beneficiaries. The $3.1 million provides for the centralized printing performed at VA’s information technology centers, and the 

$522,000 provides for printing conducted at VBA regional processing offices. The 

$3.1 million ‘‘increase’’ shown in the budget is not a new requirement. Instead, it 

is a shift in accounting for costs of the Post-9/11 GI Bill program. In FY 2013 and 

previous years, centralized printing and mailing of Post-9/11 GI Bill letters were 

provided as an operating expense of the information technology centers. Although 

printing and mailing functions may, at times, require information technology support, the functions are more operational. As such, in FY 2014 and beyond, the centralized printing and mailing costs for Post-9/11 GI Bill letters is being realigned 

more appropriately as an operating expense of VBA. 

BOARD OF VETERANS’ APPEALS

Question 59. In response to questions about the fiscal year 2014 budget request, the Board indicated that it expects to spend over $2 million per year on ‘‘costs (salary and benefits) of union representatives’’ and ‘‘costs (salary and benefits) of BVA 

managers who work on labor relations matters, labor relations counsel, and other 

labor relations support staff.’’ 

A. In fiscal year 2013, how much was actually expended for those purposes? 

Response. In fiscal year (FY) 2013, the Board of Veterans’ Appeals (the Board) spent a total $1,925,654 for labor relations matters, including $1,022,024 for costs 

(salary and benefits) of union representatives, and $903,630 for costs (salary and 

benefits) of Board managers, labor relations counsel, and other labor relations support staff who work on labor relations matters. 

B. In fiscal years 2014 and 2015, how much is now expected to be spent for those 

purposes? 

Response. Based on historical data from FY 2002 to April 2014, the Board expects to pay a total of approximately $2,307,582 in FY 2014 ($1,267,111 for costs (salary 

and benefits) of union representatives and $1,040,471 for costs (salary and benefits) 

of Board managers, labor relations counsel, and other labor relations support staff 

who work on labor relations matters); and $2,380,610 in FY 2015 ($1,303,631 for 

costs (salary and benefits) of union representatives and $1,076,979 for costs (salary 

and benefits) of Board managers, labor relations counsel, and other labor relations 

support staff who work on labor relations matters). 

C. During fiscal years 2014 and 2015, how many hours of ‘‘official time’’ (or union 

time) are expected to be paid for by the Board with Federal funding? 

Response. Based on a historical data from FY 2002 to April 2014, the Board estimates paying for a total of approximately 17,077 hours of official union time (official 

time) in FY 2014, and 17,261 hours of official time in FY 2015. 

Question 60. According to the fiscal year 2015 budget request, the Board is requesting $3 million for Other Services for fiscal year 2015. Please provide an 

itemized list of how these funds are expected to be spent during fiscal year 2015. 

Response. The $2,975,200 for Other Services in fiscal year 2015 will be allocated 

in the following manner: 

Xerox ............................................................................................................................................ $575,000.00 

Transcription Services (2 Vendors) ............................................................................................. 560,000.00 

Promisel and Korn, Inc. Electronic Research Materials Service and Maintenance Contract .... 405,000.00 

JD Power and Associates Contract for customer satisfaction analysis for hearing and nonhearing processes .................................................................................................................. 332,000.00 

West Group Contract-On-line Access to Westlaw Legal Database for legal research by the 

Board’s judges and attorneys ................................................................................................ 320,000.00 

79 

Department of Homeland Security .............................................................................................. 140,000.00 

Financial Service Center ............................................................................................................. 140,000.00 

Board’s Share of VA Central Office’s (VACO) Human Capital Investment Plan ....................... 135,000.00 

Office of Personnel Management ............................................................................................... 105,000.00 

United Parcel Services Appellant Records Shipment Contract .................................................. 80,000.00 

Defense Finance and Accounting Services ................................................................................. 64,000.00 

Security and Investigations Center ............................................................................................ 42,000.00 

Office of Resolution Management .............................................................................................. 40,000.00 

NextCut Document Shredding Contract for disposition of sensitive materials ......................... 27,000.00 

VACO Services Cost .................................................................................................................... 10,000.00 

VA Record Center and Vault ....................................................................................................... 200.00 

Total Other Services ........................................................................................................... $2,975,200.00 

GENERAL ADMINISTRATION

Office of the Secretary 

Question 61. According to the fiscal year 2015 budget request, 88 FTE are requested for the Office of the Secretary. Please provide a list of the positions that 

would be filled with that funding and the pay-grades for those positions. 

Response. A list of 95 positions in the Office of the Secretary is provided below. 

Grade Number of Positions 

Senior Executive Service 13 

15 15 

14 31 

13 16 

12 6 

11 4 

9 5 

8 1 

7 2 

6 2 

Question 62. In 2010, the VA Center for Innovation was established as part of the 

Secretary’s strategy to modernize the Department of Veterans Affairs and move the 

agency into the 21st Century. Over the last several years, this office has focused 

on piloting innovative ideas to support the Secretary’s initiative. 

A. Please provide the Committee with the amount of funding utilized for grants 

during fiscal year 2013 through Industry Competitions, Employee Competitions, 

Special Projects, and Prize Contests. 

Response. Department of Veterans Affairs Center for Innovation (VACI) funding 

is provided by Veterans Health Administration, Veterans Benefits Administration, 

and Office of Information and Technology. VACI utilized funding as follows across 

the categories mentioned above: 

Industry Competition ................................ $17,783,605 

Employee Competition .............................. $15,475,594 

Special Projects ........................................ $10,303,064 

Prize Competitions .................................... $0 

Total ........................................ $43,562,263 

B. Please provide the Committee with the amount of funding that would be available for grants during fiscal year 2015 through Industry Competitions, Employee 

Competitions, Special Projects, and Prize Contests. 

Response. Department of Veterans Affairs Center for Innovation (VACI) expects 

funding in the amount of $56 million in fiscal year 2015. Exact disposition of these 

funds across the Industry Competition, the Employee Competition, Special Projects, 

and Prize Contests has yet to be determined. Please note that VACI typically utilizes the acquisition process rather than grant mechanisms when working with exVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00083 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
80 

ternal entities. Funding mechanism to support internal activities is dependent upon 

the specifics of the project. 

Office of General Counsel 

Question 63. The Office of General Counsel is requesting $2 million for Other 

Services for fiscal year 2015. Please provide an itemized list of how these funds 

would be spent during fiscal year 2015. 

Response. 

Question 64. Within the Office of General Counsel, Professional Staff Group VII 

represents VA before the U.S. Court of Appeals for Veterans Claims. 

A. Currently, how many employees are assigned to Professional Staff Group VII 

and what is the average number of active cases per attorney? 

Response. Professional Staff Group (PSG) VII has 104 full-time equivalent employees onboard and 5 approved vacancies that are in the process of being filled. 

The average number of active cases per attorney is 44. An ‘‘active case’’ is one in 

which the Secretary has yet to file his dispositive pleading. 

B. For fiscal year 2015, what level of funding is requested to support Professional 

Staff Group VII and how many employees would that level of funding support? 

Response. 

FTE Funding 

PSG VII ................................................... 109 $15,818,532 

C. With the requested funding level, what would be the expected average number 

of active cases per attorney during fiscal year 2015? 

Response. The average number of active cases per attorney will be maintained in 

the range between 45 and 50. 

D. How many motions for extension of time did Professional Group VII file during 

fiscal year 2013? 


312Bur63.eps
81 

Response. Professional Staff Group VII filed a total of 1,864 extension motions in 

fiscal year 2013. 

E. How many motions for extension of time has Professional Staff Group VII filed 

to date during fiscal year 2014? 

Response. During the period between October 1, 2013, and March 31, 2014, Professional Staff Group VII filed approximately 1,296 extension motions. 

Question 65. In response to questions about the fiscal year 2013 budget request, 

VA indicated that ‘‘implementation budget planning will occur in 2013’’ for the Regulation Rewrite Project. Then, on November 26, 2013, VA made this announcement: 

After many years of collaborative work between VA and Veterans Service 

Organizations (VSOs), the VA Compensation and Pension Regulation Rewrite Proposed Rule combines all previous iterations of the proposed rule 

and will be posted on the Federal Register (www.regulations.gov) starting 

November 27, 2013 for 120 days of public comment and review. However, 

VA does not intend to publish a final rulemaking anytime soon * * *. 

A. When was the determination made to indefinitely delay the final publication 

of these regulations? 

Response. The determination to delay the final publication of these regulations 

until after Department of Veterans Affairs (VA) has successfully eliminated the 

claims backlog was made in September 2011 in order to avoid conflicts with VA’s 

highest priority effort to eliminate the claims backlog in 2015. VA already had decided to honor the request of several Veterans Service Organizations (VSO) to provide the public with an additional opportunity to review and comment on the entire 

body of proposed regulations before the new 38 CFR Part 5 regulations were published as final. Consequently, in November 2013, the Rewrite Project published its 

21st proposed rule, which consolidated VA’s responses to the 20 previous proposed 

rules and solicited any additional comments from the public and VSOs. In 2014, VA 

will review the comments, draft a final rule containing VA’s responses, and draft 

and publish any additional proposed rules necessary to keep the Rewrite Project up 

to date until it can be implemented. 

B. Are any funds requested for fiscal year 2015 to advance this project? 

Response. The Secretary’s delegate for the written portion of the Regulation Rewrite Project in the Office of the General Counsel, the Office of Regulation Policy 

and Management, does not require additional funding. Funding necessary for implementing the Regulation Rewrite Project will be determined once the claims backlog 

has been eliminated. 

Question 66. In a 2013 report on VA’s program for accrediting individuals to represent claimants seeking veterans’ benefits, the Government Accountability Office 

reported that ‘‘VA has dedicated only a few staff to administer its accreditation program, which has resulted in limited monitoring efforts and workload backlogs.’’ 

A. Currently, how many full-time equivalent employees are dedicated to VA’s accreditation program? 

Response. Currently we have approximately four full-time equivalent employees 

(FTE) dedicated to the accreditation program: 

• 3 FTEs for 3 legal assistants 

• Approximately 0.1 FTE for an Assistant General Counsel 

• Approximately 0.4 FTE for a Deputy Assistant General Counsel 

• Approximately 0.5 FTE total for 10 staff attorneys 

B. How much funding is requested for the accreditation program for fiscal year 

2015 and what level of staffing would that funding support? 

Response. For fiscal year 2015, Office of General Counsel has allocated approximately $372,175.77 for the 4 FTEs dedicated to the accreditation program 

Office of Management 

Question 67. According to the fiscal year 2015 budget request, the Office of Management requests $41 million for Other Services for fiscal year 2015. Please provide 

an itemized list of how those funds would be used. 

Response. A major portion of the $41 million in ‘Other Services’ includes $37.4 

million in reimbursable authority that the Office of Management (OM) will collect 

to provide services across the Department, including: 

• $33 million for Department-wide Defense Finance and Accounting Services payroll support; 

• $4 million for reviewing and testing internal controls over financial reporting, 

as required by Appendix A of Office of Management and Budget Circular A–123; 

and 

82 

• $400,000 for operations support to the Department of Veterans Affairs (VA) 

Center for Innovation. 

The portion of the request for appropriated funding in ‘Other Services’ is $3.6 million and includes: 

• $1 million for service level agreements for the Financial Services Center, Security Investigations Center, and other service and maintenance agreements for conducting normal operations; 

• $1 million for audit readiness and verification of annual financial reporting; 

• $320,000 for training related to the VA Learning University and Human Capital Investment Plan; and 

The remaining balance of funds in ‘‘Other Services’’ is primarily for the Office of 

Personnel Management’s user fees related to USAJobs, USA Staffing, e-Classification and e-OPF (Official Personnel Folder) and for internal legacy automation services. 

Question 68. According to the fiscal year 2015 budget request, the Office of Finance within the Office of Management manages the Debt Management Center. 

A. For fiscal year 2015, what level of resources is expected to be used to operate 

the Debt Management Center and what level of staffing would those resources support? 

Response. The anticipated total expenses related to the Debt Management Center 

for fiscal year 2015 is $28,632,384 supporting a staff of 229 full-time equivalent employees. 

B. How many telephone lines does the Debt Management Center currently operate and how many would be operated during fiscal year 2015? 

Response. The Debt Management Center (DMC) currently operates 192 incoming 

toll-free telephone lines with our inbound 800 service. In fiscal year (FY) 2014, DMC 

increased from 144 toll-free lines to 192 toll-free lines, which is a 35-percent increase in phone line capacity. This increase provides more Veteran access to the 

DMC and further reduces blocked call situations. In FY 2015, we plan to continue 

to provide that service level unless Veteran demand increases. 

C. During fiscal year 2013, how many debts were referred to the Debt Management Center, what was the total value of those debts, and how much did the Debt 

Management Center recoup? 

Response. In fiscal year (FY) 2013, 769,443 Veterans Benefits Administration 

(VBA) debts were referred to the Debt Management Center (DMC) totaling 

$1,386,566,000. During FY 2013, the DMC recouped $1,202,023,000 in VBA debts. 

In FY 2013, 810,853 Veterans Health Administration (VHA) debts were referred 

to the DMC totaling $383,281,000. During FY 2013, the DMC recouped 

$220,267,000 in VHA debts. 

D. How many new debts are expected to be referred to the Debt Management 

Center during fiscal years 2014 and 2015? 

Response. The Debt Management Center (DMC) estimates 823,000 Veterans Benefits Administration (VBA) debts will be referred in fiscal year (FY) 2014 and 

880,900 VBA debts will be referred in FY 2015. 

The DMC estimates 379,597 Veterans Health Administration (VHA) debts will be 

referred in FY 2014 and 386,435 VHA debts will be referred in FY 2015. 

Office of Human Resources and Administration 

Question 69. In response to questions about the fiscal year 2014 budget request, 

VA indicated that initiatives undertaken through the Human Capital Investment 

Plan ‘‘are expected to have immediate, tangible, and measureable impact on the 

services provided to veterans.’’ 

A. Please describe any measurable outcomes that have resulted from these initiatives to date. 

Response. In support of the Secretary’s vision to transform VA and equip employees to work in alignment with that vision, VA launched the Human Capital Investment Plan (HCIP). HCIP programs include those that improve VA’s ability to hire 

and retain high-quality employees, empower employees to advance their careers, improve their performance and skills, and increase their personal and professional development. All VA employees impact the services provided to Veterans. Trained and 

high performing VA employees in support roles enable physicians, nurses, benefits 

administrators, or cemetery operators to focus directly on serving our Veterans. 

Quantifiable outcomes from HCIP funding to date include: 

• Provided over 2.3 million instances of leadership and managerial training 

through the VA Learning University to improve employee performance and skills; 

develop and enable VA employees to meet the rapidly changing healthcare and benVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00086 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
83 

efits environment; and to increase personal employee development and empower 

employees to advance their careers and provide more precise and efficient service. 

• Trained over 30,000 managers and supervisors on mandatory Equal Employment Opportunity (EEO), diversity and inclusion, and conflict management training. 

• Assisted over 126,900 Veterans in skills translation and resume writing 

through the VA4Vets Web site. 

• Hired over 2,290 Veterans at VA, with ired Veterans hired under noncompetitive appointments achieved in under 29 calendar days on average. 

• Provided employment assistance to 43,929 Veterans by: 

– Conducting over 119 employment preparation presentations. 

– Participating in over 94 Veteran Career Events, reaching more than 24,790 

Veterans. 

• Officially partnered with 12 Federal agencies through resource agreements to 

utilize VA’s services developed through HCIP funding to facilitate Veteran hiring 

across the Federal Government. 

• Provided human resource (HR) training opportunities to over 4,700 VA H.R. 

professionals, which improved support to those who directly serve our Veterans. 

• Delivered virtual H.R. professional training curriculum with 1,688 training instances to close competency gaps. 

• Provided career guidance through the MyCareer@VA portal to over 200,000 VA 

employees. 

• Responded to 2,458 calls from VA employees through the Resolution Support 

Center and resolved 1,598 of their complaints and issues at the earliest opportunity, 

enhancing job satisfaction and diverting them from more costly avenues of redress. 

• Sponsored 400 student interns from diverse and minority serving institutions 

and anticipates sponsoring an additional 155 interns in fiscal year (FY) 2014 to 

build a diverse qualified pipeline for VA employment. 

• Supported over 2,100 accommodations for employees with disabilities through 

VA’s Centralized Reasonable Accommodations Fund since its inception, and projects 

funding approximately $500,000 in accommodations in FY 2014. 

• Funded the hiring of nearly 100 students and employees with disabilities under 

term or permanent appointments through VA’s Centralized Workforce Recruitment 

Program, in support of Executive Orders supporting the employment of individuals 

with disabilities and disabled Veterans. As a result of this and other related initiatives, VA has one of the highest representations of individuals with targeted disabilities in all of Federal Government (over 2 percent). 

• Implemented diversity and inclusion programs that have resulted in the increase of VA’s Workforce Diversity Index for the last 4 years, and the decrease of 

per capita informal EEO complaints from 1.39 to 1.26 percent, and formal complaints from 0.73 percent to 0.61 percent since FY 2012. 

B. With the funding requested for fiscal year 2015, what measureable outcomes 

would be expected during that year? 

Response. In FY 2015, the measurable outcomes that would be expected through 

use of the total obligational authority provided from budget authority, HCIP and 

other reimbursables are: 

• Improved acquisition of diverse, high-performing, fully engaged VA employees 

delivering excellent service to Veterans. 

• Improved retention of diverse and high-performing employees. 

• Increased survey indicators of a fully engaged workforce. 

• Improved H.R. services by developing and certifying H.R. professionals to succeed in a dynamic environment. 

• Improved reintegration for VA’s deployable Reserve Component Servicemember 

employees. 

• An increase in the number, diversity, and gender representation of Veteran employees at VA. 

• Improved responses to customer satisfaction survey for direct Veteran services. 

• An increase in the accommodation and number of disabled Veteran employees. 

• Strengthened management of workers’ compensation claims to reduce costs by 

returning employees with work capacity back to work. 

• Improved employee perceptions of safety programs through Department-wide 

surveys and training programs. 

Question 70. According to the fiscal year 2015 budget request, the Office of 

Human Resources and Administration (HR&A) requests $198 million for Other 

Services for fiscal year 2015. Please provide an itemized list of how those funds 

would be used. To the extent any of these funds will be spent on contracts, please 

explain the nature of the contract and the expected outcomes. 

84 

Response. In addition to the ongoing initiatives provided throughHCIP, HRA requests funding in Other Services for Office of Resolution Management (ORM), Office 

of Administration, and Office of Human Resources Management (OHRM). The specific amounts for contracts aligned to these respective services are identified below. HCIP funding of $161 million includes initiatives such as: leadership and managerial training; the career portal, MyCareer@VA; the skills translator and resume 

builder, VA for VETS; the Human Resource Academy; the Senior Executive Service 

Collaborative Web site and Performance Management; the National Diversity Internship Program; the Reasonable Accommodation Program; and Conflict Management Training. Continued training investment in these areas is necessary to improve service to our Nation’s Veterans and their families through a more effective 

and engaged VA workforce. 

ORM contracts include: Alternative Dispute Resolution Mediations; conflict management training; development and maintenance of info tech equipment; and temporary services for a visually impaired employee. 

OHRM funding includes: the Child Care Subsidy Program (CCSP). CCSP is a nationwide program that assists lower income VA employees whose total family income is less than $59,999 per year with the cost of child care. Eligible employees 

receive a subsidy based on their total family income. Over 2,000 VA employees have 

applied to participate in the program and new applications are received daily. 

Additionally, funding is provided for the next generation human resource information system, HR•Smart. HR•Smart is a state-of-the-art human resource solution to 

VA’s personnel management and pay challenges. The new HR•Smart will replace 

VA’s 51-year-old-legacy system and will provide the following H.R. functions: 

1) Personnel action processing, to include an entry-on-duty solution; 2) Benefits 

management; and 3) Compensation management, to include an interface to the Defense Finance and Accounting Service (DFAS) for payroll services. The new system 

will also interface with other internal and external systems, such as VA’s electronic 

official personnel Folder (eOPF), VA’s Time and Attendance System, and the Office 

of Personnel Management’s USA Staffing System. 

A breakdown of current estimated FY 2015 contract costs of $198 million follows: 

Current Estimated FY 2015 Contract Costs 

Office Contract Description Cost (in Millions) 

HCIP Training and Transformation Initiatives $161 

ORM (EEO complaint processing) Contracts for Investigation of EEO complaints, 

Court Transcription Services 

$9 

Administration Contracts with Other Government Agencies for Mailroom 

Operations, Employee Health Unit/Employee Fitness Center, Transit 

Benefits, and Records Storage/Management, etc. 

$7 

OHRM Child Care Subsidies; HR•Smart $21 

Total $198 

Question 71. According to the fiscal year 2015 budget request, the Office of 

Human Resources and Administration plans to spend $11.2 million on travel during 

fiscal year 2014 and requests $10.8 million for travel during fiscal year 2015. 

A. In total, how many employees are expected to travel during fiscal year 2014, 

how many unique travel trips are expected to occur, and what is the expected average cost per expected trip? 

Response. Please see the response to question 71B. 

B. For fiscal year 2015, how many unique travel trips is the $10.8 million expected to support? 

Response. The travel budget identified in the HRA chapter of the budget request 

is primarily for travel provided for HCIP. The current 2014 estimates for travel 

have been reduced from what was submitted in the original budget request last 

year. 

HCIP allocates most of its travel funds for training programs conducted by the 

VA Learning University (VALU). VALU provides training on a corporate level in the 

areas of leadership development, competency improvement, and technical training. 

These training courses are provided to all VA employees, not just HRA employees. 

85 

VALU, through its HCIP funding, covers the cost not only of the training but all 

travel costs associated with attendance at the training. Travel associated with 

HCIP-funded, VALU-sponsored training is tracked separately in the travel management system from all other HRA travel and therefore is listed separately from other 

HRA travel in the tables below. 

Other travel not associated with HCIP, but included in the HRA budget is for 

ORM, which handles the processing of discrimination allegations and conflict resolution for both field and VA Central Office EEO-related cases. HRA travel funds also 

provide reimbursements to other VA offices for travel incurred for attendance at 

training sessions associated with new union contracts as well as travel associated 

with normal HRA business. 

HRA Travel Costs 

($ in millions) 

FY 2014 FY 2015 

VALU-sponsored travel ............................................................................................................................. $8 .5 $9 .4 

All other HRA travel not included in VALU totals ................................................................................... $1 .4 $1 .4 

Total ................................................................................................................................................ $9 .9 $10 .8 

Number of Trips FY 2014 FY 2015 

VALU-sponsored travel ............................................................................................................................. 5,363 5,900 

All other HR&A travel not included in VALU totals ................................................................................ 910 918 

Total ................................................................................................................................................ 6,273 6,818 

Average Cost of Trip 

(whole $) 

FY 2014 FY 2015 

VALU-sponsored travel ............................................................................................................................. $1,585 $1,593 

All other HRA travel not included in VALU totals ................................................................................... $1,540 $1,540 

Total ................................................................................................................................................ $1,578 $1,584 

Question 72. The Corporate Senior Executive Management Office (CSEMO), within the Office of Human Resources and Administration, was created to provide a 

‘‘centralized approach to the executive life cycle management.’’ Under its responsibilities, CSEMO has created two training programs—Senior Executive Leadership Development Course I (SLC I) and Senior Executive Leadership Development Course 

II (SLC II). According to the budget request, CSEMO is developing a third developmental training program referred to as SLC III. 

A. Please provide the Committee with a detailed description of the SLC III course, 

including curriculum, cost estimate (travel, facility rentals, course material, etc.) 

and when the course will be available to VA senior executives. 

Response. CSEMO is considering SLC III as a follow-on course for senior executives who have completed SLC I and II. VA is presently in the concept pre-design 

phase of future SLC courses and does not have such information. 

B. For each training program (SLC I, SLC II, and SLC III), please provide the 

amount VA expects to spend in fiscal year 2015. 

Response. VA projects holding 2–3 cohorts (sessions) of SLC I and II in 2015, 

based on the volume of new senior executive hires through the end of FY 2014 and 

into FY 2015. For SLC I and II, the estimated cost per cohort is based on the average cost of previous year cohorts with an added 5 percent, assuming the program 

content and cohort size remain about the same. 

Course # Cohorts Estimated cost 

SLC I ...................................................... 2 $179,096 

SLC II ..................................................... 3 $506,066 

Total .............................................. 5 $685,162 

VA will be able to provide SLC III cost estimates after the design is completed. 

86 

C. How much was spent on each training course (SLC I, SLC II, and SLC III) 

for fiscal year 2009 through fiscal year 2014? Please breakdown by fiscal year, by 

category of spending (travel, facility rentals, course material, etc.), and by training 

program. 

Response. 

• SLC I: There were two cohorts of SLC I, a training course for newly appointed 

senior executives, in late FY 2012 (SLC I was initiated in 2012). 

SLC I Dates Program Costs Travel Total 

Cohort 1 ............. July 22-27, 2012 ............................................................. $58,728 $32,938 $91,666 

Cohort 2 ............. Aug 25-31, 2012 ............................................................ $53,464 $25,436 $78,900 

* There were no SLC I cohorts held in FY 2013. 

• SLC II: This course on strategic thinking and leading change began in FY 2011. 

SLC II Cohorts Program Costs OPM Fee Travel Total 

FY 2011 .............. Cohorts 1 - 3 ....................................... $528,986 $23,804 $49,777 $602,567 

FY 2012 .............. Cohorts 4 - 16 ..................................... $2,535,946 $95,098 $273,391 $2,904,435 

FY 2013 .............. Cohorts 17 - 19 ................................... $428,367 $16,063 $39,441 $483,871 

Question 73. The Veteran Employment Services Office (VESO) was established by 

VA HR&A to comply with Executive Order 13518. Please provide a detailed budget 

for VESO, including the number of FTE, requested appropriations, and the amount 

projected to be spent on all VESO initiatives including VA for Vets. 

Response. VESO is funded through reimbursements received from HCIP. VESO 

has 49 full-time equivalent employees. The detailed budget estimates for VESO and 

the VA for Vets initiative for FYs 2014 and 2015 are included below: 

Initiative Name 2014 Cost 2015 Cost 

Subtotal Personnel Compensation ............................................................................................... 4,275,296 4,318,049 

Subtotal Regular Benefits ........................................................................................................... 1,206,096 1,218,157 

Total Pay ............................................................................................................................. 5,481,392 5,536,206 

VA for Vets Web Site and Helpdesk ............................................................................................ 8,437,625 8,690,754 

Total Initiative .................................................................................................................... 8,437,625 8,690,754 

Travel ........................................................................................................................................... 301,000 306,117 

Transportation of Things ............................................................................................................. 3,000 3,051 

Printing & Reproduction .............................................................................................................. 75,000 76,275 

Training ........................................................................................................................................ 70,000 71,190 

Other Services .............................................................................................................................. 411,298 418,290 

Supplies & Materials ................................................................................................................... 28,000 12,250 

Total Non-Pay (Including Initiative) ................................................................................... 9,325,923 9,577,927 

Total Cost .................................................................................................................. $14,807,315 $15,114,133 

Office of Policy and Planning 

Question 74. The fiscal year 2015 budget request includes $27 million to be spent 

on Other Services by the Office of Policy and Planning. Please provide a specific 

itemized list of how these funds would be spent. To the extent any of these funds 

will be spent on contracts, please explain the nature of the contract and the expected outcomes. 

Response. Of the $27 million to be spent on other services by OPP, $19.3 million 

is from reimbursement from customer offices for servies provided, supplementing 

$7.8 million from budget authority. Descriptions of work and expected outcomes are 

as follows: 

87 

Estimated $ 

Amount for 

Contract 

Description of Work Performed Expected Outcomes 

$1,800,000 Support the enterprise Program Management Office (ePMO) 

in the expansion and operation of the Program Management Center of Excellence (PMCOE) to further develop and 

promulgate program management standards, doctrine, 

and policy. The PMCOE addresses all disciplines of program management including general program management, requirements, cost estimation, acquisition strategy, 

systems engineering, enterprise architecture, test and 

evaluation, and construction management. Further, the 

PMCOE supports the institutionalization of the Department’s acquisition program management framework and 

supports the development of a subordinate end-to-end requirements gathering, prioritization, and approval process. 

Establish an integrated requirements development framework, enabled by a 

world-class program management capability, which aligns project plans and 

outcomes to Department goals and objectives to improve services to Veterans. 

$1,100,000 Provide support to ePMO’s oversight of the planning and 

execution of key programs within VA’s benefits, health, 

and corporate portfolios to ensure effective oversight, integration, and sustainment of new capabilities into the 

routine operations of the Department. 

Enable performance monitoring and support resolution of risks within VA’s 

highest priority programs to increase 

opportunities for program success to 

improve services that benefit Veterans. 

$500,000 Assist ePMO in executing the Secretary’s Carey Performance 

Excellence Program by training personnel to understand 

the Baldrige criteria to develop application packages, 

provide support to examiners during consensus week, provide technical editing support, and provide feedback reports to applicants for continuous improvement purposes. 

Quality feedback reports for applicants 

used to continuously improve management systems and service to Veterans. 

$600,000 Provide the Office of Interagency Collaboration and Integration project management support, technical support, performance measurement, and process improvements/business process reengineering support for the implementation and oversight of the IDES. 

Ensure IDES meets program goals and 

continues to improve the delivery of 

seamless, cost-effective quality services to transitioning Veterans. 

$1,500,000 Support the Office of Corporate Analysis and Evaluation 

(CAE) in maturing the multi-year planning, programming, 

budgeting, and execution (PPBE) framework established 

to optimally align VA services with 21st century Veterans’ 

needs. The work will aid VA’s multi-year programming 

process and conduct independent analysis/review, corporate studies and analysis, and other PPBE activities 

across VA. 

Establish programming excellence and 

data-driven analytical capabilities that 

inform effective strategic resource allocation and stewardship of VA resources 

to effectively serve Veterans. 

$500,000 Automation of CAE’s requirements development system, 

which currently uses spreadsheets and other ′′flat files′′ 

to perform the complex tasks of annual programming including: 

• Automated input functions for capability requirements 

proposals and special interest analysis; 

• Ability to save all input data in a relational database 

(RDB); and 

• Easy data-downloads from RDB to standard Microsoft 

tools. 

Streamline and automate programming 

capability to allow more efficient and 

effective analytical capabilities that inform effective strategic resource allocation and stewardship of VA resources. 

88 

Estimated $ 

Amount for 

Contract 

Description of Work Performed Expected Outcomes 

$950,000 Assist the Office of Policy in: 

• Supporting internal business process and VA’s governance 

process; 

• Executing strategic studies environmental scanning and 

analysis processes to identify long-range issues and drive 

innovation and transformation; 

• Executing VA’s quadrennial strategic planning process focused on strategic outcomes that influence policies, programs and resources; and 

• Executing VA’s policy analysis process that is proactive, 

externally engaged, and internally aligned. 

Enable better strategic decision making 

among VA senior leaders regarding 

services to Veterans and management 

of the Department. 

$16,091,000 Support VA in developing Customer Data Integration (CDI), 

establishing enterprise accountability and the integration 

of processes and systems to support an integrated, Veteran-centric authoritative view of VA’s customers and 

their needs. 

Provision of the most appropriate, effective and efficient service possible while 

reducing burden on Veterans and improving delivery of VA services and 

benefits. 

$380,000 Assist the Office of Data Governance and Analysis (DGA) in 

the expansion and support of the U.S. Veteran Eligibility 

Trends and Statistics (USVETS) multidimensional database and analysis system; provide statistical application 

system (SAS) programming support for the National Center for Veterans Analysis and Statistics. 

Provide an integrated view of Veteran 

users and non-users of VA benefits or 

services, as well as statistical analysis 

and reports on Veterans to support VA 

planning, policy development, and decision making. 

$370,000 Provide DGA with global information systems (GIS) analysis 

to: 

• Provide technical and professional GIS services to supplement staff’s efforts by compiling, creating, and modifying 

GIS layers and related tools; 

• Enhance DGA’s integrated Web-based mapping capability 

with analysis system datasets and fully integrate the 

geospatial analysis dashboard (GAD) and geospatial 

analysis tools (GAT) into the analysis system and intranet 

portal; and 

• Develop interactive web applications and display interactive maps presenting data on Veteran population and 

VA programs. 

Enhance GIS platform and integration of 

SAS and GIS technologies which improve Veteran data dissemination and 

data analysis by deploying new mapping capabilities in the ArcGIS intranet 

and internet portal. 

$859,000 Support the Office of the Actuary by using cutting edge 

analytic tools to develop predictive models that predict 

future demand, utilization, and cost for various VA benefit programs and health care services. 

Provide models to predict Veterans’ demands and use of VA products and 

services, and identify key metrics to 

support VA policy analysis and strategic planning process, enabling VA to 

identify and strategically target its resources to better serve Veterans. 

$750,000 Develop training, guidance, and other materials for DGA to: 

• Support enterprise-wide implementation of advanced data 

governance concepts and practices; 

• Further develop the concepts in VA’s data governance 

training program; and 

• Provide program support to the data governance activities 

and CDI efforts. 

Improve the Department’s data governance maturity, improving management 

and governance of data for quality improvement. 

$1,300,000 Acquire Veteran demographics and socio-economic data 

from commercial data sources for DGA to supplement existing VA data sources. 

The integrated data will enable a more 

complete view of Veteran users and 

non-users of VA benefits or services for 

enhanced statistical analyses, outreach, and modeling. 

89 

Estimated $ 

Amount for 

Contract 

Description of Work Performed Expected Outcomes 

$200,000 Provide DGA with a special supplement to the current population survey on Veterans on such topics as demographics, VA status, VA health, education, etc. This is a 

critical survey to capture Veteran employment statistics. 

Better understanding of Veteran employment challenges to alleviate Veteran 

unemployment. 

$215,000 Policy analysis conducted on new legislation and emerging 

needs of Veterans. 

Robust analysis to inform the Department 

on future Veteran requirements. 

$130,000 Supports Departmental franchise activities, such as security 

clearances and payroll processing. 

N/A 

Question 75. For fiscal year 2015, the budget request includes over $25 million 

for the Office of Policy and Planning and would support 116 employees. For each 

office within the Office of Policy and Planning, please identify the positions and paygrades for employees that would be assigned to that office during fiscal year 2014 

and fiscal year 2015 and the number of contractors that are expected to be assigned 

to each such office. 

Response. 

2014 

Title Series Grade 

Office of the Assistant Secretary

Assistant Secretary ...................................................................................................... 301 ES

Executive Assistant to the Assistant Secretary .......................................................... 301 GS 15 

Scheduler/Program Support to Assistant Secretary .................................................... 301 GS 11 

Principal Deputy Assistant Secretary .......................................................................... 301 SES 

Scheduler/Program Support to Principal Deputy Assistant Secretary ........................ 301 GS 11 

Senior Policy Advisor ................................................................................................... 343 GS 15 

Operations 

Director of Operations ................................................................................................. 343 GS 15 

Human Capital Manager ............................................................................................. 301 GS 14 

Administrative Officer .................................................................................................. 301 GS 13 

Communications Specialist ......................................................................................... 343 GS 9 

Budget Officer ............................................................................................................. 343 GS 13 

Office of Interagency Collaboration and Integration

Executive Director ........................................................................................................ 301 SES 

Scheduler/Program Support ......................................................................................... 301 GS 11 

Integrated Disability Evaluation System Service (IDES) 

Director IDES ................................................................................................................ 301 GS 15 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 11 

Joint Executive Council/Senior Oversight Committee Service (JEC/SOC) 

Director JEC/SOC .......................................................................................................... 301 GS 15 

Special Assistant ......................................................................................................... 301 GS 15 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 9/11 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 11 

Management Analyst ................................................................................................... 343 GS 9 

Corporate Analysis and Evaluation Service

Executive Director ........................................................................................................ 343 SES 

Programming Service 

Director ........................................................................................................................ 343 GS 15 

Budget Analyst ............................................................................................................ 560 GS 14 

Operations Research Analyst ....................................................................................... 1515 GS 14 

Budget Analyst ............................................................................................................ 560 GS 14 

Operations Research Analyst ....................................................................................... 1515 GS 14 

90 

2014—Continued 

Title Series Grade 

Management Analyst ................................................................................................... 343 GS 14 

Program Analyst .......................................................................................................... 343 GS 13/14 

Program Analyst .......................................................................................................... 343 GS 13/14 

Analysis & Evaluation Service 

Director ........................................................................................................................ 343 GS 15 

Operations Research Analyst ....................................................................................... 1515 GS 14 

Operations Research Analyst ....................................................................................... 1515 GS 14 

Operations Research Analyst ....................................................................................... 1515 GS 14 

Management Analyst ................................................................................................... 343 GS 13 

Operations Research Analyst ....................................................................................... 1515 GS14 

Operations Research Analyst ....................................................................................... 1515 GS 14 

Office of Policy

Deputy Assistant Secretary .......................................................................................... 343 SES 

Program Support .......................................................................................................... 301 GS 9 

Policy Analysis Service 

Director ........................................................................................................................ 343 GS 15 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 11 

Management Analyst ................................................................................................... 343 GS 13 

Management Analyst ................................................................................................... 343 GS 9/11 

Management Analyst ................................................................................................... 399 GS 13 

Management Analyst ................................................................................................... 301 GS 9 

Strategic Studies Group 

Director ........................................................................................................................ 343 GS 15 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 12 

Management Analyst ................................................................................................... 343 GS 11 

Strategic Planning Service 

Director ........................................................................................................................ 343 GS 15 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 13 

Management Analyst ................................................................................................... 343 GS 11 

Management Analyst ................................................................................................... 343 GS 11 

Office of Data Governance and Analysis

Deputy Assistant Secretary .......................................................................................... 343 SES 

National Center for Veterans Analysis and Statistics 

Executive Director ........................................................................................................ 301 SES 

Program Support .......................................................................................................... 301 GS 11 

Analysis and Statistics Service 

Director ........................................................................................................................ 1530 GS 15 

Statistician .................................................................................................................. 1530 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Statistician .................................................................................................................. 343 GS 13 

Management Analyst ................................................................................................... 343 GS 14 

Statistician .................................................................................................................. 1530 GS 14 

Statistician .................................................................................................................. 1530 GS 14 

Management Analyst ................................................................................................... 343 GS 13 

Statistician .................................................................................................................. 343 GS 13 

Reports and Information Service 

Director ........................................................................................................................ 343 GS 15 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 12 

Management Analyst ................................................................................................... 343 GS 9 

Management Analyst ................................................................................................... 343 GS 14 

91 

2014—Continued 

Title Series Grade 

Management Analyst ................................................................................................... 343 GS 12 

Management Analyst ................................................................................................... 343 GS 12 

Office of the Actuary 

Chief Actuary ............................................................................................................... 1510 SL 

Deputy Chief Actuary ................................................................................................... 1510 GS 15 

Actuary ......................................................................................................................... 1510 GS 14 

Economist .................................................................................................................... 110 GS 14 

Actuary ......................................................................................................................... 1510 GS 14 

Actuary ......................................................................................................................... 1510 GS 14 

Actuary ......................................................................................................................... 1510 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Enterprise Program Management Office

Executive Director ........................................................................................................ 301 SES 

Management Analyst ................................................................................................... 343 GS 11 

Deputy Director ............................................................................................................ 301 GS 15 

Executive Program Manager ........................................................................................ 301 SES 

Program Management Policy Service 

Director ........................................................................................................................ 343 GS 15 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 13 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Operational Management Review 

Director ........................................................................................................................ 343 GS 15 

Management Analyst ................................................................................................... 343 GS 11 

Management Analyst ................................................................................................... 343 GS 13 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 9 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Resource Management Service 

Director ........................................................................................................................ 343 GS 15 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 14 

Management Analyst ................................................................................................... 343 GS 13 

Additionally, OPP has contracts in place with third parties that involve their employees working in VA facilities. However, VA does not control those companies’ 

independent business decisions regarding staffing requirements. Thus, VA is unable 

to give a number of contractor employees assigned to OPP. 

Office of Operations, Security, and Preparedness 

Question 76. For fiscal year 2015, the Office of Operations, Security, and Preparedness requests total resources of $31.3 million and 133 employees. Please provide a list of the positions that would be filled with that funding and the pay-grades 

for those positions. 

Response. The Office of Operations, Security, and Preparedness (OSP) request 

consists of $17.9 million in budget authority and $13.4 million in reimbursable authority for a total of $31.3 million in FY 2015 budget. The personnel services portion 

of that request is $17.6 million to support 133 full-time employee equivalents. 

Grade Title Organization Position 

OSP Front Office 

Honorable Assistant Secretary (A/S) OSP Assistant Secretary 

92 

Grade Title Organization Position 

GS-12 Special Assistant to A/S OSP Staff Assistant 

Office of Resource Management (ORM) 

GS-15 Director, Resource Mngt. Resource Management Director, ORM 

GS-13 Staff Assistant to Director Resource Management Staff Assistant 

GS-12 Program Analyst Resource Management Program Analyst 

GS-14 Budget Analyst Resource Management Budget Officer 

GS-14 Administrative Officer Resource Management Admin Officer 

GS-12 Staff Assistant Resource Management Admin Officer 

GS-14 Resource Manager Resource Management Management Analyst 

Office of Emergency Management (OEM) 

SES Deputy Assistant Secretary OEM Emergency Management DAS OEM 

GS-14 Senior Staff Assistant Emergency Management Support 

GS-11 Staff Assistant Emergency Management Support 

GS-12/13 Management Analyst (Public Health) VACANT Support 

Planning, Exercise, Training, and Evaluation Service (PETE) 

GS-15 Dir—Emergency Management Spec. OEM/PETE Director PETE 

Planning 

GS-14 Lead Emergency Mgt. Spec. OEM/PETE Planning 

GS-11/12/13 Emergency Management Spec. (Planner/Liaison Officer (LNO)) OEM/PETE Planning 

GS-13 Program Analyst—Geographic Information 

System (GIS) 

OEM/PETE Planning 

Intern OEM/PETE 

Planning 

GS-11/12/13 Emergency Management Spec.(DHS LNO) OEM/PETE Planning 

GS-9/11/12 Program Analyst—GIS OEM/PETE Planning 

GS-11/12/13 Management Analyst (Planner/LNO) OEM/PETE Planning 

Exercise, Training, and Evaluation 

GS-14 Team Lead/Exercises OEM/PETE Planning 

GS-11/12/13 Emergency Management Spec. (Exercise) OEM/PETE Planning 

GS-12/13 Emergency Management Spec. (Continuity) OEM/PETE Planning 

GS-12/13 Emergency Management Spec. (Training) OEM/PETE Planning 

GS-12/13 Emergency Management Spec. (Evaluator) OEM/PETE Planning 

VA Integrated Operations Center (IOC) 

GS-15 Director/(Supv.) VA IOC (FY 12) OEM IOC 

GS-14 (Supv.) Readiness Operation Spec OEM IOC 

GS-13 Readiness Operation Spec. (Team Lead) OEM IOC 

GS-9/11/12 Readiness Operation Spec. OEM IOC 

GS-9/11/12 Readiness Operation Spec. OEM IOC 

GS-9/11/12 Readiness Operation Spec. OEM IOC 

GS-9/11/12 Readiness Operation Spec. OEM IOC 

GS-9/11/12 Readiness Operation Spec. OEM IOC 

GS-9/11/12 Readiness Operation Spec. OEM IOC 

GS-9/11/12 Readiness Operation Spec. OEM IOC 

GS-9/11/12 Readiness Operation Spec. OEM IOC 

GS-12/13 Program Analyst OEM IOC 

GS-12/13 Program Analyst OEM IOC 

GS-12/13 Program Analyst OEM IOC 

GS-12/13 Readiness Operations Specialist (National 

Operations Center Liaison) 

OEM IOC 

93 

Grade Title Organization Position 

Operations & National Security 

GS-15 Director (Readiness Op. Spec.) OEM COOP/COG 

GS-14 Emergency Management Spec. OEM National Security 

Operations 

GS-14 Readiness Operation Spec. (Site B Director) OEM COOP/COG 

GS-13 Readiness Operation Spec. (Deputy Director 

for Site B) 

OEM COOP/COG 

GS-11 Readiness Operation Spec. OEM COOP/COG 

GS-9/11/12 Readiness Operations Spec. OEM COOP/COG 

GS-9/11/12 Readiness Operations Spec. OEM COOP/COG 

GS-12 Readiness Operation Spec. (Director Site C) OEM COOP/COG 

National Security Service 

GS-14 Special Security Officer OEM National Security 

GS-13 Special Security Representative OEM National Security 

GS-13 Special Security Representative OEM National Security 

GS-13 Special Security Representative (ROS) OEM COOP/COG 

Personnel Security & Identity Management (PSIM) 

SES Director, Personnel Security and Identity 

Management 

PSIM PSIM 

GS-12 Staff Assistant to Director PSIM PSIM 

GS-15 Director, HSPD-12 PSIM HSPD-12 

GS-14 Deputy Director, Homeland Security 

Presidental Directive (HSPD)-12 

PSIM HSPD-12 

GS-13 Physical Security Specialist PSIM HSPD-12 

GS-13 Program Analyst PSIM HSPD-12 

GS-11 Director, Personnel Identification Verification 

(PIV) Office 

PSIM HSPD-12 

GS-343-11 Program Analyst PSIM HSPD-12 

GS-7 Program Specialist PSIM PIV Office 

GS-7 Program Specialist PSIM PIV Office 

GS-7 Program Specialist PSIM PIV Office 

GS-7 Program Specialist PSIM PIV Office 

GS-7 Program Specialist PSIM PIV Office 

GS-7 Program Specialist PSIM PIV Office 

GS-15 Director, Personnel Security and Suitability 

(PSS) 

PSIM PSS 

GS-14 Acting Director/Deputy Director, PSS PSIM PSS 

GS-12/13 Security Specialist PSIM PSS 

GS-12/13 Security Specialist PSIM PSS 

GS-12 Security Specialist PSIM PSS 

GS-12 Security Specialist PSIM PSS 

GS-11 Security Specialist PSIM PSS 

Identity, Credentials, and Access Management (ICAM) 

GS-15 Director, ICAM ICAM ICAM 

GS-11 Staff Assistant ICAM ICAM 

GS-14 Administrative Officer ICAM ICAM 

GS-12 Staff Assistant ICAM ICAM 

GS-14 Program Analyst ICAM ICAM 

Identity Management (Identity Mgt.) 

GS-14 Director—Identity Management Identity Mgt. Identity Mgt. 

GS-11 Staff Assistant Identity Mgt. Identity Mgt. 

GS-14 Program Analyst Identity Mgt. Identity Mgt. 

GS-14 Program Analyst Identity Mgt. Identity Mgt. 

GS-11/12/13 Program Analyst Identity Mgt. Identity Mgt. 

94 

Grade Title Organization Position 

GS-11/12/13 Program Analyst Identity Mgt. Identity Mgt. 

GS-7/9/11 Program Support Identity Mgt. Identity Mgt. 

GS-7/9/11 Program Support Identity Mgt. Identity Mgt. 

Access Management 

GS-14 Director—Access Management Access Mgt. Access Mgt. 

GS-11 Staff Assistant Access Mgt. Access Mgt. 

GS-14 Program Analyst Access Mgt. Access Mgt. 

GS-14 Program Analyst Access Mgt. Access Mgt. 

GS-11/12/13 Program Analyst Access Mgt. Access Mgt. 

GS-11/12/13 Program Analyst Access Mgt. Access Mgt. 

GS-7/9/11 Program Support Access Mgt. Access Mgt. 

GS-7/9/11 Program Support Access Mgt. Access Mgt. 

On-Board/Monitor/Off Board 

GS-14 Director-On-Board/Off-Board On-Board/Off-Board On-Board/Off-Board 

GS-11 Staff Assistant On-Board/Off-Board On-Board/Off-Board 

GS-14 Program Analyst On-Board/Off-Board On-Board/Off-Board 

GS-11/12/13 Program Analyst On-Board/Off-Board On-Board/Off-Board 

GS-7/9/11 Program Support On-Board/Off-Board On-Board/Off-Board 

Office of Security & Law Enforcement (OSLE) 

SES Director for OSLE OSLE OSLE Lead 

GS-13 Program Analyst OSLE Operations 

GS-13 Administrative Officer OSLE Operations 

GS-11 Staff Assistant OSLE Operations 

GS-15 Director, Police Service OSLE Police Lead 

GS-07 Program Support Assistant OSLE Operations 

LEO/Investigations 

GS-14 Chief Oversight & Investigations Lead 

GS-13 Criminal Investigator Oversight & Investigations Crim Inv. 

GS-13 Criminal Investigator (Watch officer) Oversight & Investigations Crim Inv. 

GS-13 Criminal Investigator Oversight & Investigations Crim Inv. 

GS-13 Criminal Investigator Oversight & Investigations Crim Inv. 

GS-12/13 Criminal Investigator Oversight & Investigations Crim Inv. 

Intelligence & Crime Analysis 

GS-14 Chief Intell & Crime Analysis Lead 

GS-12/13 Criminal Investigator (Watch officer) Intell & Crime Analysis Crim Inv. 

GS-13 Criminal Investigator (Watch officer) Intell & Crime Analysis Crim Inv. 

GS-13 Criminal Investigator (Watch officer) Intell & Crime Analysis Crim Inv. 

GS-12/13 Criminal Investigator Intell & Crime Analysis Crim Inv. 

Executive Protection (EX Pro) 

GS-14 Chief Executive Protection Lead 

GS-13 Criminal Investigator Executive Protection EX Pro 

GS-13 Criminal Investigator Executive Protection EX Pro 

GS-13 Criminal Investigator Executive Protection EX Pro 

GS-11 Criminal Investigator Executive Protection EX Pro 

GS-13 Criminal Investigator Executive Protection EX Pro 

GS-13 Criminal Investigator Executive Protection EX Pro 

GS-12 Criminal Investigator Executive Protection Security 

GS-12 Criminal Investigator Executive Protection Security 

GS-12 Security Specialist Executive Protection EX Pro 

GS-12 Security Specialist Executive Protection EX Pro 

WL-9 Motor Vehicle Operator Executive Protection EX Pro 

95 

Grade Title Organization Position 

Infrastructure Security & Policy 

GS-14 Chief Policy & Infrastructure Protection Lead 

GS-13 Security Specialist Policy & Infrastructure Protection Security 

GS-12 Security Specialist Policy & Infrastructure Protection Security 

GS-12/13 Criminal Investigator Policy & Infrastructure Protection EX Pro 

Question 77. For fiscal year 2015, the Office of Operations, Security, and Preparedness requests $10.3 million for Other Services. Please provide a specific 

itemized list of how these funds would be spent. To the extent any of these funds 

will be spent on contracts, please explain the nature of the contract and the expected outcomes. 

Response. OSP uses contract support in the following areas: Department of Homeland Security/Federal Protective Service Contract Guards for General Service Administration leased spaces in the Capital Region ($3.0 million); and Program support for the HSPD–12 program management office ($3.0 million). The new ICAM/ 

On-Boarding and Off-Boarding Program uses contract Program Management support ($3.0 million). OSP also pays for support for Continuity of Operations sites and 

Continuity of Government sites, which are located outside of the National Capital 

Region ($750,000). OSP also has internal VA Service Level Agreements totaling 

$525,000 and some small maintenance contracts. 

Office of Public and Intergovernmental Affairs 

Question 78. For fiscal year 2015, the Office of Public and Intergovernmental Affairs requests total resources of $22.8 million and 90 employees. Please provide a 

list of the positions that would be filled with that funding and the pay-grades for 

those positions. 

Response. 

GRADE # POSITIONS 

SES/EX 6 Assistant Secretary, Office of Public and Intergovernmental Affairs; Executive Director; Director 

Intergovernmental Affairs; Director Public Affairs; Deputy Assistant Secretary Intergovernmental Affairs 

15 16 Executive Assistant; Special Assistant; Program Management; Public Affairs Specialist; Program Specialist; Deputy Director Homeless Veterans Initiative Office; Director of Media Relations; Speechwriter 

14 27 Public Affairs Specialist; Program Specialist; Staff Assistant; Program Analyst; Management 

Analyst 

13 15 Budget Analyst; Program Specialist; Public Affairs Specialist; Program Specialist 

12 5 Staff Assistant; Special Assistant; Program Analyst; Program Specialist 

11 12 Public Affairs Specialist; Staff Assistant 

10 2 Program Support Assistant 

9 5 Program Specialist; Program Support Assistant; Public Affairs Specialist; Student Trainee 

8 0 

7 2 Program Support Assistant 

Question 79. In response to questions about the fiscal year 2014 budget request, 

VA indicated that the Office of Public and Intergovernmental Affairs employs at 

least four speechwriters, paid at the GS–15 level. 

A. In total, how much funding is requested for fiscal year 2015 for speechwriters 

for this office? 

Response. For fiscal year (FY) 2015, the Office of Public and Intergovernmental 

Affairs (OPIA) requests $555,370 for three speechwriters. 

96 

B. On average, how many speeches do these individuals write per year and for 

which VA officials are they drafting speeches? 

Response. Currently, there are three OPIA speechwriters, though there are four 

billets—the fourth position was added in 2008 in anticipation of expected retirements, to ensure continuity in senior leaders’ communications; there are currently 

no plans to fill the fourth position. The three speechwriters directly support the Secretary, Deputy Secretary, and Chief of Staff of the Department of Veterans Affairs. 

As required, they may also provide expertise, editing, fact checking, and review of 

products written for Undersecretaries, Assistant Secretaries, and other VA executives. 

Duties of the three speechwriters in support of the three principals extend well 

beyond writing speeches and include composing, refining, and revising Congressional testimony; composing select correspondence; conducting current and historical 

research for a variety of written products, drafting articles on behalf of senior leaders for various publications; writing Department messages on behalf of senior leaders; composing scripts for senior leaders’ videotaped remarks; editing products pertinent to the Office of the Secretary composed by other offices; reviewing and providing input for White House and other government agencies’ documents involving 

Veterans; and occasional travel to support the Secretary at major speaking events. 

Each of the three speechwriters works on estimated 225–250 products annually. 

Question 80. Responses to questions about the fiscal year 2014 budget request indicate that public affairs personnel from the Office of Public and Intergovernmental 

Affairs are located in New York, Atlanta, Chicago, Denver, Los Angeles, and Dallas. 

A. Please identify the locations of the offices for public affairs personnel located 

outside of Washington, DC. For example, are they co-located with VA medical centers or regional offices? 

Response. 

New York—Located with the New York Veterans Benefits Administration 

(VBA) Regional Office 

Washington, DC—Located in VBA Business Office 

Atlanta—Located in Atlanta VBA building 

Chicago—Located in Chicago VBA Regional Office 

Denver—Located in Denver VBA Regional Office 

Los Angeles—Located on Greater Los Angeles Medical Center campus 

Dallas—Located with Veterans Integrated Service Network (VISN) 17 offices 

B. Please provide a description of the responsibilities and performance metrics for 

personnel located at these public affairs regional offices. 

Response. 

Responsibilities: 

• Manage Office of Public Affairs (OPA) regional office in accordance with Department policy. Efficiently organize staff workload, establish deadlines, and ensure 

achievement of quality standards. Recommend appropriate training and career-development activities, submit nominations for performance awards. 

• Maintain appropriate liaison with Administrations, VISNs, and facility staffs. 

Monitor professional development of public affairs officers at the regional and facility levels, assist by informal coaching and formal training. 

• Respond to queries from the news media in a timely manner. Make referrals 

in accordance with OPA and department policy. 

• Initiate contacts with the news media and generates news media interest in VA 

programs, officials and events. 

• Advise facilities, regional leadership and senior departmental leadership on the 

media relations aspect of issues. Stay informed of topics of Department-wide interest in addition to local and regional issues. 

• Develop timely, accurate event memos, briefing papers, read-ahead files and 

other information to prepare senior Department leaders during visits to the region. 

• Accompany senior Department leaders during visits to the region or help in arranging appropriate assistance from other personnel. Maintain the flexibility to assist senior leaders with little or no advance warning. 

• Assist in the preparation of news releases, fact sheets, media advisories, and 

letters to the editor, op-eds, and media pitches, in accordance with the highest professional standards. 

• Inform in a timely manner facility and regional directors and public affairs officers of Departmental policy affecting various issues. 

• Maintain regular contact with all facilities and appropriate regional offices 

within the region, assist regional and facility public affairs offices on the preparaVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00100 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
97 

tion of public affairs products, promote and participate in regional public affairs 

councils. 

• Alert the Director of Media Relations, the Deputy Assistant Secretary for Public 

Affairs and the Assistant Secretary for Public and Intergovernmental Affairs, the 

press secretaries, other staff members and the chain-of-command of situations involving the news media that may require their attention. 

• Monitor activities of the news media and advise the press secretaries and Office 

of Media Relations director on appropriate VA response. 

• Make recommendations on media relations plans, crisis communications strategies and promotional campaigns based upon the highest professional standards and 

a practical understanding of issues and the workings of the media. 

Performance Metrics: 

Number of personnel trained; media queries fielded; feedback from senior leaders 

on trip support; results of media pitches; assessment of relationships with senior 

leaders and associated public affairs officers in their region. 

C. For fiscal year 2015, what level of funding is requested to maintain public affairs personnel in locations outside of Washington, DC? 

Response. OPA would need the same infrastructure funding as that of FY 2014, 

for 22 full-time employees, associated travel and automation needs. 

Question 81. For fiscal year 2015, the Office of Public and Intergovernmental Affairs requests $9.5 million for purposes of an adaptive sporting program for veterans 

with disabilities. Please provide a breakdown of how those funds are expected to be 

expended. 

Response. For FY 2015, OPIA requests $9.5 million for purposes of the adaptive 

sports grant program and the monthly assistance allowance for disabled Veterans 

training in Paralympic sports (Paralympic allowance). During FY 2015, the adaptive 

sports grant program is expected to expend $7.5 million through the adaptive sports 

grant. With the passage of P.L.113–59 in December 2013, VA is transitioning to a 

competitive grant program as opposed to awarding grants only to the United States 

Olympic Committee as authorized under previous legislation. Since the transition 

is still in progress, specific details of FY 2015 fund expenditures cannot be projected 

at this time. However, VA fully expects eligible entities to apply for grants up to 

$7.5 million to provide adaptive sporting opportunities for disabled Veterans and 

disabled members of the Armed Forces. As for the Paralympic allowance, $2.0 million is projected to be expended in Paralympic allowance payments and authorized 

expenses. 

Question 82. In response to questions about the fiscal year 2014 budget request, 

the Office of Public and Intergovernmental Affairs indicated that it planned to 

spend $300,000 in fiscal year 2013 to ‘‘establish an agency-wide VA History Office’’ 

and ‘‘develop history outreach programs.’’ 

A. In total, how much has been expended on these initiatives and how much is 

requested for these purposes for fiscal year 2015? 

Response. The expended (contract) amount is $209,073 for FY 2014. Currently, 

there are no FY 2015 funds programmed for a continuation of this effort. 

B. What measurable outcomes does VA expect to achieve as a result of these initiatives? 

Response. The ongoing and short-duration FY 2014 effort is intended to assess the 

Department’s current history and archival programs, and offer recommendations on 

what can be done to improve and enhance those existing programs. 

Question 83. In the fiscal year 2015 budget request, the Office of Public and Intergovernmental Affairs seeks $495,000 for Other Services. Please provide a breakdown of how those funds would be expended. To the extent any of these funds will 

be spent on contracts, please explain the nature of the contract and the expected 

outcomes. 

Response. 

Object Class 24 Amount (Est) Description 

Printing Services .... $100,000 Printing of the Veterans’ benefits handbook; Translation services. 

Total .............. $100,000 

98 

Contracts/Name Amount (Est.) Description 

Barbaricum LLC ..... $234,400 To establish, maintain, and distribute a customized executive daily news summary. 

Gov-Delivery ........... $25,000 Gov. delivery provides an enterprise (Department-wide) customized email service 

for users who subscribe/opt in to updates from VA. 

Misc. Contracts ...... $135,600 Rent, Transit Subsidy, UPS Service, Service Level Agreements, Copier 

Maintenances. 

Total .............. $395,000 

Question 84. According to the fiscal year 2015 budget request, the Office of Public 

and Intergovernmental Affairs requests $344,000 for travel for fiscal year 2015. How 

many trips is that level of funding expected to support and what is the average expected cost per trip? 

Response. OPIA’s request of $344,000 for travel in FY 2015 is expected to support 

an estimated 189 trips with an average estimated cost of $1,811. These trips support the OPIA mission including tribal affairs, State Veterans Affairs offices, the 

Adaptive Sports Program and employee training. 

Question 85. Please provide the Committee data on how much VA spent on outreach activities in fiscal year 2014 and is projected to be spent during fiscal year 

2015. The information should include, but is not limited to: 1) the amount in aggregate VA spent enterprise-wide on advertising outreach, 2) a breakdown by administration of the amount spent on outreach, and 3) the categories of spending VA believes encompass all forms of outreach undertaken and the funding breakdowns. 

Response. 

FY 2014 Advertising and Outreach Spending 

Television Ads Radio Ads Print Ads Social/ Digital 

Media Outreach Total 

VHA ........................ See ** 

below 

See ** 

below 

See ** 

below 

See ** 

below 

**VHA does not centrally 

track costs associated 

with outreach events 

$21,726,574 

VBA ........................ See * below See * below $878,068 $878,068 

NCA ........................ $74,325 

attendance at outreach 

conventions/conferences 

$74,325 

Center for Faith 

Based and 

Neighborhood 

Partnerships.

$15,576 

Travel/Per Diem to attend 

outreach activities 

$15,576 

Center for Minority 

Veterans.

$50,837 

Travel/Per Diem/Booth 

Rentals, participating in 

outreach activities 

$50,837 

Center for Women 

Veterans.

$3,000 $3,000 

National Veterans 

Outreach.

$2,241,822 $322,402 $1,216,064 $2,000,000 

Ad council 

$5,780,288 

*VBA has a FY 2014/2015 contract that includes Public Service Announcement (PSA) development. Airing of radio and TV PSAs are through 

donated air time. 

**VHA does not centrally track costs associated with outreach events. 

**The total VHA advertising dollars spent by program offices, VISNs, and VAMCs (as of 3d qtr) is $21,726,574. 

99 

Projected FY 2015 Advertising and Outreach Spending 

Television Ads Radio Ads Print Ads Social/Digital 

Media Outreach Total 

VHA ........................ $27,647,865 

VBA ........................ See ** 

below 

See ** 

below 

$912,500 $912,500 

NCA ........................ $80,875 

attendance at outreach 

conventions/conferences 

$80,875 

Center for Faith 

Based and 

Neighborhood 

Partnerships.

$8,004 

Travel/Per Diem to attend 

outreach activities 

$8,004 

Center for Minority 

Veterans.

$65,000 

Travel/Per Diem/Booth 

Rentals, participating in 

outreach activities 

$65,000 

Center for Women 

Veterans.

$3,000 

participating in outreach 

activities 

$3,000 

National Veterans 

Outreach.

See *** 

Below 

See *** 

Below 

See *** 

Below 

See *** 

Below 

See *** Below $0 

*VBA has a FY 2014/2015 contract that includes Public Service Announcement (PSA) development. Airing of radio and TV PSA’s are 

through donated air time. 

**VHA does not centrally track costs associated with outreach events. 

**The total VHA advertising dollars spent by program offices, VISNs, and VAMCs for FY 2015 is $27,647,865. 

***All FY 2015 National Veterans Outreach Advertising and outreach activities were pre-paid with FY 2013 and FY 2014 dollars. 

The National Veterans Outreach (NVO) office, in collaboration with respective VA 

administration and OSVA special assistant staff outreach leads, comply with the 

premise that outreach is undertaken by VA to increase awareness of VA benefits 

and services and how to access them. The information provided in the preceding 

outreach responses entail the major categories in which outreach is planned and executed: advertising, event participation and through on-line engagement. Where appropriate, funding for those outreach programs is reported. Increasingly, VA is expanding outreach to better engage through public private partnerships. VA is presently developing policy to help guide public private partnerships while VHA, in particular, is developing best practices and procedures as part of their community engagement mission. There is no funding line identified at this time for establishing 

public private partnerships across VA. VA will report all outreach activities conducted in accordance with title 38U.S.C, Chapter 63, for the submission of the biennial report. 

Question 86. Please provide a detailed budget for the National Veterans Outreach 

Office (NVO), including the number of FTE, a leadership chart, requested appropriations and budget projections, and current outreach initiatives and projects underway. 

Response. Number of FTE: 4 

FY 2015 Budget Forecast 

Object Class Amount 

24 (Printing & Reproduction) .................................................................. $45,000 

25 (Contracts: Advertising, Outreach) ..................................................... $4,080,000 

26 (Supplies & Materials) ....................................................................... $3,600 

Total ........................................................................................... $4,128,000 

100 

Current Outreach Initiatives: 

• Contract management and execution of the media buy and Web development 

contract for the VA Explore Web site. • Management and preparation of the Congressionally-mandated Biennial Outreach Report. • Planning, coordination, and execution of the National Veterans Day Observance 

at Arlington National Cemetery. • Planning for an outreach training program as part of the 2014 OPIA National 

Training Academy. • Quarterly updates with VSO/NGO communications leads on VA Outreach Initiatives and teaming opportunities. 

Question 87. In response to questions about the fiscal year 2014 budget request 

regarding what metrics NVO uses to determine whether a program is duplicative, 

VA stated: ‘‘NVO leadership and team members confer regularly with other VA Staff 

Offices and with all three VA Administrations to review the status of current programs and review proposals for new projects. Through this detailed process, potential for duplicity is identified and plans developed to ensure programs that may be 

duplicative in nature are not executed by NVO.’’ 

A. During fiscal year 2014, which outreach programs or projects were identified 

as duplicative? Please list all programs and projects that were identified. 

Response. VA purchased digital keyword advertising with Google and Bing for the 

VA Explore outreach campaign. The Veterans Health Administration (VHA), at the 

VISN level, submitted some of the same keywords for use in a local campaign. VA 

and VHA compared the lists of search terms for the campaigns and the zip codes 

of the areas targeted. The two groups negotiated which terms each campaign would 

purchase and determined the best way to optimize both campaigns while avoiding 

conflicts. 

B. Which programs were not implemented because of this determination? 

Response. No advertising campaign was terminated. 

Office of Congressional and Legislative Affairs 

Question 88. For fiscal year 2015, the Office of Congressional and Legislative Affairs requests $6 million and 45 employees. Please provide a list of the positions 

that would be filled with that funding and the pay-grades for those positions. 

Response. The 45 positions and their corresponding pay-grades are as follows: 

Assistant Secretary ...................................................................................................................... EX 

Director Congressional Affairs ..................................................................................................... SES 

Associate Deputy Assistant Secretary .......................................................................................... SES 

Director of Operations .................................................................................................................. GS-15 

Director, Benefits Legislative Service .......................................................................................... GS-15 

Director, Health Legislative Service ............................................................................................. GS-15 

Director, Legislative Service ......................................................................................................... GS-15 

Director, Corporate Enterprise Legislative Service ...................................................................... GS-15 


312Bur86c.eps
101 

Director, Congressional Reports and Correspondence ................................................................. GS-15 

2—Special Assistants ................................................................................................................. GS-15 

2—Administrative Officers .......................................................................................................... GS-14 

Executive Correspondence Analyst ............................................................................................... GS-14 

13—Congressional Relations Officers ........................................................................................ GS-12/13/14 

Government Accountability Office (GAO) Liaison Officer ............................................................. GS-14 

6—Program Analysts ................................................................................................................... GS-9/11 

Assistant Director, Congressional Liaison Service ...................................................................... GS-14 

Senior Congressional Liaison Representative .............................................................................. GS-13 

Congressional Liaison Officer ...................................................................................................... GS-13 

3—Congressional Liaison Representatives ................................................................................. GS-12 

Staff Assistant ............................................................................................................................. GS-11 

3—Congressional Liaison Assistant ........................................................................................... GS-7/8/9 

Program Assistant ........................................................................................................................ GS-8 

Question 89. In response to questions regarding the fiscal year 2014 budget request, the Office of Congressional and Legislative Affairs indicated that, during fiscal year 2013, only 13 percent of questions for the record had been submitted on 

time; 75 percent of testimony had been submitted on time; and only 24 percent of 

reports had been submitted on time. By comparison, during fiscal year 2012, 75 percent of questions for the record had been submitted on time; 88 percent of testimony 

had been submitted on time; and 68 percent of reports had been submitted on time. 

Please explain the root causes for the increased delays during fiscal year 2013 in 

providing this information to Congress and the deterioration in timeliness since 

2012. 

Response. During fiscal year (FY) 2013, the Office of Congressional and Legislative Affairs (OCLA) experienced a decrease in specific performance metrics while experiencing a dramatic increase in workload requirements. In FY 2013, the Department conducted 999 briefings, both as a result of Congressional requests and Departmental initiatives. This was a 45-percent increase over FY 2012. During 

FY 2013, OCLA responded to 3,544 requests for information; a 29-percent increase 

over the number responded to in FY 2012. 

In 2013, OCLA developed a Workload Dashboard that identifies all of the congressional action items the office is currently working. As of March 20, 2014, the OCLA 

Dashboard listed the following outstanding items: 

• 8 Hearings • 158 Congressional Requests for Information • 101 Executive Congressional Correspondence items addressed to the Secretary • 86 Questions for the Record • 11 Hearing Deliverables • Additionally, OCLA is also working: 

– 688 Congressional Constituent Casework Inquires 

– 21 GAO actions 

– 18 Requests for Technical Assistance on Legislation 

– 52 Briefings within the next 30 days 

The total volume of work constitutes over 1,000 concurrent action items. Given 

this extensive volume of work, OCLA reviews and prioritizes its efforts to support 

both the Department and Congress. Unfortunately, with such a large workload, 

there will be items that will take longer to complete than we would like. In FY 2014 

through the end of May 2014, the Department has responded to 94 percent of the 

questions for the record on-time and has submitted 97 percent of its testimony ontime. 

Question 90. In response to questions regarding the fiscal year 2014 budget request, the Office of Congressional and Legislative Affairs indicated that, during fiscal year 2014, its goal was to submit 90 percent of questions for the record on time; 

to submit 90 percent of testimony on time; and to submit 85 percent of reports on 

time. 

A. To date, are those goals being met? If not, please identify the percent of questions for the record, testimony, and reports that have been submitted on time during 

fiscal year 2014. 

Response. In FY 2014 through May, 2014, OCLA had achieved the following 

results: 

• Percent of Questions for the Record submitted on time: Goal 85 percent/Actual 

94 percent 

• Percent of Testimony submitted on time: Goal 90 percent/Actual 97 percent 

102 

• Percent of Congressionally Mandated Reports submitted on time: Goal 85 percent/Actual 18 percent 

B. Are there any personnel consequences for any VA employees (such as in performance reviews or receipt of bonuses) caused by failure to meet those goals? If so, 

please specify which employees and the potential consequences. 

Response. OCLA employee performance plans include provisions regarding meeting performance measures and metrics which directly affect the employee’s overall 

performance rating. The overall performance rating determines whether an employee will be recommended for a potential performance award. 

Question 91. For fiscal year 2015, please identify the goals set by the Office of 

Congressional and Legislative Affairs for submitting questions for the record, testimony, and reports on time. 

Response. For FY 2015, OCLA’s target goals are as follows: 

• Percent of Questions for the Record submitted on time: 85 percent 

• Percent of Testimony submitted on time: 90 percent 

• Percent of Congressionally Mandated Reports submitted on time: 85 percent 

Question 92. According to information in the fiscal year 2015 budget request, the 

Office of Congressional and Legislative Affairs (OCLA) stated: ‘‘In 2013, OCLA supported 62 hearings and conducted over 999 congressional briefings, including educational seminars. OCLA responded to 3,544 requests for information in addition to 

477 questions for the record.’’ 

A. How many briefings, requests for information, and questions for the record submitted in 2013 were not answered or fulfilled by December 31, 2013? 

Response. At the end of calendar year 2013, OCLA had the following workload: 

• Briefings: 41 (includes Congressionally requested and Departmental proposed 

briefings within 30 days) 

• Requests for Information: 119 

• Questions for the Record: 625 

B. How long, on average, did it take OCLA to respond to requests from the Hill? 

Response. VA strives to provide Congress with accurate and quality information 

in a timely manner. As indicated in FY 2013, OCLA facilitated over 999 congressional briefings (45-percent increase over FY 2012), including educational seminars, 

responded to 3,544 requests for information (29-percent increase over FY 2012), and 

provided responses to 477 questions for the record. OCLA also supported 311 requests for technical assistance on proposed legislation. OCLA facilitated 51 GAO 

Entrance Conferences, 36 Exit Conferences, and responded to 31 Draft Reports and 

35 Final Reports. Given the complexity, and competing priorities of many requests, 

not every request for information receives a response within requested timeline. 

OCLA is working to improve its communications with Congress regarding priorities 

to ensure needed information is received on time. OCLA does not maintain an average time to completion statistic for responding to Congressional requests. 

Office of Acquisition, Logistics, and Construction 

Question 93. For fiscal year 2015, the Office of Acquisition, Logistics, and Construction requests $9.5 million for Other Services. Please provide a specific itemized 

list of how these funds would be spent. To the extent any of these funds will be 

spent on contracts, please explain the nature of the contract and the expected outcomes. 

Response. The $9.5 million in the fiscal year (FY) 2015 Office of Acquisition, Logistics, and Construction (OALC) budget request includes the expenditure categories 

shown in the chart below. 

Obligation Type Amount 

Permanent Change of Station Obligations ............................................... $700,000 

Repair of Furniture and Equipment, Equipment Rental .......................... 57,000 

Department of Homeland Security Services ............................................. 463,000 

Recurring Maintenance and Repair .......................................................... 50,000 

Training ..................................................................................................... 362,000 

Contracts ................................................................................................... 7,832,000 

Total ................................................................................................. $9,464,000 

The $7.8 million for contracts includes the items shown in the chart below. 

103 

FY 2015 Description Comments 

$370,000 Financial Service Center Memorandum 

of Understanding (MOU) 

MOU between VA centralized accounting and finance center and 

Construction and Facilities Management (CFM) for necessary 

support. 

$140,000 Interagency Agreement Historic American Buildings Survey (HABS) Documentation of VA’s most significant historic properties, National Historic Landmarks, in compliance with Section 110 of 

the National Historic Preservation Act to document the official 

Historic American Building and Landscape Surveys submitted 

to the Library of Congress. 

$500,000 Base Competency Scheduling Contract to continue development of competencies which are 

general to Construction Management and apply to all roles 

and positions. 

$30,000 Federal Facilities Council (FFC) National Academy of Sciences contract in support of FFC activities to identify advancing technologies, processes, and management practices to improve the planning, design, construction, management, operation and evaluation of Federal facilities. 

$293,000 US Army Corps Engineers Interagency 

Agreement 

Engage the Army Corps of Engineers to review major construction projects. 

$262,041 Miscellaneous Multiple small contracts for less than $10,000 each. 

$150,000 Human Capital Investment Plan Reimbursement Reimbursement for Human Resources and Administration services to CFM for support of recruitment, hiring and employee 

development training programs. 

$35,000 LYNX Photo Management Secure construction photo management software support annual 

renewal. 

$170,000 National Institute of Building 

Sciences—CII Benchmarking 

The contract is for participation in a research project that will 

establish industry benchmarks for medical facilities. The 2- 

year study concludes with this second year of funding. VA 

was a cosponsor of the research project to facilitate 

benchmarking VA medical facility contribution to other medical facility construction projects. The outcome will allow VA 

to evaluate projects and processes to define future improvements. 

$50,959 Defense Finance and Accounting Service (DFAS) Interagency agreement to process VA and CFM payroll. 

$200,000 OALC Front Office Mission support service contract(s). 

$2,000,000 Plans and Programs Construction Review Council (CRC) and Program 

Management (PM) Support contracts 

This effort will provide support to CFM in the implementation 

and reporting of the capital program improvement plan. The 

contract will provide support documentation and tracking of 

improvements in the construction process. 

$1,000,000 Construction Project Management— 

TRIRIGA 

This effort continues the sustainment of the TRIRIGA software for 

construction management. The software will provide a collaborative construction management tool for VA. The utilization of this product will improve contract administration and 

project oversight. 

$750,000 Corporate and Regional Matrixed Budget System (CRMBS) Post Production 

Support contract 

Provide post-production support on an existing Government-OffThe-Shelf product to include bug-fixes, security updates, routine maintenance and updates to ensure compliance with US 

Congress Rehabilitation Act to make their electronic and information technology accessible to people with disabilities. 

104 

FY 2015 Description Comments 

$1,691,000 VA Facilities Management School MOU MOU with the Department of Veterans Affairs Acquisition Academy (VAAA), to develop multi-modal delivery of comprehensive 

curricula of educational programs and courses relevant to 

VA’s infrastructure and the total healthcare environment.

$190,000 Advisory Council Historic Preservation 

Liaison 

Renewal of Interagency Agreement to provide dedicated support 

to VA on complex and controversial historic preservation 

issues. 

$7,832,000 Total 

Question 94. The fiscal year 2015 budget request for Construction, Major Projects, 

includes a request of $75.5 million for the Advanced Planning Fund. This appropriated fund is comprised of ‘‘no year money’’ and is used to develop the early stages 

of construction projects for VHA, the National Cemetery Administration, the Veterans Benefits Administration, and VA central office staff offices. 

A. To date, what is the unobligated balance of the Advanced Planning Fund? 

Response. As of March 31, 2014, the unobligated balance is $180 million. 

B. For fiscal year 2015, please provide a detailed description and amount for each 

project expected to be funded through the Advanced Planning Fund. 

Response. VA plans to obligate $107.8 million for the remainder of FY 2014. The 

table below reflects the anticipated use of the Advanced Planning Fund in FY 2015: 

Project 

Planned 

Obligations 2015 

Bronx, New York—Spinal Cord Injury (SCI) ........................................................................................................... $2,000,000 

Perry Point, Maryland—Replace Community Living Center (CLC) ........................................................................ $300,000 

Livermore, California—Realignment and Closure Palo Alto (Design) .................................................................. $2,000,000 

Long Beach, California—Seismic Correction Building 7 and 126; Demolition Building 7 .................................. $200,000 

Long Beach, California—Mental Health and CLC ................................................................................................ $300,000 

Palo Alto, California—Ambulatory Care/Polytrauma Rehab .................................................................................. $3,000,000 

Portland, Oregon—Retrofit and Renovation .......................................................................................................... $17,000,000 

San Francisco, California—Seismic Retrofit B 1,6 and 8/Replace B12 .............................................................. $200,000 

American Lake, Washington—Building 81 Seismic Replacement ........................................................................ $7,000,000 

West Los Angeles—New Tower and Building 500 Seismic Correction ................................................................. $25,000,000 

West Los Angeles—12 Buildings Seismic Upgrade .............................................................................................. $3,200,000 

National Cemetery Administration Projects ........................................................................................................... $11,000,000 

Staff Offices ........................................................................................................................................................... $4,000,000 

Veterans Benefits Administration Projects ............................................................................................................ $1,000,000 

Historic Preservation, Environmental, and Cost Estimating Services ................................................................... $7,400,000 

Facilities Standards and Criteria ........................................................................................................................... $20,000,000 

Integrated Strategic Master Plans ......................................................................................................................... $30,000,000 

$133,600,000 

C. Please describe in detail the metrics used to determine the size of the budget 

request for the Advanced Planning Fund? 

Response. VA’s request for this line item is based on the estimated need to support project and other requirements funded through this fund. VA’s Advanced Planning Fund line item provides funding for schematic design, design development, and 

construction document phases up to 100 percent of design for Major Construction 

projects. This will allow VA to complete at least 35 percent of total design prior to 

requesting construction funds. It can be used to prepare facility master plans, historic preservation plans, conduct environmental assessments and impact studies, energy studies or audits, and design and construction-related research studies including post-occupancy evaluations. The funds are also utilized to maintain construction 

standards, such as: design guides, design standards, specifications, and space criteria. 

Question 95. VA has a large inventory of buildings across the Nation to carry out 

its mission. According to a response to questions about the fiscal year 2014 budget 

request, VA expected to have approximately 941 unused or underutilized buildings. 

105 

A. In fiscal year 2013, how much, if any, cost avoidance or savings did VA realize 

by selling vacant or underutilized buildings and how many vacant or underutilized 

buildings did VA have at the end of fiscal year 2013? 

Response. At the end of FY 2013, VA had approximately 922 vacant or underutilized buildings, of which 427 (46 percent) were historic buildings. Of the 922, 242 

were vacant and 680 were underutilized. 

The 922 buildings account for approximately 9.9 million square feet (SF) of space 

in vacant or underutilized buildings. Of that total, 4.2 million SF is located in vacant buildings and 5.6 million SF is located in underutilized buildings. 

VA does not track actual costs at the building level; however, the Department 

does use a proration methodology to report building level costs to the Federal Real 

Property Profile annually. For FY 2013, VA estimates it spent approximately $20.2 

million on the 922 vacant and underutilized assets in its portfolio. A further breakdown of those costs is an estimated $4.6 million on the 242 vacant buildings and 

$15.6 million on the 680 underutilized assets. 

Compared to FY 2012, when the estimated cost to operate vacant and underutilized buildings was $23.4 million annually, the FY 2013 estimated cost ($20.2 million) represents a cost avoidance of approximately $3.2 million. The reduction in operating costs for these buildings is the result of reuse and disposal of vacant and 

underutilized buildings; it is not the result of revenue gained from selling any properties. VA did not sell any vacant or underutilized properties in FY 2013. 

B. In fiscal year 2014, how much, if any, cost avoidance or savings does VA expect 

to realize by selling vacant or underutilized buildings and how many vacant or underutilized buildings does VA expect have at the end of fiscal year 2014? 

Response. VA projects it will dispose or reuse 50–60 vacant or underutilized buildings in FY 2014, resulting in an estimated 867 vacant or underutilized buildings at 

the end of FY 2014. Of that 867, approximately 197 are projected to be vacant and 

670 underutilized. 

Based on the planned disposal or reuse of 50–60 buildings, the overall cost to operate vacant and underutilized buildings is projected to drop to $19.7 million annually in FY 2014, a reduction of approximately $0.5 million from the FY 2013 amount 

($20.2 million). The projected reduction in operating costs for these buildings is the 

result of reuse and disposal of vacant and underutilized buildings; it is not the result of revenue gained from selling any properties. 

VA continues to pursue disposing or reusing un-needed assets; however, there are 

challenges in further reducing VA inventory in this area. Of the projected 867 vacant or underutilized assets, 391 (45 percent) are considered historic buildings, limiting VA’s ability to dispose or reuse these assets in many cases. 

Competing stakeholder interests in some of these vacant or underutilized assets 

also has hampered disposal or reuse efforts. VA is looking at further opportunities 

to reduce our vacant and underutilized footprint, as mentioned earlier. Having tools 

in place, such as the expansion of VA’s Enhanced-Use Lease (EUL) authority, currently in proposed legislation under consideration by Congress, would help overcome 

some of these challenges and allow VA to more effectively reduce its inventory of 

vacant and underutilized assets. 

Question 96. The Office of Small and Disadvantaged Business Utilization 

(OSDBU) is an office within the Office of the Secretary, although the budget for the 

office is paid for by the Office of Acquisition and Logistics Supply Fund. 

A. Please provide a detailed budget for OSDBU, including FTE and requested 

budget for fiscal year 2015. 

Response. Because the Office of Small and Disadvantaged Business Utilization 

(OSDBU) is funded by the Supply Fund, the OSDBU budgeting cycle is not the 

same as the Presidential budget request. The OSDBU 2015 budget request is due 

to the Supply Fund Board in August 2014 and is currently under development. The 

following budget history is provided: 

OSDBU Total Budget 

($ in thousands) 

2012 Actual 2013 Actual 2014 Estimate 

Budget FTE Budget FTE Budget FTE 

VA Veteran-Owned Small Business Verification .............. $11,892 19 $16,818 19 $18,545 16 

Strategic Outreach ........................................................... $7,050 8 $1,645 7 $4,814 7 

Acquisition Support .......................................................... $761 6 $1,087 7 $1,892 8 

106 

OSDBU Total Budget—Continued 

($ in thousands) 

2012 Actual 2013 Actual 2014 Estimate 

Budget FTE Budget FTE Budget FTE 

Operations ........................................................................ $878 9 $10,866 9 $5,112 10 

Total Expenditures ................................................... $20,581 42 $30,416 42 $30,363 41 

B. Please provide a detailed budget for the Center for Verification and Evaluation 

(CVE) within OSDBU, including FTE, requested budget for fiscal year 2015, and 

metrics used by CVE to measure effectiveness. 

Response. Because the Center for Verification and Evaluation (CVE) is within the 

Office of Small and Disadvantaged Business Utilization (OSDBU), which is funded 

by the Supply Fund, the CVE budgeting cycle is not the same as the Presidential 

budget request. The OSDBU 2015 budget request is due to the Supply Fund Board 

in August 2014 and is currently under development. The following budget history 

is provided: 

CVE Budget 

($ in thousands) 

2012 

Actual 

2013 

Actual 

2014 

Estimate 

FTE .................................................................................................................................... 19 19 16 

Obligations: 

FTE ................................................................................................................................ $ 1,874 $2,166 $1,778 

Professional Services .................................................................................................... $0 $6,630 $7,537 

Travel ............................................................................................................................ $7 $37 $30 

Training ........................................................................................................................ $0 $669 $8 

Printing and reproduction ............................................................................................ $0 $0 $0 

Contract Support .......................................................................................................... $9,912 $7,246 $8,912 

Supplies and materials ................................................................................................ $97 $29 $13 

Equipment .................................................................................................................... $2 $41 $7 

Rents ............................................................................................................................ $0 $0 $240 

Security ......................................................................................................................... $0 $0 $20 

Total obligations ...................................................................................................... $11,892 $16,818 $18,545 

Department of Veterans Affairs (VA) has invested heavily in building a robust 

and effective system for verifying Veteran-Owned Small Business eligibility for the 

VA Veterans First Program. In fiscal year (FY) 2013 we spent $6.9 million to build 

verification capacity and in FY 2014 we are spending $12.3 million in non-recurring 

investments to ensure that the system is efficient and cost-effective. As a result we 

expect the verification program costs to be approximately $14.7 million in FY 2015 

to handle 6,000 applications. 

Metrics used by CVE to determine effectiveness: 

• Total applications processed 

• Number of initial applications processed 

• Number of requests for reconsideration processed 

OFFICE OF INSPECTOR GENERAL

Question 97. For fiscal year 2015, the Office of Inspector General requests $11.8 

million for Other Services. Please provide an itemized list of how those funds would 

be utilized. 

VA OIG Response: The fiscal year (FY) 2015 request for Other Services includes 

the following contractual services, interagency agreements, employee training, VA 

cross-cutting services, and other procured services: 

• Consolidated Financial Statement Audit contract for FY 2015 

• Human Resources/Payroll Processing Services—Departments of Treasury and 

Agriculture 

• Federal Information Security Management Act Review contract 

• Employee Training 

107 

• VA Franchise Fund Services—Information Technology processing, financial 

services, employee relocation services, background investigations, and records 

storage 

• Council of the Inspectors General for Integrity and Efficiency 

• Building security services—Department of Homeland Security and VA 

• Investigative Services—credit/database access, forensic examinations, transcription services, fingerprinting, communications agreements 

Other miscellaneous administrative/support services provided by VA and other 

sources. 

Question 98. With the requested level of resources for fiscal year 2015, how many 

benefits inspections would the Office of Inspector General plan to conduct? 

VA OIG Response: The Office of Inspector General plans to conduct 20 inspections 

of VA Regional Office operations in FY 2015. Our independent inspections provide 

recurring oversight focused on disability compensation claims processing and the 

performance of Veterans Service Center operations. 

VETERANS HEALTH ADMINISTRATION

Question 99. According to the budget request, VA will spend $534 million to activate medical facilities in fiscal year 2015. And, the estimate for activations for fiscal 

year 2015 increased $404 million over the amount included in advanced appropriations. 

A. Please break out the $534 million by appropriations account. 

Response. Please refer to the table below: 

Medical Services ......................................................................... $395,416 

Medical Support & Compliance ................................................. $42,800 

Medical Facilities ....................................................................... $96,200 

Activations, 2015 Estimate ............................................... $534,416 

B. How much, in total, does VA intend to spend in fiscal year 2016 for medical 

facility activations? Please break this figure out by appropriations account. 

Response. Please refer to the table below: 

Medical Services ......................................................................... $96,200 

Medical Support & Compliance ................................................. $10,400 

Medical Facilities ....................................................................... $23,400 

Activations, 2016 Estimate ............................................... $130,000 

C. Please provide a full list of the facilities that will be activated with these funds, 

with the amount of funding estimated for each facility broken down into non-recurring and recurring costs. 

Response. Please see attached. 

108 


312Burr99c1.eps
109 

D. Please provide a detailed explanation for the $404 million increase above the 

advanced appropriations amount for medical facility activations for fiscal year 2015. 

Response. Please refer to above attachment. 


312Burr99c2.eps
110 

Question 100. In an effort to ensure veterans are getting the mental health care 

they need, VA recently ended an initiative to hire 1,600 new mental health providers and more than 900 Peer Specialists. This effort also included filling the open 

positions that already existed within the mental health program. 

A. To date, what is the number of mental health positions currently unfilled? 

Response. As of June 2014, the current number of unfilled positions for mental 

health is 2,762.83, which is a vacancy rate of 10.15 percent. For peer specialists the 

vacancy rate is 7.7 percent. 

B. Have all mental health providers hired under this initiative been trained in 

evidence-based therapies? If not, when will the providers be trained? 

Response. No. All mental health providers hired have not been trained in evidence-based psychotherapies. Determination of the need for training in evidencebased psychotherapies is based on clinical role, provider credentials, and program 

assigned. For example, while some of the staff hired included registered nurses, 

their role is to provide case management services and not evidenced-based psychotherapy. Since May 2012, VA has trained 3,446 unique VHA staff and trainees (not 

including Vet Center) in one or more of the 15 evidence-based psychotherapies that 

have centralized training. The tracking database cannot distinguish between staff 

hired as a result of the initiative and those hired before the initiative. Training in 

evidenced-based therapies is an ongoing process based on expansion of these therapies as well as staff turnover. 

C. Have all the Peer Specialists been trained and are they currently providing 

care to veterans? If not, when will they be trained? Please provide the Committee 

with a list of facilities that received Peer Specialists positions and the number of 

Peer Specialists at each facility. 

Response. VHA currently has 952 peer support staff hired or converted to support 

the hiring initiative, delivering services to Veterans at every medical center and at 

every very large CBOC. (Please note, as of April 2014, very large is defined as a 

CBOC that has more than 10,000 Veterans enrolled.) VHA hired 420 Peer Specialists who were already trained and certified and have been providing counselor services upon being hired. VHA has trained and certified 564 Peer Support Apprentices; 

202 Peer Support Apprentices have since been promoted to Peer Specialists and the 

remaining 362 Peer Support Apprentices are waiting their 12-month time limited 

appointment requirement before eligibility for promotion to Peer Specialist. VHA 

has 22 Peer Support Apprentices scheduled for training and an additional 24 Peer 

Support Apprentices awaiting confirmation on scheduled training. Attached below 

is a complete facility listing and the number of peer-to-peer counselors per facility. 

111 


312Bur100C1.eps
112 


312Bur100C2.eps
113 


312Bur100C3.eps
114 


312Bur100C4.eps
115 


312Bur100C5.eps
116 

Question 101. According to the budget request, VA estimates a ‘‘net increase in 

enrollment will be 56,000 in 2014 and 63,000 in 2015’’ due to the mandate that all 

Americans have health care under the Affordable Care Act. How many veterans 

does VA estimate would leave the system for other health care in 2014 and 2015? 

Response. VA has been closely monitoring Veteran enrollment in response to 

ACA, but it is likely still too early to assess changes in enrollment and to attribute 

them directly to the ACA. VA can report that of the Veterans to whom VA sent ACA 

outreach letters, almost 7,150 enrolled in VA health care after receiving such a letter (through February 2014). From July 2013 through January 2014, VA also received 252 requests from Veterans to disenroll from VA health care. Although Veterans are not required to provide a reason for enrolling or disenrolling, and other 

factors may also influence Veterans’ decisions to enroll in or disenroll from VA 

health care, only 49 Veterans requested to disenroll during the same 6-month timeframe in the previous year (July 2012 through January 2013). The experience to 

date in 2014, based on this data, for both enrollment and disenrollment, is lower 

than originally projected in the budget request. VA will continue to monitor the imVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00120 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN

312Bur100C6.eps
117 

pact of ACA on the VA health care system and make necessary changes to future 

budget estimates. 

As background, the analysis to estimate the impact of ACA on VA health care was 

based on data from three sources—the 2010 Public Use Microdata Sample files from 

the American Community Survey (ACS), The Lewin Group’s Health Benefit Simulation Model (HBSM), and VA’s EHCPM. The HBSM predicts how Veterans’ health 

care choices might change as a result of ACA. This model was used to estimate the 

change in VA enrollment (both those enrolling and those leaving VA for other coverage) in response to the ACA. For an individual with a given primary health coverage status before ACA, the HBSM predicts the individual’s likelihood of remaining 

in the same primary coverage status or transitioning to another status after implementation of ACA. These likelihoods are based on individual-level factors that are 

also modeled, such as the individual’s Federal poverty level, whether the individual 

is employed, employer type, and employer size. The results of the analysis suggested 

that most Veterans who have employer-provided insurance as their primary insurance will not have a change of status as a result of ACA, nor will Veterans who 

have coverage provided by Medicaid, Medicare, TRICARE, or the Indian Health 

Service. According to The Lewin Group’s initial assessment, the vast majority of 

Veterans will not choose to change their source of health care coverage as a result 

of the ACA. 

Veterans who are most likely to newly enroll in VA health care to obtain minimum essential coverage are Veterans who currently have no health coverage. The 

2010 ACS data indicate that about 1.4 million Veterans have no form of health coverage. About 1 million of these Veterans may be eligible to enroll in VA by meeting 

VA’s income-eligibility requirements. However, because many of these Veterans may 

also be eligible for Medicaid or for tax credits if they buy insurance in the health 

insurance marketplaces, not all of them are likely to enroll in VA health care. 

Veterans who are likely to obtain non-VA coverage in response to the ACA are 

those who rely very little on VA for their health care. There are about 924,000 Veterans in this category. Some of them are expected to disenroll from VA in order to 

avail themselves of premium tax credits (if otherwise eligible) to purchase qualifying 

coverage in the health insurance marketplace. Another portion of this group would 

enroll in Medicaid if their state expands Medicaid coverage and some would take 

up employer-provided insurance in response to the ACA. Veterans who obtain coverage through Medicaid or employer-provided insurance are not expected to 

disenroll from VA (and instead maintain dual enrollment), but their reliance on VA 

is likely to decline. 

Question 102. VA provides dental care to veterans who are 100 percent serviceconnected disabled, for dental conditions that are service-connected, or care that is 

medically necessary. In addition, VA provides access for veterans to dental insurance through the VA Dental Insurance Program. 

A. Please describe in detail the metrics VA uses to measure access to VA’s dental 

clinics. 

Response. VA uses access measures to quantify how many patients waited and 

how many are currently waiting for care. Dental clinics use the same access metrics 

that are used for all VA medical appointments. The VHA Support Service Center 

Wait Time Pending report was designed to help reduce the number of future appointments with long waits. The report shows the number of patients and appointments in the queue but gives greater detail for those patients who have already 

waited more than 14 days from the recorded create date for an upcoming visit. 

B. What is the current wait time for an appointment in a VA dental clinic? Please 

break this information out by facility. 

Response. As of June 30, 2014, 5.50 percent of all pending dental appointments 

for new patients were greater than 14 days of the create date. The facility specific 

access list report is attached. 

118 


312Bur102B1.eps
119 


312Bur102B2.eps
120 


312Bur102B3.eps
121 

Embedded in the above spreadsheet, five pages: 


312Bur102B4.eps
122 


Burr102Bapp1.eps
123 


Burr102Bapp2.eps
124 


Burr102Bapp3.eps
125 


Burr102Bapp4.eps
126 

C. How many open positions does VA currently have for dental providers and on 

average how long does it take to hire a dental clinician? 

Response. As of July 15, 2014, there are 20 dentist vacancies and 2 dental hygienist vacancies listed on the USAJobs Web site. As of April 2014, the average SOH 

timeframe to hire dental clinicians is 41.99 days, which exceeds the VA SOH goal 

of 60 days. The SOH metric begins with the date request received through the date 

of tentative offer. 

D. Please submit to the Committee the Dental Patient Satisfaction Survey. 

Response. Please see attached eight pages. 


Burr102Bapp5.eps
127 


312Bu102D1.eps
128 


312Bu102D2.eps
129 


312Bu102D3.eps
130 


312Bu102D4.eps
131 


312Bu102D5.eps
132 


312Bu102D6.eps
133 


312Bu102D7.eps
134 

Question 103. In a response to a question about the fiscal year 2014 budget request on consolidating VHA Fee Programs processing system, VHA indicated they 

had not consolidated in the same manner as the Consolidated Patient Account Centers (CPAC) but had begun ‘‘work on a centralized claims processing system, known 

as * * * Health Claims Processing’’ (HCP). Please provide the Committee a detailed update on the implementation of HCP. 

Response. HCP was chartered by VA to demonstrate the use of VA’s Financial 

Service Center (FSC) to process health care claims for Non-VA Medical Care (previously known as FEE). The project is managed by the VHA Chief Business Office 

(CBO) in a partnership with the FSC. The FSC supports CBO with claims processing support for several VISNs experiencing high claim volume/ backlogs. For 

claims processed by FSC, VAMCs continue to be responsible for the Non-VA Care 

Coordination component, which includes eligibility determination and authorization 

for Purchased Care. 

In addition, FSC has supported CBO in developing two HCP modules which support and introduce improvements to the upfront processes of Non VA Care including 

eligibility determinations as well as the authorization of inpatient care in the comVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00138 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN

312Bu102D8.eps
135 

munity (known as Hospital Notification). The Eligibility module is in production use 

at 3 VAMCs and is in the process of being integrated with the existing Fee Basis 

Claims System (FBCS). The national release of this functionality is currently scheduled to begin in March 2015. The module for Hospital Notification is scheduled for 

a January 2015 deployment to a second VAMC for testing and will be integrated 

with FBCS in the second half of 2015. 

Question 104. Because information on VISN headquarters funding was left out of 

last year’s request, Ranking Member Burr submitted a question for the record asking ‘‘[h]ow much does VA expect to spend in fiscal years 2014 and 2015 for VISN 

headquarters functions?’’ While VA never answered the question, this year’s budget 

request provided the answer. 

A. What accounts for the $115 million increase between fiscal year 2013 and 2014 

at a time when VA was reducing the size the VISN staff? 

Response. There was a $105 million increase in obligations from 2013 actuals to 

2014 estimate. The 2013 actual of $186.8 million reflects actual obligations at the 

end of the fiscal year for the VISN headquarters only. The 2014 estimate of $291.6 

million reflects projections for VISN headquarters and includes consolidated VISN 

functions, such as laundry, laboratory, and human resources. In 2013, these funds 

were initially sent to the VISN headquarters and then disseminated to the VAMCs. 

FY 2014 reflects a transition year for how these funds are initially disseminated to 

the field. 

B. VISN Directors were given a deadline of December 31, 2013, to reduce their 

staff to no more than 65 FTEs; why did VISN 23 miss this target date? Please describe what remedies are being put in place to help VISN 23 reach the target. 

Response. VISN 23 was compliant with the required staffing levels, with the exception of Bio-Medical Engineering and Health Care Technology which they requested to function as a consolidated service. The VISN Staffing Workgroup is conducting a review of all requests for consolidated service to validate those occupational functions which are best suited for consolidation. 

If VISN 23’s Bio-Medical Engineering/Health Care Technology proposal is approved, the staff are either moved to a consolidated service account or dispersed 

back to the local medical facilities. The VISN would then be 8 full-time equivalent 

employees (FTEE) under their currently approved ceiling of 59 FTEE. 

C. In a meeting with Ranking Member Burr in 2012, senior VHA officials indicated they planned to reduce the number of VISN staff first, and then explore the 

overall number of VISNs needed. Has the second phase started? If not, when does 

VA expect to begin this phase of the VISN reorganization? 

Response. The former Under Secretary for Health convened a workgroup in 2013 

to review the composition of VISNs relative to Veteran population, health care service complexity levels, geography, budget, and other factors that are unique to each 

VISN. The workgroup developed the criteria and methodology that would be used 

to review the size and composition of the VISNs. The workgroup presented its findings and recommendations to VHA leadership in late 2013. VHA leadership instructed the review team to reevaluate certain criteria and revise recommendations 

for consideration. These recommendations were to provide for a tiered or staggered 

approach to any reorganization effort that would allow for a phased implementation 

of any changes. 

Question 105. The Honoring America’s Veterans and Caring for Camp Lejeune 

Families Act was signed into law 18 months ago. VA started treating Camp Lejeune 

Veterans in August 2012 when the President signed the law; however, family members are still waiting. When will VA start processing claims for Camp Lejeune 

families? 

Response. VA can begin reimbursing eligible Camp Lejeune family members now 

that the interim final rule has been published and is effective. The interim final rule 

was published in the Federal Register on September 24, 2014 and became effective 

on October 24, 2014. Now that the Camp Lejeune family member rule is effective, 

VA will reimburse family members, as the last payer, for health care costs that are 

related to the 15 conditions in the law and were incurred from March 26, 2013, the 

day the Congressional appropriations were made, onward. 

Question 106. In response to a question by Chairman Sanders in the Committee 

hearing on the budget about what debt forgiveness programs are available to attract 

primary care physicians to work for VA, Dr. Petzel stated the $60,000 cap of the 

Education Debt Reduction Program (EDRP) ‘‘could be higher.’’ In fact, the Caregivers and Veterans Omnibus Health Services Act authorizes the Secretary to waive 

the $60,000 cap. In addition, the budget request states ‘‘EDRP was not utilized to 

the extent expected for the Mental Health Hiring Initiative (MHHI).’’ 

136 

A. How many times has the Secretary waived the $60,000 cap? Please provide a 

list by provider type and the amount of debt eventually paid. 

Response. No Education Debt Reduction Program (EDRP) applicants have re- quested a waiver above the $60,000 cap; therefore, no waiver requests have required 

Secretary action/approval. 

B. How did VA expect to utilize EDRP for MHHI? Please provide a detailed explanation of why it was not utilized as envisioned. 

Response. In May 2012, VHA dedicated funding for 1,000 EDRP awards specifically for title 38 and hybrid title 38 permanent hires for the Mental Health Hiring 

Initiative (MHHI). All VISNs and facilities were notified of the availability of these 

funds to enhance their recruitment and retention efforts. Each facility is responsible 

for determining which positions are hard to recruit and include the EDRP incentive 

in the vacancy announcement accordingly. Over 4,000 clinical mental health professionals have been hired as part of the MHHI; 634 vacancy announcements for 

MHHI positions included the offer of the EDRP incentive. Of the employees hired 

from those vacancy announcements, 109 new employees have applied and been approved for EDRP in the amount of $5,243,001. As of April 1, 2014, there are 27 

MHHI Psychology hires that have been offered EDRP but cannot apply until they 

have been licensed and converted to an excepted appointment. While VHA anticipated more EDRP usage for this important hiring initiative, there are a number of 

reasons it may not have been used to the extent expected. In particular, not all 

newly hired mental health professionals have qualifying education loan debt, and 

facilities may have determined that many of the positions hired were not hard to 

recruit. For example, pay for social workers in VHA is considered quite competitive 

with private sector, and nearly one-fourth of the clinical professionals hired as part 

of the MHHI were social workers. A survey of EDRP Coordinators is being conducted to identify barriers to using the program; that may prove beneficial to understanding the program’s usage. 

Homelessness 

Question 107. Since the beginning of the Administration’s initiative to eliminate 

veterans homelessness by 2015, VA’s programs to assist homeless veterans have received a 67 percent increase in funding since fiscal year 2010. In 2013, there were 

57,849 homeless veterans on any given night in January; however, this only represents a 24 percent decrease in the number of homeless veterans since 2010. 

A. As we move into the end of rescue phase, how will the Administration define 

success? 

Response. VA’s goal is a systematic end to Veteran homelessness, which means 

there are no Veterans sleeping on our streets. Should Veterans become homeless, 

or be at-risk of becoming homeless, VA will have the capacity to quickly connect 

them to the help they need to achieve housing stability. The ultimate goal is that 

all Veterans have permanent, sustainable housing with access to high-quality health 

care and other supportive services that improve their quality of life. 

B. What process will VA use to determine whether the rescue phase will need to 

be extended beyond 2015? 

Response. VA recognizes there will always be a rescue component to homelessness. An end to homelessness among Veterans does not mean that a Veteran will 

never experience a housing crisis again. Changing economic realities and the unpredictability of life may create situations where a Veteran could experience or fall 

back into homelessness, or be at-risk of homelessness. We can prevent the number 

of homeless Veterans by identifying those who are most at-risk and quickly connecting them to programs that provide temporary financial assistance and access to 

housing, health care, employment assistance and other supportive services that help 

them obtain and sustain housing. Through coordination with other Federal and local 

partners, each community will have coordinated entry systems that can rapidly connect the Veteran to housing, health care and other supportive services that not only 

ends the episode of homelessness but promotes full reintegration back into the community. VA must also continue to utilize identified data to monitor its progress in 

ending homelessness and, when necessary, make local adjustments based on need. 

C. What steps has the Administration taken to ensure that, as the troop 

drawdowns begin and continue over the next couple of years, these newly separated 

servicemembers do not fall into homelessness? 

Response. VA has put into place a robust integrated system of care that focuses 

on both homeless prevention and rapid re-housing. Through its partnerships at the 

Federal and local levels, VA is using data-driven solutions that are evidenced-based 

and research-informed to quickly connect homeless Veterans to services and to prevent those at highest risk for becoming homeless to maintain housing. VA has coordinated with DOD to retool the Transition Assistance Program, which asks quesVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00140 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
137 

tions related to housing and vocational instability. This partnership promotes VA’s 

capacity to more rapidly identify those most at risk for housing instability and connect them to preventative services, like the GI Bill, SSVF, benefits and other health 

care supports to mitigate risk and promote greater community readjustment and 

improved quality of life. 

Question 108. The fiscal year 2016 advanced appropriation request currently has 

a significant decrease in funding for current homeless programs. If VA does not 

meet its goal for fiscal year 2015, will there be an increase in funding for homeless 

programs for fiscal year 2016 and will this be an increase above fiscal year 2015 

funding? 

Response. VA must sustain the progress that has been made thus far by maintaining the level of resources that have been allocated to date. VA’s FY 2015 budget 

request calls for critical investments toward ending homelessness among Veterans 

while strengthening our systems of care for all individuals and families who experience homelessness. Although the Point-in-Time (PIT) estimate is an important data 

point for measuring progress, it is not the sole or primary data source VA uses to 

draft its budget. In preparation for the FY 2015 Budget Submission, VA used its 

own program evaluation data, poverty data, census data, and other health care data 

sources. VA will use all of these data sources to evaluate the effectiveness of VA’s 

homeless programs and the PIT data to help adjust investments to priority communities where progress needs to accelerate to achieve the goal of ending Veteran 

homelessness. 

Progress to date demonstrates that when new resources are invested in proven 

solutions and existing programs adopt best practices, it will be possible to end Veteran homelessness. To achieve the promise of ending Veteran homelessness, VA 

needs both investments in known, effective programs and a continued transformation of our existing systems to help Veterans swiftly achieve and maintain permanent housing. VA will need continued support from Congress for targeted programs like HUD-VASH, SSVF, Continuums of Care-funded Permanent Supportive 

Housing, Emergency Solutions Grants for Rapid Re-Housing and other programs 

that increase access to safe, affordable, permanent housing. 

Question 109. The fiscal year 2015 budget request includes an additional 10,000 

Housing and Urban Development Veterans Affairs Supportive Housing (HUDVASH) vouchers, which would bring the total number of vouchers to roughly 68,155. 

A. The fiscal year 2015 advance appropriation request submitted with the fiscal 

year 2014 budget request did not include an additional 10,000 vouchers for fiscal 

year 2015. What metrics were used to determine the need for additional vouchers 

for fiscal year 2015? 

Response. The most recent data available from the 2013 PIT Count, suggests that 

there are still over 58,000 homeless Veterans on any given night. HUD-VASH 

vouchers are a critical component of our system and its ability to house these Veterans. With so many Veterans still homeless, it is clear that additional vouchers 

would be needed to end Veteran homelessness. 

B. What is the total number of vouchers needed to meet the Administration’s goal 

of ending veterans homelessness by 2015? 

Response. At this point in time, it is not possible to definitively state the total 

number of vouchers needed to end Veteran homelessness. The total number of 

vouchers needed is dependent upon future data points, which HUD and VA can only 

estimate. The future data points include the future inflow of Veterans into homelessness, future placement rates accomplished with existing resources, and future 

placements rates accomplished with any new resources. 

Question 110. The fiscal year 2015 budget request includes a $200 million increase for the Supportive Services for Veteran Families (SSVF) program. Since the 

beginning of SSVF, this program has seen a significant increase in funding each fiscal year. What type of analysis was conducted to determine the need for an additional $200 million in funding for fiscal year 2015? 

Response. In determining the need for additional funding for the SSVF Program, 

VA used a stock and flow analytic tool that included data from the national PIT 

Count of homeless persons, VA’s program utilization data, and national poverty data 

to model future homelessness trends. Based on these results, VA was able to project 

the number of homeless and at-risk Veteran families that would need access to 

SSVF rapid re-housing and prevention services. This model showed a gap in services 

that could impact VA’s ability to end Veteran homelessness by the end of 2015. As 

a result, VA requested an additional $200 million for SSVF. It is important to note 

that SSVF emphasizes short-term crisis interventions that focus on the Veterans 

needing time-limited support to help them stabilize in permanent housing. Once VA 

138 

meets its goal of ending Veteran homelessness, SSVF will be able to shift resources 

in order to prevent episodes of Veteran homelessness. 

Question 111. Recently, VA changed the eligibility requirements for several programs, which has caused concern among the provider community. 

A. How will the changes in eligibility requirements impact veterans seeking services through VA’s homeless programs? 

Response. No changes to VA homeless program eligibility requirements are in effect at this time. VA is currently reviewing the implications that changes in eligibility would have on Veterans and the homeless program provider community. 

B. How many veterans currently seeking services will no longer be eligible for 

services through VA’s homeless programs? 

Response. No changes to VA homeless program eligibility requirements are in effect at this time. VA is currently reviewing the implications that changes in eligibility would have on Veterans and the homeless program provider community. 

C. What steps is VA taking to ensure that veterans who are currently receiving 

services but will no longer be eligible for these programs are transitioned to other 

community resources? 

Response. No changes to VA homeless program eligibility requirements are in effect at this time. VA is currently reviewing the implications that changes in eligibility would have on Veterans and the homeless program provider community. 

Question 112. In December 2011, VA signed 38 leases creating a public-private 

partnership to develop housing units for homeless veterans. Through the Building 

Utilization Review and Repurposing initiative, VA identified unused or underutilized property, which would create an additional 4,100 housing units. How many additional units of housing were available through this program in fiscal year 2013 

and how many will be available by the end of fiscal year 2014? 

Response. VA currently has approximately 1,674 units of housing available 

through its EUL program. Of that number, 222 units are the direct result of EUL 

leases that are part of the Building Utilization Review and Repurposing (BURR) initiative. In FY 2013, 74 units were made available, and in FY 2014, an additional 

148 units will be brought online, totaling 222 units directly related to BURR. 

Rural Health 

Question 113. Project ARCH was established through Public Law 110–387 to provide non-VA care to eligible highly rural enrolled veterans in five VISNs. This pilot 

program is set to expire at the end of 2014. 

A. Please provide the Committee with the total number of veterans who participated in this pilot and the total costs at each pilot site. 

Response. 

VISN Unique 

Veterans 

Cost (Invoiced as 

of February 2014) 

1 ............................................................ 1,051 $3,914,105 

6 ............................................................ 336 $386,607 

15 .......................................................... 400 $345,233 

18 .......................................................... 1,745 $12,261,291 

19 .......................................................... 1,690 $19,544,700 

Total .............................................. 5,222 $36,451,936 

B. When does the Department plan to determine whether to extend and/or expand 

this program? 

Response. Section 104 of Public Law 113–146, the Veterans Access, Choice, and 

Accountability Act of 2014, extended Project ARCH for an additional two years, specifically until August 7, 2016. Section 104 specifies that the pilot program be carried 

out in Veterans Integrated Service Networks (VISNs) 1, 6, 15, 18, and 19 (and such 

other locations as the Secretary considers appropriate), and amends the eligibility 

criteria under the pilot to include Veterans enrolled in VA’s system of patient enrollment as of August 1, 2014. The legislation sets standards for timely scheduling and 

occurrence of medical appointments under the pilot, requires outreach about the 

pilot program, and requires VA to make use of existing contracts or, in lieu of extending current contracts, enter into new contracts to carry out the pilot program. 

In carrying out Project ARCH, VA conducted competitive acquisitions and awarded contracts with performance periods established commensurate with the law. All 

current contracts for Project ARCH were set to expire on September 30, 2014, but 

a six month extension to those contracts was executed. On September 26, 2014 the 

139 

President signed H.R. 5404 ‘‘The Department of Veterans Affairs Expiring Authorities Act of 2014.’’ Section 409 provides contracting requirement relief, permitting 

sustainment of the existing contractors under Project ARCH. VA appreciates 

Congress’s support of Project ARCH, and is actively working contracting activities 

to continue the pilot as required by Section 104. 

Additionally, VA is working diligently to ensure Veteran access to care is not interrupted when Project ARCH concludes. VHA’s Patient-Centered Community Care 

(PC3) program will be available to rural Veterans to help bridge this gap. 

Under PC3, VHA has contracted with Health Net Federal Services and TriWest 

Healthcare Alliance to develop a network of providers to deliver covered care. This 

will provide eligible Veterans coordinated, timely access to specialty care through 

a comprehensive network of non-VA providers who meet VA quality standards when 

VA cannot readily provide the specialty care in-house due to geographic inaccessibility, lack of available specialists, and other factors. PC3 contracts have been 

awarded in six regions. 

VA envisions the integration of PC3 will perpetuate increased access for Veterans 

in distance-challenged areas, provide quality health specialty care within all applicable VISN locations, and systematically reduce cost over time to ensure Veterans 

have accessible health care closer to their homes. 

Question 114. In fiscal year 2014, the Office of Rural Health funded approximately 

114 Rural Veteran Transportation Programs. Please provide the Committee with a 

list of where these projects are currently located, how many veterans are participating, and what metrics are used to determine the success of these projects. 

Response. The 14 Rural Veteran Transportation Programs are being used in the 

following locations: Wilmington, Delaware; Beckley, West Virginia; Dayton, Ohio; 

Danville, Illinois (two projects); Battle Creek, Michigan; Indianapolis, Indiana (two 

projects); Iron Mountain, Michigan; Muskogee, Oklahoma; Harlingen, Texas; Spokane, Washington; Yuba City, California; Saginaw, Michigan. 

In fiscal year 2014, VHA data indicates that these transportation programs served 

14,494 rural Veterans and saved those Veterans over 379,000 travel miles. In addition, these projects have traveled 986,000 miles transporting rural Veterans in nearly 34,500 separate trips and an overall Veteran satisfaction rating 4.8 (5.0 scale, 

with 5 indicating completely satisfied). 

Long-term Care 

Question 115. More than half of the veterans seeking healthcare through VA are 

over the age of 65. As the veterans population continues to age, the Department will 

be faced with challenges of chronic health conditions as well as increasing demand 

for long-term care services. The fiscal year 2015 budget request includes a decrease 

in funding for State Veterans Homes grants. How will the decrease in construction 

funding impact the availability of beds for veterans seeking long-term care through 

State Homes? 

Response. The decrease in the FY 2015 budget for funding State Veterans Home 

construction grant applications is projected to have a minimal impact. Although it 

is not possible at this time to predict with certainty how the FY 2015 budget will 

affect the number of new bed construction grant applications received, the two unfunded construction bed projects on the FY 2014 priority list were applications to 

replace existing beds. Therefore, these two projects would not affect bed availability. 

The current bed levels in the State Veterans Home program are such that occupancy rates average 85 percent. An occupancy rate averaging 85 percent indicates 

that a significant number of nursing home beds throughout the State Veterans 

Home program are consistently unfilled or unused. 

As VA examined budgetary needs for Long-Term Services and Supports (LTSS), 

the focus remained on anticipated shifts in LTSS utilization from institutional to 

non-institutional care. As enrollees have greater access to home and communitybased services, it is expected there will be less demand for long-stay facility-based 

services. This not only applies to VA’s own Community Living Centers and contracted nursing home programs but to State Veterans Nursing Home programs as 

well. 

Transportation 

Question 116. VA has several transportation programs, including the Veterans 

Transportation Service (VTS), beneficiary travel, and numerous pilot programs that 

are supported through the Office of Rural Health. 

A. How does VA track all funding utilized to provide for the transportation of veterans to VA facilities? 

Response. Funding for transportation of Veterans comes from several sources depending on the program utilized. For VTS, VHA’s CBO and Office of Rural Health 

140 

partner to provide funds to the VA facilities. Funds are tracked by the respective 

programs through the dispersal process and also at the facilities by using specific 

budget object codes and fund control points. Funding for the Beneficiary Travel program is part of the individual facility budget and is also tracked at the local level 

by use of budget object codes and fund control points, and nationally via the VHA 

Support Service Center. 

B. What metrics does VA have in place to ensure that these programs and pilot 

programs are not duplicative? 

Response. VTS has a well-established collaborative partnership with VHA’s Office 

of Rural Health. VTS and the Office of Rural Health meet on a monthly basis to 

discuss joint efforts and to consider all aspects of shared projects, including expansion/deployment of program functions, programs interaction and coordination of efforts. This process is defined in a Memorandum of Understanding between the programs that includes several features to guarantee non-duplication and enhanced collaboration at the facility level. These features include: 

• Joint review of all medical center and VISN submissions/applications for participation and requests for funding to both programs; 

• An identified methodology for comprehensive planning, identifying locations for 

joint funding and the funding formulas; 

• Specific agreements regarding sustainment funding; and 

• Specific metric reporting elements and a metric reporting system. 

Medical Support and Compliance 

Question 117. The Medical Support and Compliance appropriations account provides funding for the management, administration, and security of the more than 

1,750 facilities throughout VHA. The VA medical centers and Other Field Activities 

subaccount is projected to decrease by $147 million or 3.7 percent between fiscal 

year 2014 and fiscal year 2015 and increase by $177 million or 4.7 percent between 

fiscal year 2015 and fiscal year 2016. The VA medical centers and Other Field Activities subaccount supported 36,977 FTE in 2013. 

A. What accounts for the $147 million decrease between fiscal year 2014 and fiscal year 2015? 

B. What accounts for the $177 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. Total Medical Support and Compliance obligation estimates for FY 

2014–2016 take into consideration anticipated changes in FTEE levels; travel and 

transportation of persons; rent, communications, and utilities; printing and reproduction; contractual services; supplies and materials, equipment; and, lands and 

structures based on past history and future requirements. Increases in FY 2015 and 

FY 2016 represent for the most part inflationary increases. Once those obligation 

estimates are determined, VA maintains the same proportion as reflected in the latest actual available (2013 actual for purposes of the FY 2015 Congressional submission) (see Percent of Overall Medical Support and Compliance Staffing by Function 

Table). VHA is undertaking an analysis of staffing levels and overall resources necessary to support the delivery of medical care. This analysis includes both central 

and field activities and may result in a shift in funding allocations among activities. 

VA has already assumed a total reduction of 1,289 FTEEs in 2015 compared to 

2014. Please refer to the table below. 

Percent of Overall Medical Support and Compliance Staffing by Function 

Description 2013 2014 2015 2016 

VAMCs and Other Field Activities .......................................................................... 65 % 65 % 64 % 64 % 

VISN Headquarters ................................................................................................. 3 % 5 % 5 % 5 % 

VHA Central Office ................................................................................................. 12 % 10 % 11 % 10 % 

Consolidated Patient Account Centers .................................................................. 5 % 5 % 5 % 5 % 

Office of Informatics and Analytics ....................................................................... 4 % 4 % 4 % 4 % 

Health Administration Center ................................................................................ 4 % 4 % 4 % 4 % 

Employee Education Service Center ....................................................................... 1 % 1 % 1 % 1 % 

VHA Service Center ................................................................................................ 4 % 4 % 4 % 4 % 

Health Resource Center ......................................................................................... 1 % 1 % 1 % 1 % 

Health Eligibility Center ......................................................................................... 1 % 1 % 1 % 1 % 

Consolidated Mail Outpatient Pharmacies ............................................................ 0 % 0 % 0 % 0 % 

National Center for Patient Safety ........................................................................ 0 % 0 % 0 % 0 % 

141 

Question 118. The VHA Central Office subaccount is projected to increase by $12 

million or 1.9 percent between fiscal year 2014 and fiscal year 2015 and increase 

by $13 million or 2 percent between fiscal year 2015 and fiscal year 2016. The VHA 

Central Office subaccount supported 1,680 FTE in 2013. 

A. What accounts for the $12 million increase between fiscal year 2014 and fiscal 

year 2015? 

B. What accounts for the $13 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 117 also applies to questions 118–125. 

Question 119. The CPAC subaccount is projected to increase by $5.7 million or 1.9 

percent between fiscal year 2014 and fiscal year 2015 and increase by $6.4 million 

or 2.1 percent between fiscal year 2015 and fiscal year 2016. The CPAC subaccount 

supported 3,082 FTE in 2013. 

A. What accounts for the $5.7 million increase between fiscal year 2014 and fiscal 

year 2015? 

B. What accounts for the $6.4 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 117 also applies to questions 118–125. 

Question 120. The Office of Informatics and Analytics (OIA) subaccount is projected to increase by $4.9 million or 1.9 percent between fiscal year 2014 and fiscal 

year 2015 and increase by $5.6 million or 2.1 percent between fiscal year 2015 and 

fiscal year 2016. The OIA subaccount supported 634 FTE in 2013. 

A. What accounts for the $4.9 million increase between fiscal year 2014 and fiscal 

year 2015? 

B. What accounts for the $5.6 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 117 also applies to questions 118–125. 

Question 121. The Health Administration Center (HAC) subaccount is projected 

to increase by $4.2 million or 1.9 percent between fiscal year 2014 and fiscal year 

2015 and increase by $4.7 million or 2.1 percent between fiscal year 2015 and fiscal 

year 2016. The HAC subaccount supported 1,055 FTE in 2013. 

A. What accounts for the $4.2 million increase between fiscal year 2014 and fiscal 

year 2015? 

B. What accounts for the $4.7 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 117 also applies to questions 118–125. 

Question 122. The Employee Education Service Center (EES) subaccount is projected to increase by $1.3 million or 1.9 percent between fiscal year 2014 and fiscal 

year 2015 and increase by $1.5 million or 2.1 percent between fiscal year 2015 and 

fiscal year 2016. The EES subaccount supported 370 FTE in 2013. 

A. What accounts for the $1.3 million increase between fiscal year 2014 and fiscal 

year 2015? 

B. What accounts for the $1.5 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 117 also applies to questions 118–125. 

Question 123. The VHA Service Center (VSC) subaccount is projected to increase 

by $4.7 million or 1.9 percent between fiscal year 2014 and fiscal year 2015 and increase by $5.3 million or 2.1 percent between fiscal year 2015 and fiscal year 2016. 

The VSC subaccount supported 2,489 FTE in 2013. 

A. What accounts for the $4.7 million increase between fiscal year 2014 and fiscal 

year 2015? 

B. What accounts for the $5.3 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 117 also applies to questions 118–125. 

Question 124. The Health Resource Center (HRC) subaccount is projected to increase by $0.9 million or 1.8 percent between fiscal year 2014 and fiscal year 2015 

and increase by $1.1 million or 2.1 percent between fiscal year 2015 and fiscal year 

2016. The HRC subaccount supported 729 FTE in 2013. 

A. What accounts for the $0.9 million increase between fiscal year 2014 and fiscal 

year 2015? 

142 

B. What accounts for the $1.1 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 117 also applies to questions 118–125. 

Question 125. The Health Eligibility Center (HEC) subaccount is projected to in- crease by $0.9 million or 1.9 percent between fiscal year 2014 and fiscal year 2015 

and increase by $1 million or 2.1 percent between fiscal year 2015 and fiscal year 

2016. The HEC subaccount supported 265 FTE in 2013. A. What accounts for the $0.9 million increase between fiscal year 2014 and fiscal 

year 2015? B. What accounts for the $1 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 117 also applies to questions 118–125. 

Medical Facilities 

Question 126. The Medical Facilities account provides for the operations and 

maintenance of VHA facilities. The Engineering and Environmental Management 

Services subaccount is projected to decrease by $23.3 million or 4.3 percent between 

fiscal year 2014 and fiscal year 2015 and increase by $19 million or 3.7 percent between fiscal year 2015 and fiscal year 2016. This subaccount supported 3,182 FTE 

in 2013. 

A. What accounts for the $23.3 million decrease between fiscal year 2014 and fiscal year 2015? B. What accounts for the $19 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016 

Response. Total Medical Facilities obligation estimates for FY 2014-FY 2016 take 

into consideration anticipated changes in FTEE levels; travel and transportation of 

persons; rent, communications, and utilities; printing and reproduction; contractual 

services; supplies and materials, equipment; and lands and structures based on past 

history and future requirements. Once those obligation estimates are determined, 

VA maintains the same proportion as reflected in the latest actual available (2013 

actual for purposes of the FY 2015 Congressional Submission) (see Percent of Overall Medical Facilities (Excluding Non-Recurring Maintenance Table). FY 2015 Estimate for Non-Recurring Maintenance (NRM) reflects the FY 2015 Advance Appropriation level. FY 2016 NRM estimate of $460.6 million continues the same program 

funding level as projected in FY 2015. VA has already assumed a total reduction 

of 823 FTEEs in 2014 compared to 2013. Overall FTEE level estimates for Medical 

Facilities are 22,818 in 2014–2016. FTEE levels are subject to change. VHA is undertaking an analysis of staffing levels necessary to support the delivery of medical 

care (estimated delivery date September 2014). 

Percent of Overall Medical Facilities 

(Excluding Non-Recurring Maintenance) 

(Obligations) 

Description 2013 2014 2015 2016 

Engineering & Environmental Management Services ........................................... 14 % 13 % 12 % 12 % 

Plant Operations and Leases ................................................................................. 31 % 37 % 42 % 42 %

Transportation Services .......................................................................................... 4 % 3 % 3 % 3 % 

Grounds Maintenance & Fire Protection ................................................................ 2 % 2 % 2 % 2 % 

Recurring Maintenance & Repair .......................................................................... 14 % 13 % 12 % 12 % 

Operating Equipment Maintenance & Repair ....................................................... 12 % 11 % 10 % 10 % 

Environmental Management Service ..................................................................... 18 % 16 % 15 % 15 % 

Other Facilities Operation Support ........................................................................ 1 % 1 % 1 % 1 % 

Textile Care Processing and Management ............................................................ 5 % 4 % 4 % 4 % 

Question 127. The Plant Operations and Leases subaccount is projected to increase by $233.3 million or 15 percent between fiscal year 2014 and fiscal year 2015 

and increase by $82.5 million or 4.6 percent between fiscal year 2015 and fiscal year 

2016. This subaccount supported 1,369 FTE in 2013. 

A. What accounts for the $233.3 million increase between fiscal year 2014 and fiscal year 2015? 

B. What accounts for the $82.5 million increase between fiscal year 2015 and fiscal year 2016? 

143 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 126 also applies to questions 127–135. 

Question 128. The Transportation Services subaccount is projected to decrease by $5.9 million or 4.3 percent between fiscal year 2014 and fiscal year 2015 and increase by $4.8 million or 3.7 percent between fiscal year 2015 and fiscal year 2016. 

This subaccount supported 1,140 FTE in 2013. A. What accounts for the $5.9 million decrease between fiscal year 2014 and fiscal 

year 2015? B. What accounts for the $4.8 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 126 also applies to questions 127–135. 

Question 129. The Transportation Services subaccount is projected to decrease by $5.9 million or 4.3 percent between fiscal year 2014 and fiscal year 2015 and increase by $4.8 million or 3.7 percent between fiscal year 2015 and fiscal year 2016. 

This subaccount supported 1,140 FTE in 2013. A. What accounts for the $5.9 million decrease between fiscal year 2014 and fiscal 

year 2015? B. What accounts for the $4.8 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 126 also applies to questions 127–135. 

Question 130. The Ground Maintenance and Fire Protection subaccount is projected to decrease by $3.6 million or 4.3 percent between fiscal year 2014 and fiscal 

year 2015 and increase by $2.9 million or 3.7 percent between fiscal year 2015 and 

fiscal year 2016. This subaccount supported 732 FTE in 2013. 

A. What accounts for the $3.6 million decrease between fiscal year 2014 and fiscal 

year 2015? 

B. What accounts for the $2.9 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 130 also applies to questions 127–135. 

Question 131. The Recurring Maintenance and Repair subaccount is projected to 

decrease by $22.5 million or 4.3 percent between fiscal year 2014 and fiscal year 

2015 and increase by $18.4 million or 3.7 percent between fiscal year 2015 and fiscal 

year 2016. This subaccount supported 3,309 FTE in 2013. 

A. What accounts for the $22.5 million decrease between fiscal year 2014 and fiscal year 2015? 

B. What accounts for the $18.4 million increase between fiscal year 2015 and fiscal year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 126 also applies to questions 127–135. 

Question 132. The Non-Recurring Maintenance subaccount is projected to decrease 

by $334 million or 42 percent between fiscal year 2014 and fiscal year 2015 and remain at $460.6 million for fiscal year 2016. This subaccount supported 121 FTE in 

2013. 

A. What accounts for the $334 million decrease between fiscal year 2014 and fiscal year 2015? 

B. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 126 also applies to questions 127–135. 

Question 133. The Operating Equipment Maintenance and Repair subaccount is 

projected to decrease by $18.9 million or 4.3 percent between fiscal year 2014 and 

fiscal year 2015 and increase by $15.4 million or 3.7 percent between fiscal year 

2015 and fiscal year 2016. This subaccount supported 2,012 FTE in 2013. 

A. What accounts for the $18.9 million decrease between fiscal year 2014 and fiscal year 2015? 

B. What accounts for the $15.4 million increase between fiscal year 2015 and fiscal year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 126 also applies to questions 127–135. 

Question 134. The Environmental Management Service subaccount is projected to 

decrease by $28.7 million or 4.3 percent between fiscal year 2014 and fiscal year 

2015 and increase by $23.5 million or 3.7 percent between fiscal year 2015 and fiscal 

year 2016. This subaccount supported 10,512 FTE in 2013. 

A. What accounts for the $28.7 million decrease between fiscal year 2014 and fiscal year 2015? 

144 

B. What accounts for the $23.5 million increase between fiscal year 2015 and fiscal year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 126 also applies to questions 127–135. 

Question 135. The Textile Care Processing and Management subaccount is projected to decrease by $7.6 million or 4.3 percent between fiscal year 2014 and fiscal 

year 2015 and increase by $6.2 million or 3.7 percent between fiscal year 2015 and 

fiscal year 2016. This subaccount supported 1,264 FTE in 2013. 

A. What accounts for the $7.6 million decrease between fiscal year 2014 and fiscal 

year 2015? 

B. What accounts for the $6.2 million increase between fiscal year 2015 and fiscal 

year 2016? 

C. What is the estimated FTE for 2014, 2015, and 2016? 

Response. The response to question 126 also applies to questions 127–135. 

NATIONAL CEMETERY ADMINISTRATION

Question 136. The fiscal year 2014 current estimate for Grants for Construction 

of Veterans’ Cemeteries is $62.1 million; however, the budget estimate for fiscal 

year 2015 was only $44.6 million, a difference of $17.4 million. The fiscal year 2015 

request for the grant program is $45 million. 

A. What led to the unobligated balance of $16.1 million that was left over from 

fiscal year 2013? 

Response. The Department of Veterans Affairs’ (VA) ability to obligate grant 

funds depends in large part on a state’s readiness to proceed. Two projects experienced issues late in the Federal fiscal year that could not be resolved by the proposed suspense date. One project could not proceed as anticipated due to Environmental Assessment issues, and the other could not proceed due to timing of conveying the underlying land to the state. By the time the two projects were deferred 

by the states, it was too late to re-allocate the funds to other projects. VA has committed the $16.1 million to other projects and plans to make awards this fiscal year. 

B. Does VA expect a similar carryover into fiscal year 2015? If so, please provide 

the amount and reasoning for the assumption. 

Response. No, Department of Veterans Affairs does not anticipate a similar carryover into fiscal year 2015. However, because final grant awards are based on a 

state’s readiness, a small amount of carryover each year is not unusual. 

C. How many states have pending requests for state veteran cemeteries grants? 

Please list the grant application by state, location, and priority status. 

Response. The fiscal year 2014 Priority List (attached) has a total of 87 pending 

grant requests for state and tribal cemeteries. These grant requests are identified 

by priority groups 1–4: 

Priority Group 1—Projects needed to avoid disruption in burial service that would 

otherwise occur at existing veterans cemeteries within 4 years of the date of the 

preapplication. Such projects would include expansion projects, as well as improvement projects (such as construction of additional or replacement facilities) when 

such improvements are required to continue interment operations. 

Priority Group 2—Projects for the establishment of new Veterans cemeteries. 

Priority Group 3—Expansion projects at existing Veterans cemeteries when a disruption in burial service due to the exhaustion of existing gravesites is not expected 

to occur within 4 years of the date of the preapplication. 

Priority Group 4—Improvement projects for cemetery landscaping or infrastructure, such as building expansion and upgrades to roads and irrigation systems, that 

are not directly related to the development of new gravesites. Operation and Maintenance Projects that address National Cemetery Administration’s national shrine 

standards of appearance are included in this group. 

145 


312Bu136c1.eps
146 


312Bu136c2.eps
147 


312Bu136c3.eps
148 


312Bu136c4.eps
149 

Question 137. The fiscal year 2015 budget requests states: ‘‘Internments in 2013 

were 124,785 and are expected to peak at about 130,000 in 2017. Internments will 

begin to decline gradually and expected to be about 126,000 in 2020.’’ 

A. Please provide the Committee with detailed information on the number of veterans whose families chose an inurnment (please breakdown between in-ground 

inurnment and those urns placed in a columbarium) as compared to the number 

who elected for an in-ground casket burial over the last five years. 

Response. 

2009 2010 2011 2012 2013 

Full Casket .......................................................................................... 57,634 59,503 61,036 59,708 61,656 

In-Ground Cremains ............................................................................ 30,023 31,547 33,155 33,327 33,588 

Columbaria .......................................................................................... 18,704 20,757 23,221 25,121 29,541 

Total Interments ......................................................................... 106,361 111,807 117,412 118,158 124,785 

B. What are the projections for inurnments compared to in-ground casket burial 

through 2020? 

Response. 

2014 2015 2016 2017 2018 2019 2020 

Full Casket ..................................................... 61,800 61,900 61,700 61,900 61,500 60,100 59,700 

In-Ground Cremains ...................................... 32,500 33,600 33,200 32,700 31,800 30,900 29,800 

Columbaria .................................................... 31,400 32,600 34,300 35,400 35,500 36,800 36,600 

Total Interments ................................... 125,700 128,100 129,200 130,100 128,800 127,800 126,100 

C. Will an increase in the numbers of inurnments versus in-ground casket burial 

affect VA’s long-term projections on the need for additional land acquisition and construction? If so, please provide a detailed explanation. 

Response. National Cemetery Administration (NCA) projects that the number of 

inurnments versus in-ground casket burials will continue to increase for the foreseeable future; however, it is unlikely that this trend will affect the need for additional 

land acquisition and construction. In fiscal year (FY) 2013, NCA conducted 60,742 

in-ground burials in national cemeteries, which comprised 49.4 percent of total interments. NCA projects to conduct approximately 50,200 in-ground casket burials in 

national cemeteries, comprising 45.5 percent of total interments in FY 2050. These 

data illustrate both the continuing need for burial space at Department of Veterans 

Affairs (VA) national cemeteries and the demand for in-ground casket burials as an 

option for Veterans who choose interment in a national cemetery. Through the use 

and continued development of land-saving features, such as pre-placed crypts, 

columbaria, and memorial walls, NCA will maximize land use at national cemeteries and slow the rate at which new land may need to be acquired. However, the 

demand for new land will continue for the foreseeable future to ensure that VA is 

able to meet the burial needs of Veterans and their eligible family members. 

Question 138. Arlington National Cemetery (ANC) has faced a number of management, infrastructure, and information technology challenges in the last five years. 

The National Cemetery Administration (NCA) was called upon to assist the Department of the Army and ANC to fix the numerous issues that were discovered at the 

cemetery. Many of these challenges have been resolved through the development of 

new technology, including geospatial tools and other grave location applications. Has 

NCA incorporated any of the new technology into its operations? If so, please detail 

the technology and how it is being used. 

Response. National Cemetery Administration (NCA) is pursuing several technologies to improve cemetery operations, ensure the accountability of remains, and 

enhance the experience of visitors at Department of Veterans Affairs national cemeteries. NCA works continuously to upgrade existing information systems, such as 

the Burial Operations Support System and the Automated Monument Application 

System. NCA has implemented automation enhancements to these systems utilized 

for critical processes, including scheduling of committal services, establishing 

records of interment, and ordering and tracking delivery of headstones and markers. 

NCA is also conducting pilot studies to integrate geospatial information technology to enhance documentation associated with the interment process and the 

marking of graves. At Indiantown Gap National Cemetery, PA, employees are testVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00153 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
150 

ing GPS technology to attach geographic coordinates to digital records of casket and 

urn tags, and temporary and permanent gravesite markers. In a separate project, 

NCA is utilizing architect engineers to survey existing gravesites at six cemeteries 

to compile GPS information along with digital photographs of each headstone and 

marker. NCA is assessing the potential for eventual nationwide adoption of such 

processes to improve the accuracy of gravesite layout maps and records of interment; to support caretakers in the field with information immediately available via 

mobile devices; and to enhance visitors’ ability to locate gravesites and obtain other 

information concerning the history and features of national cemeteries. NCA plans 

to adopt geospatial information technology with all interments that are conducted 

at five new national cemeteries that are planned to open nationwide beginning in 

2015. 

Question 139. When burial requests are initiated with the National Cemetery 

Scheduling Office, NCA personnel ask a number of questions regarding burial arrangements, including whether a veteran is ineligible pursuant to title 38, United 

States Code (U.S.C.), section 2411. Please provide a list of all the questions that are 

asked by NCA to funeral homes, family members, and other individuals who have 

contacted NCA for burial. 

Response. The National Cemetery Administration employee asks a series of questions during the initial interview process to establish a record of interment and eligibility for burial. The following points guide the gathering of information from families or their representatives who call to schedule a burial in a Department of Veterans Affairs national cemetery. 

1. National cemetery selected. 

2. Determine if this is a first interment using the burial eligibility of a Veteran 

or a subsequent interment (Veteran or dependent is already interred). 

3. If subsequent interment, name of the decedent who is already interred. 

4. Decedent’s full name, gender, SSN, date of death, date of birth, and relationship to Veteran. 

5. Contact information (Funeral Home, director’s name, phone number, and email 

address). 

6. Next of Kin information (name, relationship to the deceased, SSN, phone number, and address). 

7. Determine if the decedent resided within 75 miles of the requested cemetery. 

8. Zip code and County of decedent at time of death. 

9. Type of burial (casket or cremation), casket size, liner size, urn size. 

10. Marital status of Veteran. 

11. If the spouse is a Veteran: Determine if a set-aside gravesite is requested. 

12. Ask if there are adult disabled dependent children who may be eligible for future interment. 

13. Determine military documentation to establish eligibility for burial. 

14. Ask whether the decedent had ever committed a capital crime. 

15. Ask whether the decedent had been convicted of a sexual offense for which 

a minimum of life imprisonment was imposed. 

16. Determine if the family has requested a service with military honors. 

17. Ask if the family desires an emblem of belief on the headstone or marker; and 

if so, what type. 

VOCATIONAL REHABILITATION AND EMPLOYMENT

Question 140. The fiscal year 2015 budget request proposes a legislative change 

to title 38, U.S.C., section 3697 to remove the annual funding limitation available 

to provide contract vocational and educational counseling to individuals qualifying 

under section 3697(A). 

A. Please provide the Committee with the number of veterans who have participated in this counseling. 

Response. The current VetSuccess on Campus contract for Chapter 36 vocational 

and educational counseling support runs from July 2013 to July 2014. 

• Utilizing FY 2013 funds to date, there were 7,418 Veterans who participated 

in contract Chapter 36 vocational and educational counseling, with an additional 

2,218 referrals for this counseling currently in progress. 

Utilizing FY 2014 funds to date, there were 339 Veterans who participated in contract Chapter 36 vocational and educational counseling, with an additional 262 referrals for this counseling currently in progress. 

B. How many contractors have been used to provide the counseling under section 

3697? 

151 

Response. Utilizing FY 2013 funds to date, a total of 22 contractors have been 

used to provide the counseling under section 3697. Utilizing FY 2014 funds to date, 

a total of 10 contractors have been used to provide the counseling under section 

3697. 

C. How much funding was used in fiscal years 2013 and 2014 for the counseling, 

and how much remained under the statutory funding cap each year? 

Response. Section 3697 of title 38 U.S.C authorizes VA to use $6 million from the 

RB account to pay for educational or vocational counseling services obtained by VA 

by contract for Veterans applying for or receiving Education or VR&E benefits. In 

FY 2013, over $5.2 million was obligated from the RB account for contract vocational and educational counseling, and approximately $0.8 million remained under 

the statutory funding cap. Of the $5.2 million obligated, over $2.6 million has been 

paid and we expect to pay invoices from the remaining $2.6 million. In FY 2014, 

obligations to date total over $1.4 million, leaving a current balance of approximately $4.6 million available to provide contract vocational and educational counseling to individuals qualifying under section 3697(A). 

Question 141. It is the Committee’s understanding that the Vocational Rehabilitation and Employment (VR&E) C-WINRS information technology system has faced 

a number of problems that have lowered its effectiveness. 

A. What steps is VR&E taking to mitigate these issues? 

Response. VR&E Service has identified both business process changes and IT system enhancements to improve data capture and reporting capability within 

CWINRS. These changes include streamlining the case status change movements 

and expanding select data points. 

B. What are the long-term plans to replace or upgrade the system? 

Response. VR&E Service has developed the business requirements for case-management technology to replace CWINRS, (a case-management software application 

named after the stations that collaborated to develop the original version: 

Waco, Indianapolis, Newark, Roanoke, and Seattle). The business requirements 

are currently being validated. The desired future system will better reflect the business and data reporting needs of the VR&E Program. 

Question 142. The VetSuccess on Campus (VSOC) program has expanded to at 

least 94 campuses over the last few years. The Committee has heard from academic 

administrators, at participating schools, that VSOC counselors do not have set performance standards and they often provide services that are outside the scope of 

services the program was originally designed for. 

A. Please provide a list of schools that currently have VSOC counselors on campus, and what schools VA currently plans to expand VSOC to during fiscal year 

2015. 

Response. The VetSuccess on Campus (VSOC) program is currently at 94 campuses nationwide, with 79 VSOC vocational rehabilitation counselors. VA is committed to the VSOC program, and will continue to evaluate schools in 2015 for potential future participation in 2016. Attached is the list of VSOC sites in alphabetical order and state. 

152 


Burr142a1.eps
153 


Burr142a2.eps
154 

B. What performance measures are currently used to determine the effectiveness 

of VSOC counselors? 

Response. To address the specific duties of a VSOC counselor on campus, separate 

performance standards were developed and implemented for FY 2014. 

VBA’s Office of Field Operations notified VBA ROs of the national performance 

standards for VSOC counselors. These performance standards highlight academic 

outreach activities, including those for Veterans on academic probation. Other performance factors include timeliness of Chapter 36 vocational and educational counseling, entitlement determinations, customer service, and accuracy. The performance 

standards include the following elements: 

Element 1: Production/outcomes identified as new student contact rate, outreach activities, and academic probation. 

• New student contact rate: 80 percent of new Veterans on campus contacted during the first semester of attendance 

• Outreach activities and events: 12 VSOC related activities per year 

• Academic probation outreach activities: Outreach to 95 percent of Veterans and beneficiaries on academic probation 

Element 2: Timeliness of claims processing 

• Chapter 36 timeliness: average of 30 days 

• Days to entitlement decisions: average of 40 days 

Element 3: Quality/accuracy of work 

• VSOC vocational rehabilitation counselor accuracy (85 percent) 

Element 4: Customer service 

• VSOC counselors will maintain professional, positive, and helpful relationships with internal and external customers by exercising tact, diplomacy, and cooperation. Performance demonstrates the ability to adjust to 

change or work pressures, to handle differences of opinion in a professional 

manner, and to follow instructions conscientiously. As a division member, 

the VSOC counselor will contribute to the success of the VetSuccess on 

Campus mission by supporting school certifying and campus officials, as 

well as Veterans and dependents from neighboring schools. 

Element 5: Program and data integrity 

• The VSOC counselor will complete all counseling actions and documentation (both written and computer entry) in compliance with VBA’s program 

directives. 

Element 6: Cooperation and organizational support 

• The VSOC counselor understands the agency mission and supports efforts to improve the work unit’s performance through positive interaction 

with others. 

• Displays professionalism and treats school officials, Veterans, and employers with courtesy and respect. 


Burr142a3.eps
155 

• Cooperates with supervisors, school officials, volunteers, and work-study 

students to accomplish work objectives and enhance efficiency. 

• Recognizes the importance of teamwork and is sensitive to the contributions of others. 

• Communicates, shares ideas, and demonstrates respect for differing viewpoints. 

• Participates in cross-functional teams to address shared challenges, facilitate better communication, and achieve agency goals. 

C. Please describe in detail the supportive services a VSOC counselor is allowed 

to provide veterans and what, if any, services are directly prohibited. 

Response. Vocational Rehabilitation Counselors (VRC) are uniquely qualified, by 

virtue of their ability to provide Veterans with information about and seamless access to VA benefits and services, to support those Veterans’ successful integration 

into college and university campuses and support their individualized educational 

goals, so they may persist, graduate, improve their life circumstances, and successfully live and thrive in the career field and community of their choice. 

VSOC supportive services are specific in order to address the need of the Veteran, 

but encompass the following main categories: 

• Adjustment counseling to resolve problems interfering with completion of education programs and entrance into employment 

• Vocational testing 

• Career and academic counseling (Chapter 36) 

• Expedited VR&E services 

• Support, assistance, and services to all Veterans eligible for VA benefits. 

Question 143. A veteran qualifies for VR&E eligibility if they a have a VA serviceconnected disability rated at least 20 percent with an employment handicap, or 

rated 10 percent with a serious employment handicap. 

A. Please provide the numbers and percentages of all VR&E participants for each 

of the five tracks by disability ratings. 

Response. This data is not readily available. VBA is currently working to pull the 

data. Once the data is available, we will provide it to the Committee. 

B. Please provide a list of the most prevalent disabilities of those veterans qualifying for VR&E services who are rated 10 percent. 

Response. VR&E Service has no reporting capability that captures disability, gender, age, or similar demographic information for VR&E program participants based 

on their employment track or independent living status. VBA is working to obtain 

this information. We will pass this information to the Committee when it becomes 

available. 

C. Once a veteran has received an entitlement decision and the veteran and 

VR&E counselor are developing a rehabilitation plan, is the type of services considered based on what limitations the veteran faces directly associated with their disability or on what type of employment the veteran wants to pursue irrespective of 

the disability? 

Response. The mission of VR&E is to provide services to eligible transitioning Servicemembers and Veterans with service-connected disabilities and an employment 

handicap to help them prepare for, find, and maintain suitable employment. Each 

VR&E program applicant participates in a comprehensive evaluation with a professional Vocational Rehabilitation Counselor (VRC) to determine entitlement to services. The comprehensive evaluation includes an assessment of the Veteran’s educational and employment history and current interests, aptitudes, and abilities, as 

well as the current and projected impact of the Veteran’s service-connected disabilities and other medical conditions on employability, to assist in identifying the Veteran’s rehabilitation needs. 

Once the evaluation is complete and the Veteran’s rehabilitation needs are identified, the VRC will work with the Veteran to develop an individualized rehabilitation 

plan. The plan takes into account the Veteran’s interests, aptitudes, and abilities, 

as well as disability/medical considerations and labor-market factors likely to impact 

successful employment. As the goal of VR&E program is to assist Veterans to overcome the effects of service-connected condition(s), the selected employment goal 

must be suitable. Specifically, it must not aggravate the Veteran’s disabilities, it 

must be stable, and it must be consistent with his or her pattern of abilities, aptitudes, and interests. While the VRC takes into account what the Veteran wants in 

terms of vocational pursuits, VR&E focuses on the needs of the individual and the 

disability impairments that may impede his or her success in a particular field. 

D. How does whether or not a veteran plans to seek employment after completing 

a course of rehabilitation factor into a counselor’s decision to approve a rehabilitaVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00159 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
156 

tion plan? If a counselor believes a veteran does not intend to pursue employment, 

is there a prohibition against approving a rehabilitation plan? 

Response. The mission of VR&E is to provide services to eligible transitioning Servicemembers and Veterans with service-connected disabilities and an employment 

handicap to help them prepare for, find, and maintain suitable employment. The 

majority of rehabilitation plans have an end goal of employment. A rehabilitation 

plan is normally developed with the stated goal of employment, and the plan may 

or may not include training. If a vocational goal/employment is not feasible at that 

point for the Veteran, then a plan is developed to focus on activities of daily living 

with desired outcome of achieving maximum independence for the Veteran. 

Independent living plans may include access to community-based support services, 

use of assistive technologies and accommodations, and independent living skills 

training. When a Veteran successfully completes a plan of independent living services, the Veteran and the VRC will work together to determine if the Veteran has 

achieved enough stability to consider pursuing employment. 

Question 144. The fiscal year 2015 budget request describes the development of 

a new VR&E Staffing Model that is scheduled for completion in 2014. 

A. Please describe the new model and how it will assist VA in making staffing 

decisions. 

Response. The new RO staffing model for the VR&E program is based on factors 

that include actual workload, type of work done by various positions (VRCs, Employment Coordinators, Program Support Specialists, etc.), and geographic locations 

of ROs, out-based offices, and Veterans. The model will provide a more systematic 

way to align staffing needs, personnel allocations, and FTE requests as part of the 

budget cycle. 

Expansion of the staffing model includes beta-testing and familiarization, adding 

new requirements, training, and a user guide. 

B. What are the key milestones and dates for completion of this model? 

Response. Requirements have been developed, and a contractor is currently working on user-acceptance testing. The model is planned to be ready for deployment in 

FY 2015. 

Question 145. Please provide the Committee data on VR&E activities by regional 

office, including but not limited to: 1) number of counselors at each office, 2) number 

required at each office, 3) rehabilitation rate, 4) timeliness, 5) cases, and 6) veterans 

served. 

Response. The number of VRCs required is based upon the Office of Field Operations (OFO) RAM, which is a staffing model based on workload demands and performance. In addition to VRC FTE allocations, OFO also allocates VR&E contract 

counseling funds to augment counseling services provided by VA employees. Station 

allocations are made based on workload demands and may be adjusted throughout 

the fiscal year to ensure coverage during workload surges and unexpected workload 

influx, or to assist in transitioning while vacant positions are backfilled. 

Number of 

Vocational 

Rehabilitation 

Counselors 

Rehabilitation 

rate 

Days to 

notification of 

entitlement 

determination 

(timeliness) 

Chapter 31 

participants 

Number of 

Veterans served 

(all Chapters) 

USA FY 2013 ................................................. 1,042 68.4 % 42 .3 135,815 140,452 

Eastern Area (16 ROs) ................................. 202 — — 29,889 30,592 

Baltimore ....................................................... 14 68.9 % 32 .9 2,073 2,156 

Boston ........................................................... 9 49.3 % 83 .5 1,415 1,426 

Buffalo ........................................................... 15 62.7 % 38 .3 2,125 2,595 

Cleveland ....................................................... 28 71.1 % 47 .1 4,779 4,795 

Detroit ............................................................ 31 63.6 % 51 .6 4,354 4,363 

Hartford ......................................................... 11 83.3 % 35 .9 1,643 1,646 

Indianapolis ................................................... 21 76.6 % 45 .8 3,401 3,403 

Manchester .................................................... 5 24.0 % 52 .2 716 719 

New York ....................................................... 16 88.8 % 46 .4 2,078 2,118 

Newark ........................................................... 11 81.9 % 43 .1 1,823 1,834 

Philadelphia .................................................. 13 71.1 % 39 .8 2,044 2,062 

Pittsburgh ...................................................... 9 46.7 % 40 .4 945 963 

Providence ..................................................... 7 73.7 % 31 .5 641 642 

Togus ............................................................. 8 83.7 % 35 .8 956 970 

White River Junction ..................................... 2 5.0 % 46 .3 597 599 

Wilmington .................................................... 2 85.1 % 43 .6 299 301 

157 

Number of 

Vocational 

Rehabilitation 

Counselors 

Rehabilitation 

rate 

Days to 

notification of 

entitlement 

determination 

(timeliness) 

Chapter 31 

participants 

Number of 

Veterans served 

(all Chapters) 

Southern Area (12 ROs) ............................... 327 — — 40,077 41,195 

Atlanta ........................................................... 46 83.9 % 41 .2 5,303 5,809 

Columbia ....................................................... 30 74.7 % 30 .6 3,127 3,131 

Huntington ..................................................... 9 92.2 % 40 .0 756 759 

Jackson .......................................................... 7 77.3 % 41 .3 1,118 1,128 

Louisville ....................................................... 25 77.9 % 39 .5 2,615 2,616 

Montgomery ................................................... 28 85.2 % 35 .9 3,883 3,891 

Nashville ........................................................ 25 73.6 % 56 .9 2,760 2,814 

Roanoke ......................................................... 30 70.3 % 39 .7 3,295 3,572 

San Juan ....................................................... 6 88.9 % 39 .3 750 761 

St. Petersburg ............................................... 64 84.4 % 37 .3 9,530 9,578 

Washington .................................................... 24 84.4 % 37 .0 2,868 2,870 

Winston-Salem .............................................. 33 78.4 % 35 .5 4,072 4,266 

Central Area (14 ROs) ................................. 275 — — 33,334 34,509 

Chicago ......................................................... 14 65.3 % 38 .4 2,258 2,268 

Des Moines .................................................... 8 73.1 % 38 .5 1,501 1,501 

Fargo ............................................................. 6 70.6 % 29 .1 497 497 

Houston ......................................................... 60 57.0 % 39 .7 7,463 7,506 

Lincoln ........................................................... 8 82.6 % 38 .6 774 774 

Little Rock ..................................................... 13 83.2 % 24 .3 1,592 1,614 

Milwaukee ...................................................... 13 89.0 % 28 .2 1,598 1,610 

Muskogee ....................................................... 22 32.1 % 46 .3 2,442 2,826 

New Orleans .................................................. 13 73.1 % 34 .6 1,631 1,635 

Sioux Falls ..................................................... 7 69.0 % 30 .4 867 870 

St. Louis ........................................................ 18 89.9 % 37 .9 2,203 2,209 

St. Paul ......................................................... 11 80.3 % 38 .0 1,519 1,533 

Waco .............................................................. 71 28.5 % 47 .6 7,870 8,540 

Wichita .......................................................... 11 84.3 % 21 .3 1,119 1,126 

Western Area (16 ROs) ................................ 238 — — 32,515 34,156 

Albuquerque .................................................. 8 79.3 % 47 .1 1,312 1,337 

Anchorage ...................................................... 8 93.8 % 54 .6 791 792 

Boise/Cheyenne ............................................. — — — — — 

Denver ........................................................... 25 81.5 % 34 .2 4,597 4,609 

Fort Harrison ................................................. 6 91.3 % 39 .9 900 902 

Honolulu ........................................................ 13 81.9 % 66 .3 1,258 1,266 

Los Angeles ................................................... 24 72.2 % 40 .6 4,284 4,355 

Manila ........................................................... 2 75.0 % 33 .8 176 176 

Oakland ......................................................... 24 80.4 % 43 .7 3,660 3,711 

Phoenix .......................................................... 21 83.5 % 43 .3 2,741 2,749 

Portland ......................................................... 21 66.3 % 57 .7 2,560 2,573 

Reno .............................................................. 5 90.8 % 42 .2 1,005 1,034 

Salt Lake City ................................................ 19 83.6 % 41 .6 1,883 1,909 

San Diego ...................................................... 30 81.9 % 38 .6 3,296 4,661 

Seattle ........................................................... 32 71.9 % 61 .9 4,052 4,082 

FILIPINO VETERANS EQUITY COMPENSATION FUND

Question 146. Information in the fiscal year 2015 budget request discusses two ongoing lawsuits that could affect the Filipino Veterans Equity Compensation Fund’s 

unobligated balance. 

A. Please describe each lawsuit, and how they could potentially affect the unobligated balance. 

Response. Both lawsuits challenge Department of Veterans Affairs’ (VA) administration of the Filipino Veterans Equity Compensation (FVEC) fund and, in particular, the ways in which VA verifies whether a claimant had the service required 

by law. 

Recinto v. U.S. Department of Veterans Affairs was brought by individual Filipino 

Veterans alleging their claims were wrongfully denied because of reliance on faulty 

records and by individual widows of Filipino Veterans challenging the statute on 

constitutional grounds. The number of individual claims directly involved in this 

case was small. However, any ruling that the Government’s process or the statute 

158 

itself is legally deficient could have conceivably expanded the scope of the program 

in ways that would have been difficult to predict. 

De Fernandez v. U.S. Department of Veterans Affairs is a putative class action 

brought by three individuals and an organization seeking declaratory and injunctive 

relief. The suit principally alleges that VA relies on faulty records and unjustified 

‘‘loyalty challenges’’ to wrongfully deny legitimate claims. If a class were certified 

and plaintiffs were successful, plaintiffs would likely ask the court to force VA to 

re-adjudicate all denied FVEC claims under new procedures crafted by the court. 

Veterans Benefits Administration projects that the end of fiscal year 2015 unobligated balance for the FVEC Fund will be $55.4 million. 

B. Does VA have a timeline for when the lawsuits will be resolved? If so, please 

provide it to the Committee. 

Response. Recinto has been fully resolved. The case was dismissed by the district 

court, and the dismissal was affirmed by the United States Court of Appeals for the 

Ninth Circuit. Recinto v. U.S. Department of Veterans Affairs, 706 F.3d 1171 (9th 

Cir. 2012). Plaintiffs petitioned the United States Supreme Court for certiorari. The 

Court denied the petition on October 7, 2013. 

The district court dismissed De Fernandez for lack of jurisdiction, relying on the 

Ninth Circuit’s holding in Recinto that district courts lack subject-matter jurisdiction over veterans’ benefits claims. The plaintiffs appealed this case to the Ninth 

Circuit, and the parties completed briefing in September 2013. We are currently 

awaiting oral arguments to be scheduled for this case. It is possible the appeal may 

be resolved within the next 12 months, depending on when the court schedules oral 

arguments and issues a decision. 

Question 147. The fiscal year 2015 budget request for the Filipino Veterans Equity Compensation Fund indicates that 333 Notices of Disagreement (NODs) have 

not been resolved. The estimate for fiscal year 2015 is that $55.4 million in unobligated funds will remain at the end of the fiscal year. 

A. When does VA believe the remaining 333 NODs will be resolved? 

Response. The 333 appeals pending were as of September 2013. Currently, 130 

Filipino Veterans Equity Compensation (FVEC) appeals are pending. 

• 64 pending at the Manila RO, of which 33 are at the NOD and substantive appeal stages and 31 remanded by the Board of Veterans’ Appeals (Board) for further 

development. 

• 56 pending at the Board. 

• 10 pending at other ROs for travel board hearings. 

The majority of the 64 appeals pending at the Manila RO are awaiting service 

verification, hearings, or a reply to the Decision Review Officer election letter. The 

Manila RO regularly provides the National Personnel Records Center (NPRC) a list 

of all pending requests for service verification. Follow ups are completed via email 

and are faxed to NPRC when necessary. Additionally, FVEC appeals are given priority in the scheduling of hearings. Some of the hearings are coordinated with the 

nearest RO where the appellant resides in the United States. Typically, the appeals 

at the Manila RO are resolved or certified to the Board in 30 to 60 days. This is 

dependent upon receiving documents from NPRC and can be extended if the claimant submits additional documents for review. 

B. Once the remaining NODs are dispensed with, when will VA close the account 

and remit the unobligated balance? 

Response. We anticipate that VA will close the FVEC Fund account once all activities are complete. In FY 2010, Congress provided authority to transfer up to $67 

million in unobligated balances from bid savings from the Major Construction account in section 901, Public Law 111–212. Any remaining funds will be returned to 

the Major Construction account for obligations as authorized by law. 

159 

RESPONSE TO POSTHEARING QUESTIONS SUBMITTED BY HON. JERRY MORAN TO

U.S. DEPARTMENT OF VETERANS AFFAIRS

Rural Health and Joint Medical Facility Projects 

Question 148. Secretary Shinseki, will you please provide analysis or report material you have received regarding the expansion of Project ARCH? What are the recommendations from staff within the VA, the Office of Rural Health and VISN 15 

on the future construct of ARCH? Do you intend to make a decision about the future 

of ARCH before the authority expires in September 2014? 

Response. Project ARCH’s congressional authority expires August 29, 2014. Section 402 of Public Law 110–387 allows the Secretary to make recommendations regarding the pilot program, including if the pilot program should be made permanent. 

In preparation for the expiration of the Congressional authority for Project ARCH, 

VHA’s CBO and Office of Rural Health are leading an integrated project team to 

review options for providing health care for rural Veterans. The team is preparing 

recommendations for senior leadership’s consideration. 

Additionally, VA is working diligently to ensure Veteran access to care is not interrupted when Project ARCH concludes. VHA’s PC3 program will be available to 

rural Veterans to help bridge this gap. 

Under PC3, VHA has contracted with Health Net Federal Services and TriWest 

Healthcare Alliance to develop a network of providers to deliver covered care. This 

will provide eligible Veterans coordinated, timely access to specialty care through 

a comprehensive network of non-VA providers who meet VA quality standards when 

VA cannot readily provide the specialty care in-house due to geographic inaccessibility, lack of available specialists, and other factors. PC3 contracts have been 

awarded in six regions. 

VA envisions the integration of PC3 will perpetuate increased access for Veterans 

in distance-challenged areas, provide quality health specialty care within all applicable VISN locations, and systematically reduce cost over time to ensure Veterans 

have accessible health care closer to their homes. 

Question 149. Secretary Shinseki, will you please provide metrics and data to ascertain how many veterans, across all VISNs, are receiving referrals for chiropractic 

care? Please describe the referral process, step by step and approximate wait time 

associated with the referral process. 

Response. The number of unique patients receiving chiropractic care on-station 

and through non-VA care for FYs 2012, 2013, and 2014 year-to-date is provided in 

the first tab of the attached spreadsheet. 

It is VA policy that access to chiropractic care, through consultation from either 

the patient’s primary care provider or another VA clinician providing care for the 

condition for which chiropractic care may be helpful, is consistent with the facility’s 

policy and practice for all other specialty care access. Additional requirements or authorizations are not to be placed on referral for chiropractic care at a VA facility 

or through the outpatient non-VA care program. 

Consistent with the same process for all medical care, when a VA provider places 

a referral for chiropractic care, a designated staff member reviews the referral for 

clinical appropriateness. If additional information is needed or if the referral appears not suited for the chiropractic clinic, the referring provider is notified for additional follow up. If the referral request is appropriate, then a staff member is notified to contact the Veteran and schedule an agreed upon appointment. If the given 

facility does not have an on-station chiropractic clinic, a designated staff member 

from the business office reviews the referral to determine eligibility and notifies the 

Veteran of follow-up steps. 

Data on wait times for on-station chiropractic care for FYs 2012, 2013, and 2014 

year-to-date are provided in the second tab of the attached spreadsheet. Wait times 

for non-VA chiropractic care is not captured by VA and cannot be reported. 

Outpatient Cube: Unique Patients for on-station (436) and non-VA (75) CHIROPRACTIC CARE 

FY 2012 Actual FY 2013 Actual FY 2014 Year-to-Date Actual 

On-station Non-VA Total On-station Non-VA Total On-station Non-VA Total 

All Payment Locations ..... 23,834 9,059 32,893 25,829 10,105 35,934 16,844 7,548 24,392 

V01 .................................. 1,462 410 1,872 1,712 246 1,958 1,131 179 1,310 

V02 .................................. 2,364 182 2,546 2,499 306 2,805 1,705 274 1,979 

V03 .................................. 171 11 182 38 17 55 59 20 79 

V04 .................................. 385 244 629 304 370 674 124 332 456 

160 

Outpatient Cube: Unique Patients for on-station (436) and non-VA (75) CHIROPRACTIC CARE— 

Continued 

FY 2012 Actual FY 2013 Actual FY 2014 Year-to-Date Actual 

On-station Non-VA Total On-station Non-VA Total On-station Non-VA Total 

V05 .................................. 445 52 497 509 106 615 376 80 456 

V06 .................................. 569 165 734 516 155 671 310 107 417 

V07 .................................. 682 126 808 742 30 772 497 13 510 

V08 .................................. 2,128 1,222 3,350 2,410 1,323 3,733 1,486 979 2,465 

V09 .................................. 960 619 1,579 974 447 1,421 560 266 826 

V10 .................................. 813 13 826 1,032 10 1,042 603 21 624 

V11 .................................. 975 509 1,484 1,223 530 1,753 688 414 1,102 

V12 .................................. 835 188 1,023 808 322 1,130 606 247 853 

V15 .................................. 1,189 638 1,827 1,212 673 1,885 755 580 1,335 

V16 .................................. 288 348 636 87 371 458 263 281 544 

V17 .................................. 3,569 92 3,661 3,645 44 3,689 2,216 8 2,224 

V18 .................................. 1,420 115 1,535 1,350 109 1,459 991 186 1,177 

V19 .................................. 767 325 1,092 753 999 1,752 360 944 1,304 

V20 .................................. 868 1,247 2,115 1,147 1,600 2,747 887 1,092 1,979 

V21 .................................. 1,012 820 1,832 1,171 802 1,973 705 491 1,196 

V22 .................................. 2,407 591 2,998 3,149 248 3,397 2,154 132 2,286 

V23 .................................. 554 1,150 1,704 564 1,404 1,968 375 905 1,280 

161 

Consult Cube: Number of Consults, Unique Patients, Average Days to Completed Consult, Percent of Consults Completed, Average Days to First Action 

(436) CHIROPRACTIC CARE 

Number of Consults Unique Patients 

Average Days to 

Completed Consult Percent of Consults Completed Average Days to First Action 

FY 2012 FY 2013 FY 2014 FY 2012 FY 2013 FY 2014 FY 2012 FY 2013 FY 2014 FY 2012 FY 2013 FY 2014 FY 2012 FY 2013 FY 2014 

All Facility ................................................................. 36,399 41,643 22,526 26,539 31,231 19,776 50 .6 49 .0 35 .2 99 .6% 95 .2% 66.1 % 59 .3 57 .1 30 .5 V01 ............................................................................ 1,983 1,972 1,049 1,478 1,570 985 61 .1 37 .9 39 .3 98 .9% 96 .1% 73.2 % 61 .9 36 .9 30 .5 V02 ............................................................................ 2,707 2,641 1,089 2,028 2,004 1,034 31 .1 29 .6 27 .4 100 .0% 96 .2% 84.1 % 46 .6 34 .1 24 .3 V03 ............................................................................ 64 174 96 60 139 88 29 .3 50 .1 50 .6 100 .0% 95 .4% 54.2 % 41 .1 52 .9 41 .1 V04 ............................................................................ 593 765 635 431 552 543 33 .1 39 .8 28 .4 100 .0% 98 .6% 64.6 % 41 .1 71 .1 38 .1 V05 ............................................................................ 592 892 436 423 637 355 65 .5 59 .3 30 .9 100 .0% 96 .5% 58.5 % 67 .5 67 .6 23 .1 V06 ............................................................................ 648 725 392 512 610 377 36 .4 56 .4 44 .8 100 .0% 95 .2% 58.7 % 36 .5 55 .2 42 .0 V07 ............................................................................ 611 651 351 581 613 341 61 .2 57 .7 28 .1 99 .7% 94 .0% 76.6 % 62 .1 54 .9 22 .5 V08 ............................................................................ 3,737 5,655 2,817 2,326 4,005 2,677 55 .2 67 .2 40 .1 99 .5% 94 .7% 54.2 % 56 .5 81 .9 39 .4 V09 ............................................................................ 1,086 1,198 639 778 942 580 33 .0 37 .7 28 .7 99 .4% 97 .4% 69.0 % 37 .4 47 .1 26 .1 V10 ............................................................................ 1,445 1,819 962 1,154 1,389 856 32 .7 24 .6 26 .3 99 .7% 96 .0% 70.2 % 37 .3 29 .3 23 .6 V11 ............................................................................ 1,926 1,582 533 1,168 984 480 28 .3 25 .1 26 .7 99 .8% 95 .8% 85.0 % 28 .0 23 .9 20 .0 V12 ............................................................................ 946 1,125 512 719 852 493 40 .0 30 .6 29 .7 99 .3% 94 .6% 82.4 % 41 .2 28 .6 22 .1 V15 ............................................................................ 3,208 3,205 1,476 2,558 2,638 1,357 106 .7 73 .7 38 .9 99 .0% 94 .3% 44.2 % 130 .0 97 .3 27 .8 V16 ............................................................................ 257 287 685 213 247 657 58 .0 77 .6 38 .8 96 .5% 90 .6% 44.1 % 64 .9 86 .4 26 .8 V17 ............................................................................ 5,379 5,100 2,441 3,957 3,892 2,287 33 .4 32 .6 33 .3 99 .6% 96 .2% 69.7 % 35 .8 32 .5 23 .8 V18 ............................................................................ 3,498 3,494 2,256 1,897 1,918 1,370 62 .3 49 .1 24 .0 99 .9% 95 .7% 81.5 % 71 .1 56 .6 22 .0 V19 ............................................................................ 765 682 195 698 626 194 32 .9 33 .6 19 .5 99 .9% 93 .0% 89.2 % 42 .4 33 .0 14 .0 V20 ............................................................................ 1,110 2,581 2,662 924 2,044 1,948 35 .1 74 .0 48 .2 99 .9% 93 .2% 65.6 % 41 .1 79 .5 40 .2 V21 ............................................................................ 1,830 2,227 1,347 1,339 1,778 1,283 49 .3 43 .8 36 .2 99 .9% 92 .9% 60.2 % 61 .3 58 .2 29 .6 V22 ............................................................................ 2,977 3,775 1,533 2,456 2,884 1,491 66 .8 62 .8 58 .3 99 .7% 94 .6% 60.2 % 89 .5 68 .5 43 .9 V23 ............................................................................ 1,037 1,093 420 841 907 380 24 .8 30 .9 14 .6 99 .5% 97 .2% 78.6 % 49 .0 50 .2 21 .5 

162 

Question 150. Secretary Shinseki, what intentions, if any, do you have to make 

certain chiropractic care referrals are streamlined for our veteran population? What 

specifically has been done to increase veterans’ access to a broader range of chiropractic services? 

Response. VA has undertaken several steps to ensure appropriate access to chiropractic services for Veterans. Considering the rates of chiropractic services use at 

VA chiropractic clinics and the U.S. population at large, VA has developed a population-based use model targeting 1.2 percent of a facility’s core unique patients. The 

chiropractic national program office continues to provide guidance and support to 

assist local VA facilities with the processes of implementing new chiropractic clinics. 

To help improve the efficiency of non-VA chiropractic services, a multidisciplinary 

workgroup developed a Clinical Patient Record System template for non-VA chiropractic consults that has been deployed and is now in use. VHA’s Office of Academic 

Affiliations has also established a pilot chiropractic residency training program 

aimed at preparing graduates to better serve VA and the Nation. 

Question 151. Secretary Shinseki, what steps are being taken or what plan has 

been developed to address physician recruitment in rural areas and the consequent 

extensive periods without physician care? Does the VA have a recruitment policy or 

framework for rural areas? Is this something the Office of Rural Health is given the 

opportunity to develop and the budget to carry it out? 

Response. VHA markets directly to physicians for rural locations through its partnership with National Rural Recruitment and Retention Network (3RNet), a national network of non-profit organizations devoted to health care recruitment for underserved and rural locations. Through this partnership, VHA has access to a robust 

database of candidates especially interested in, and leveraged against, rural vacancies. National recruiters routinely post VHA practice opportunities on 3RNet’s career page. In addition, 3RNet annually dedicates the month of November to Veteran 

health care awareness by making VHA its featured employer for the month. In FY 

2013, national recruiters increased recruitment of Veteran physicians by 43 percent 

of which 24 percent were for rural or highly rural facilities. 

Additionally, VHA’s Office of Rural Health’s goal is to develop innovative methods 

to identify, recruit and retain health care professionals in rural and highly rural 

communities. The Office of Rural Health has made significant investments to 

strengthen the rural VA provider workforce and continuously seeks to understand 

current and future rural provider workforce needs. Research shows that exposing 

students to rural health care during medical or health professions school is an effective way to recruit providers to rural areas. 

In FY 2013 and so far FY 2014, VA invested more than $15 million to support 

rural provider training and continuing education initiatives to include: 

Rural Health Training Initiative (RHTI)—This pilot program between the Office 

of Rural Health and the Office of Academic Affiliations increases rural health care 

workforce recruitment by providing opportunities for medical students and other 

health professions trainees to receive clinical training at rural health care sites. 

Launched in the fall of 2012, RHTI funds 7 projects where more than 260 clinicians 

have trained at 22 VHA rural sites of care. 

VA Geriatric Scholars Program—The Office of Rural Health supports a successful 

program to train clinicians at rural VA facilities in the most current practices in 

geriatric care. In FY 2013, this program served all 21 VISNs, including 185 facilities 

and 1,356 staff. 

Specialty Care Access Network—Extension for Community Healthcare Outcomes— 

In FY 2013, the Office of Rural Health provided funds to expand this already successful program that uses telehealth technology to provide specialty care consultation, clinical training, and clinical support from urban-based specialty care teams 

to over 100 rural VA providers at 40 rural facilities so that they can manage patients with chronic conditions closer to home. Providers trained included primary 

care physicians, nurse practitioners, and social workers. The Office of Rural Health 

is expanding this program in FY 2014 to up to 19 additional sites. 

Women’s Health Provider Training—The Office of Rural Health has provided 

funding to support the training of rural primary care providers in women’s health 

care topics. 

Rural Provider and Staff Training Initiative (RPSTI)—New in FY 2014, RPSTI 

funds 21 VHA clinical sites serving rural Veterans to implement locally based, innovative training and educational programs for health care providers and clinic staff 

on topics ranging from palliative care and dementia to polypharmacy and substance 

use disorders. 

Question 152. Secretary Shinseki, the VA FY 2015 Budget Request referred to the 

Dole VA and McConnell AFB Joint Facility in the context of: ‘‘Several major conVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00166 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
163 

struction projects that were included on the 2014 SCIP priority list were not scored 

in FY 2015 as they did not pass SCIP 2015 validation process, or were pulled from 

consideration in 2015.’’ Was the Dole VA project pulled from consideration? If not, 

please provide the steps, measures and relevant detail associated with the aforementioned validation process, to include analysis and data that substantiates the 

submission by the Dole VA did not pass the SCIP validation process. 

Response. The SCIP validation process is a multi-step effort to ensure projects are 

fully conceived and based on the most rigorous application of data possible. Validation is done at both the action plan and business case level; action plan validation 

review begins in early spring each year. 

The FY 2015 SCIP validation process found that the Wichita project’s business 

case did not address critical validation concerns and, therefore, the project was not 

scored or considered for FY 2015 funding. The scope of the project submitted was 

not well-defined and lacked clarity concerning the Department of Defense’s (DOD) 

involvement in the project. The Wichita project was removed from consideration and 

was not scored in FY 2015 because the final business case included: 

1. A cost estimate with more than a 25 percent variance from the established VA 

cost-estimating guidance; 

2. Cost data for only one valid alternative was provided (major construction), 

when a minimum of three of the five additional alternatives (major lease, contract 

out, acquire an existing facility, VA/DOD collaboration, and renovation) are required; and 

3. Cost estimates that conflicted with other supporting materials. 

VA capital planning staff will work closely with the facility, DOD, and all stakeholders to improve the project’s business case for consideration in the FY 2016 

process. 

Question 153. According to the VA FY 2015 Budget Request, ‘‘DOD CPC members 

participate actively in VA’s SCIP evaluation process and assist in identifying possible locations that would support increased collaboration.’’ Please explain the participation of DOD CPC members. How does the SCIP ‘‘evaluation’’ process differ 

from the SCIP ‘‘validation’’ process? Did DOD CPC members have the opportunity 

to assess and evaluate the Dole VA and McConnell AFB Joint Project in SCIP FY 

2015, to include the numerous MOU’s currently shared between Dole and McConnell? If not, why not? If so, what was their assessment and did it include a review 

of current MOU’s? 

Response. DOD Construction Planning Committee (CPC) members do actively 

participate in VA’s SCIP process. DOD CPC and VA members share data each year 

on facility space (excess space or need space), workload, population, and proximity. 

This information is provided to all SCIP users before the start of the annual SCIP 

process to complete their action plans. Key contacts lists by location for VA and 

DOD planners are also provided so that they can easily reach out to each other and 

work together in collaboration where potential opportunities exist. 

One of the key components of each Veterans Integrated Service Network’s (VISN) 

action plan review is the Subject Matter Expert Teams (SMET) reviews. One SMET 

focuses on DOD/VA collaboration, and each VISN is reviewed to ensure joint opportunities are fully explored and included in the VA long-range plan. In addition, DOD 

CPC members attend the VISN action plan presentations to the SCIP Board and 

can ask VISNs questions concerning DOD/VA joint opportunities. 

The validation, scoring, and prioritization of business cases is accomplished by the 

Department-wide SCIP Panel, which consists of senior staff from nine VA Administrations and Staff Offices. A project that increases sharing between DOD and VA 

would receive prioritization credit in DOD’s collaboration sub-criteria. A project that 

lowers or does not increase sharing would not receive prioritization credit. Additional information on Departmental criteria is found in response to question 154. 

Question 154. According to the VA FY 2015 Budget Request, ‘‘DOD collaboration 

is one of the national criteria elements VA uses to evaluate, score, and rank its capital projects.’’ How does the VA numerically value ‘‘DOD collaboration’’ in the overall 

SCIP process and criteria? Currently, this element is one of four ‘‘Departmental Initiatives’’ and treated separately from ‘‘major and supporting initiatives.’’ Why? If 

overlap occurs with major and/or supporting initiatives, how does that impact the 

score? Please explain ‘‘DOD collaboration’’ linkages, overlap, and duplication to separate criteria elements, particularly ‘‘best value solution’’ and ‘‘maximize efficiencies.’’ For the Dole VA and McConnell AFB Joint Project, what was the numerical score for the ‘‘land transfer’’ by McConnell AFB as criteria for cost savings, best 

value solution and maximizing efficiencies? For major initiatives, how are educational institution partnerships numerically scored and ranked in comparison to 

other major initiatives? 

164 

Response. The FY 2015 SCIP Decision Criteria with priority weights are provided 

below. 

FY 2015 SCIP Decision Criteria Weights 

(sorted by Major Criterion) 

Major Criterion Priority 

Weight Sub-Criterion Priority Weight 

Overall 

Weight 

Improve Safety and Security 0 .324 Seismic .............................................................................. 0 .437 0 .142 

Safety/Compliance (excludes Seismic) ............................. 0 .345 0 .112 

Physical and Building Security/Emergency Preparedness 0 .218 

Departmental Initiatives 0 .216 Major Initiatives ................................................................ 0 .543 0 .117 

Supporting Initiatives ....................................................... 0 .289 0 .062 

DoD Collaboration ............................................................. 0 .094 0 .020 

Energy Standards .............................................................. 0 .074 0 .016 

Fixing What We Have 0 .200 Reduce Facility Condition Assessment Deficiencies ........ 0 .770 0 .154 

Other Gaps (self-defined) ................................................. 0 .230 0 .046 

Increasing Access 0 .155 Utilization/Workload .......................................................... 0 .327 0 .051 

Veteran Access to Services ............................................... 0 .213 0 .033 

Internal Access to Services .............................................. 0 .052 0 .008 

Wait Times ........................................................................ 0 .222 0 .034 

Support Structures (parking) ............................................ 0 .186 0 .029 

Right-Sizing Inventory 0 .057 Space—New Construction/Renovation/Lease ................... 0 .560 0 .032 

Space—Collocation .......................................................... 0 .229 0 .013 

Space—Disposal/Reuse .................................................... 0 .118 0 .007 

Space—Telework .............................................................. 0 .093 0 .005 

Ensure Value of Investment 0 .048 Best Value Solution .......................................................... 0 .657 0 .032 

Cost Saving Strategies ..................................................... 0 .343 0 .016 

The DOD collaboration sub-criterion of the 2015 SCIP decision model has an overall priority value of .020. This sub-criterion is separated from the Major Initiatives 

(MI) and Supporting Initiatives criterion to emphasize the importance of these 

projects, as it effectively results in those types of projects earning ‘‘extra’’ points that 

non-VA/DOD projects cannot earn. If two decision sub-criteria were so similar as to 

overlap, then a project’s score would include a ‘‘double-counted’’ score. Depending on 

how thoroughly the ‘‘overlapping’’ decision criteria questions were answered, the impact could range from no impact to significant because each sub-criterion is scored 

as a separate element. Duplication in the decision model is avoided where possible. 

DOD collaboration is one of 20 sub-criteria in the decision model, which are 

grouped by their relationship to the major criteria. Addressing one sub-criterion 

does not automatically result in points given to another sub-criterion. A project is 

evaluated on how well each sub-criterion is addressed. For example, the project may 

receive a high score for the DOD collaboration question based on the written answer 

and supporting documentation demonstrating VA’s and DOD’s mutual interest in 

the project, and then score very low on the safety/compliance question because the 

narrative answer does not demonstrate that the project will mitigate a known safety 

violation or bring the medical center into compliance for a sited deficiency. 

This type of project could earn points for the cost saving strategies question by 

demonstrating how this project saves money by allowing VA to acquire land at no 

cost. The effect of a no-cost land transfer would be factored into the Best Value Solution question as part of the Net Present Value (NPV) calculation of that alternative. For example, if the cost of the new construction option and the VA/DOD Collaboration option were equal except for the cost of land acquisition, the NPV for the 

VA/DOD Collaboration project would be better than the new construction option. 

The highest score in the Best Value Solution question can only be given to projects 

where the chosen option has the best NPV. 

Because the Wichita VA/DOD major construction project did not pass the business 

case validation process, the project was not scored for the FY 2015 budget and planning cycle. There are no numerical ratings for this project. 

The Major Initiatives for the FY 2015 budget and planning cycle are: 

(1) Eliminate Veteran Homelessness; 

(2) Improve Veterans’ Mental Health; 

165 

(3) Perform Research and Development to Enhance the Long-term Health and 

Well-Being of Veterans; 

(4) Enable 21st Century Benefits Delivery and Services; 

(5) Automate GI Bill Benefits; 

(6) Build Veterans Relationship Management Capability to Enable Convenient, 

Seamless Interactions; 

(7) Enhance the Veteran Experience and Access to Health Care; 

(8) Establish Strong VA Management Infrastructure and Integrated Operating 

Model; 

(9) Transform Human Capital Management (telework); and 

(10) Transform health care delivery through health informatics. 

Educational institution partnerships are not ranked in relationship to the MIs. 

Question 155. According to the VA FY 2015 Budget Request, ‘‘The VISN future 

year potential list includes several potential future collaborative efforts,’’ listing the 

Dole VA and McConnell AFB Joint Project as one of six future collaborative efforts. 

Will you please explain why the VA FY 2015 Budget Request promotes and identifies this joint project as a specific example of VA/DOD collaboration but does not 

score or rank it in the same FY 2015 budget document? What is the rationale behind the decision to list a Wichita, KS joint project in VA collaboration with DOD 

but remove it from consideration to attain resources to develop this joint project? 

Response. Though the Dole VA and McConnell AFB Joint Facility was not scored 

in the FY 2015 SCIP, it is listed in the SCIP long-range plan as a potential outyear major construction project. There is still an opportunity for future collaboration 

between VA and DOD at the Wichita location. VA is working with local facility planning to staff to assist in developing their business case to be considered for funding 

during the FY 2016 SCIP process. 

Question 156. How will VA’s proposed changes to ‘‘allow transfers to/from VA capital accounts in support of joint Federal facilities’’ lead to more joint projects, such 

as the Dole VA and McConnell AFB Joint Project? Has the VA identified existing, 

potential and planned projects that would utilize this new authority? Please provide 

a list of those projects. Please describe the differences in VA’s FY 2015 proposal on 

‘‘transfer of funds’’ from Sections 223, 224 and 8098 of the FY 2014 Omnibus Appropriations Act that provides for additional ‘‘transfer of funds’’ authority to the Joint 

Department of Defense- Department of Veterans Affairs Medical Facility Demonstration Fund. Are major and minor construction projects currently considered in 

the Joint Department of Defense—Department of Veterans Affairs Medical Facility 

Demonstration Fund? If not, please recommend a legislative alternative that would 

give the Medical Facility Demonstration Fund the authority to expend funds on 

minor and major construction projects. 

Response. VA has proposed changes to its authorization to allow the Department 

to plan, design, construct, or lease shared medical facilities with the goal of improving access to, and quality and cost effectiveness of, the health care provided by the 

Department and other Federal agencies (e.g., DOD) to their beneficiaries. The proposal would allow the Department to transfer and/or receive funds (major and minor 

construction) to/from another Federal agency for use in the planning, design, and/ 

or construction of a shared medical facility. Currently, VA cannot build space to accommodate non-VA workload. It also cannot build on non-VA owned land without 

specific authorization. 

The VA proposal would also allow the transfer (from the Medical Facilities appropriation) or receiving of funds to/from other Federal agencies for the purpose of leasing space for a shared medical facility, after section 8104 authorization requirements have been met. In order to foster collaboration, VA also requested to amend 

the definition of ‘‘medical facility’’ to include any facility or part thereof which is, 

or will be, under the jurisdiction of the Secretary, or as otherwise authorized by law, 

for the provision of health care services. 

The potential VA/DOD collaboration locations provided in Volume 4 of the 2015 

budget submission are the locations that would most likely have the highest potential for using this new authority. These include Wichita, Kansas, El Paso, Texas, 

Fort Knox, Kentucky, Beaufort, South Carolina, San Antonio, Texas and Oakland, 

California. 

In contrast to VA’s FY 2015 proposal on ‘‘transfer of funds,’’ Sections 223, 224 and 

8098 of the FY 2014 Omnibus Appropriations Act, which provide for additional 

‘‘transfer of funds’’ authority to the Joint Department of Defense—Department of 

Veterans Affairs Medical Facility Demonstration Fund, only allow for minor construction funds to be transferred to the Demonstration Fund to support operations 

at the Captain James A. Lovell Federal Health Care Center at North Chicago. ImVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00169 Fmt 6633 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
166 

plementing VA’s proposed authorization changes would provide VA and DOD the 

greatest potential for increase joint collaborative projects. 

RESPONSE TO POSTHEARING QUESTIONS SUBMITTED BY HON. JOHN BOOZMAN TO

U.S. DEPARTMENT OF VETERANS AFFAIRS

Question 157. What process is the VA Office of Acquisition and Logistics (OA&L) 

using to mitigate procurement risk associated with companies who are debarred, 

meaningfully related to debarred entities, have criminal activity, are financially 

stressed, and have other high risk characteristics? 

Response. As part of the Office of Management and Budget Circular A–123 Acquisition Assessment, OALC conducts extensive file reviews, one of the goals of which 

is to assess the extent of compliance with the requirement to award only to responsible parties. File reviews include determining compliance with specific VA policies 

established by OALC, such as: 

• VA Procurement Policy Memo (PPM) 2013–05, Determining Contractor Responsibility, dated August 12, 2013. This policy requires contracting officers to check the 

exclusions in the System for Award Management before any transaction (award or 

modification) is made with a contractor. The policy provides implementing guidance 

in determining contractor responsibility. File reviews assess whether the required 

contractor responsibility determination was made properly. • VA Information Letter (IL 001AL–09–02), Integrated Oversight Process (IOP), 

dated June 19, 2009. The IOP policy requires procurement reviews of specific contract actions at various dollar thresholds, and the reviews are performed by contracting organizations of each Head of Contracting Activity (HCA) within VA. 

OALC’s A–123 assessments and file reviews evaluate whether the IOP policy was 

followed and to what extent. 

Question 158. Is there anything you are doing to prevent fraud or improper payments post-award? (This question is relevant because the Senator has a history of 

working on improper payment issues) 

Response. To prevent fraud or improper payments, Department of Veterans Affairs continues to take the following actions: 

• Partners with Treasury to leverage the Do Not Pay (DNP) solution, which 

matches payments monthly against the Public Death Master File (DMF) and the 

Excluded Parties List System (EPLS)/System for Award Management (SAM); • Matches benefits payments against the Social Security Administration’s Private 

Death Master File before they are submitted to Treasury; • Compares vendors on our financial management system to the EPLS/SAM on 

a daily basis; and • Performs recapture and recovery audits for our programs, which result in corrective actions to improve business processes and ensure compliance. 

Question 159. Does the VA have a post award process that tracks contractor performance? If so, are there any metrics around the value of government data vs. commercial data sources for this purpose? 

Response. VA’s Policy for Past Performance reinforces the Federal Acquisition 

Regulation requirements and requires use of the Contractor Performance Assessment Reporting System (CPARS), managed by the General Services Administration, 

that generates status reports for their respective HCA. These include: Contract Status Reports, Ratings Metrics Report, and Processing Times Reports. These reports 

provide a record, both positive and negative, on a given contractor during a specific 

period of time. These reports are supported by program and contract management 

data, such as cost performance reports, customer comments, quality reviews, technical interchange meetings, financial solvency assessments, construction/production 

management reviews, contractor operations reviews, and performance evaluations. 

These reports are used as a resource to ensure VA is awarding best value contracts 

and orders to contractors that consistently provide quality, and on-time products 

and services that conform to contractual requirements. To our knowledge, there are 

no commercially available metrics which compare government data to commercial 

data. 

RESPONSE TO POSTHEARING QUESTIONS SUBMITTED BY HON. DEAN HELLER TO

U.S. DEPARTMENT OF VETERANS AFFAIRS

Question 160. When does the VA expect to fully deploy all components and subcomponents in VBMS across all VA Regional Offices so that all 56 will qualify as 

electronic Regional Offices (eRO)? 

167 

Response. Veterans Benefits Management System (VBMS) utilizes an agile development approach that allows the Veterans Benefits Administration (VBA) to continually build functionality to support claims processing in 12-week sprints. With continuous development, VBMS will allow the electronic distribution of workload on a 

national level and assist in automating portions of the claims process. As of 

June 2013, VBMS was fully deployed to all 56 regional offices (RO). 

The Newark RO was chosen as the electronic Regional Office (eRO) pilot station 

to simulate the future operating model of a paperless RO. This allows VBA to understand the operational differences that a paper versus electronic environment 

poses. This also provides an opportunity for VBA to test additional initiatives to continue to understand the future state and impact of those initiatives in an electronic 

environment. Although VBA does not have the resources to remove all active paper 

claims folders from all ROs, the remaining ROs are naturally moving into a 

paperless state and adopting lessons learned through the distribution of the electronic Standard Operation Procedures and the realignment of responsibilities of 

clerical staff. As of April 9, 2014, almost 90 percent of VBA’s rating inventory is 

electronic. VBA has not established a timeline for full transition to eROs. 

Question 161. What percentage of claims being submitted at the Reno VA Regional Office are fully developed claims? 

Response. In FY 2013, 25.4 percent of claims received by the Reno RO were fully 

developed claims (FDC). In FY 2014 through March, this increased to 39.5 percent. 

Question 162. How has VA partnered with the Veteran Service Organizations 

(VSOs) to encourage and assist veterans with filing fully developed claims? 

Response. VBA’s Benefits Assistance Service (BAS) has partnered with VSOs on 

several programs in support of assisting Veterans with FDCs. VA ROs conducted 

workshops for their local Veterans Service Organizations (VSO) partners on the 

FDC program. Each RO has a very active partnership with their local VSO community and has representatives attend local VSO trainings and meetings to provide information on filing electronic FDCs. BAS also has ongoing bi-weekly meetings with 

VSOs and monthly meetings with VSO executive leadership, at which FDC filing 

and assistance are regularly discussed. An FDC Forum was held during the VSO 

bi-weekly meeting on February 6, 2014. This forum allowed national, state, and 

county VSOs to ask clarifying questions about the FDC program and inform VBA 

where additional training in the field may be needed. Additionally, BAS provides 

monthly FDC reporting to the ‘‘Big 6’’ VSOs. These reports provide the total number 

of FDC claims submitted to each RO and the number that have been removed from 

the FDC program. Based on these reports, VSOs are able to ascertain which of their 

offices require more training on FDC submissions. FDC claims subm4ission is addressed and encouraged during all VSO eBenefits training sessions. Finally, VBA 

also began a new partnership with VSOs and other stakeholders known as the Community of Practice (COP). The COP seeks to reduce the compensation claims backlog for Veterans by increasing the number of FDCs filed by Veterans and their advocates. The Disabled American Veterans and The American Legion are founding 

members, and The National Association of State Directors of Veterans Affairs is a 

member. In August 2013, VA also welcomed William & Mary Law School’s Lewis 

B. Puller, Jr., Veterans Benefits Clinic to the FDC COP. The Puller Clinic was the 

first law school clinic in the Nation to join the FDC COP. VA consults with members 

of the COP throughout the development and implementation of VA’s plan to end the 

backlog in 2015 to ensure best practices and their unique insights are incorporated. 

Question 163. Does the DOD and VA’s current agreement regarding the electronic 

transfer of service treatment records also apply to service treatment records for 

members of the reserve components of the U.S. Armed Forces? 

Response. On January 1, 2014, the Department of Defense (DOD) ceased sending 

VA paper Service Treatment Records (STR). An interface was implemented to automatically transmit STRs between DOD’s Healthcare Artifact and Image Management System and VA’s VBMS in an electronic format. If a member of the Reserves 

or National Guard did not serve on active duty on or after January 1, 2014, an automated request for electronic STRs is not generated. VA continues to manually request these STRs from DOD, and DOD sends the STRs back electronically. VA and 

DOD are reviewing options to close this gap. 

Question 164. Between January 1, 2013 and December 31, 2013, dependency 

claims, which are not included in the VA’s rating bundle for backlog, rose from 

170,000 to 230,000. What is the VA’s plan to ensure that non-rating related claims 

are completed in as timely a manner as rating-related claims? 

Response. VBA holds employees at all levels of the organization accountable for 

performance. Objective measures and performance standards are used to determine 

if our managers and employees are meeting or exceeding their job requirements. 

168 

Performance of Veterans Service Representatives (VSR), Ratings Veterans Service 

Representatives (RVSR), and Decision Review Officers (DRO) is tracked in a national work credit system that is aligned with individual performance standards (attached). Employees are evaluated based on quality of work, production, customer 

service, workload management, cooperation, and organizational support. 

VBA sets the standards for work to be completed based on the position and experience level of the employee. VBA performance standards are consistent for all 

claims processors across the Nation. Performance credit for VSRs is weighted based 

on the complexity of the action completed. For example, completing an initial letter 

in response to a Veteran’s claim for benefits is weighted higher than a follow-up contact with a Veteran via telephone. RVSR work credit is weighted based on the complexity of the case and number of issues rated. For example, an RVSR on the special 

operations team that rates a highly complex claim with nine medical contentions 

will receive a higher weighted credit than a RVSR on the express team that rates 

a claim with two medical contentions. 

Question 165. What measurements does the VA currently use for the VBA claims 

processors’ work credit system? 

Response. VBA holds employees at all levels of the organization accountable for 

performance. Objective measures and performance standards are used to determine 

if our managers and employees are meeting or exceeding their job requirements. 

Performance of VSRs, RVSRs, and DROs is tracked in a national work credit system 

that is aligned with individual performance standards (attachments 1-3 follow). Employees are evaluated based on quality of work, production, customer service, workload management, cooperation, and organizational support. 

Attachment 1 

NATIONAL PERFORMANCE PLAN 

VETERANS SERVICE REPRESENTATIVE (VSR) 

(Excludes PMC and PCT VSRs) 

ELEMENT 1—QUALITY (Critical) 

The VSR must consistently and conscientiously exercise sound, equitable judgment in applying stated laws, regulations, policies and procedures to ensure accurate information is disseminated to Veterans and accurate decisions are provided on 

all benefit claims administered by the Department of Veterans Affairs. 

Standard 

Quality of Work 

Successful Level 

GS–7: The accuracy rate during the evaluation period equals or 

exceeds 80% (cumulative) 

GS–9: The accuracy rate during the evaluation period equals or 

exceeds 85% (cumulative) 

GS–10: The accuracy rate during the evaluation period equals or 

exceeds 92% (cumulative) 

GS–11: The accuracy rate for work produced during the evaluation 

period equals or exceeds 93% (cumulative) 

Indicators 

A random selection will be made of an average of 5 actions per month regardless 

of number of contentions claimed. Quality of action taken on each contention will 

be evaluated. The selection of actions, while random, must reflect an appropriate 

mix of work performed by the employee throughout the month (i.e. not from a single 

day or single week). 

If a routine review of a VSR’s work demonstrates the need for quality improvement, an expanded sample of an average of 10 actions per month will be reviewed 

for quality purposes. 

The ASPEN checklist to be used will mirror the STAR worksheet and will include 

a component on systems compliance, which will be considered a substantive error. 

ELEMENT 2—TIMELINESS/WORKLOAD MANAGEMENT (Critical) 

Timely processing of Veterans claims is of paramount importance, as it is highly 

correlated with customer satisfaction. The VSR will operate in an efficient manner 

to accurately finalize claims using all appropriate workload management tools and 

processes. 

169 

VSRs are responsible for the cycles/type of work respective to their assigned duties. If multiple timeliness sub-elements apply to a VSR (e.g. average days awaiting 

award, non-rating, and corrective actions) they must meet the Fully Successful level 

for all applicable sub-elements to be successful for the element. 

Extenuating circumstances and notification to the employee’s supervisor will be 

considered. An incident will not be called until after the first notification of noncompliance of the above standard. 

Timeliness 

Timeliness of Rating End Products (including EP 930 series) 

Fully Successful 

All grade levels must meet locally established timeliness requirements, which are 

to be derived from end of year station targets. 

The percentage of claims in each cycle pending over the locally established cycle 

goal must align with station goals for percentage of claims greater than 125 days. 

Management for each station sets goals. 

Cycle Times 

a. Average Days Awaiting Development 

b. Average Days Awaiting Evidence 

c. Average Days Awaiting Award 

d. Average Days Awaiting Authorization 

Timeliness of Non-Rating & Control End Products (i.e. EPs 600, writeouts, 800 

series) 

Fully Successful 

All grade levels must meet locally established timeliness requirements, which 

should be derived from station targets. 

Timeliness of Direct Services (i.e. IRIS, Congressional Inquiries, etc.) 

Fully Successful 

All grade levels must meet locally established timeliness requirements, which 

should be derived from station targets. There will be no more than 5 instances 

where the VSR fails to meet established timeliness, or failure of employee to notify 

their supervisor when cases cannot be worked within established timeframes and 

reasons thereof. 

Timeliness of Special Projects & Duties (i.e. Women Veterans Coordinators, 

AEW Project, etc.) 

Fully Successful 

There will be no more than 3 instances of tasks not being worked within established timeframes, or failure of employee to notify their supervisor when cases cannot be worked within established timeframes and reasons thereof. 

Timeliness of Corrective Actions 

Fully Successful 

There will be no more than 3 instances of failure to complete a returned corrective 

action, or failure of employee to notify their supervisor when cases cannot be 

worked, within three days of the case being returned to them for correction. 

Workload Management 

Fully Successful 

All grade levels must manage their workload in accordance with locally established workload management plans. There will be no more than 2 instances where 

the VSR fails to show compliance with established workload management procedures. 

Local management will be responsible for creating and communicating a workload 

management plan that will identify the types of work to be completed. 

Indicators 

• VETSNET Operations Reports 

• Local Tracking Reports 

• Supervisory Observation 

170 

ELEMENT 3—OUTPUT (Critical) 

Fully Successful 

VSRs process a minimum cumulative average number of outputs per day. Outputs 

will be counted as follows: 

• Development (Initial Development, Subsequent Development, and Ready 

for Decision including rating Eps, EP 930s, administrative decisions, appeals, non-rating Eps, and EP 600s)—.7 • 1–2 contention claim development (Initial Development, Subsequent Development, and Ready for Decision including rating Eps, EP 930s, administrative decisions, appeals, non-rating Eps, and EP 600s)—.5 • Telephone development -.1 • Process award/decision (generate award, clear end product)—.7 • Authorize award—.33 

Note 1: Subsequent development includes any actionable item, which moves the 

claim forward and is subject to quality review. 

Note 2: Telephone development requires contact with claimant, representative, or 

medical facility to further the development of the claim. Credit for telephone development may be taken in addition to development credit. 

Note 3: VSRs performing Post-Determination authorization duties will receive an 

additional .5 weighted action for more complex cases involving out of system payments or retroactive effective dates preceding 1982 (earliest generate line in 

VETSNET). 

Successful Level 

GS–7: 4 

GS–9: 5 

GS–10: 5.5 

GS–11: 6 

Indicators 

• VOR • ASPEN 

There will be no output element expectation for 90 days following the completion 

of challenge training regardless of entry grade. 

Duplicate credit will not be allowed for self-correction of a VSR’s error. 

Leave, union time, and special projects or assignments pre-approved at the discretion of the supervisor are considered deductible time. Unmeasured time, such as informal training, was considered in developing the successful level and is not reportable deductible time. 

ELEMENT 4—TRAINING (Critical) 

VSR will stay abreast of current laws and regulations, work processes, policies 

and procedures and computer applications in order to provide optimum service to 

our Veteran population. 

Employees are encouraged to actively participate in self-developmental activities. 

Performance for this standard will be mitigated when the VSR’s supervisor has 

not allotted sufficient time for VSR to complete training requirements or if the VSR 

is not provided a schedule of available training and the deadline they are to complete. 

It is the responsibility of supervisors to provide VSRs with a training schedule 

in advance so they can complete their training requirements. 

Successful Level 

GS–7/9/10/11: Timely completion of nationally mandated training hours to include 

core requirements and mandated local training during evaluation period. Completes 

mandatory training within assigned deadlines with no more than 1 violation during 

evaluation period. 

Indicators 

• TMS 

• Supervisory Observation 

ELEMENT 5—Organizational Support (Non-critical) 

Functions as a team member to enhance resolution of claims and customer service 

contacts by work actions. Maintains professional, positive, and helpful relationships 

with customers by exercising tact, diplomacy, and cooperation. 

Performance demonstrates the ability to adjust to change or work pressures, to 

handle differences of opinion in a businesslike fashion, and to follow instructions 

171 

conscientiously. As a team member, contributes to the group effort by supporting fellow teammates with technical expertise and open communications and by identifying problems and offering solutions. Performance also demonstrates the ability to 

effectively communicate in a courteous manner with customers during the personal 

or telephone interview process. 

Successful Level 

GS–7/9/10/11: No more than 3 instances of valid complaints or incidents.* 

* A valid complaint or incident is one where a review by the supervisor, after considering both sides of the 

issue, reveals that the complaint/incident should have been handled more prudently and was not unduly aggravated by the complainant. Disagreeing, per se, does not constitute ‘‘discourtesy.’’ Valid complaints or incidents will be determined by the supervisor and discussed with the employee. 

Indicators 

• Verbal and/or written feedback from internal and/or external customers 

• Observations by a supervisor with the complaint documented 

Attachment 2 

NATIONAL PERFORMANCE PLAN 

RATING VETERANS SERVICE REPRESENTATIVE (RVSR) 

(Excludes PMC and IDES RVSRs) 

ELEMENT 1—QUALITY (Critical) 

The RVSR must consistently and conscientiously exercise sound, equitable judgment in applying stated laws, regulations, policies and procedures to ensure accurate information is disseminated to veterans and accurate decisions are provided on 

all benefit claims administered by the Department of Veterans Affairs. 

Fully Successful (Issue Based) 

Experience level defined by time in position: 

6–12 months: The accuracy rate during the evaluation period equals or 

exceeds 80% (cumulative) 

13–18 months: The accuracy rate during the evaluation period equals or 

exceeds 85% (cumulative) 

19–24 months: The accuracy rate during the evaluation period equals or 

exceeds 90% (cumulative) 

Over 24 months: The accuracy rate during the evaluation period equals or 

exceeds 92% (cumulative) 

Indicator 

A random selection will be made of an average of 5 end products per month regardless of number of issues decided. This includes completed cases and partial ratings to determine the accuracy of the originator. The selection of actions, while random, must reflect an appropriate mix of work performed by the employee throughout the month (i.e. not from a single day or single week). 

If a routine review of a RVSR’s work demonstrates the need for quality improvement, an expanded sample of 10 total end products per month will be reviewed for 

quality purposes. 

Once an error is found and recorded concerning a specific issue associated with 

the claim (ex: effective date), no additional errors related to that issue should be 

recorded (consistent with M21–4 under the Quality Review Structure for cascading 

effect). 

ELEMENT 2—TIMELINESS (Critical) 

Timely processing of veterans claims is of paramount importance as it highly correlates with customer satisfaction. The RVSR will operate in an efficient manner 

to accurately finalize claims using all appropriate workload management tools and 

processes. 

RVSRs are responsible for the types of work respective to their assigned duties. 

Extenuating circumstances and notification to the employee’s supervisor will be considered. 

Timeliness of Workload Management (includes rating, non-rating and appeals) 

Fully Successful 

RVSRs must manage their workload in accordance with locally established workload management plans. 

172 

There will be no more than 3 instances of RVSR specific duties not being completed within locally established timeframes, or failure of employee to notify their 

supervisor when cases cannot be worked within established timeframes and reasons 

thereof during the evaluation period. An incident will not be called until after the 

first notification of non-compliance of the above standard. 

Indicators 

1 VETSNET Operations Reports (VOR) 

2 Local Tracking Reports 

3 Supervisory Assignments and Observation 

4 Folder Aging Reports 

5 VACOLS Reports 

ELEMENT 3—OUTPUT (Critical) 

Processes a minimum cumulative average number of weighted actions on rating 

related end products and the following: EP 930 series, statements of the case, supplemental statements of the case, claims certified to BVA, hearing decisions, EP 

290, 600, 095, 070, 172, 165. 

Weighted action credit will be given based on number of issues completed per the 

following: 

1–2 issues completed: .5 weighted action 

3–4 issues completed: 1 weighted action 

5–9 issues completed: 1.5 weighted actions 

Each additional 5 issues completed will be given .5 weight actions (i.e. 10–14 

issues completed: 2 weighted actions; 15–19 issues completed: 2.5 weighted actions; 

20–24 issues completed: 3 weighted actions; et cetera) 

Fully Successful 

Experience level defined by time in position: 

6–12 months: 1.5 weighted actions 

13–18 months: 2 weighted actions 

19–24 months: 2.5 weighted actions 

Over 24 months: 3 weighted actions 

* RVSRs on the Special Operations team will have an additional .25 weighted actions added 

to their output for each claim worked meeting special operations criteria to account for the complexity of these cases. 

Indicators 

VOR 

ASPEN 

VACOLS Reports 

* Duplicate credit will not be allowed for self-correction of an RVSR’s error. 

** Leave, union time, and special projects or assignments pre-approved at the discretion of the 

supervisor are considered deductible time. Unmeasured time, such as informal training, was 

considered in developing the successful level and is not reportable deductible time. 

ELEMENT 4—TRAINING (Critical) 

RVSR will stay abreast of current laws and regulations, work processes, policies 

and procedures and computer applications in order to provide optimum service to 

our veteran population. 

RVSRs are encouraged to actively participate in developmental activities of self 

and others. For example, this may include volunteering to conduct needed training, 

mentoring and second signature reviews. 

The RVSR will complete mandatory Core Technical Training Requirements 

(CTTR) as outlined on a published training schedule and within specified deadlines. 

It is the responsibility of supervisors to provide RVSRs with a training schedule 

in advance so they can complete their training requirements. It is the responsibility 

of the RVSR to complete all required training within established guidelines. 

Performance under this element will be mitigated when the RVSR’s supervisor 

has not allotted sufficient time for RVSR to complete training requirements or if the 

RVSR is not provided a schedule of available training and the deadline they are to 

complete. 

Fully Successful 

Timely completion of nationally mandated training hours to include core requirements and mandated local training during evaluation period. Completes training 

within assigned deadlines with no more than 1 violation during evaluation period. 

173 

* Leave, union time, special projects or assignments pre-approved at the discretion of the supervisor, and 2nd signature reviews (of trainees only) are considered deductible time. 

Indicators 

TMS 

Supervisory Observation 

ELEMENT 5—Organizational Support (Non-critical) 

Functions as a team member to enhance resolution of claims by work actions. 

Maintains professional, positive, and helpful relationships with internal and external customers (to include fellow employees and all stakeholders) by exercising tact, 

diplomacy, and cooperation. 

Performance demonstrates the ability to adjust to change or work pressures, to 

handle differences of opinion in a businesslike fashion, and to follow instructions 

conscientiously. As a team member, contributes to the group effort by supporting fellow teammates with technical expertise and open communications and by identifying problems and offering solutions. Performance also demonstrates the ability to 

effectively communicate in a courteous manner with internal and external customers (to include fellow employees and all stakeholders). 

The RVSR provides information to veterans and claimants that is accurate, concise, complete and written in a non-adversarial, respectful manner that demonstrates courtesy and compassion. This information may be in the form of rating 

decisions, written correspondence to claimants and other verbal communication with 

claimants such as personal hearings. 

Fully Successful 

No more than 3 instances of valid complaints or incidents.* 

* A valid complaint or incident is one where a review by the supervisor, after considering both 

sides of the issue, reveals that the complaint/incident should have been handled more prudently 

and was not unduly aggravated by the complainant. Disagreeing, per se, does not constitute 

‘‘discourtesy.’’ Valid complaints or incidents will be determined by the supervisor and discussed 

with the employee. 

Indicator 

Verbal and/or written feedback from internal and/or external customers. Observations by a supervisor with the complaint documented. 

Attachment 3 

PERFORMANCE PLAN DRO 

ELEMENT 1—QUALITY OF WORK 

The DRO must consistently and conscientiously exercise sound, equitable judgment in applying stated policies to ensure accurate and timely decisions on compensation and pension benefit claims administered by the Department of Veterans 

Affairs. 

Successful Level: Accuracy rate during the evaluation period equals or exceeds 

90%. 

Indicators 

An unbiased selection will be made of an average of five cases per month per employee. The cases selected will be reviewed [prior to concurrence by a second signature, if applicable] to determine the accuracy of the originator of the decision. Only 

one error is counted per case reviewed. The errors will be called using the categories 

identified on Attachment A below. 

ELEMENT 2—PRODUCTIVITY* 

Processes a minimum cumulative average number of 3 weighted cases per day. 

Cases will be counted for production purposes as follows: 

• 1/2 case = deferred/supplemental development actions when no other action listed below is possible. This excludes sending/preparing a DRO election letter. This 

credit is not limited to formal appeal cases and can include any case for which substantive review and deferred/development by a DRO is appropriate. 

• 1/2 case = Informal conference held; case certified to BVA; preparation time for 

a hearing; formal hearing held (the 1/2 case for preparing for a hearing should be 

reported separately from the 1/2 case awarded for holding a formal hearing). 

174 

• 1 case = SOC, SSOC or DRO decision (includes EPs 172/174/070) with less than 

8 issues decided. • 2 cases = SOC, SSOC or DRO Decision with 8–15 issues decided. • 3 cases = 16–23 issues rated; 4 cases = 24–31 issues decided, etc. 

Note: 

1. Only one type of case credit can be taken at a time. For example, if a DRO 

does a separate SOC and a rating, only one credit would be taken. The credit with 

the greater weight should always be used. If separate decisions combine to eight or 

more issues, this can be combined and 2 case credits taken. 

2. The 1/2 case development credit may apply to cases where an NOD has not 

been filed. To be applicable, the cases must have already had a decision made on 

them, and brought to the DRO’s attention because of some conflict with the facts 

or law as applied in the case. This would also apply to any cases assigned to the 

DRO by VSC management based on the complexity/sensitivity of the case. This credit does not apply to routine rating development cases and, again, can only be 

claimed exclusive of any other weighted action listed above. 

3. The case credit review for an SOC [EP 172 or 174] should be taken per the 

parameters in M21–4 Appendix C. Concerning formal hearings (EP 174), a full case 

credit is only available if the formal hearing is actually held; otherwise, the only 

credit available is the 1/2 case for preparation time, if applicable. 

4. The term ‘‘DRO decision’’ is defined as any rating related to an appeal where 

the DRO has made a favorable decision requiring some type of award action. Separate DRO decision and rating decision documents for the same issue are not required. 

5. Weighted case credit for non-appeal cases is the same as the RVSR weights. 

Successful Level: weighted cases per day (cumulative) 

Indicators 

Production reports 

ELEMENT 3—CUSTOMER SERVICE 

Functions as a team member to enhance resolution of claims and customer service 

contacts by work actions. Maintains professional, positive, and helpful relationships 

with internal/external customers by exercising tact, diplomacy, and cooperation. 

Performance demonstrates the ability to adjust to change or work pressures, to 

handle differences of opinion in a businesslike fashion, and to follow instructions 

conscientiously. As a team member, contributes to the group effort by supporting fellow teammates with technical expertise and open communications and by identifying problems and offering solutions. Successful achievement in this element reflects support of all scorecard goals. 

Successful Level: No more than 3 instances of valid complaints or incidents. 

Indicators 

Verbal and/or written feedback from internal and/or external customers. Observations by a manager with the complaint documented. 

A valid complaint or incident is one where a review by the supervisor, after considering both sides of the issue, reveals that the complaint/incident should have 

been handled more prudently and was not unduly aggravated by the complainant. 

Disagreeing, per se, does not constitute ‘‘discourtesy.’’ Valid complaints or incidents 

will be determined by the supervisor and discussed with the employee. 

ELEMENT 4—TIMELINESS 

Works in a manner that supports and contributes to meeting established VBA 

timeliness requirements. 

At present the timeliness element is not officially measured. Methods are currently being discussed concerning accurate and equitable ways to measure appeals 

timeliness. At that time, this element will be revisited. 

ATTACHMENT A

Were all claimed issues addressed? 

Were all inferred issues addressed? 

Were all ancillary issues addressed? 

Was effort to obtain all indicated evidence documented? 

Was requested VA exam necessary & appropriate or was a necessary exam requested? 

Was all evidence received prior to denying claim? 

Was the grant or denial of all issues correct? 

175 

Were there percentage evaluations assigned correct? 

Was the combined evaluation correct? 

Were the effective dates correct? 

Was all of the applicable evidence discussed? 

Was the basis of each decision explained? 

[end of attachments 1-3] 

VBA sets the standards for work to be completed based on the position and experience level of the employee. VBA performance standards are consistent for all 

claims processors across the Nation. Performance credit for VSRs is weighted based 

on the complexity of the action completed. For example, completing an initial letter 

in response to a Veteran’s claim for benefits is weighted higher than a follow-up contact with a Veteran via telephone. RVSR work credit is weighted based on the complexity of the case and number of issues rated. For example, an RVSR on the special 

operations team that rates a highly complex claim with nine medical contentions 

will receive a higher weighted credit than a RVSR on the express team that rates 

a claim with two medical contentions. 

Question 166. The fiscal year 2015 VA Budget Submission for Major Construction Projects for the Veterans Health Administration notes that there remained $13.8 

million in unobligated funds for the Las Vegas VA Medical Center through September 30, 2013. What is the VA’s plan for utilizing unobligated funds to improve 

any inadequacies at the Las Vegas VAMC? Response. As of March 31, 2014, $11.5 million remains unobligated. Currently, ap- proximately $2.9 million is set aside to complete open contract issues on the original 

construction project, which includes the remaining contingency for active contracts. 

VA is examining potential enhancements to the Las Vegas VA Medical Center with 

the remaining $8.6 million. 

Question 167. What progress has the VA made in establishing a National Veterans Burial Ground in a rural area of Nevada? 

Response. Department of Veterans Affairs (VA) is proposing to establish a national cemetery presence in highly rural areas where the Veteran population is less 

than 25,000 within a 75-mile service area. The proposal targets those states in 

which there is no national cemetery within the state open for first interments and 

areas within the state that are not currently served by a state Veterans cemetery 

or a national cemetery in another state. Elko, Nevada is one of the eight locations 

in which VA intends to establish a national cemetery presence as part of VA’s Rural 

Initiative. This location will serve a population of over 4,000 Veterans currently 

unserved by a Veterans cemetery burial option. Funding is available for the site selection process. 

VA advertised for potential sites in September 2013, and then assembled a site 

evaluation team to visit Elko, Nevada, in December 2013 to review all responses. 

Because the results of that site evaluation tour yielded only marginally acceptable 

sites, VA is currently placing another advertisement seeking additional sites and 

will conduct further site selection visits after reviewing responses. VA is also collaborating with officials of the City and County of Elko and the U.S. Bureau of Land 

Management to seek available land that meets VA requirements. Once VA identifies 

preferred sites, it will proceed with due diligence studies on those sites to ensure 

that they are fully developable. 

Chairman SANDERS. Thank you very much. 

Let me begin by picking up on a point that Members have raised 

and you just discussed yourself. For the last several years, there 

has been a loud concern about the backlog. 

General Shinseki, when you came into your position, you announced a very ambitious goal, and that goal was to process all 

claims in 125 days with 98 percent accuracy by 2015. Your goal 

was to go from a paper system to an electronic system. 

Can you or General Hickey give us some explicit information 

about where you are in that process? 

Secretary SHINSEKI. Certainly, Mr. Chairman. Let me just open, 

and then I will turn to Secretary Hickey for the specifics. 

First, I would say that no veteran should have to wait to have 

their claims adjudicated, and we are committed to doing that as 

quickly as we can. Hence, 5 years ago, we had no standard for 

what was a backlog, so we established one at 125 days—every 

176 

claim, not an average, but every claim handled in 125 days or 

less—and all of our work done at 98 percent accuracy. That has not 

changed. 

What you have seen over the last 3 years was a commitment to 

do that by investing resources you provided to come up with an automation tool called VBMS, Veterans Benefits Management System. It has taken us time to design, develop, test, pilot, and make 

sure we had a good platform that we could hang capability on as 

we continued to improve it. 

You have seen all of that over the last 3 years. We completed 

fielding it in June 2013. 

Chairman SANDERS. If I may, because I only have 5 minutes, I 

just want to—the bottom line is you believe you are on path to 

achieve the goal that you established? 

Secretary SHINSEKI. We are on path to do that. 

Chairman SANDERS. General Hickey, do you want to add anything to that? 

General HICKEY. Just to say that we have taken 237,000 out of 

inventory in a single year, and we have reduced the backlog by 40 

percent in a single year. Our veterans are now waiting 117 days 

less on average for a claim decision, and our quality in all those 

decisions is up over 90 percent. 

Chairman SANDERS. OK. Let me ask Dr. Petzel a question if I 

might. 

Dr. Petzel, within the VA and throughout our country, there has 

been a concern that we overmedicate. The VA has done some cutting-edge work in terms of using complementary and alternative 

medicine to treat a variety of problems. 

My understanding is that you have launched what is called an 

Opioid Safety Initiative in Minnesota. Can you tell us a little bit 

about that and what you see in terms of the future regarding complementary and alternative medicine? 

Dr. PETZEL. Yes, Mr. Chairman. Thank you for that question. 

We have actually launched this across the entire system. All of 

our medical centers are now participating in an opioid safety program, which entails five elements. 

It is an opioid dashboard which elucidates high prescribers and 

high users and then a process by which the users and the providers 

are met with and treatment is discussed. 

Two, every medical center has a pain clinic. 

Three, every medical center uses the Stepwise pain process— 

which the VA developed—a real revolutionary approach to using 

the least risky alternatives in managing pain. 

I think from your perspective, most importantly, we require right 

now that every pain program offer at least one alternative medicine-process and that they develop within this year another alternative medicine program. So, acupuncture for pain is probably the 

most common thing, and you will find that we have about 90 acupuncture programs around the country. 

Chairman SANDERS. Are you finding veterans gravitating to 

those types of therapies? 

Dr. PETZEL. Absolutely. People want to use the least risky way 

to manage their pain. 

177 

I mean, this is something that they have come with in general 

out of their experiences in combat, and it can be a terrible burden 

for them. And, yes, they want to find ways without using opioids 

or narcotics to manage their pain. 

Chairman SANDERS. All right. My last question is for whoever 

may want to answer it, and that is with the health care budget. 

As I understand it, Mr. Secretary, the VA anticipates seeing an 

increase of approximately 100,000 new patients in the coming year. 

We are delighted that more veterans are accessing VA health care, 

but I am concerned whether the 3 percent increase in medical care 

in this budget will be sufficient to care for these new users, existing users, expand available services, and keep pace with all of the 

issues that we have there. 

Is that enough money? It sounds to me like it is not. 

Secretary SHINSEKI. Mr. Chairman, I would tell you we have, for 

several years now, been working with DOD to understand how our 

patient load may change when they arrive at the point that they 

are going to make a decision about downsizing. 

I believe that decision has been made. We are working with them 

now to understand the plan. So, this budget request is prior to that 

plan being provided, but we continue to work that. 

We believe we have in this budget anticipated what our needs 

are going to be in 2015, but then, again, this will depend on what 

the downsizing plan entails. 

Chairman SANDERS. OK. I am going to go vote and will be back 

as soon as I can. 

Senator Brown, will you take over, and do we have anybody who 

has voted yet? 

All right. We think Senator Isakson will be back soon. He will 

take over the Chair, and we will rotate back. 

Senator Johanns. 

Senator JOHANNS. I was just going to offer, Mr. Chairman. It 

looked like I had taken control. [Laughter.] 

Just joking. Just joking. 

Chairman SANDERS. Do not be reckless. 

[Laughter.] 

Senator JOHANNS. Secretary, let me focus on capital improvements, if I could. 

The fiscal year 2015 budget request is for $561.8 million. As I 

understand the way that request is put together, it is actually for 

four ongoing projects that are in some state of construction. 

So, the first question I have on that is, does that 561.8 represent 

a sufficient amount of money to get those projects to the finish 

line? Are they done at the end of that, or do we see this again next 

year? 

Secretary SHINSEKI. Senator, the four construction projects—and 

I will list them: Los Angeles, for seismic corrections; Long Beach 

Mental Health and Community Living Center; Canandaigua, New 

York, domiciliary outpatient facility, community living center; San 

Diego, spinal cord and seismic deficiency. These are all projects 

that are on the execution list under the major construction program for 2015. 

Senator JOHANNS. My question, though, is, does the $561.8 million complete those projects this year? 

178 

* Secretary Shinseki corrects this statement later in his testimony. 

Secretary SHINSEKI. Yes, they do.* 

Senator JOHANNS. It does. 

Secretary SHINSEKI. Yes. 

Senator JOHANNS. OK. The concern I have, I guess, is probably going to be obvious here. $561.8 million checks the box on those 4 

projects. As you know, we have been working our way somewhere 

through the list in Nebraska, although I do not want to single out 

Nebraska. There are a whole bunch of other States out there, many 

of which are ahead of us. 

What I am looking at is all of these projects. There has been an estimate—it is probably a pretty rough estimate-that $23 billion is 

necessary to address what is on the waiting list; and if Omaha is 

that far down the list, I can only imagine the problems ahead of 

us. 

Tell me how we can best put a process in place to address what 

you are dealing with and what we are dealing with? 

It is a lot of money. It would be very hard to come up with. 

I do not think we would want some 20-some projects all going at 

once. That stretches everybody pretty thin. 

So, how do we move these projects in a more aggressive way? 

Secretary SHINSEKI. I would say, Senator, we have done our best 

to prioritize these projects so that at the very top are the safety 

and security issues that we have to address for safety of employees 

and veterans. And when we do that, of course, then you can see 

an ordering. 

Second, the priority would be to ensure that what we have today 

is kept at a good standard. And therefore, for minor construction, 

not just major but minor construction and nonrecurring maintenance, those funds, in addition to the $561 million you talked 

about, we have $495 million for minor construction, another $460 

million for nonrecurring maintenance. So, these other funds keep 

us at a safe standard in the facilities we have today. 

Our commitment is as we work toward getting to Omaha, for example, that what we have today in Omaha, the hospital there, will 

be kept at a safe, functioning standard that veterans will see as 

their hospital delivering high-quality care. 

Senator JOHANNS. Yes, I see the work. I was just out at the medical center recently, and I saw the work. They were talking to me 

about the minor construction that they are doing. 

I always receive it as a bit of a mixed blessing. Yes, I want that 

facility to be safe and do things for veterans; on the other hand, 

no one is going to argue that that facility should have a long-term 

future. 

So, all these millions we are putting into these facilities across 

the country—I just hope we are not chasing good money with bad 

money, if you know what I am saying. 

I am sure it is a dilemma for you. 

There is a point at which the buildings have just served their 

useful life. 

Secretary SHINSEKI. We do have facilities that are underutilized 

and are vacant, and with those, we do our very best to take them 

down so we can husband resources that would ordinarily go on to 

179 

some level of maintenance there, husband those resources to put in 

new facilities where they are needed. 

I would also say, Senator, besides our major, minor and nonrecurring maintenance, these projects, we also have a leasing program that is important to us which primarily does not come out of 

the construction budget; it comes out of the medical care account. 

It is a powerful tool for us to be able to provide, in communities 

where community-based outpatient clinics may be needed, a lease 

arrangement. We stand it up very quickly, and it provides the services needed; and we are not going through a long-term development 

process. 

I would add a sixth component here and that would be our telehealth/telemedicine capability. We have invested heavily in that. 

So, not only do you see 151 medical centers and 820 communitybased outpatient clinics and 300 Vet Centers, they are all linked 

through telehealth/telemedicine, especially important in rural areas 

where travel and access are not what they need to be. 

But, if we can provide in those communities a clinic where veterans can find access, even if we do not have a kidney expert there, 

through our telehealth means, we can give them access to one. 

So, when we are talking about the construction program, I like 

to view it as access; that is, the walk-in access and how we link 

this through technology, to provide the best quality care and try to 

level the playing field here so that a veteran, no matter where they 

live, will be able to enjoy the quality care we can provide. 

Senator JOHANNS. We will continue this discussion. I am going 

to head to the floor so I can cast my vote before they close it. 

Thank you. 

Senator ISAKSON [presiding]. Well, the rest of the team will be 

back in a little bit. I just passed them while coming back, so, we 

will have the whole complement of Members pretty soon. 

Mr. Warren, did I understand it correctly that you are the information technology person? 

Mr. WARREN. Yes, sir, I have that role. 

Senator ISAKSON. Well, I am about to demonstrate that I am not, 

but I have a question about that which I would like to get an answer to. 

I have been reading out the VBMS, the Veterans Benefits Management System, and I understand it is fully deployed now from 

the standpoint of being installed, yet it is not operational. Is that 

right? 

Secretary SHINSEKI. Senator, it is fully deployed, fielded, and was 

completed last June, 6 months ahead of schedule. It is being used, 

but it is not the only means of processing a claim today. 

This is probably the big crossover year for us. We still have 

claims in paper, and so the great workforce that we have is dribbling two basketballs at the same time. They have to be able to do 

paper today because that is the legacy system, but every day less 

paper, and sometime later this year it will be only digital, and they 

have to do digital at the same time today. 

So, it is functional, but we are not totally reliant on just VBMS 

today. 

180 

Senator ISAKSON. From what I read, I think there is about $44.5 

million in the budget for the continued installation of that. Is that 

correct? 

Secretary SHINSEKI. Let me turn to Mr. Warren on that. 

Mr. WARREN. The number is actually $137 million—— 

Senator ISAKSON. OK. 

Mr. WARREN [continuing]. Being requested in the 2015 budget, 

and we would appreciate your support for that, sir. 

Senator ISAKSON. And here comes my question that is going to 

illustrate my IT ignorance, probably. It is said in here that you are 

using an agile approach in terms of the installation and that you 

are deploying different patches and that this will take some time 

to complete. Would you tell me what kind of patches you are talking about or what they are referring to? 

Mr. WARREN. Thank you for that question, sir. 

Agile is an approach where instead of putting all your requirements together and then many years down the road you bring capability online, as the Secretary mentioned, the system has been 

brought online, and every 90 days we add more capability, more 

function, in the hands of the employees in VBA so they can keep 

processing more. 

So, it is an iterative process. Every 90 days, major functionality 

gets deployed. In between the 90 days, if there are things we need 

to adjust or tweak, we add that capability in as well. 

So, high frequency, high cycle rate, making sure we are putting 

capability on the ground so that the folks in VBA can drive ourselves to that outcome. 

Secretary SHINSEKI. Senator, if I can try to—he is a techy person. 

I am not either, so let me try to put it in our terms. 

There are two ways to approach a large IT project, which do not 

apply to the smaller IT projects. They are a little more manageable. 

But, a large IT project—you can wait to design the entire elephant and then try to field that whole thing at once. And what 

sometimes happens is you will find something does not work in this 

large project, and then it is difficult to find it because everything 

is out there. 

The agile approach that Steph Warren is describing is we have 

an idea where we want to go, and we know where we want to start, 

so we start modestly. We put a segment in. We let it run for 90 

days, and we see what hiccups and burps, and then we fix that because we can find it in that narrow slice. Then we realize we need 

to add some more capability, and we do that. 

Over time, it sounds like these incremental approaches would 

take longer, but they are actually faster, and that has been our 

experience. 

Senator ISAKSON. The thing I want to be sure of in leading up 

to what I am about to ask you, is I have had one experience with 

a statewide installation of a computer system into 179 schools that 

I had to fix a bad problem that was related to patches where they 

had tried to custom-make the software to be site-specific rather 

than system-specific and the patches were used to correct that. 

I am taking it from what Mr. Warren has said that you are phasing in the installation of the software but that it is universal. You 

181 

are not patching at each site. You are patching it for the universal 

system. Is that right? 

Mr. WARREN. Yes, sir, that is the case. It is a national deployment. So, when we roll out capability, every regional office gets 

that capability and they are able to use it the next day once it 

comes online. 

Senator ISAKSON. And you are not correcting a problem. What 

you are doing is phasing in an activity. Is that right? 

Mr. WARREN. Sir, we are adding more capability every time we 

bring new functions online for the benefits folks. 

Senator ISAKSON. Well, you are doing it the right way because 

I did it the wrong way in the State of Georgia and I paid a terrible 

price for it. So, that is why I ask that question—because you cannot patch site-specific stuff; you have got to do it universally in the 

system. 

Mr. WARREN. Yes, sir. 

Senator ISAKSON. Dr. Petzel, I want to correct something that 

was in the record. It was reported that you inferred that—I do not 

think you probably did infer because I have talked to you about 

this before when you testified at our field hearing. 

But you had a hearing in February with the House Veterans’ Affairs Committee, and you stated, ‘‘ * * *the IG report related to 

mismanagement of the [Atlanta] VAMC did not connect deaths to 

mismanagement.’’ 

But I believe you have stated before the hearing in Atlanta, as 

well as personally to me on a number of occasions, that there were 

mismanagement issues that contributed to the suicides in Atlanta. 

Is that correct? 

Dr. PETZEL. You are absolutely right, Senator Isakson. I had 

misspoken in that I was referring to the review of the contract, not 

the review of the care on the facility. 

The contract review by the IG—they did not directly connect it, 

but they did very definitely connect the activities on that ward 

with a suicide death. You are absolutely right. 

Senator ISAKSON. Well, because of what you have done on this, 

I wanted the record to reflect accurately what you said in both 

cases. 

I want to publicly acknowledge the fact that you have come to 

Atlanta and met personally with survivors of some of the suicide 

victims in Atlanta where you provided a great service at a great 

sacrifice on your part to do so. It is very much appreciated. 

Secretary Shinseki, on this issue of suicides, one of the big questions that is being asked—and there is a lot of press looking into 

this in Atlanta, and I am sure something is going to be uncovered 

one of these days, so I want to be prepared to answer this question. 

Are there contractual limits or union limits, or what kind of limits do you have, to reprimand or correct or otherwise dismiss an 

employee for inappropriate activity, mismanagement, or contributing to the failure of the system to deliver what it is supposed to 

deliver? 

Explain to me what you have to do to discipline or reprimand or 

move or fire an employee. 

Secretary SHINSEKI. Senator, I would say that I believe we have 

the tools that we need. First of all, VA employees, by and large, 

182 

30 percent of us are veterans ourselves. So, we have familiarity 

with the issues veterans face, and there is a tie to them; and we 

are deeply committed to our mission. In these discussions, transparency and accountability count as we are trying to establish and 

maintain trust. 

I would say that in 2012 we dismissed—involuntarily removed— 

over 3,000 employees. In 2013, we did the same. 

Senator ISAKSON. Is that total VA or just the medical services? 

Secretary SHINSEKI. This is all of VA, but a very large part of 

us is the Veterans Health Administration. They account for 70 or 

80 percent of our workforce, and at 3,000, we are talking about a 

percent of our workforce. Six senior executives were also dismissed 

over the past 2 years. 

I think what I would also like to add here is that many of these 

incidents were discovered by VA employees, raised by them for our 

attention. We then, as transparently as we could, did our investigation, shared the information so others could learn from it and then 

set about correcting and then preventing future occurrences. 

An important part of this is the courage and willingness of VA 

employees to stand up and report—in some cases on themselves if 

they made a mistake—which allows us to take the corrective actions we have been able to do. 

I, for one, value that. I never want to see us lose that. So, this 

is part of the environment of trust that we are trying to retain. 

It is unfortunate anytime a suicide happens. It is a terrible tragedy. Or, anytime we lose a patient under our care. The important 

thing is to never let it happen again or, at least, commit to never 

letting it happen again. 

To do that, we have to find out what happened and get about 

taking corrective action, then holding people responsible where 

their performance did not meet our standard. As I said, I think we 

have done that here in the past 2 years. 

Senator ISAKSON. I appreciate that answer. 

I have run over my time. I want to go to Senator Murray, but 

before I do, very briefly, 3,000 per year the last 2 years have been 

dismissed in terms of VA employment for various, different failures 

to perform services. 

Secretary SHINSEKI. That is correct. 

Senator ISAKSON. How long does it take from the time you initiate an action to dismiss an employee for cause until you actually 

dismiss them? How long does it take you to go through that 

process? 

Secretary SHINSEKI. A good question. I probably ought to do a little research and provide that to you for the record. 

[Responses were not received within the Committee’s timeframe 

for publication.] 

Senator ISAKSON. Send me a memo. By the way, this is coming 

from a reporter out of Atlanta, so, I am trying to give you a headsup, because I want to be able to have the right answer when they 

call me, too. 

Secretary SHINSEKI. OK. Well, let me provide you a good answer. 

Senator ISAKSON. Senator Murray. 

183 

STATEMENT OF HON. PATTY MURRAY, 

U.S. SENATOR FROM WASHINGTON 

Senator MURRAY. Thank you very much, Senator. 

Secretary Shinseki, thank you for being here as well as all your 

team. 

Secretary Shinseki, several times you and I have discussed my 

concerns about getting medical centers the researchers they need 

to provide top quality care for our veterans. 

The Spokane Medical Center recently prepared a draft response 

to questions from the network about their budget. They talk about 

the significant challenges of declining budgets, of numerous staffing vacancies, and leading the network in new veterans patients. 

They also said, ‘‘Overall, senior management is very aware of the 

budget shortfall and is taking actions to limit the deficit. However, 

most actions will significantly limit staffing levels and access to 

care. These actions will have, and have had, a significant negative 

impact on moral and will drive some dissatisfaction among patients.’’ 

Dr. Petzel, I asked you a similar question about a similar budget 

problem at Indianapolis, at our hearing back on the 2012 budget, 

and you told me there was no evidence that any medical center 

would be unable to provide the care that we all expect. Unless your 

view has changed, Spokane’s assessment seems to disagree, and I 

wanted to ask you what you and the network are going to do to 

get Spokane the resources that they do need. 

Secretary SHINSEKI. Let me turn to Dr. Petzel for details here. 

Dr. PETZEL. Senator Murray, thank you. 

I am assuming that that is some employee’s assessment of the 

situation; it is not the senior leadership’s assessment of the circumstances in—— 

Senator MURRAY. It is the senior leadership’s assessment. 

Dr. PETZEL. I am not aware of this. 

We do believe—and the budget was distributed back in October, 

and at that time, it was the consensus of the network directors and 

the facility directors that they had sufficient funds to—— 

Senator MURRAY. The questions were asked to them of the VISN, 

and they responded back. So, it was the senior leadership at the 

Spokane VA center, saying very clearly, they do not have the dollars to be able to do the duties that they need. 

Dr. PETZEL. Senator Murray, I will have to go back and talk with 

both the network and with Spokane. This is information that is 

new to me. 

Senator MURRAY. OK. Well, their draft response also calls for a 

discussion about the mission of their medical center. It asks if they 

are going to remain a full-service medical center and whether programs and services should be eliminated. This is deeply concerning 

to me. 

Are there plans to reduce services at the Spokane Medical 

Center? 

Dr. PETZEL. We have no plans to do so. 

Senator MURRAY. OK. Well, I need you to follow up on that and 

let me know what is happening, why they are facing such a budget 

shortfall. It was very clear in the documents that we have seen 

184 

that they are facing an extreme budget shortfall that is hampering 

their ability to care for the veterans in that region. 

Dr. PETZEL. We will follow up. 

[Responses were not received within the Committee’s timeframe 

for publication.] 

Senator MURRAY. OK. I also wanted to ask both of you about the 

Walla Walla State Veterans Home. As you know, I am very concerned about that, especially because the budget request proposes 

reducing funding for State veterans homes grants. These veterans 

have been waiting a very long time for this facility. We have more 

than 1,000 veterans who need care. 

So, I want to ask whether this system that we currently have is 

correctly prioritizing State home projects? Do we have enough flexibility, and how are we going to ensure that we have got the funds 

for State veterans homes like Walla Walla? 

Dr. PETZEL. Senator Murray, you and I have discussed on numerous occasions the Walla Walla State Veterans Home, and I 

share your angst about that particular project. 

We are looking at whether there is a solution that will allow us 

to use the 2014 money in order to accomplish that construction, but 

we are not finished looking at what the alternatives are. Obviously, 

after we have done that and discussed it with the Secretary, we 

will get back to you. 

Senator MURRAY. OK. We need to know where that is going and 

overall, meaning not just that one, but all of them. How are we 

going to deal with these veterans homes with declining budgets? 

I think that as members of Congress we need to know what the 

need is, and then we need to figure out how to fund it rather than 

just being told everything is OK. 

So, I want to know specifically about Walla Walla—what we are 

going to do, and the funding of State veterans homes in general. 

Finally—and I know we have another vote—the War in Afghanistan is drawing to a close. We have more and more veterans coming home, who are going to seek care at the VA, and we are going 

to see this continue, I think, in the years ahead. 

I think we all have this thought that when the war is over we 

do not have to worry about spending care on veterans anymore, but 

the exact opposite is true. A lot of veterans are going to come to 

the VA for the very first time in the coming years, and sometimes 

the conditions that they have have dramatically worsened. 

So, I am very, very concerned about the budget request reduction 

for funding of TBI-specific health care and research. Why are you 

proposing to reduce spending on TBI care when we know that as 

these servicemembers come home and their conditions worsen they 

are going to be seeking care at the VA for the first time? 

Dr. PETZEL. That is an excellent question, Senator Murray. 

If you look at the money spent in 2011, 2012 and 2013, there is 

a slight decline in that, which is projected to continue. The specific 

reason for that is that we have had an almost 70 percent decline 

in the number of severely injured Traumatic Brain Injury patients 

that are going into our polytrauma centers. The number of people 

with mild-to-moderate TBI has continued to increase. 

Senator MURRAY. That is right. 

185 

Dr. PETZEL. The cost of taking care of those people is much, 

much less than it is providing care for the patients that end up in 

our polytrauma program. 

So, while we are going to be taking care of more people, absolutely true, we are going to be doing it at less cost because we are 

not going to be dealing with the people that are so severely injured 

in the war. 

And the second thing is that the mild-to-moderate TBI patients, 

much of their care is absorbed into and seen in the mental health 

budget; we are talking about PTSD, depression, and other mental 

health conditions. 

There is no relaxation of our concern about TBI. This is a—— 

Senator MURRAY. All right. I just want to make sure we stay focused on that, and if we do see the costs are not being met, that 

we are aware of that situation sooner, not later. 

Dr. PETZEL. Yes. 

Senator MURRAY. OK. Senator Isakson, I know another vote has 

been called so you and I need to go to the floor. 

I appreciate this time here today. Thank you and thank you to 

our witnesses. 

Senator ISAKSON. Bernie and I are about the same age. I think 

he can make it, and I will keep the hearing going. If he runs out 

of gas, then we will adjourn the hearing real quick. 

I have another question if I can ask it while we are still going. 

And we apologize for the gymnastics with the vote. 

Mr. Secretary, in your implementation of several initiatives regarding the transformation process at VA, you have instituted 

mandatory overtimes, segmented lanes, the Veterans Benefits 

Management System, fully developed claims, e-benefits, et cetera. 

Can you tell us which of those initiatives have proved successful 

and beneficial to VA? 

Secretary SHINSEKI. Certainly. I think I would just cap it all and 

say all of those have been successful, some more so than others, 

but in some cases their delivery came at an earlier point, and we 

have had more time to assess them. 

Let me turn to Secretary Hickey for some details here. 

General HICKEY. Senator Isakson, I would couch it by saying the 

following: We have implemented them, as the Secretary has said, 

on sort of a staggered approach. I can tell you that many of them 

contributed to our record-breaking 1.17 million claims production 

at a high quality and accuracy level last year alone. 

I will tell you we are 26 percent ahead of where we were even 

last year at our record-breaking levels of production. In fact, by example, our hard-working VBA employees, who are 52 percent veterans themselves, are, as you said, working overtime 20 hours a 

month to produce, in the month of February alone, double the production than we have made in any February before. 

So, we are seeing all of these different efforts producing good 

value for our veterans in terms of timeliness and accuracy. 

I would call out one success in particular from our veterans service organizations, and that is our fully developed claims process, 

where since February of last year we have gone from 3 percent of 

our claims being fully developed to over 28 percent of our claims 

186 

being fully developed, and that will do nothing but add to the benefit to a veteran as we move forward. 

Senator ISAKSON. Thank you for the answer, and I will turn it 

back over to Chairman Sanders. 

Chairman SANDERS [presiding]. Thank you very much, Senator 

Isakson. 

I apologize for not knowing what just proceeded, but let me go 

to an issue that I think is on the minds of many Americans and 

people in the veterans community, which I know the VSOs are concerned about, and that is the overall issue, Secretary Petzel, about 

mental health in general. 

The country, above and beyond the VA, faces a crisis in lack of 

quality, affordable access to mental health care. With several hundred thousand folks coming back from Iraq and Afghanistan, dealing with TBI or PTSD, it certainly is a problem within the VA. 

Can you give us an overview of how we are doing in dealing with 

these serious problems and then also deal with another issue that 

is of concern of us; that is the issue of suicide? 

Secretary SHINSEKI. Let me start and then I will ask Secretary 

Petzel to provide some detail. I will start on mental health first. 

I would say it is a discussion we have had with you, Mr. Chairman, 

and other Members of the Committee here. 

Frankly, we have been at war for over a decade, and we have 

small professional formations, smaller than when I served, who 

have carried this responsibility for carrying on these two operational missions now for this long. So, because of the size of the 

force, they are rotated a number of times, multiple times, which 

compound the issues, especially in mental health. 

Over these 5 years—six budgets now—we have worked and increased the mental health budget by over 60 percent because of the 

discussions we have had. We owe these youngsters the best we can 

provide. 

Budgeting is a little bit reactive. We look at whom showed up at 

our medical facilities, and we then ask for resources to take care 

of the next population if, in fact, there has been an increase. 

We are working with DOD to try to anticipate what our requirements are going to be just at large and trying to understand what 

the mental health piece of that is. 

With that, let me ask Dr. Petzel to address some of the details 

here. 

Dr. PETZEL. I want to add, Senator, to what the Secretary has 

said. 

This is a very important consequence of what we have seen in 

this war—small force, repeated deployments, and a very recognizable number of people, perhaps 15 to 20 percent, returning from 

that conflict with depression, PTSD, anxiety disorders, chemical dependency, sleep disorders—things that very much have a bearing 

on their mental health. In 2015, we are expecting to treat about 

1.7 million people with our specialty mental health services and 

spend about $7.1 billion on mental health services. 

Let me just go through a few of the things, Mr. Chairman, that 

have been done over the last several years. 

First of all, since March 2012, we have hired 2,400 additional 

mental health clinical providers so that we now have onboard over 

187 

20,000 clinical professionals delivering mental health services. It 

has had an impact on a number of things. 

The access measures have improved. They are not perfect yet, 

and they are not where we want them to be—— 

Chairman SANDERS. We heard this morning, if I can interrupt, 

that there are still unacceptably long wait times in certain facilities 

around the country. 

Dr. PETZEL. That is absolutely true, sir. There are places where 

we are having difficulty with wait times, primarily because we 

have difficulty recruiting people into the positions that we need. Individual psychotherapy, as an example, is something that in some 

parts of the country we have to wait long periods of time for. 

However, established patients across the country—95 percent of 

them are being seen for an appointment with 14 days. The most 

important group, patients that are new to the VA and new to mental health, 90 percent of those patients are being seen within 14 

days. Of course, if someone walks into urgent care or walks into 

the emergency room, they are seen immediately. 

Chairman SANDERS. All right. I know, Senator Tester, you have 

to leave soon. Why don’t you take over? 

Senator TESTER. Well, thank you, Mr. Chairman. 

I want to echo and thank you all for being here today. I very 

much appreciate your service in the past and currently. 

General Shinseki, the backlog is always a big thing, and we will 

be talking about the backlog until we get it down to a point where 

we do not have to talk about it anymore. Can you give us an idea 

on what the shutdown did to your backlog numbers? 

Secretary SHINSEKI. Say that again please. 

Senator TESTER. What did the government shutdown in October 

2013 do to your backlog numbers? 

Secretary SHINSEKI. Frankly, the impact was less than we were 

concerned about, primarily because our employees went into high 

gear and just worked overtime, anticipating that this thing would 

grow. So, they were able to hold it stable for the month of October, 

but since last year we have greatly reduced the backlog. 

A great concern at the end of October was if the shutdown continued we would put at risk all the benefits checks that were already decided and veterans receive every month, that we were not 

going be able to process, cut those checks and distribute them—a 

significant number of veterans and large monies. 

Senator TESTER. Thank you. 

I want to talk a little bit about the paper versus electronic medical record. You are running both right now, correct—paper and 

electronic? 

Secretary SHINSEKI. Yes, we are. 

Senator TESTER. How has the DOD been as far as have they 

made the transition to electronic medical records yet, or are they 

still lagging back? 

I know we had a meeting with the Chairman of Appropriations, 

I think about a year ago right now, as a matter of fact, with both 

of you and others. 

Secretary SHINSEKI. DOD has its own electronic health record 

just as we do. 

Senator TESTER. Do they interface? 

188 

Secretary SHINSEKI. They do not interface in the way that we 

think is the future, but we have created a joint viewer developed 

by our people that will reach into the DOD database, reach into 

ours and pull up a single screen where a clinician, either in DOD 

or VA, can care for patients, then those decisions reside in their respective databases. 

Right now, DOD is developing, or acquiring—they are on an acquisition track to see what the next electronic health record could 

be for them. 

We are tracking them. We have our electronic health record, and 

our plan is to, with the support of the Congress, release some dollars that are on hold—— 

Senator TESTER. OK. 

Secretary SHINSEKI [continuing]. To allow us to get up to level 4. 

Senator TESTER. It would seem to me that part of the backlog 

has to do with two different medical records. Is that fair to say? 

Secretary SHINSEKI. It has been, and we have worked to try to 

mitigate some of that. 

Senator TESTER. OK. Well, let us know what we can do to help. 

I know there are some on this Committee that serve on the Armed 

Services Committee, too, and I think we can push because you 

should be—I mean, it should be, quite frankly, seamless. I think 

that is the way it should be. 

Secretary SHINSEKI. Senator, after good work between both our 

staffs, in January, DOD began sending us service treatment 

records electronically. So, we are beginning to get those records 

electronically now. 

Senator TESTER. OK, good. 

Stating some statistics that you guys already know: there are 3.1 

million veterans enrolled in the VA health system that live in rural 

America; that is about 36 percent of those that are enrolled. Out of the total request for telehealth of $567 million—I am talking about telehealth—73 goes to rural telehealth. That is about 13 

percent. It seems like it is about a third of what it should be. 

Could one of you tell me why the amount is where it is? 

Secretary SHINSEKI. Let me ask Dr. Petzel to provide some 

detail. 

Senator TESTER. Sure. 

Secretary SHINSEKI. In addition to telehealth and the breakout 

that you describe, we also have a rural health care account that 

also provides money for rural areas. 

Senator TESTER. OK. 

Dr. PETZEL. Senator Tester, providing adequate and good health 

care and accessible health care to rural veterans is a high priority 

for us, as you know, because that is a large percentage of the people that live in this country, of our veterans. 

The telehealth program primarily serves rural America. 

Senator TESTER. OK. 

Dr. PETZEL. I would have to—I do not know where you got your 

figure, so I have to go back and see it. 

Senator TESTER. I got my glasses now. So, it came from my staff. 

Dr. PETZEL. If we put all the equipment that is in our tertiary 

care medical facilities as focused on providing consultation to more 

rural areas, I would imagine—— 

189 

Senator TESTER. OK. 

Dr. PETZEL. I would like to, if you do not mind—— 

Senator TESTER. We can flesh that. 

Dr. PETZEL [continuing]. Go back and look at that. 

[Responses were not received within the Committee’s timeframe 

for publication.] 

Senator TESTER. Yes, I would appreciate that. 

So, I was down in Salt Lake City and saw the telehealth booth 

where the folks out there were delivering services—I believe to 

Bozeman, MT, when I saw it. It is very impressive, and I think it 

has got tremendous upsides. 

I say that as somebody who was opposed to telehealth for mental 

health conditions, though you have turned me around on it although I do think you have to look eye-to-eye once in a while, too. 

Thank you, Mr. Chairman. 

Chairman SANDERS. Thank you, Senator Tester. 

Let me get back to the issue—I am sorry. Senator, Johanns, I 

apologize. 

Senator JOHANNS. Thank you, Mr. Chairman. 

Mr. Secretary, during the break here, we have had an opportunity to take a look at the funding on the four capital projects that 

you have mentioned. 

Secretary SHINSEKI. So, have I, Senator. 

Senator JOHANNS. Yes, do you want to correct the record? 

Secretary SHINSEKI. I was going to look for—correct the record. 

Senator JOHANNS. Yes. As I see it, the New York facility is requesting $150 million in the future. 

Secretary SHINSEKI. I believe that is correct. 

Senator JOHANNS. Long Beach, 161. San Diego, 21, thereabouts. 

And, West Los Angeles, about 300. So, for a total of $631 million, 

which is not that far north of what you are getting this year for 

capital improvements. 

So, I look out there another year, recognizing that those are 

probably just estimates—it could be higher. It could be lower, I 

guess, although my suspicion is they will be higher at the end of 

the day. 

We are probably not going to make any progress on the list next 

year either. We seem to be stalling here. 

Secretary SHINSEKI. Yes. I would not say that I am totally comfortable with where we are. I mean, this is something we have 

worked hard for 5 years. 

I would add to the numbers that you just described, Senator, 

that we do have this Opportunity, Growth and Security Initiative. 

It is in the investment fund, and we have another $400 million in 

there. So, if we were able to leverage that, it would provide us 

about a $1.9 billion construction capability this year. 

This year, 2014, it is 1.7. So, there is a slight increase. 

What I can tell you is that the facilities we have today will continue to be maintained to be safe and secure environments even as 

we wait on these long-term projects. I will continue to work to try 

to get more leverage into our major construction account. This 

year’s major construction account is about a 60 percent increase 

over the 2014 enterprise. 

190 

I will seek your help and try to do better at getting some of these 

projects addressed, but it is a long-term program. 

Senator JOHANNS. Yes. 

Thank you, Mr. Chairman. 

Chairman SANDERS. Thank you. 

Senator Blumenthal. 

STATEMENT OF HON. RICHARD BLUMENTHAL, 

U.S. SENATOR FROM CONNECTICUT 

Senator BLUMENTHAL. Thank you, Mr. Chairman. 

Thank you, General, and thank you to your team for being here 

today. Thank you for your service to our Nation over many years 

and for providing information to me at our last meeting. 

I think at that meeting your staff was going to provide some of 

the information relating to Connecticut on backlogs, and if they 

could do so, I would be very appreciative—Connecticut-specific information and then any additional information that you feel will inform us on the trends in those backlogs nationwide. 

Secretary SHINSEKI. I regret we have not gotten those to you yet, 

Senator. We will have it to you today. 

Senator BLUMENTHAL. Thank you. 

I want to ask about homelessness. You have made homelessness 

a priority. Ending homelessness by 2015 is one of your preeminent 

goals, and you have a number of strategies that have been proposed for ending veteran homelessness, including the use of VA/ 

HUD vouchers, which keeps veterans in their communities. 

We have a facility in Rocky Hill, CT, that is essentially about 

half unused. There are more than 450 available dormitory-style 

beds. I am going to write you a letter about it because only about 

250 or so of those beds are used at the moment. It is a facility that 

includes dormitory-style living as well as individual housing. 

But I am very troubled by the lack of usage, which may well reflect the need to provide psychiatric care for residents or help counseling and medical care for people suffering from addiction. But 

whatever the cause, I am hopeful that the Federal VA, your agency, will help our State Department of Veterans Affairs in providing 

the services that are necessary to make sure that this facility is 

fully utilized. There are beds unused because of issues that really 

should be addressed. 

The partnership between our State and Federal VA facilities, I 

think, is tremendously important. 

I am not asking you the question now to seek your detailed responses to what the VA would do, but simply, number 1, to ask for 

your commitment that you will work with me and our State VA in 

seeking solutions; and, number 2, that you will inform the Committee more generally as to whether these kinds of issues are national in scope. 

Just in case I have not made clear what I view the issue as 

being, it is essentially that there are perhaps physical facilities 

available to provide homes to veterans who are suffering on our 

streets, in our alleys, under bridges, but cannot be used because of 

the need for services addressing addiction, psychiatric care, other 

kinds of issues that obviously are complex and challenging, as you 

and I have discussed on occasion. 

191 

I know of your commitment to addressing those issues. 

So, really, it is a commitment to work with me and our VA officials and address the problem more broadly, if you see it as a national problem. 

Secretary SHINSEKI. Sure. Senator, I will make that commitment 

to work with you. 

I do not know the specifics here, but I would say in the past 2 

years we have created a fund called the Supportive Services to Veteran Families, which is a fund that allows us to provide grants to 

a variety of non-profit, local as well as national, agencies who work 

with us in housing the homeless. For the last 2 years, we have distributed about $300 million each 

year, and I believe we are looking at, if this budget is approved, 

increasing that to $500 million. I know we have—it is a competitive 

process, and there is not enough to satisfy all the bids that are in, 

but it is handled in a way that every State gets attention. 

We are more than happy to work with you on this. 

Senator BLUMENTHAL. I very much appreciate that. 

I know you are also aware and attuned to the medical records 

interoperability issue. Senator Tester has asked you about it. 

I just want to say to you on the record here, as I have said privately in our meetings, if there is anything that I can do as a member of the Armed Services Committee to speed or expedite the Department of Defense’s more positive approach on this issue, I would 

be more than happy to do so. I think our Committee is very interested in this issue, as you know. 

Secretary SHINSEKI. Thank you. Thank you, Senator. 

I would assure you that Secretary Hagel and I discussed this. We 

meet routinely, and this is a topic of discussion between us. And 

so, at our level, this has the priority you would expect. 

Senator BLUMENTHAL. Thank you. 

My time is expired. I thank you, Mr. Chairman. 

Chairman SANDERS. Let me get back to health care—two issues. 

I am a great believer in primary health care. I think one of the 

reasons as a nation we end up having the most expensive health 

care system in the world is we do not do enough primary care and 

we do too much specialty care. 

The VA has historically, or at least in recent years, done a good 

job. What do we have?—over 800 CBOCs around the country. 

We also have a whole lot of federally qualified community health 

centers, and I have worked very hard to expand those programs, 

and I believe in them. 

I know that we have a partnership now that has been piloted, 

I guess, with both the Indian Health Service and, I think, federally 

qualified health centers. In other words, where you have a veteran 

who may be a distance away from a medical center or a distance 

away from a CBOC, that person can now access an Indian Health 

Service clinic or an FQHC in some pilots. 

Can you talk about what is going on and what you would like 

to see, plus what is the potential there? 

Secretary SHINSEKI. Dr. Petzel. 

Dr. PETZEL. Thank you, Mr. Secretary. 

Chairman Sanders, we have two different programs. We have a 

program with the Indian Health service, which has been very valuVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00195 Fmt 6633 Sfmt 6601 Z:\113TH HEARINGS PRINTED\88404 PAULIN
192 

able in serving an incredibly needy group of veterans, and that is 

that we pay the Indian Health Service to provide services for veterans in their—— 

Chairman SANDERS. So, a non-Indian can walk into an Indian 

Health Clinic? 

Dr. PETZEL. No, this is VA paying for veterans to be cared for 

in Indian Health Service—— 

Chairman SANDERS. Right. 

Dr. PETZEL [continuing]. Or tribal clinics, not non-Indians, but 

Native Americans. So, we pay the bill, and they get treated in their 

own clinic. 

Chairman SANDERS. Oh, I see. OK, if a CBOC is not nearby. 

Dr. PETZEL. Right. 

Chairman SANDERS. And this is limited to Native Americans. 

Dr. PETZEL. That is correct. This is not a program that is involved in the federally qualified health care program. 

Chairman SANDERS. Right. 

Dr. PETZEL. We are piloting contracts with 24 of those around 

the country to see how it works in terms of the exchanges of 

money, et cetera. And I fully expect that we will expand that program as it proves successful. 

Chairman SANDERS. All right, so let me understand. A Native 

American can now go into the Indian Health Service, and their 

service is paid for by the VA. 

Dr. PETZEL. If they are a veteran. 

Chairman SANDERS. Right. 

Dr. PETZEL. An eligible veteran, correct. 

Chairman SANDERS. Right. OK. And you have now a pilot with 

a number of FQHCs around the country. 

Dr. PETZEL. Right, to care for veterans in those communities. 

Chairman SANDERS. So, this is where an FQHC is near a veteran 

and a CBOC is not; is that the—— 

Dr. PETZEL. That is correct although in this case they have to be 

enrolled with us. 

Chairman SANDERS. Right. 

Dr. PETZEL. And we make the referral to the Federal clinic, but 

that is, in essence, yes. 

Chairman SANDERS. And do you see the opportunity to expand 

that partnership? 

Dr. PETZEL. We are going to be evaluating that pilot project. If 

it looks like it is a success, we will find other places where we can 

expand this, correct. 

Chairman SANDERS. So, the bottom line there—a veteran lives 

near a community health center, not near a CBOC; the VA would 

pay for the care at a community health center. 

Dr. PETZEL. If they were enrolled with us—— 

Chairman SANDERS. Right. 

Dr. PETZEL [continuing]. And if we made the referral, correct. 

Chairman SANDERS. OK. Let me ask you another question, General Shinseki or Dr. Petzel. 

We all understand the mental health needs that have arisen out 

of the wars, and we have heard from you that you have greatly expanded the number of mental health counselors and therapists and 

so forth. 

193 

Say a word about—at the end of the day, I mean, obviously, we 

need that. We need to make sure that people have access to mental 

health services in a timely manner. 

But, how effective are the therapies now being offered in terms 

of dealing with the very difficult issues of Traumatic Brain Injury 

and Post Traumatic Stress Disorder? Are we making progress? 

Secretary SHINSEKI. Dr. Petzel. 

Dr. PETZEL. Thank you, Mr. Chairman. 

We are making progress. Traumatic Brain Injury actually has 

been quite dramatic. The Secretary has frequently talked about the 

Emerging Consciousness Program, where people have been unconscious for periods of three to 4 months and now have emerged from 

consciousness and, if you were to casually talk with them, you 

would not know that they had ever had a significant brain injury. 

So, with the severely injured individuals, we are making 

progress. 

We are also making progress in treating PTSD. The evidencebased therapies that the VA has developed have been shown in the 

literature to be successful in ameliorating the symptoms of PTSD. 

You have mentioned something that is very important to us, and 

we are dealing with this group of veterans who need our services 

so badly coming back from the war, and that is: 

How do we measure how well we are doing? 

How can we tell that the $7.1 billion that we are requesting 

to provide care is actually improving the health of these people? 

We have embarked now in mental health on a series of outcome 

measures, which we will be looking at over this year and be able 

to talk about at this time next year, that measure the influence of 

care on the symptoms of PTSD, that measure the influence of care 

on the Beck Depression Scale administered over time. 

We are going to be looking at outcomes in anxiety disorders and 

depression. 

We are going to be looking more carefully at people who are at 

risk for suicide and if we have actually improved their chances of 

not having another suicide attempt. 

Chairman SANDERS. But, in general, you are telling us that you 

think the therapy—— 

Dr. PETZEL. We believe that we are having an impact on the 

mental health of the people that we are treating, correct. 

Chairman SANDERS. OK. 

Secretary SHINSEKI. Mr. Chairman, let me just add to this. 

Chairman SANDERS. Sure. 

Secretary SHINSEKI. This is a tough area for us, and we continue 

to apply. I think you will see that we are putting $7 billion against 

mental health. We have a separate funding line for Traumatic 

Brain Injuries, and then we do research in this area. 

If you think of TBI, I would invite you to think about our polytrauma centers, the five polytrauma centers that ring the country—Tampa; Richmond; Milwaukee; Palo Alto, CA; San Antonio, 

TX. These are the five tier–1 polytrauma TBI centers of excellence 

which began many years ago. 

Chairman SANDERS. In general, Mr. Secretary, these are for the 

more severe cases; is that correct? 

194 

Secretary SHINSEKI. More severe cases. 

Once they are stabilized, then there is a tier 2, which I think 

there are about 82 tier–2 polytrauma locations. 

And then there is even a tier 3. 

The whole point of this system is as people improve they are 

moved closer to home, where, ultimately, they will be sustained. 

All of us had a chance to sit in the State of the Union address 

recently. In closing, the President introduced Sergeant Cory 

Remsburg. Sergeant Remsburg is a graduate of one of our Emerging Consciousness programs—a 70 percent success rate in bringing 

patients back from deep comas, comatose. Years before, people 

would have given up and said there is no hope. 

Chairman SANDERS. So, these are people who were injured in an 

explosion, became unconscious, and remained unconscious for 

months. 

Secretary SHINSEKI. For months. 

Chairman SANDERS. Now you are saying we are having a 70 percent rate in bringing people back to normal? 

Secretary SHINSEKI. Bringing back to consciousness. And their 

return is—over time, we have some tremendously wonderful successes, where if you and I were having a discussion with one of our 

graduates we would have a hard time understanding that; but, 

then there are others who are not as far along. And there are various stages. 

Chairman SANDERS. So, you see the VA making some significant 

breakthroughs in this? 

Secretary SHINSEKI. This is a great contribution here. It is part 

of the TBI research, although it is being done in one of our polytrauma centers. It is research that is giving us opportunities to see 

a win. 

Chairman SANDERS. My time expired a long time ago. 

Senator Boozman. 

STATEMENT OF HON. JOHN BOOZMAN, 

U.S. SENATOR FROM ARKANSAS 

Senator BOOZMAN. Thank you. It is good to see you, Secretary 

Shinseki. We appreciate all of you all’s hard work for our veterans. 

In following up with that, last Congress, we passed a law that 

would guarantee veterans with TBI that they would receive treatment aimed at maximizing quality-of-life rather than restoring 

function, though I do not think we have really seen the implementation language of that. Can you expound on that? 

And it is great to hear the stories that you are telling. 

One of our concerns with these things is that we do not want to 

have some arbitrary cutoff date when science tells us that you have 

gone as far as you can go, and yet, we are learning things. And 

then, too, we want to restore quality-of-life issues rather than just 

function. 

Secretary SHINSEKI. Yes. I am going to call on Dr. Petzel for the 

specifics here. 

Senator BOOZMAN. Sure. 

Secretary SHINSEKI. But I would say that the program I just described, the Emerging Consciousness, is proof of your point, that 

we know more today than we did 5 years and there should not be 

195 

an arbitrary line drawn that says we cannot help this individual 

anymore. 

In fact, it is the folks down in Tampa who have tried anything 

and everything to try to get a response, and 70 percent of the time 

they succeed, which is great for the rest of the country. It can benefit from the learning that has been created through this research 

effort on TBI, which this Committee has funded. 

Senator BOOZMAN. And we are not—you know, we are talking 

about a finite number of individuals. I mean, this is not a tremendous amount of people. It is certainly a very significant amount. 

You may know that I am an optometrist by training. A year or 

so ago some of the residents were in that worked at the medical 

center and also were helping, rotating through the veterans’ hospital there. But, just individuals that had things that you really 

could not actually quantify as to what was going on, but you knew 

from their histories that they were different now and having trouble with cognitive this and that. 

Can you elaborate, Dr. Petzel, on what we are doing to make 

sure, again, that we are dealing with quality-of-life issues versus 

some arbitrary function number? 

Dr. PETZEL. Thank you, Senator Boozman. 

I want to echo the comments that the Secretary made and also 

add that I think one of the pieces of evidence about your concern 

about restoring people to the quality-of-life that they would have 

wanted, or as near to what they wanted had they not been injured, 

is over 75 percent of the people that go through our polytrauma 

centers actually return home, sometimes with great effort and tremendous amounts of support, but they are back in their homes, 

with their families, getting the support services that they need in 

order to be able to participate in their community. 

The people that I think you are referring to are those that are 

less severely injured, have injuries but are not confined to a bed, 

are not people that have spent a year and a half in a polytrauma 

center, and there is a tremendous—— 

Senator BOOZMAN. Well, really both, in the sense it is one thing 

to go home, with restored function as best we can do; it is another 

thing to go home and be somewhat integrated into society but not 

fully integrated or integrated to the—so really, a little bit of both. 

Dr. PETZEL. And that is our aim with every single one of these 

patients, to provide them the capacity to do the maximum that 

they can and want to do in terms of integrating their life back into 

society. 

The example is it is not quite polytrauma, but it used to be that 

you were happy to get—somebody was happy to get an artificial leg 

if they lost their leg. That is not true anymore. 

If you live in Minnesota, that soldier wants to go out and play 

hockey. He wants to be able to function on the ice there. He wants 

to be able to play baseball. 

That is the kind of approach that we are taking with all of these 

injured soldiers, sailors, airmen, and Marines that are coming to us 

and really want to get back into society to do the things that they 

had always done. 

Senator BOOZMAN. Very good. 

196 

We have advanced funding in the health care aspect. Has that 

been a positive or a negative, or has it been something that has 

given you the ability to plan a little bit better? How has that gone 

along? 

Secretary SHINSEKI. Senator, we first received that advance appropriation capability in 2012. So, here we are several years later. 

We have had a little learning to go through. We are better at it 

today. 

Having a 1-year budget and planning and programming for a 1- 

year cycle versus two—there is an adjustment you have to make. 

So, we are pretty much through that, still learning from it. 

For our health care account—medical care, medical services, 

medical facilities—that has been a great fit for what we do in 

health care administration. On October 1, without having to wait 

to see how the budget turns out, because of advance appropriations, they can write a contract for services for the entire year. Patients and employees are very well served, but primarily, our veteran patients are very well served by that. 

Senator BOOZMAN. There are some of us that would like to give 

you that authority, you know, extend that authority to other accounts. From your experience that you have had with the health 

care aspect, would that be a positive or a negative? 

The trouble that we have, as you all know better than any—we 

were celebrating not too long ago, only a few weeks ago, that we 

finally passed an appropriations bills and that was 3 months into 

the year. 

So, it is not like you generally go year to year. It is more like 

you do not know what is going on for several months, and then finally you get some certainty. 

Can you comment on if you feel like that perhaps would be a 

positive thing? 

I mean, common sense to me dictates that it would. 

Secretary SHINSEKI. Senator, I would say anytime those of us 

who are trying to help our workforce provide services, anytime we 

can provide them predictability about what those services are going 

to be for the entire year it is helpful for them. So, in the health 

care account this makes pretty good sense. It would make sense in 

other accounts as well. 

But, I raise this issue as I did in testimony last October when 

there was this discussion. In the case of the Veterans Benefits Administration, we cannot process a claim within our own confines. 

To process a claim, we have to go to Social Security to validate 

other disabilities. We have to go to IRS to validate, by the law, 

threshold income requirements. We deal with DOD. We deal with 

Department of Education, the post-9/11 GI Bill. We deal with the 

Department of Labor on employability issues. 

So, for me to say that we can do this without the investment 

from other Departments, I think I would not be giving you the full 

picture. 

As I said in October—and I do not mean to lecture anyone here— 

the best way for us to see meeting our full mission would be to 

have a budget for the Federal Government every year. That is 

what would make all of our work much easier. 

197 

Senator BOOZMAN. Thank you, Mr. Chair. I apologize for going 

over. 

Chairman SANDERS. Senator Blumenthal. 

Senator BLUMENTHAL. Thank you, Mr. Chairman, and thank you 

for having a second round of questions. 

Thank you, Mr. Secretary, for being so forthright and helpful in 

your answers to my questions. 

Let me just begin again on a seemingly local issue. Our VA facility in West Haven has been found to be deficient in a number of 

serious respects by the inspector general of the VA. So, I would like 

your commitment that you will work with me in seeking remedies 

for those failings. They have been documented. The VA officials 

have been very forthcoming and responsive to my visits and inquiries. 

I would like to have the resources of the VA committed to providing the highest quality care in that West Haven facility. 

Secretary SHINSEKI. You and I have the same goal, Senator. 

Senator BLUMENTHAL. Thank you. 

Secretary SHINSEKI. I commit to working with you. 

Senator BLUMENTHAL. Next item, going to PTS, you may be 

aware of legal action that has been brought by the Yale Veterans 

Clinic. The good news is you are not a defendant. 

It was brought against the Secretary of the Army and a number 

of other officials. For me, it is a very serious legal action but also 

one that really embodies a moral imperative. It relates to veterans 

of the Vietnam War, who have suffered from PTS. 

The named plaintiff, Conley Monk, has suffered from PTS for 40 

years. He was wounded in combat, and then he was wounded a second time because he was denied VA medical treatment for Post 

Traumatic Stress. That condition was unrecognized at the time. It 

was undiagnosed and, therefore, not treated at all. 

As you and I have discussed, both in public and private, I know 

you have a deep understanding and concern on this issue and that 

changing his discharge from less than honorable to honorable is not 

within your power. It is the authority of the review board in the 

Department of Defense. 

You have mentioned that you have regular conversations and 

meetings with Secretary Hagel. I have asked about this subject in 

the course in the Armed Services hearings. I believe that you are 

sympathetic and supportive, as his he. 

And, again, I would just like your commitment that you will 

raise it privately and publicly with him because the urgency of this 

cause, I think, is no less, perhaps even more than it was when we 

last discussed it, and yet, there has been no general action to address this concern among the Vietnam veteran population generally, who may have suffered from PTS at the same rate as the 

Iraq and Afghanistan veterans have done. 

Secretary SHINSEKI. Certainly, Senator, I will commit to continuing to work this with you and work this as a priority as well. 

We approached DOD and had those discussions that I have described and looking for a review of the character of discharge. 

For one thing, as you point out, we did not do well by the Vietnam generation, and I happen to know many of them. So, part of 

our commitment here is never—not to repeat what happened there. 

198 

So, if you go back 3 years, you will see a decision within the VA 

that if a combat veteran has medically verifiable PTSD, we will 

make the service connection and allow that individual to submit a 

claim for benefits as well as treatment and move beyond this discussion of putting the burden of proof on the veteran to demonstrate how and why PTSD was an issue. 

We have increased awareness about PTSD. We have increased 

our funding in this area. I do think we are doing better but still 

not enough with the current generation. 

Many of our mental health issues, PTSD issues, still go back to 

the Vietnam generation. We owe them better, and we are doing our 

best to make up for lost time here. 

We owe this generation, as well, the best care we can provide. 

Senator BLUMENTHAL. I really appreciate your support on this 

issue. I know you have a deep understanding and concern, as I 

mentioned earlier. 

By the way, I refer to it as PTS rather than PTSD because I 

think that calling it a disorder gives it a kind of stigma that is 

completely unjustified. It is Post Traumatic Stress. 

I welcome your making this policy flexible so as to provide the 

medical benefits, but of course, those benefits cannot be supplemented by other benefits, whether relating to employment and 

homelessness and so forth that the VA has to offer, because of the 

less-than-honorable discharge, not to mention the stigma of that 

kind of discharge that they have suffered for 40 years or more. 

So, I agree with you that it is a moral imperative, an obligation 

of this country, not to mention the need to settle this lawsuit, 

which I fully support because I think legally it is well-justified. 

Secretary SHINSEKI. I would just offer to you, Senator, that the 

character discharge clearly still remains a DOD issue; and I can 

tell you that this is at the top of discussion. I know Secretary 

Hagel is looking at it. 

In the meantime, we have asked DOD to provide us a list by 

name of veterans who, in some cases, may have been discharged 

under rules that no longer exist—‘‘don’t ask, don’t tell,’’ for example, behavior issues that could be PTSD. 

We have about 73,000 names, and we are running those names 

against our registry of homeless veterans, and thus far, we have 

found about a 6,500 name match. 

So, we are pulling those individuals into our review to see whether or not we can provide benefits and care, and we are. In those 

6,500 cases, we are. 

I think here shortly we have either written 73,000 letters to folks 

on that list or will complete doing that shortly. 

For those that we do not get a response from by this summer, 

we will turn around and try to follow up on that, again, trying to 

close this loop on folks who have been denied benefits and services 

that they earned. 

Senator BLUMENTHAL. Let me make one last comment which is 

to thank you for, again, expanding the circle. I think it has been 

a mark of your leadership that you have sought to increase the circle of accessibility and eligibility, whether it is Agent Orange or 

other disability claims. Rather than kind of circling the wagons 

199 

more closely, you have had the courage to try to increase availability and access. 

I really do appreciate the point that you just made and, finally, 

would say I am very concerned about discrimination against veterans, particularly in employment situations and most especially 

when it comes to PTS. 

My concern is embodied in legislation that I have offered that 

prohibits discrimination. Whether it will pass, I certainly cannot 

say. The odds are against any single piece of legislation. 

But the evidence I am seeing, again, indicates that among a 

small proportion—and I emphasize it is maybe a small minority, 

but it is there—of employers, there is this discrimination for whatever reason against veterans. 

A law is a blunt and cumbersome instrument to work against it, 

but I hope that perhaps I can work with you in documenting the 

discrimination if it exists, then doing something to counter it. 

Chairman SANDERS. Let me—I am going to have to interrupt and 

go to Senator Moran now. 

Senator Moran. 

Senator BLUMENTHAL. I apologize. I thought I was the last. So, 

I apologize, Mr. Chairman. 

Senator MORAN. Now my feelings are hurt. I just thought you 

were windy. I did not realize you were—— 

[Laughter.] 

Senator BLUMENTHAL. Well, that, too, but—— 

STATEMENT OF HON. JERRY MORAN, 

U.S. SENATOR FROM KANSAS 

Senator MORAN. Mr. Chairman, thank you very much. 

Mr. Secretary and your colleagues, thank you for being here. 

I have three or four questions I would like to raise about specific 

programs particularly of interest to me as a Senator from Kansas. 

The first one is a program—a law that was passed in 2010. I was 

in the House of Representatives then and chaired the Health Care 

Subcommittee on Veterans, and we were successful in passing a 

bill called Access Received Closer to Home, ARCH. The crux of that 

effort was to recognize, in particularly a State like ours, like mine, 

that VA hospitals are a long way from many veterans. 

We initially addressed that with outpatient clinics, and that provided routine services closer to home, but still miles and hours 

away from many of the veterans in our State. 

With the support of many of my colleagues, including the Senator from Arkansas, we were successful in passing legislation that 

would require the VA to provide services, in a sense, in hometowns, 

where the veteran chose to have those services provided if they 

lived more than a certain number of miles from a CBOC or VA 

hospital. 

That was narrowed down before the bill was passed and became 

a pilot program. That pilot program has been in place now for 3 

years. Reports, I assume, are either on your desk or soon to be on 

your desk. 

My initial question is, do you have thoughts about this program’s 

success and what is the Department’s plan for its continuance? 

200 

Secretary SHINSEKI. The report has not yet arrived. So, I await 

that. 

I think we learned a lot from Project ARCH, and we have in the 

meantime put in place some other initiatives that are VA programs 

that address some of those lessons that we got out of ARCH. 

I do not know what the next step is going to be with ARCH, but 

let me call on Dr. Petzel to talk about some of the things that we 

have implemented, not the least of which is telehealth to help try 

to bridge even those remote and rural areas where veterans have 

no access to health. 

Dr. PETZEL. Senator Moran, thank you. 

The pilot was done in five different networks, and as you know, 

Kansas was one of them. Pratt County was actually the place 

where we did that. 

Various things were done. In a couple of instances, primary care 

was provided, but in the bulk of places it was a specialty care kind 

of phenomenon where if the veteran needed and wanted specialty 

care in the community we were able to provide that. 

We made progress in other areas since then, as the Secretary alluded to. With telehealth, telehome health, we are in a much better 

position now to provide specialty care in remote areas that we 

might have been three or 4 years ago. 

In addition to that, in anticipation of the pilot for ARCH ending, 

we have developed a new program nationwide called PC3, which is 

a program by which we have developed networks around the country to provide specialty care on referrals. In other words, a referral 

network, where if somebody lives in a remote area and a decision 

is made they need to have specialty care and it is inconvenient and 

not appropriate for them to travel, we can go to that contract provider under the PC3 contract and provide that care in the 

community. 

The program started in January when the first network was set 

up. It is now fully operational around the country, and the business 

is booming, so to speak. We are seeing the contract and the network being used all over the country. 

In addition to that, we do have the capacity—we always have 

had—to provide for fee-basis care in the community and have used 

that extensively, particularly in places like Kansas, again, where it 

is just not appropriate for someone to travel 200 miles to Topeka 

or to Wichita or into Kansas City. 

Senator MORAN. I appreciate that answer. 

We want to continue to work with the VA to expand this program. Pratt County is one of them. It is important that we test 

this, I suppose, in a small county although when the legislation 

passed I expected it to be tested VISN-wide and the VA narrowed 

it to a county, which is a significant difference in the outcome. 

Let me highlight something that you said, which causes me to 

bring up two other questions. You talked about telemedicine, for 

example. 

One of the problems that we have discovered in CBOCs is the 

lack of physicians, of mid-levels. The Liberal CBOC on the Kansas/ 

Oklahoma border has not had a physician for more than 2 years. 

You have been recruiting for more than 2 years with no success. 

201 

The Topeka VA recently closed its emergency room services, 

claiming they have a lack of physicians to man or person an emergency room. Now the VA in Topeka is telling veterans who show 

up at their hospital that we have no emergency services; you need 

to go to a commercial hospital. 

The Secretary and I have had this conversation at, I think, every 

occurrence in which he has appeared before this Committee or the 

Appropriations Committee in this admonition, this request. 

I understand the difficulty. I am a rural person. I know how difficult it is outside the VA to recruit physicians. But the VA has yet, 

in my view, to find the solution to the lack of physicians and other 

mid-level professionals within the system. 

So, this problem—if we delay going to the private sector, if we 

delay going to the community hospital and the local physician, we 

are exacerbating the problem where the CBOCs have no ability to 

provide the necessary level of care and treatment. And even at a 

hospital the size of Topeka—the VA hospital—we are told there are 

not enough doctors to staff an emergency room. 

One of the other aspects—and I do not want to be accused of Mr. 

Blumenthal’s problem, of speaking beyond my time, so I am moving 

quickly to my other questions. 

Chiropractors. Again, a piece of legislation authored in the House 

of Representatives in my day requires the VA to place chiropractic 

care to meet the needs of veterans in every VISN. It seems to me 

that the VA has been very slow to implement that legislation. We 

have chiropractic are available, but there is no systemwide effort 

at providing chiropractic care. 

One, it can be a value. But, again, in a State like mine in the 

absence of other health care professionals, chiropractic care becomes critical. 

And before my 2 minutes past time goes any further, the final 

thing I would raise with you is we are confused by something that 

has happened in Wichita. The Dole VA Hospital and the McConnell 

Air Force Base has been working. 

And, again, the Secretary and I had the conversation I think the 

last time you were in front of this Committee, about how do we get 

the project that will combine those two facilities—a hospital that 

is already at McConnell and a VA hospital, the Dole Hospital. The 

plan by the VA has been to combine those two and build a new facility on McConnell Air Force Base property. 

Last year—and I need to look at my notes—it was included in 

the list, and I asked you, how do we move that up? 

Well, Mr. Secretary, not only has it not moved up, but it is no 

longer on the list. And, at least to our knowledge, no one at the 

Dole VA Center can explain why last year it was being considered. 

It was ranked. 

My question to you is, how do we get a higher ranking? 

And now it is gone entirely. 

Secretary SHINSEKI. Senator, I owe you a better answer than I 

am going to give you, which is that every year we re-look at priorities, and where we have a safety or security project that leaps up 

that we have to do something about in the ordering that will move 

a project forward. 

202 

I will go back and research what the issue is with the Dole/ 

McConnell project. 

My guess is it is still on our list of things to do. You do not see 

it in the budget because the available funding covered those 

projects that we could fund this year—$1.5 billion in the base account and then $400 million in the investment account. 

Senator MORAN. Thank you, Mr. Secretary. 

The project was ranked No. 197 in fiscal year 2014; not on the 

list this time. 

Mr. Chairman, thank you. 

Chairman SANDERS. If it is OK with the members—— 

Senator BLUMENTHAL. Mr. Chairman, could I just give General 

Shinseki an opportunity to respond to the question I asked. 

I did not know whether you had a response on the issue of discrimination. You may have been interrupted without having a 

response. 

Before my friend from Kansas leaves, I want to say that I apologize to him. Senator Moran, my apologies to you for keeping you 

longer. 

Senator MORAN. Well, you set the precedent, and I followed 

your—— 

Senator BLUMENTHAL. You took advantage of it. 

Sorry, General, please. 

Secretary SHINSEKI. I would just say our approach has been— 

and it did not begin with my arrival—that VA is a welcoming 

place, and we have generously taken care of veterans for many 

generations now. I think if you look at the decisions that have been 

made in at least the last 5 years, our effort has been to provide veterans the care and benefits that they have earned without drawing 

any walls around that statement. 

Senator BLUMENTHAL. And I am not talking about VA benefits 

right now. I am talking about private employers who may discriminate against veterans for whatever reason. 

Secretary SHINSEKI. This is what I put into the area of what I 

call ‘‘the undiscussables,’’ and it is a topic I discuss every opportunity I have with potential employers. 

I assure them that at VA our experience is when we diagnose 

and treat whatever the issue is, but even PTS or PTSD, that people 

improve and that they should not let that be a barrier to them 

making a hiring decision. They will not regret it. Our veterans are 

very capable youngsters. They come with tremendous experience, 

along with the kind of work ethic and discipline we all like seeing. 

They will not regret making that hiring decision. 

I am happy to work with you on how do we make that a more 

compelling argument. 

Senator BLUMENTHAL. Thank you very much. 

Thank you, Mr. Chairman. 

Chairman SANDERS. If it is OK, let me just ask one last question, 

picking up on a question that Senator Moran raised. 

I wear another hat. I am chairman of the Subcommittee on Primary Care. We know that as a Nation we have a real crisis in 

terms of whole areas, including in Kansas. I think it is a serious 

problem in areas of Kansas, above and beyond the VA, where peoVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00206 Fmt 6633 Sfmt 6601 Z:\113TH HEARINGS PRINTED\88404 PAULIN
203 

ple cannot access a primary care physician. We have some of that 

in parts of Vermont as well. 

We tripled a couple of years ago, in the Affordable Care Act, 

funding for the National Health Service Corps. The President’s 

budget was very generous again for the National Health Service 

Corps, which provides debt forgiveness for those medical school 

graduates or dentists who are practicing in underserved areas. 

What kinds of programs does the VA have in terms of debt forgiveness or scholarships, or whatever it may be, to attract primary 

care physicians into the VA to handle the problems that Senator 

Moran raised? 

Dr. PETZEL. Mr. Chairman, the VA has got a number of possibilities of attracting people into these remote areas. Let me just go 

through them quickly. Then I will talk specifically about debt forgiveness. 

We have retention bonuses. We have recruitment bonuses. We 

have home buyouts, where we can buy people’s homes, allowing 

them to make the move. We have got quite a bit of flexibility in 

terms of salary. Our salary rates are competitive, and they are 

flexible. 

In terms of loan forgiveness, right now, I think the Secretary’s 

limit on forgiving educational loans is $60,000. That could be higher; I will just be blunt. 

There are not many instances where you need to do that, and the 

cost of it is not particularly extensive, but it can be a great incentive for somebody that is carrying $200,000 worth of educational 

debt, coming out of college and medical school, to be able to have 

a goodly portion of that actually forgiven. 

Chairman SANDERS. If my memory is correct, what the Department of Defense does is say we will send you to medical school and 

then get X number of years of your life after you graduate. 

Dr. PETZEL. They do. And we have a program that is not unlike 

that. 

The difficulty is that you cannot predict where they are going to 

go. It would be wonderful if you could take somebody that is a senior in college—— 

Chairman SANDERS. Well, can’t you write that into the contract? 

We will pay for your medical school. We will send you—— 

Dr. PETZEL. You do not get anybody to sign that contract. 

With DOD, it is you are going to serve in the military, but you 

have got a lot of flexibility in terms of what you do in the military. 

With us, if we wanted to direct these people into things like rural 

health, to go to Helena, MT, or Liberal, KS, you would have to 

write that into the contract, and we have not been able to accomplish that right now. 

Chairman SANDERS. I think it is an important issue that is worth 

further discussion. 

Dr. PETZEL. Could I mention just one more thing for rural? And 

that is the use of advanced practice nurses, who are very versatile 

and very flexible and actually have helped keep Liberal and its 278 

patients going—that and we have a provider that visits that area. 

That is the only place in Kansas we are having trouble, interestingly. The rest of our clinics—I just checked—have got the full complement of providers. 

204 

We will continue to work on it, Senator. 

Chairman SANDERS. Because people are shocked about Liberal, 

KS. They cannot get that through their heads. [Laughter.] 

Senator Boozman, did you want—— 

Senator BOOZMAN. I would just—I did not realize that you were 

also involved in another committee. 

This really is a huge problem, and it is not just with VA. It is 

regardless of where anybody is at on the health care bill we are 

going to have more people into the system. OK? 

So, many of the providers are our age, and it is just something 

that we really need to look at. 

We can work hard and work hard on our making sure that the 

veterans have the benefits that were promised, but if you have this 

great deal and you cannot find anybody to provide the care it really 

is a big thing. 

Maybe that is something that at some point we could actually 

have a hearing on. 

Chairman SANDERS. I think that is a good idea. 

Senator BOOZMAN. Get them to get the data over—where we are 

at now, where they feel like we are going to be five—— 

Chairman SANDERS. And the point is, this is not just a VA problem. 

Senator BOOZMAN. Exactly. 

Chairman SANDERS. It is a national problem 

Senator BOOZMAN. The trouble is, though, you cannot—this is 

something that if we are going to be short on physicians 5 years 

from now you cannot decide 3 years from now that you are going 

to do something. 

Chairman SANDERS. Absolutely right. 

All right, can we—Senator Moran, are you all right? 

[No response.] 

Chairman SANDERS. OK, let me—— 

Senator MORAN. If I have a chance to follow up, I would be glad 

to. 

Chairman SANDERS. A brief, brief follow-up. 

Senator MORAN. First of all, I would ask Secretary Shinseki if he 

would give us an idea of when he is going to receive the report 

about ARCH and when we then could see the results. 

And for Secretary Petzel, I would just say that your response to 

the Chairman’s question about all the array of things we have to 

offer physicians—it may be a long list, but it does not seem 

sufficient. 

I have asked this question at every hearing. What is it that we 

can do? What are you missing? 

I have never had an answer that says that we have now examined this; a solution to our problem that does not go away would 

be additional pay, additional loan forgiveness, all the things that 

are on that list but maybe more. 

So, for the answer to the Chairman’s question to be this is all 

the things we have, I appreciate knowing that, but I just would remind you that it still does not seem to solve the problem. 

Chairman SANDERS. Let me suggest this. I think Senator 

Boozman raised the issue. Let’s do a hearing on this. Does that 

sound good? 

205 

Senator MORAN. Sounds good. 

Chairman SANDERS. OK. And we will get you guys back to do 

some thinking about that. 

Senator MORAN. And the answer to when we could receive a 

report? 

Secretary SHINSEKI. It is coming to me from Dr. Petzel. I just 

asked him that question, Senator, and he said, shortly. So, I assume I will have it before the sun sets today. 

Senator MORAN. All right. [Laughter.] 

Thank you for holding his feet to the fire. 

Secretary SHINSEKI. That is the way we define shortly. 

Chairman SANDERS. With that, I want to thank all of the panel 

for spending over 2 hours with us, for your thoughtful answers; 

and in these very difficult times, we are proud of the work that you 

are doing. 

With that, this hearing is adjourned. 

[Whereupon, at approximately 4:08 p.m., the Committee was adjourned.] 

(207) 

A P P E N D I X 

PREPARED STATEMENT OF DIANE M. ZUMATTO, NATIONAL LEGISLATIVE DIRECTOR, AMVETS 

Chairman Sanders, Ranking Member Burr, and distinguished Members of the 

Committee: As an author of The Independent Budget (IB), I appreciate this opportunity to share with you the IB’s recommendations in what we believe to be the 

most fiscally responsible way of ensuring the quality and integrity of the care and 

benefits earned by Americans veterans. 

The venerable and honorable history of our national cemeteries spans roughly 150 

years when the earliest military graveyards were, not surprisingly, situated at battle sites, near field or general hospitals and at former prisoner-of-war sites. With 

the passage of the National Cemeteries Act of 1973 (PL 93–43), the Department of 

Veterans’ Affairs (VA) became responsible for the majority of our national cemeteries. The single most important obligation of the National Cemetery Administration (NCA) is to honor the memory of America’s brave men and women who have 

selflessly served in this Nation’s Armed Forces. As of late 2010, there were more 

than 20,021 acres of cemetery landscape, funerary monuments, grave markers, as 

well as, other architectural features and memorial tributes, much of it historically 

significant, included within established installations in the NCA which are therefore 

representative of the very foundations of these United States. 

The signing of the Veterans Programs Enhancement Act of 1998 (PL 105–368) officially re-designated the National Cemetery System (NCS) to the now familiar National Cemetery Administration (NCA). The NCA currently maintains stewardship 

of 133 of the Nation’s 147 national cemeteries, as well as 33 soldiers’ lots, including 

two new national cemeteries scheduled to open in 2015. Since 1862 when President 

Abraham Lincoln signed the first legislation establishing the national cemetery concept, more than 3.5 million burials have taken place in national cemeteries currently located in 39 states and Puerto Rico, with approximately 128,100 interments 

expected in 2015. 

There are an estimated 22.4 million veterans alive today and with the transition 

of an additional 1 million servicemembers into veteran status over the next 12 

months, this number is expected to continue to rise until approximately 2017. On 

average, 14.4 percent of veterans choose a national or state veterans’ cemetery as 

their final resting place. As new national and state cemeteries continue to open, and 

as our aging veterans’ population continues to grow and we continue to be a nation 

at war, the demand for burial at a veterans’ cemetery will continue to increase. 

The Independent Budget veterans service organizations (IBVSOs) would like to acknowledge the devotion and commitment demonstrated by the NCA leadership, especially Undersecretary Steve Muro, and his staff in their continued dedication to 

providing the highest quality of service to veterans and their families. It is in the 

opinion of the IBVSOs that the NCA continues to meet its goals and the goals set 

forth by others because of its true dedication and care for honoring the memories 

of the men and women who have so selflessly served our Nation. We applaud the 

NCA for recognizing that it must continue to be responsive to the preferences and 

expectations of the veterans’ community by adapting or adopting new interment options and ensuring access to burial options in the national, state and tribal government-operated cemeteries. We also believe it is important to recognize the NCA’s efforts in employing both disabled and homeless veterans. 

NCA ACCOUNTS

While NCA’s operating budget has remained fairly stagnant at around $250 million for 4 out of the last 5 years, their workload has been anything but static and 

this trend is expected to continue for the foreseeable future. The IBVSO’s are appreciative of the roughly $8 million increase in NCA’s overall FY 2015 budget, however, 

208 

that increase comes with a simultaneous $8.4 million reduction in the National 

Shrine account. 

Between FY 2014 and FY 2015, the number of gravesites needing maintenance 

will increase by approximately 2.4%, while interments will increase by roughly 

1.9%. 

The NCA was also able to award 44 of its 48 minor construction projects and had 

four unobligated projects that will be moved to FY 2012. Unfortunately, due to continuing resolutions and the current budget situation, the NCA was not able to 

award the remaining four projects. 

The IBVSOs support the operational standards and measures outlined in the National Shrine Commitment (PL 106–117, Sec. 613) which was enacted in 1999 to ensure that our national cemeteries are the finest in the world. While the NCA has 

worked diligently improving the appearance of our national cemeteries, they are still 

a long way from where they should be. 

The NCA has worked tirelessly to improve the appearance of our national cemeteries, investing an estimated $39 million into the National Shrine Initiative in FY 

2011. According to NCA surveys, as of October 2011 the NCA has continued to make 

progress in reaching its performance measures. Since 2006, the NCA has improved 

headstone and marker height and alignment in national cemeteries from 67 percent 

to 70 percent and has improved cleanliness of tombstones, markers and niches from 

77 percent to 91 percent. Although the NCA is nearing its strategic goal of 90 percent and 95 percent, respectively, for height and alignment and cleanliness, more 

funding is needed to continue this delicate and labor-intensive work. Therefore, the 

IBVSOs recommend the NCA’s Operations and Maintenance budget to be increased 

by $20 million per year until the operational standards and measures goals are 

reached. 

The IBVSOs recommend a minimum Operational and Maintenance budget of 

$260 million for the National Cemetery Administration for FY 2015, so it can meet 

the demands for interment, gravesite maintenance and related essential elements 

of cemetery operations. This request includes $34.5 million for the National Shrine 

Initiative to ensure that our national cemeteries meet or exceed the highest standards of appearance required by their status as national shrines. 

The national shrine funds would be used, among other things, to maintain: 

• occupied graves; 

• developed acreage; 

• historic structures; and 

• cemetery infrastructure 

The IBVSOs call on the Administration and Congress to provide the resources 

needed to meet the critical nature of the NCA’s mission and to fulfill the Nation’s 

commitment to all veterans who have served their country so honorably and faithfully. 

STATE CEMETERY GRANT PROGRAMS

The State Cemetery Grants Program (SCGP) complements the National Cemetery 

Administration’s mission to establish gravesites for veterans in areas where it cannot fully respond to the burial needs of veterans. Several incentives are in place to 

assist states in this effort. For example, the NCA can provide up to 100 percent of 

the development cost for an approved cemetery project, including establishing a new 

cemetery and expanding or improving an established state or tribal organization 

veterans’ cemetery. New equipment, such as mowers and backhoes, can be provided 

for new cemeteries. In addition, the Department of Veterans’ Affairs may also provide operating grants to help cemeteries achieve national shrine standards. 

In FY 2011 the SCGP operated on an estimated budget of $46 million, funding 

16 state cemeteries. These 16 state cemeteries included the establishment or ground 

breaking of five new state cemeteries, three of which are located on tribal lands, 

expansions and improvements at seven state cemeteries, and four projects aimed at 

assisting state cemeteries to meet the NCA national shrine standards. Since 1978 

the Department of Veterans’ Affairs has more than doubled the available acreage 

and accommodated more than a 100 percent increase in burials through this 

program. 

With the enactment of the ‘‘Veterans Benefits Improvement Act of 1998,’’ the NCA 

has been able to strengthen its partnership with states and increase burial services 

to veterans, especially those living in less densely populated areas without access 

to a nearby national cemetery. Through FY 2010, the state grant program has established 75 state veteran’s cemeteries in 40 states and U.S. territories. Furthermore, in FY 2011 VA awarded its first state cemetery grant to a tribal organization. 

209 

The Independent Budget veteran’s service organizations recommend that Congress fund the State Cemetery Grants Program at $48 million for FY 2015. The IBVSOs 

believe that this small increase in funding will help the National Cemetery Administration meet the needs of the State Cemetery Grant Program, as its expected demand will continue to rise through 2017. Furthermore, this funding level will allow 

the NCA to continue to expand in an effort of reaching its goal of serving 94 percent 

of the Nation’s veteran population by 2015. 

VETERAN’S BURIAL BENEFITS

Since the original parcel of land was set aside for the sacred committal of Civil 

War Veterans by President Abraham Lincoln in 1862, more than 3 million burials 

have occurred in national cemeteries under the National Cemetery Administration. 

In 1973, the Department of Veterans’ Affairs established a burial allowance that 

provided partial reimbursement for eligible funeral and burial costs. The current 

payment is $2,000 for burial expenses for service-connected deaths, $300 for nonservice-connected deaths and a $700 plot allowance. At its inception, the payout covered 72 percent of the funeral costs for a service-connected death, 22 percent for a 

non-service-connected death and 54 percent of the cost of a burial plot. 

Burial allowance was first introduced in 1917 to prevent veterans from being buried in potter’s fields. In 1923 the allowance was modified. The benefit was determined by a means test until it was removed in 1936. In its early history the burial 

allowance was paid to all veterans, regardless of their service connectivity of death. 

In 1973, the allowance was modified to reflect the status of service connection. 

The plot allowance was introduced in 1973 as an attempt to provide a plot benefit 

for veterans who did not have reasonable access to a national cemetery. Although 

neither the plot allowance nor the burial allowance was intended to cover the full 

cost of a civilian burial in a private cemetery, the recent increase in the benefit’s 

value indicates the intent to provide a meaningful benefit. The Independent Budget 

veterans’ service organizations are pleased that the 111th Congress acted quickly 

and passed an increase in the plot allowance for certain veterans from $300 to $700 

effective October 1, 2011. However, we believe that there is still a serious deficit 

between the original value of the benefit and its current value. 

In order to bring the benefit back up to its original intended value, the payment for service-connected burial allowance should be increased to $6,160, the non-service-connected burial allowance should be increased to $1,918 and the plot allowance 

should be increased to $1,150. The IBVSOs believe Congress should divide the burial benefits into two categories: veterans within the accessibility model and veterans 

outside the accessibility model. 

Congress should increase the plot allowance from $700 to $1,150 for all eligible 

veterans and expand the eligibility for the plot allowance for all veterans who would 

be eligible for burial in a national cemetery, not just those who served during wartime. Congress should increase the service-connected burial benefits from $2,000 to 

$6,160 for veterans outside the radius threshold and to $2,793 for veterans inside 

the radius threshold. 

Congress should increase the non-service-connected burial benefits from $300 to 

$1,918 for all veterans outside the radius threshold and to $854 for all veterans inside the radius threshold. The Administration and Congress should provide the resources required to meet the critical nature of the National Cemetery Administration’s mission and to fulfill the Nation’s commitment to all veterans who have 

served their country so honorably and faithfully. 

PREPARED STATEMENT OF PAUL R. VARELA, ASSISTANT NATIONAL LEGISLATIVE

DIRECTOR, DISABLED AMERICAN VETERANS (DAV) 

Chairman Sanders, Ranking Member Burr, and Members of the Committee: On 

behalf of the DAV and our 1.2 million members, all of whom are wartime disabled 

veterans, I am pleased to present recommendations of The Independent Budget (IB) 

for the fiscal year (FY) 2015 budget related to veterans’ benefits and the Veterans 

Benefits Administration (VBA). The IB is jointly produced each year by DAV, 

AMVETS, Paralyzed Veterans of America and Veterans of Foreign Wars of the 

United States. This year’s IB contains numerous recommendations to improve veterans’ benefit programs and the claims processing system; however, in today’s testimony I will highlight just some of the most critical ones for this Committee to 

consider. 

Mr. Chairman, the timely delivery of earned benefits to the millions of men and 

women who have served in our Armed Forces is one of the most sacred obligations 

of the Federal Government. The award of a service-connected disability rating does 

210 

more than provide compensation payments; it is the gateway to an array of benefits 

that support the recovery and transition of veterans, their families and survivors. 

However, when these benefits are delayed or unjustly denied, the consequences to 

veterans and their families can be devastating. For those wounded heroes who file 

claims for disability compensation, the wait to receive an accurate rating decision 

and award can take anywhere from a few months to several years; longer if they 

have to appeal incorrect decisions. 

In early 2010, Secretary Shinseki laid out an extremely ambitious goal for VBA 

to achieve by 2015: process 100 percent of claims in less than 125 days, and do so 

with 98 percent accuracy. Since that time, VBA has worked to completely transform 

their IT systems, business processes and corporate culture, while simultaneously 

continuing to process more than a million claims each year. VBA is actively rolling 

out new organizational models and practices, and continuing to develop and deploy 

new technologies almost daily. 

Today there are about 685,000 claims for compensation and pension awaiting decisions at VBA. At the beginning of 2013, there were more than 860,000 pending 

claims for disability compensation and pension. By the end of the year, that number 

had dropped by more than 20 percent, down to about 685,000 pending. The number 

of claims in the backlog—greater than 125 days pending—dropped by about a third, 

from more than 600,000 in January 2013 to just over 405,000 in January 2014. The 

VBA increased the number of claims completed each month from an average of 

about 89,000 during the first four months of the year to more than 114,000 during 

the succeeding six months prior to the government shutdown. Claims production 

dropped significantly following the shutdown and during the subsequent holiday 

period. 

In the midst of this massive transformation, it can be hard to get the proper perspective to measure whether their final systems will be successful, but we believe 

there has been sufficient progress to merit continued support of the current transformation efforts. Now is not the time to stop or change direction. 

We urge this Committee and Congress to provide the support and resources necessary to complete this transformation as currently planned, while continuing to exercise strong oversight to ensure that VBA remains focused on the long-term goal 

of creating a new claims processing system that decides each claim right the first 

time. In particular, the proposed FY 2015 budget for VBA includes additional funding for scanning and conversion of existing paper claims files, absolutely critical for 

VBA to complete its transformation from an outdated, paper-based claims system 

to a modern, paperless, automated claims system. 

Mr. Chairman, one of the most important aspects needed to assure ongoing positive changes within the VBA is their willingness to remain open and partner with 

veterans service organizations. Our organizations possess significant knowledge and 

experience of the claims process and collectively we hold power of attorney (POA) 

for millions of veterans who are filing or have filed claims. VBA recognized that 

close collaboration with VSOs could not only reduce its workload, but also increase 

the quality of its work. We make VBA’s job easier by helping veterans prepare and 

submit better claims, thereby requiring less time and resources for VBA to develop 

and adjudicate them. 

The IB veterans service organizations (IBVSOs) have been consulted about initiatives proposed or underway at VBA, including Fully Developed Claims (FDC), Disability Benefit Questionnaires (DBQs), the Veterans Benefit Management System 

(VBMS), the Stakeholder Enterprise Portal (SEP), and the update of the Department of Veterans Affairs (VA) Schedule for Rating Disabilities (VASRD). Both Secretary Shinseki and Under Secretary Hickey have reached out to consult and collaborate with VSOs and we are confident that VBA’s success going forward will require a continued and enhanced partnership that will result in better service and 

outcomes for veterans. 

Since 2009, VBA has made some significant changes in how claims are processed. 

The most important amongst these is the development of the VBMS, its new IT system. VBMS has been rolled out to all 56 Regional Offices and VBA was able to complete implementation of the VBMS ahead of schedule in June; by the end of 2013, 

nearly all of VBA’s pending claims were processed using electronic files. It is important to remember that VBMS is not yet a finished product; rather, it continues to 

be developed and perfected as it is deployed so it is still premature to judge whether 

it will ultimately deliver all of the functionality and efficiency required to meet 

VBA’s future claims processing needs. 

Another very important milestone was VBA’s decision and commitment to scan 

all paper claims files for every new or reopened claim requiring a rating-related action, and creating digital e-folders to serve as the cornerstone of the new VBMS system. E-folders facilitate instantaneous transmission and simultaneous reviewing of 

211 

claims files. At present, there are an estimated 500,000 e-folders and that number 

will continue to grow as the remaining ROs convert to VBMS this year. 

In addition, the Appeals Management Center (AMC) is now working in VBMS and 

able to review e-folders. The Board of Veterans Appeals (BVA) will also begin receiving appeals in VBMS on a pilot basis. 

VBA also continues to strengthen its e-Benefits and SEP systems, which allow 

veterans and their representatives to file claims, upload supporting evidence and 

check on the status of pending claims. VBA has rolled out a new transformation organizational model (TOM) to every Regional Office that has reorganized workflow 

by segmenting claims into different processing lanes depending upon the complexity 

of the issues to be decided for each claim. Other key process improvements that we 

strongly support include the FDC program, which expedites ready-to-rate claims, 

and DBQs, which standardize and encourage the collection of private medical evidence to aid in rating decisions. To improve the accuracy of their work, VBA also 

fulfilled one of our long-standing recommendations by creating local Quality Review 

Teams (QRTs), whose primary function is to monitor claims processing in real time 

to catch and correct errors before rating decisions are finalized. 

CLAIMS PROCESSING RECOMMENDATIONS

Over the next year, Congress must continue to perform aggressive oversight of 

VBA’s ongoing claims transformation efforts, particularly new IT programs, while 

actively supporting the completion and full implementation of these vital initiatives. 

In order for VBA’s current transformation plans to have any reasonable chance of 

success, VBA must be allowed to complete and fully implement them. Congress 

must continue to fully fund the completion of VBMS, including providing sufficient 

funding for digital scanning and conversion of legacy paper files, as well as the development of new automation components for VBMS. At the same time, the IBVSOs 

recommend that Congress encourage an independent, expert review of VBMS while 

there is still time to make course corrections. 

Congress must also encourage and support VBA’s efforts to develop a new corporate culture based on quality, accuracy and accountability, as well as strengthen 

the transmission and adoption of these values and appropriate supportive policies 

throughout all VBA Regional Offices. The long-term success of all of VBA’s transformation efforts will depend on the degree to which these changes are institutionalized and disseminated from the national level to the local level. In addition to 

strengthening training, testing and quality control, VBA must be encouraged to 

properly align measuring and reporting functions with desired goals and outcomes 

for both its leadership and employees. 

For example, as long as the most widely reported metric of VBA’s success is the 

Monday Morning Workload Reports, particularly the weekly update on the size of 

the backlog, there will remain tremendous pressure throughout VBA to place production gains ahead of quality and accuracy. Similarly, if individual employee performance standards set unrealistic production goals, or fail to properly credit ancillary activity that contributes to quality but not production, those employees will be 

incentivized to focus on activities that maximize only production. VBA must develop 

more and better measures of work performance that focus on quality and accuracy, 

both for the agency as a whole and for individual employees. 

Furthermore, VBA must ensure that employee performance standards are based 

on accurate measures of the time it takes to properly perform their jobs. 

Congress must also ensure that VBA does not change its reporting or metrics for 

the sole purpose of achieving statistical gains, commonly referred to as ‘‘gaming the 

system,’’ in the absence of actual improvements to the system. For example, VBA 

recently announced that they will change how errors are scored for multi-issue 

claims. 

Previously, a claim would be considered to have an error if one mistake on at 

least one issue in the claim was detected during a STAR review. Under the new 

error policy, if there are 10 issues in the claim and a single error is found on one 

of the issues, that would now be scored as only 0.1 errors for that claim. While this 

may be a more valid way of measuring technical accuracy, it also has the effect of 

lowering the error rate without actually lowering the number of errors committed. 

For instance, if VBA measures errors by issue, then the backlog of claims would not 

be the reported 405,000, but a multiple of that based upon the total number of 

issues, which would be in the millions. Likewise, VBA’s allowance rate must be adjusted with this type of change in reporting to accurately reflect the number of 

issues allowed out of the total number of issues claimed, which would be significantly lower than the current allowance rate per claim. In essence, VBA cannot simply change the metrics to suit their need to reflect gains or improvements; they 

212 

must change all corresponding metrics such as claims versus issues, allowances 

versus denials and remands, or similar. 

Additionally, to make the system more efficient, Congress should enact and promote legislation and policies that maximize the use of private medical evidence to 

conserve VBA resources and enable quicker, more accurate rating decisions for veterans. The IBVSOs have long encouraged VBA to make greater use of private medical evidence when making claims decisions, which would save veterans time and 

VBA the cost of unnecessary examinations. 

DBQs, many of which were developed in consultation with IBVSO experts, are designed to allow private physicians to submit medical evidence on behalf of veterans 

they treat in a format that aids rating specialists. However, we continue to receive 

credible reports from across the country that many Veterans Service Representatives (VSRs) and Rating Veterans Service Representatives (RVSRs) do not accept 

the adequacy of DBQs submitted by private physicians, resulting in redundant VA 

medical examinations being ordered and valid evidence supporting veterans’ claims 

being rejected. 

Although there are currently 81 approved DBQs, VBA has only released 71 of 

them to the public for use by private physicians. In particular, VBA should allow 

private treating physicians to complete DBQs for medical opinions about whether 

injuries and disabilities are service-connected, as well as DBQs for PTSD, which 

current VBA rules do not allow; only VA physicians can make PTSD diagnoses for 

compensation claims. Congress should work with VBA to make both of these DBQs 

available to private physicians. 

To further encourage the use of private medical evidence, Congress should amend 

title 38, United States Code, section 5103A(d)(1) to provide that, when a claimant 

submits private medical evidence, including a private medical opinion, that is competent, credible, probative, and otherwise adequate for rating purposes, the Secretary shall not request a VA medical examination. This legislative change would 

require VSRs and RVSRs to first document that private medical evidence was inadequate for rating purposes before ordering examinations, which are often 

unnecessary. 

VBA STAFFING AND RESOURCE RECOMMENDATIONS

Compensation Service Staffing 

In recent years, VBA has seen a significant staffing increase because Congress 

recognized that rising workload, particularly claims for disability compensation, 

could not be addressed without additional personnel and thus provided additional 

resources each year to do so. More than 5,000 full-time employee equivalents 

(FTEE) were added to VBA over the past five years, a 33 percent increase, with 

most of that increase going to the Compensation Service. In FY 2013, VBA’s budget 

supported an additional 450 FTEE above the FY 2012 authorized level, and the FY 

2014 level added less than 100 new FTEE, and for FY 2015 the level of staffing remains unchanged. 

Since the early part of 2013, the VBA has clearly made positive strides toward 

increasing productivity, reducing the backlog of disability claims and, by the end of 

2015, reaching the Secretary’s goal of completing all claims in less than 125 days 

with 98 percent accuracy. Over the past year, the total number of claims pending 

dropped by about 20 percent, and the number in the backlog (over 125 days) decreased by more than a third. The VBA has employed a variety of aggressive initiatives, such as processing all claims pending longer than two years and then, when 

completed, moving to process all claims pending longer than one year. 

We believe allowing the VBA to again hire employees for a two-year temporary 

term could supplement and/or alleviate the reliance on mandatory overtime and further reduce the backlog of disability claims to help reach the Secretary’s goal by the 

end of 2015. Such an initiative would also provide an outstanding opportunity for 

VBA to have a generous pool of fully trained, qualified candidates to choose from 

as replacements for full-time VBA employees who will undoubtedly be lost over the 

next few years because of attrition. 

However, rather than hiring ‘‘new’’ employees who need training and time to become fully productive, VBA would have instantly productive replacements ready and 

would have the ability to hire only the best of these candidates. Therefore, we urge 

Congress to provide the funding and resources necessary for VBA to hire a minimum of 1,000 new employees for a temporary two-year term. 

Board of Veterans’ Appeals Staffing 

Based on historical trends, the number of new appeals to the Board averages approximately five percent of all claims received, so as the number of claims processed 

213 

by the VBA is expected to rise significantly, so too will the Board’s workload rise 

accordingly. Yet the budget provided to the Board has been declining, forcing it to 

reduce the number of employees. Although the Board had been authorized to have 

up to 544 FTEE in FY 2011, its appropriated budget could support only 532 FTEE 

that year. In FY 2012, that number was further reduced to 510. At present, due 

to cost-saving initiatives, the Board may be able to support as many as 518 FTEE 

with the FY 2013 budget; however, this does not correct the downward trend over 

the past several years, particularly as workload continues to rise. 

The FY 2014 budget actually proposed cuts to funding for the Board and further 

reduced staffing down to 492 FTEE, despite expected workload increases each year. 

Projecting for FY 2014, the IBVSOs recommended a modest increase in staffing to 

544 FTEE. 

We are pleased Congress supported this recommendation and actually went beyond the suggested number by providing enough funding for BVA to increase staffing to approximately 640 FTEE to be in place by the end of FY 2014 and an FY 

2015 budget request to increase the number of FTEE to 650. 

VOCATIONAL REHABILITATION

Employment Service Staffing 

In FY 2012, VA’s Vocational Rehabilitation and Employment (VR&E) program, 

also known as the VetSuccess program, had 121,000 participants in one or more of 

the five assistance tracks of VR&E’s VetSuccess program, an increase of 12.3 percent above the FY 2011 participation level of 107,925 veterans. In FY 2012, VR&E 

had a total of 1,446 FTEE, and anticipates an increase of approximately 150 FTEE 

for FY 2013. Given the estimated 10 percent workload increases for both FY 2013 

and FY 2014, the IB estimated VR&E would need an additional 230 counselors in 

FY 2014 in order to reduce their counselor-to-client ratio down to their stated goal 

of 1:125. 

An extension for the delivery of VR&E assistance at a key transition point for veterans is through the VetSuccess on Campus program. This program provides 

support to student veterans in completing college or university degrees. VetSuccess 

on Campus has developed into a program that places a full-time Vocational Rehabilitation Counselor and a part-time Vet Center Outreach Coordinator at an office 

on campus specifically for the student veterans attending that college. These VA officers are there to help the transition from military to civilian and student life. The 

VetSuccess on Campus program is designed to give needed support to all student 

veterans, whether or not they are entitled to one of VA’s education benefit 

programs. 

In FY 2015, Congress must provide the Vocational Rehabilitation and Employment Service with sufficient funding to support an adequate number of FTEE to 

meet growing demand of the program and achieve its current caseload target of one 

counselor for every 125 veteran clients and equitably allocate resources among 

VAROs in a manner to achieve that target. This includes assuring that as other programs, such as the VetSuccess on Campus staffed with tenured VR&E counselors, 

the workforce gaps left behind at the ROs are backfilled to keep pace with local 

workload demands. 

IT Enhancements 

In addition, the VBMS was ultimately intended to include all of VBA’s business 

lines so that no matter where a veteran or survivor applied for benefits, the VBMS 

would seamlessly connect them to all benefits they may be entitled to receive. While 

some programs, such as Education Service, have developed adequate IT systems in 

recent years, others, especially the Vocational Rehabilitation and Employment 

(VR&E) service, are in dire need of a complete IT overhaul. VR&E’s processing system, called the Corporate Winston-Salem, Indianapolis, Newark, Roanoke, Seattle 

(CWINRS) system, is incapable of managing the many needs of this program. Rather than invest in short-term upgrades and patches, the IBVSOs believe that VBMS 

development for VR&E should be accelerated. 

VBA must complete the full development and integration of the VBMS to the 

AMC, BVA, and Court of Appeals for Veterans Claims as well as to the other VBA 

business lines and in particular VR&E. 

The IBVSOs are pleased that the Administration’s budget request for FY 2015 is 

approximately $200 million more than the FY 2014 IT funding, and we support that 

level of funding. More importantly, Congress must ensure that from the total IT 

funding made available to VBA, that VR&E receives the necessary resources and 

support to upgrade its antiquated IT systems. 

214 

RECOMMENDATIONS FOR IMPROVEMENTS TO VA BENEFITS

Annual Cost-of-Living Adjustment (COLA) 

Congress has annually authorized increases in compensation and dependency and 

indemnity compensation (DIC) by the same percent as Social Security is increased. 

Under current law, the government monitors inflation throughout the year and, 

if inflation occurs, automatically increases Social Security payments by the percent 

of increase for the following year, which the Congress then applies to veterans’ 

programs. 

While Congress has always increased compensation and DIC based on inflation, 

there have been years when such increases were delayed, which puts unnecessary 

financial strain on veterans and their survivors. 

The IBVSOs urge Congress to enact legislation indexing compensation and DIC 

to Social Security COLA increases. 

End Rounding Down of Veterans’ and Survivors’ Benefits Payments 

In 1990, Congress, in an omnibus reconciliation act, mandated that veterans’ and 

survivors’ benefit payments be rounded down to the next lower whole dollar. While 

this policy was initially limited to a few years, Congress has continued that policy. 

The cumulative effect of this provision of the law effectively levies a tax on totally 

disabled veterans and their survivors. Congress should repeal the current policy of 

rounding down veterans’ and survivors’ benefits payments. 

On November 21, 2013, with the President’s signature, the Veterans’ Compensation Cost-of-Living Adjustment Act became Public Law 113–52. The Act provided a 

1.5% increase in veterans’ disability compensation, DIC and other related veterans 

benefits, effective December 1, 2013. Unlike COLAs in the past, this COLA did not 

include the provision of rounding down increases to the nearest whole dollar 

amount. 

The IBVSOs urge Congress not to return to a policy of rounding down veterans’ 

and survivors’ benefits payments. 

Reject Any Proposal to Use the ‘‘Chained CPI’’ 

In the past year, there has been much discussion about replacing the current CPI 

formula used for calculating the annual Social Security COLA with the Bureau of 

Labor Statistics (BLS) new formula commonly termed the ‘‘chained CPI.’’ Such a 

change would be expected to significantly reduce the rates paid to Social Security 

recipients, and thereby help to lower the Federal deficit. Since the Social Security 

COLA is also applied annually to the rates for VA disability compensation, DIC, and 

pensions for wartime veterans and survivors with limited incomes, its application 

would mean systematic reductions for millions of veterans, their dependents and 

survivors who rely on VA benefit payments. The IBVSOs urge Congress to reject 

any and all proposals to use the ‘‘chained CPI’’ for determining Social Security 

COLA increases, which would have the effect of significantly reducing the level of 

vital benefits provided to millions of veterans and their survivors. 

The IBVSOs also note that the CPI index used for Social Security does not include 

increases in the cost of food or gasoline, both of which have risen significantly in 

recent years. While no inflation index is perfect, the IBVSOs believe that VA should 

examine whether there are other inflation indices that would more appropriately 

correlate with the increased cost of living experienced by disabled veterans and their 

survivors. 

End Prohibition against Concurrent Receipt of VA Disability Compensation and 

Military Longevity Retired Pay 

Many veterans retired from the Armed Forces based on longevity of service must 

forfeit a portion of their retired pay, earned through faithful performance of military 

service, before they receive VA compensation for service-connected disabilities. This 

is inequitable—military retired pay is earned by virtue of a veteran’s career of service on behalf of the Nation, careers of usually more than 20 years. Entitlement to 

compensation, on the other hand, is paid solely because of disability resulting from 

military service, regardless of the length of service. Most nondisabled military retirees pursue second careers after serving in order to supplement their income, thereby 

justly enjoying a full reward for completion of a military career with the added reward of full civilian employment income. In contrast, military retirees with serviceconnected disabilities do not enjoy the same full earning potential since their earning potential is reduced commensurate with the degree of service-connected 

disability. 

In order to place all disabled longevity military retirees on equal footing with nondisabled military retirees, there should be no offset between full military retired pay 

and VA disability compensation. To the extent that military retired pay and VA disVerDate Mar 15 2010 16:07 Mar 25, 2015 Jkt 000000 PO 00000 Frm 00218 Fmt 6601 Sfmt 6621 Z:\113TH HEARINGS PRINTED\88404 PAULIN
215 

ability compensation offset each other, the disabled military retiree is treated less 

fairly than is a nondisabled military retiree by not accounting for the loss in earning 

capacity. Moreover, a disabled veteran who does not retire from military service but 

elects instead to pursue a civilian career after completing a service obligation can 

receive full VA disability compensation and full civilian retired pay—including retirement from any Federal civil service position. 

While Congress has made progress in recent years in correcting this injustice, current law still provides that service-connected veterans rated less than 50 percent 

disabled who retire from the Armed Forces on length of service may not receive disability compensation from VA in addition to full military retired pay. The IBVSOs 

believe the time has come to remove this prohibition completely. Congress should 

enact legislation to repeal the inequitable requirement that veterans’ military longevity retired pay be offset by an amount equal to the disability compensation 

awarded to disabled veterans rated less than 50 percent, the same as exists for 

those rated 50 percent or greater. 

SURVIVOR BENEFITS

Increase DIC for Surviving Spouses of Servicemembers 

The current rate of compensation paid to the survivors of certain deceased veterans rated permanently and totally disabled and deceased servicemembers is inadequate and inequitable. Under current law, the surviving spouse of a veteran who 

had a total disability rating is entitled to the basic rate of DIC. A supplemental payment is provided to those spouses who were married for at least eight years during 

which time the veteran was rated permanently and totally disabled. 

However, surviving spouses of veterans or military servicemembers who die before 

the eight-year eligibility period, or who die on active duty, respectively, only receive 

the basic rate of DIC. 

Insofar as DIC payments are intended to provide surviving spouses with the 

means to maintain some semblance of financial stability after losing their loved 

ones, the rate of payment for service-related deaths of any kind should not vastly 

differ. Surviving spouses, regardless of the status of their sponsors at the time of 

death, face the same financial hardships once deceased sponsors’ incomes no longer 

exist. Congress should authorize DIC eligibility at increased rates to survivors of 

servicemembers who died either before the eight-year eligibility period passes or 

while on active duty at the same rate paid to the eligible survivors of totally disabled service-connected veterans who die after the eight-year eligibility period. 

Repeal of the DIC-SBP Offset 

The current requirement that the amount of an annuity under the Survivor Benefit Plan (SBP) be reduced on account of, and by an amount equal to, DIC is inequitable. A veteran disabled in military service is compensated for the effects of service-connected disability. When a veteran dies of service-connected causes, or following a substantial period of total disability from service-connected causes, eligible 

survivors or dependents receive DIC from the VA. This benefit indemnifies survivors, in part, for the losses associated with the veteran’s death from service-connected causes or after a period of time when the veteran was unable, because of 

total disability, to accumulate an estate for inheritance by survivors. 

Career members of the Armed Forces earn entitlement to retired pay after 20 or 

more years of service. Survivors of military retirees have no entitlement to any portion of the veteran’s military retirement pay after his or her death, unlike many retirement plans in the private sector. Under the SBP, deductions are made from the 

veteran’s military retirement pay to purchase a survivor’s annuity. This is not a gratuitous benefit, but is purchased by a retiree. 

Upon the veteran’s death, the annuity is paid monthly to eligible beneficiaries 

under the plan. If the veteran died from other than service-connected causes or was 

not totally disabled by service-connected disability for the required time preceding 

death, beneficiaries receive full SBP payments. However, if the veteran’s death was 

a result of military service or after the requisite period of total service-connected 

disability, the SBP annuity is reduced by an amount equal to the DIC payment. 

When the monthly DIC rate is equal to or greater than the monthly SBP annuity, 

beneficiaries lose the SBP annuity in its entirety. 

The IBVSOs believe this offset is inequitable because no duplication of benefits 

is involved. Payments under the SBP and DIC programs are made for different purposes. Under the SBP, coverage is purchased by a veteran and at the time of death, 

paid to his or her surviving beneficiary. On the other hand, DIC is a special indemnity compensation paid to the survivor of a servicemember who dies while serving 

in the military, or a veteran who dies from service-connected disabilities. In such 

216 

cases, DIC should be added to the SBP, not substituted for it. Surviving spouses 

of Federal civilian retirees who are veterans are eligible for DIC without losing any 

of their purchased Federal civilian survivor benefits. 

The offset penalizes survivors of military retirees whose deaths are under circumstances warranting indemnification from the government separate from the annuity funded by premiums paid by the veteran from his or her retired pay. 

Congress should repeal the inequitable offset between DIC and the SBP because 

there is no duplication between these two distinct benefits. 

Retention of Remarried Survivors’ Benefits at Age 55 

Congress should lower the age required for remarriage for survivors of veterans 

who have died on active duty or from service-connected disabilities to be eligible for 

retention of DIC to conform with the requirements of other Federal programs. 

Current law allows retention of DIC on remarriage at age 57 or older for eligible 

survivors of veterans who die on active duty or of a service-connected injury or illness. Although the IBVSOs appreciate the action Congress took to allow restoration 

of this rightful benefit, the current age threshold of 57 years is arbitrary. 

Remarried survivors of retirees of the Civil Service Retirement System, for example, obtain a similar benefit at age 55. This would also bring DIC in line with SBP 

rules that allow retention with remarriage at the age of 55. Equity with beneficiaries of other Federal programs should govern Congressional action for this deserving group. Congress should enact legislation to enable survivors to retain DIC 

on remarriage at age 55 for all eligible surviving spouses. 

Mr. Chairman, that concludes my statement and I would be happy to answer any 

questions you or other Members of the Committee may have. 

PREPARED STATEMENT OF PARALYZED VETERANS OF AMERICA

Chairman Sanders, Ranking Member Burr, and Members of the Committee, as 

one of the four co-authors of The Independent Budget (IB), Paralyzed Veterans of 

America (PVA) is pleased to present the views of The Independent Budget regarding 

the funding requirements for the Department of Veterans Affairs (VA) for FY 2015. 

As Congress and the Administration continue to face immense pressure to reduce 

Federal spending, we cannot emphasize enough the importance of ensuring that sufficient, timely and predictable funding is provided to the Department of Veterans 

Affairs (VA). The co-authors of The Independent Budget—AMVETS, Disabled American Veterans, Paralyzed Veterans of America, and Veterans of Foreign Wars—recognize the pressure that the Administration and Congress face; however, we believe 

that the ever-growing demand for health care services certainly validates the continued need for sufficient funding. We also understand that the VA has fared better 

than most Federal agencies with regards to budget proposals and appropriations. 

However, we are concerned that discretionary funding for the VA is no longer keeping pace with medical care inflation or health care demand. 

That being said, we certainly appreciate the increases offered by the Administration’s budget for FY 2015 and the FY 2016 advance appropriations, particularly 

with regards to health care and benefits services. Unfortunately, we have real concerns that the serious lack of commitment to infrastructure funding to support the 

system will undermine the VA’s ability to deliver those services. Similarly, we remain concerned that the funding levels provided by the House and Senate Committees on Appropriations in the recently passed omnibus appropriations bill will be insufficient to address the continuously growing demand for VA health care services. 

Moreover, The Independent Budget co-authors oppose the steps VA has taken in 

recent years in order to generate resources to meet ever-growing demand on the VA 

health-care system. The Administration continues to rely upon ‘‘management improvements,’’ a popular gimmick that was used by previous Administrations to generate savings and offset the growing costs to deliver care. Unfortunately, these savings are often never realized leaving VA short of necessary funding to address evergrowing demand on the health-care system. 

Of even greater concern is the fact that the VA continues to overproject and 

underperform with its medical care collections estimates. Overestimating collections 

estimates affords Congress the opportunity to appropriate fewer discretionary dollars for the health care system. However, when the VA fails to achieve those collections estimates, it is left with insufficient funding to meet the projected demand. 

As long as this scenario continues, the VA will find itself falling farther and farther 

behind in its ability to care for those men and women who have served and sacrificed for this Nation. In fact, we believe that is exactly what is happening now. 

For example, the VA originally projected collections of approximately $3.3 billion in 

217 

FY 2013 and FY 2014 and approximately $3.2 billion in FY 2015. Congress based 

its appropriations for the VA for those fiscal years on those projected collections. 

However, the VA subsequently revised its estimates anticipating collections of $2.8 

billion in both FY 2013, $2.9 billion in FY 2014, and less than $3.1 billion for FY 

2015. The flawed projections estimates and the dollars appropriated by Congress in 

each of those fiscal years suggest that the VA may have received $1.0 billion too 

little in resources during that period. And yet, this shortfall has never been addressed through supplemental appropriations. 

Too often in meetings with congressional offices, staff members have proclaimed 

the belief that VA has received too much money. We would ask the Committee how 

that logic passes when we have clearly identified a shortfall simply based on faulty 

collections estimates. Similarly, we would ask that the Committee proceed with caution in FY 2016 as the VA has once again projected a collections estimate of $3.3 

billion despite the fact that its recent performance suggests that it will not achieve 

that level. The fact that the VA continues to experience problems with its medical 

care collections reflects an even greater need for Congress to properly analyze, and 

if necessary, revise the advance appropriations from previous years to ensure that 

the VA health care system is getting the resources it actually needs. 

FUNDING FOR FY 2015

For FY 2015, The Independent Budget recommends approximately $61.1 billion for 

total medical care, an increase of approximately $3.4 billion over the FY 2014 operating budget. Meanwhile, the Administration recommended in its FY 2015 Budget 

Request a revised advance appropriation estimate for FY 2015 of approximately 

$56.0 billion in discretionary funding for VA medical care. This revised estimate reflected a projected increase in discretionary funding of approximately $368 million 

over the recently approved advance appropriations level. When combined with the 

approximately $3.1 billion revised projection for medical care collections (decreased 

from $3.2 billion in last year’s estimate), the total available operating budget recommended for FY 2015 is approximately $59.1 billion. This reflects an increase of 

$1.7 billion over the previously approved FY 2014 operating budget, an amount that 

we believe is inadequate to fully meet health care demand. 

The medical care appropriation includes three separate accounts—Medical Services, Medical Support and Compliance, and Medical Facilities—that comprise the 

total VA health-care funding level. For FY 2015, The Independent Budget recommends approximately $49.3 billion for Medical Services. Our Medical Services 

recommendation includes the following recommendations: 

Current Services Estimate .................................................................... $47,616,189,000 

Increase in Patient Workload ............................................................... 1,171,260,000 

Additional Medical Care Program Costs ............................................. 500,000,000 

Total FY 2014 Medical Services .................................................... $49,287,449,000 

Our growth in patient workload is based on a projected increase of approximately 

87,000 new unique patients—priority groups 1–8 veterans and covered nonveterans. 

We estimate the cost of these new unique patients to be approximately $853 million. 

The increase in patient workload also includes a projected increase of 83,350 new 

Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF), as well as 

Operation New Dawn (OND) veterans at a cost of approximately $318 million. The 

increase in utilization among OEF/OIF/OND veterans is supported by the average 

annual increase in new users from FY 2002 through the 3rd quarter of FY 2013. 

The Independent Budget also believes that there are additional projected funding 

needs for VA. Specifically, we believe there is real funding needed to address the 

array of long-term care issues facing the VA, including the shortfall in institutional 

capacity, and to provide additional centralized prosthetics funding (based on actual 

expenditures and projections from the VA’s prosthetics service). The Independent 

Budget recommends $375 million directed toward VA long-term care programs. In 

order to support the rebalancing of VA long-term care in FY 2015, $125 million 

should be provided. Additionally, $95 million should be targeted at the VA’s Veteran 

Directed-Home and Community Based Services (VD-HCBS) program. The remainder 

of the $375 million ($155 million) should be dedicated to increasing the VA’s longterm care average daily census (ADC) to the level mandated by Public Law 106– 

117, the ‘‘Veterans Millennium Health Care and Benefits Act.’’ In order to meet the 

increase in demand for prosthetics, the IB recommends an additional $125 million. 

This increase in prosthetics funding reflects an increase in expenditures from FY 

2013 to FY 2014 and the expected continued growth in expenditures for FY 2015. 

218 

For Medical Support and Compliance, The Independent Budget recommends ap- proximately $6.1 billion. Finally, for Medical Facilities, The Independent Budget rec- ommends approximately $5.7 billion. Our Medical Facilities recommendation includes the addition of $650 million to the baseline for Non-Recurring Maintenance 

(NRM). The Administration’s request over the last two cycles represents a wholly 

inadequate request for NRM funding, particularly in light of the actual expenditures 

that are outlined in the budget justification. In fact, the VA’s FY 2015 and FY 2016 

advance appropriations request for infrastructure is wholly insufficient (a topic that 

will be addressed by the VFW in its statement to the Committee), particularly with 

regards to Major and Minor Construction and Non-Recurring Maintenance (NRM). 

The VA continues to slash funding for NRM as evidenced by the rapidly decreasing 

estimates for Medical Facilities. And yet, the VA admits in its own documents that 

it spends between $1.3 billion and $1.4 billion per year on NRM. Similarly, we are 

extremely disappointed that the VA has requested such a laughable funding level 

for Major and Minor Construction, particularly considering the rapidly advancing 

age and condition of its infrastructure. It is time for Congress to take the necessary 

steps to reverse this course before the VA system collapses on itself. 

The Independent Budget co-authors have ongoing concerns about the lack of investment in Medical and Prosthetic Research. While we recognize that the Administration requested an increase in the research account for FY 2015, the $3 million 

increase does not even keep pace with inflation. If the VA is to remain a world leader in research, it is imperative that the Administration get serious about requesting 

real dollars and that Congress provide adequate resources to continue those efforts. 

With this point in mind, The Independent Budget recommends $611 million for Medical and Prosthetic Research funding for FY 2015. Similarly, we recommend at least 

$50 million in Major Construction and $175 million in Minor Construction and NRM 

to address the deteriorating state of VA research infrastructure. Failure to make 

these investments will undermine the VA’s ability to continue to attract the best 

medical professionals into the research field and promote cutting edge advancements to benefit the men and women who have made great physical and mental sacrifices in defense of this Nation. 

ADVANCE APPROPRIATIONS FOR FY 2016

Just as we did for the first time last year, The Independent Budget once again 

offers baseline projections for funding through advance appropriations for the medical care accounts for FY 2016. While we have previously deferred to the Administration and Congress to provide sufficient funding through the advance appropriations process, we have growing concerns that this responsibility is not being taken 

seriously. 

For FY 2016, The Independent Budget recommends approximately $62.5 billion for 

total medical care. The Administration’s Budget Request includes approximately 

$62.0 billion for total medical care—$58.7 billion in discretionary spending and approximately $3.3 billion in medical care collections. We appreciate the fact that the 

Administration has offered a substantial increase in health care funding from FY 

2015 to FY 2016 (as a part of its advance appropriations request). 

For FY 2016, The Independent Budget recommends approximately $50.8 billion for 

Medical Services. Our Medical Services recommendation includes the following recommendations: 

Current Services Estimate .................................................................... $49,193,067,000 

Increase in Patient Workload ............................................................... 1,074,225,000 

Additional Medical Care Program Costs ............................................. 510,000,000 

Total FY 2015 Medical Services .................................................... $50,777,292,000 

Our growth in patient workload is based on a projected increase of approximately 

67,000 new unique patients—priority groups 1—8 veterans and covered nonveterans. We estimate the cost of these new unique patients to be approximately 

$746 million. The increase in patient workload also includes a projected increase of 

83,350 new Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF), 

as well as Operation New Dawn (OND) veterans at a cost of approximately $328 

million. 

Last, The Independent Budget believes that there are additional projected funding 

needs for VA. For FY 2016, we believe that an additional $375 million should be 

invested to address the spectrum of long-term care issues within the VA. Additionally, we believe that a continued increase in centralized prosthetics funding will be 

essential. In order to meet the continued increase in demand for prosthetics, the IB 

recommends an additional $135 million. 

219 

For Medical Support and Compliance, The Independent Budget recommends approximately $6.0 billion. Finally, for Medical Facilities, The Independent Budget recommends approximately $5.7 billion. Our Medical Facilities recommendation includes the addition of $900 million to the baseline for Non-Recurring Maintenance 

(NRM). Last year, the Administration’s recommendation for NRM reflected a projection that would place the long-term viability of the health care system in serious 

jeopardy. 

ADVANCE APPROPRIATIONS FOR ALL VA ACCOUNTS

The Independent Budget co-authors are concerned that the broken appropriations 

process continues to have a negative impact on the operations of the VA. Once again 

this year Congress failed to fully complete the appropriations process in the regular 

order. In fact, many Federal operations were shuttered as part of a partial government shutdown in October 2013. This had a significant negative impact on many 

of the services provided by the VA. While VA health care was shielded from this 

political disaster, benefits services, research activities, and general operations for 

the rest of the VA were impacted. Additionally, many of the operations that support 

the health care system, particularly through the Information Technology system, 

were negatively impacted complicating the VA’s ability to delivery timely, quality 

health care. 

We also have real concerns about the advance appropriations process as it currently functions. Our intent for this process was for the Administration to request 

an advance appropriation for a given fiscal year (two years ahead of the start of that 

fiscal year), and then revise that recommendation in its next budget request immediately prior to the start of the fiscal year in question. We appreciate the fact that 

the Administration’s FY 2015 Budget Request does include a significant revision for 

Medical Services reflecting an increased need for funding of approximately $368 million. However, during past budget cycles, the Administration has offered very little 

revision in its advance appropriations requests essentially asking for the same funding level. Moreover, we believe that Congress has not done its due diligence to adequately analyze the advance appropriations recommendations and make any necessary changes through supplemental appropriations. In fact, once Congress has approved an advance appropriations level for VA, it has not revised its previous years’ 

decision in any appreciable way. This undermines the principle benefit of advance 

appropriations—having additional time to ensure that sufficient funds are provided. 

With this in mind, we call on Congress to immediately approve legislation that 

would extend advance appropriations to all VA discretionary and mandatory appropriations accounts. Advance appropriations have shielded VA health care from most 

of the harmful effects of the partisan bickering and political gridlock that has paralyzed Washington in recent years. Now Congress must provide the same protections 

to all remaining discretionary programs, including Medical and Prosthetic Research, 

General Operating Expenditures, Information Technology, the National Cemetery 

Administration, Inspector General, Major Construction, Minor Construction, State 

Home Construction Grants, State Cemetery Grants and other discretionary accounts, and all mandatory funded programs, including disability compensation, pension, education benefits, and dependency and indemnity compensation. 

Chairman Sanders, the co-authors of The Independent Budget sincerely appreciate 

your commitment to this effort. Similarly, we applaud Senator Boozman and Senator Begich for leading this effort in the Senate by introducing S. 932, the ‘‘Putting 

Veterans Funding First Act.’’ We commit to you our steadfast support to see this 

legislation through to final passage and enactment. Enactment of S. 932 will generally free all VA services from the political gridlock that has crippled the appropriations process in Congress. 

In the end, it is easy to forget that the people who are ultimately affected by 

wrangling over the budget are the men and women who have served and sacrificed 

so much for this Nation. We hope that you will consider these men and women 

when you develop your budget views and estimates, and we ask that you join us 

in adopting the recommendations of The Independent Budget. 

This concludes our statement. We would be happy to answer any questions you 

may have. 

Æ