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THE FISCAL YEAR 2014 BUDGET FOR 

VETERANS AFFAIRS 

HEARING 

BEFORE THE

COMMITTEE ON VETERANS’ AFFAIRS 

UNITED STATES SENATE 

ONE HUNDRED THIRTEENTH CONGRESS 

FIRST SESSION 

APRIL 15, 2013 

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 

APRIL 15, 2013 

SENATORS 

Page 

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

Burr, Hon. Richard, Ranking Member, U.S. Senator from North Carolina ....... 4 

Rockefeller, Hon. John D., IV, U.S. Senator from West Virginia ........................ 7 

Johanns, Hon. Mike, U.S. Senator from Nebraska ............................................... 8 

Tester, Hon. Jon, U.S. Senator from Montana ...................................................... 9 

Isakson, Hon. Johnny, U.S. Senator from Georgia ............................................... 10 

Boozman, Hon. John, U.S. Senator from Arkansas .............................................. 10 

Begich, Hon. Mark, U.S. Senator from Alaska ..................................................... 11 

Blumenthal, Hon. Richard, U.S. Senator from Connecticut ................................ 243 

Moran, Hon. Jerry, U.S. Senator from Kansas ..................................................... 245 

Hirono, Hon. Mazie, U.S. Senator from Hawaii .................................................... 248 

WITNESSES 

Shinseki, Hon. Eric K., 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, Acting Assistant Secretary for the Office of Information and Technology; and W. Todd 

Grams, Executive in Charge for the Office of Management and Chief Financial Officer ............................................................................................................. 12 

Prepared statement .......................................................................................... 13 

Response to posthearing questions submitted by: 

Hon. Bernard Sanders .................................................................................. 25 

Hon. Richard Burr ........................................................................................ 76 

Response to request arising during the hearing by: 

Hon. Richard Burr ........................................................................................6, 252 

Hon. Jerry Moran ......................................................................................... 246, 247 

APPENDIX 

Hall, Jeffrey C., Assistant National Legislative Director, Disabled American 

Veterans (DAV); prepared statement ................................................................. 255 

Tarantino, Tom, Chief Policy Officer, Iraq and Afghanistan Veterans of America (IAVA); prepared statement .......................................................................... 261 

Paralyzed Veterans of America (PVA); prepared statement ................................ 262 

Wounded Warrior Project (WWP); prepared statement ....................................... 266 

(1) 

THE FISCAL YEAR 2014 BUDGET FOR 

VETERANS AFFAIRS 

MONDAY, APRIL 15, 2013 

U.S. SENATE, COMMITTEE ON VETERANS’ AFFAIRS, Washington, DC. 

The Committee met, pursuant to notice, at 2:30 p.m., in room 

418, Russell Senate Office Building, Hon. Bernard Sanders presiding. 

Present: Senators Sanders, Rockefeller, Tester, Begich, 

Blumenthal, Hirono, Burr, Isakson, Johanns, Moran and Boozman. 

OPENING STATEMENT OF HON. BERNARD SANDERS, 

CHAIRMAN, U.S. SENATOR FROM VERMONT 

Chairman SANDERS. OK. We have got a lot of work, so let’s get 

the hearing underway. 

And I want to welcome everyone to this afternoon’s hearing on 

the fiscal year 2014 budget and the fiscal year 2015 advanced appropriations request for the Department of Veterans Affairs. 

Earlier this year, as I think we will all recall, we heard from 

nearly all of the veterans service organizations. These groups 

shared with us their priorities which reflect the needs of the men 

and women who have served our country. I want to thank all of 

the service organizations not only for the important testimony but 

for the great work they do every single day, protecting the interests 

of America’s veterans. 

If there is anything that many of us have learned in recent 

years, it is that the real cost of war is far, far greater than simply 

paying for the tanks and guns and planes and the manpower to 

fight those wars. I believe that we now understand more fully than 

we have in the past that soldiers who come home from war are 

often very different people than when they went. 

We now understand that the cost of war includes significant care 

not only for those who lost their legs and their arms and their eyesight but for those who came home with what we now call the invisible wounds of war. Most recently, this includes the hundreds of 

thousands of brave soldiers who returned from Iraq and Afghanistan with Traumatic Brain Injury and Post Traumatic Stress Disorder. 

So, while this $152 billion budget we discuss today is a complicated document with a whole lot of numbers, it all comes down 

to how the people of our country, through their government, honor 

their commitments to those who have sacrificed so much and to the 

spouses and children who have often also sacrificed. 

2 

In their testimonies, the VSOs discussed many of the important 

and positive things that the VA does, which sometimes we overlook, but let me talk a little bit about what the VSOs discussed. 

In terms of health care, in a nation with over 45 million people 

lacking any health insurance and at a time when the cost of health 

care in this country is far higher than any other country on earth, 

the VA is recognized by many as providing excellent quality health 

care in a cost-effective way to those who have served our Nation. 

Like every other health care organization, the VA can do better— 

and it must do better—but most will agree that the VA has come 

a very long way in the last 20 to 30 years in terms of health care. 

In terms of another important issue—homelessness. At a time 

when too many Americans and people in my own State of Vermont 

are sleeping out in the streets or in their cars, the VA has undertaken an aggressive and successful effort to significantly reduce the 

number of homeless veterans in our country. Since 2009, there has 

been a 17 percent decline in veterans homelessness despite the 

tough economy. That is the good news. The bad news is that there 

were still more than 62,000 homeless veterans in January 2012. 

The VA must sustain its positive efforts in combating veterans 

homelessness. Progress is being made; more must be done. 

Through its world-class research program, the VA is making significant advances in health care not only for veterans but for the 

entire country. That progress must continue. 

The VSOs, while praising the VA in many areas, also highlighted 

the significant challenges and problems that continue to confront 

veterans of all generations, and I agree with many of their concerns. Among many other issues, they spoke of the obligation to address the tragic number of servicemember and veteran suicides. 

This is a horrendous tragedy. It is a tough issue. We have got to 

address it. 

Further, the need to accelerate the transformation of the compensation claims system in order to deal with the unacceptably 

long delays that we are now seeing and the huge backlog in cases— 

if there is any issue that I think veterans and the veterans community are concerned about, it is that issue, and I share that concern. 

While the VA is now processing far more claims than ever before, 

the movement to a paperless and efficient system must be completed on schedule. I know we will be discussing that issue during 

this hearing. 

Further, the responsibility to make smart investments in infrastructure and information technology systems to ensure that the 

VA can continue to provide the care and benefits veterans have 

earned is a major issue. This means—and this, again, is a huge 

issue which this Committee will delve into—a significant improvement in the relationship between the VA and the Department of 

Defense. We may be dealing with two separate agencies, but we are 

dealing with one human being who goes through the DOD into the 

VA. 

I believe that this year’s budget request, especially within the 

overall budget restraints facing Congress, again reflects a strong 

commitment by this Administration to provide veterans and their 

families with the care and benefits they deserve. 

3 

This year’s total budget request is $152.7 billion—$86.1 billion for mandatory entitlements and $66.5 billion for the discretionary 

account. This is a 10.2 percent increase over last year’s enacted 

amount. 

While the VA budget presented by the Administration is a strong 

one, and I applaud the President for that, I remain deeply disappointed that the White House included in their budget request 

the so-called chained CPI. Switching to a chained CPI would mean 

major cuts in Social Security and the benefits that disabled veterans receive. Veterans who started receiving VA disability benefits 

at age 30 would have their benefits reduced by $1,425 at age 45, 

$2,341 at age 55 and over $3,000 a year at age 65—tens of thousands of dollars within their lifetime. This, to my mind, is unconscionable, and I will do all that I can to prevent these cuts from 

taking place. 

When it comes to the issue of funding for suicide prevention, the 

budget is literally a matter of life or death. Ensuring timely access 

to high quality mental health care is critical for our veterans and 

their loved ones. To that end, I am pleased to see the President’s 

budget recommendation calls for a 7.2 percent increase in funding 

for mental health. 

At our last hearing, when we discussed the issue of mental 

health and suicide, Dr. Petzel testified that the VA is on track to 

hire the 1,600 mental health clinicians called for in the President’s 

Executive Order by the deadline of June 30. As I noted at that 

hearing, I remain concerned that the VA has hired just 47 clinicians in the 2 months prior to that hearing. I understand VA must 

ensure that they are hiring high-quality clinicians, but VA must 

pick up the pace of hiring if it intends to meet its goal of 1,600 new 

clinicians by the end of June of this year. 

When hiring these clinicians, the VA must recognize that individual veterans respond differently to different treatments and not 

all veterans respond well to traditional therapies. I appreciated 

Senator Boozman at our last hearing raising the important issue 

of over-medicating veterans seeking mental health treatment. I 

share that concern, as I believe do many Americans. 

I also know that many veterans respond positively to complementary and alternative medicine. As the name indicates, such treatments—which include therapies such as acupuncture, guided imagery, meditation, chiropractic care and yoga—can be provided in 

conjunction with traditional care or as stand-alone care. I commend 

the VA’s top leadership for embracing these therapies but worry 

that that interest has not penetrated all levels of the VA health 

care system. VA must do a better job to make sure that these 

therapies are available to all interested veterans. 

In terms of the claims backlog, the fact that nearly 70 percent 

of claims are pending longer than 125 days is completely unacceptable as is the fact that it took, on average, 287 days to complete 

a compensation rating claim in 2012. 

The inability to provide compensation benefits in a timely manner tarnishes VA’s reputation among the very population it serves. 

I never want a veteran’s negative experience with the claims system to prevent him or her from seeking mental health care or help 

in battling homelessness. 

4 

Mr. Secretary, I see your testimony reiterates VA’s goal of eliminating the claims backlog by 2015. VA has set ambitious goals, put 

forward a plan and has been working hard to transform the 

system. 

I think we can all agree that the VA took too long to start transforming itself from a paper-based to electronic system. Clearly, that 

effort should have begun a decade ago, or longer, and not just 4 

years ago. Yet, despite these facts, one must certainly understand 

how it is difficult for the average person to believe VA is making 

progress when we continue to see the unacceptably long wait times 

faced by veterans and their survivors in obtaining benefits. 

VA must do a better job of showing not only the Congress but 

also veterans and their survivors about how VA plans to accomplish their ambitious goals. And I look forward to working with you 

to establish benchmarks which will allow us to see the progress, or 

lack of progress, that VA is making in this vitally important area. 

VA must be able to construct, repair, or lease the physical infrastructure necessary to provide the high-quality care that veterans 

deserve. Yet, for the fourth year in a row the President’s request 

has been out of touch with the realities on the ground. Adequate 

funding to maintain VA’s aging infrastructure must be a critical 

part of the discussion on providing quality health care. 

Further, the fiscal year 2014 budget request includes another 13 

major medical facility leases but does not include funding for the 

full cost of authorizing these leases despite the challenges Congress 

is still working to surmount. This is an issue I would like to address later today. 

Last, let me repeat; the importance of information technology 

cannot be understated as VA seeks to deliver the care and benefits 

that our veterans deserve in a more efficient and effective way. I 

think the bottom line is there must, must, must be much better cooperation between the DOD and the VA. 

So let me conclude my remarks by thanking the Secretary and 

his staff for being with us today. The issues that we are going over 

are of enormous importance to millions of veterans and the American people. I look forward to a very productive hearing. 

Senator Burr. 

STATEMENT OF HON. RICHARD BURR, RANKING MEMBER, 

U.S. SENATOR FROM NORTH CAROLINA 

Senator BURR. Good afternoon, Mr. Chairman, and Secretary 

Shinseki, welcome. And to your team, welcome. 

Mr. Chairman, thank you for that very thorough opening statement. 

As the Chairman indicated, we will be discussing the President’s 

budget request for the Department of Veterans Affairs for fiscal 

year 2014. 

As I have said at past budget hearings, it’s important that we 

provide adequate funding for the VA so that all veterans receive 

the benefits and care that they have earned and deserve. Yet, along 

with that funding we must conduct vigorous oversight to make sure 

programs which benefit veterans are working properly and lead to 

better outcomes for veterans, their families, and their survivors. 

5 

Yet, in looking over the budget request, the lack of consistent 

predictions and a lack of transparency lead me to question if VA’s 

stewardship of the taxpayers’ money is leading to better outcomes. 

First, VA has been consistently inconsistent with its workload 

projections. These changing projections mask whether they have 

the backlog situation under control. 

Second, the unclear accounting practices in the IT budget make 

it difficult for us to conduct the necessary oversight into these 

programs. 

Regarding claims processing, we all know that the backlog and 

delays have gotten worse over the past 4 years even though VA has 

hired more staff, spent millions on IT solutions, and rolled out dozens of initiatives. Today, we will again hear VA assure that despite 

these trends this situation will be completely under control by 

2015; but in my view, this budget provides one more reason to seriously question those assurances. 

For starters, the budget reflects that in 2013 and 2014 VA will 

receive 2.6 million claims and decide 2.5 million. But in the VA’s 

strategic plan for eliminating the backlog, which was sent to Congress less than 3 months ago, VA projected output of 2.8 million 

claims during those years. That means VA has already lowered its 

productivity expectations by 12 percent. 

As for receipts, the backlog plan estimated that VA would take 

in 2.7 million claims this year and next year combined, but VA acknowledged it could receive as many as 774,000 additional claims 

as a result of recent laws. Despite that caution, the budget shows 

that VA will have even lower receipts in those years than the backlog plan estimated. 

The budget also reflects that incoming claims will continue to exceed output during this year and next year, which means that the 

number of pending claims will continue to grow. In fact, VA now 

projects that it will have an inventory of roughly 960,000 claims at 

the end of 2014—about 100,000 more than are pending today. 

Compare that with VA’s backlog plan, which predicted that the 

decisions would outpace claims receipts next year, and, as a result, 

the level of claims would drop to less than 800,000. 

Finally, the budget projects that no more than 40 percent of 

claims will be pending long enough this year and in 2014 to be considered backlogged even though 70 percent of claims are currently 

backlogged. On the other hand, VA’s strategic plan showed a backlog of 68 percent this year and 57 percent next year, just 3 months 

ago. 

Even if VA has updated these estimates based on more recent 

data, it is difficult to understand how all of these projects could 

change so dramatically in less than 12 weeks. These fluctuating 

predictions, together with a history of missed milestones and deteriorating performance, make it extremely difficult to believe that 

VA has the backlog situation under control. 

As I said earlier, another area of concern for me is the ambiguity 

of the IT projects that are becoming the backbone of operations at 

VA medical centers and VA regional offices. 

Currently, VA has several IT projects that are vital to providing 

benefits and services to our Nation’s veterans. In the President’s 

6 

request, the Office of Information Technology, or OIT, requested 

roughly $3.7 billion, a $360 million increase over last year. 

There are three areas of concern within the IT budget I believe 

are worth highlighting. 

First, OIT requested $252 million for the IPO for development 

activities of the iEHR and VLER. How much of this money will be 

spent on a new strategy of quick wins versus the two initial operating capabilities at two sites in 2014 is a question. 

Second, according to the budget justifications, the 2014 allocation 

for VBMS development is roughly $33 million, which would be a 

$71 million decrease from fiscal year 2012. However, we are being 

told that there is another $155 million for VBMS in this budget. 

Is this additional funding coming from VBA’s budget? 

Finally, in my questions from last year’s budget hearing, I asked 

about the cost of the new patient scheduling system. VA’s response 

stated that they planned to have a Life Cycle Cost Estimate completed by January 2013. 

As of today, this life cycle cost analysis has yet to be received by 

my office. Since the 2014 budget request has a $30 million allocation for the development of a new scheduling package, I wonder if 

the life cycle cost analysis has now been completed. [See below for 

answer.] 

This unclear nature of the IT budget stands in the way of 

Congress’s ability to conduct effective oversight into these programs to make sure they are working properly and, more importantly, meeting their milestones. Unfortunately, these inconsistent 

projections and lack of transparency are becoming the standard operating procedure at VA, which is even more troubling when it is 

our Nation’s veterans that stand to lose the most. 

Mr. Chairman, I thank you, and I look forward to spending some 

time with our panel today. 

RESPONSE TO REQUEST ARISING DURING THE HEARING BY HON. RICHARD BURR FROM

OFFICE OF INFORMATION AND TECHNOLOGY, U.S. DEPARTMENT OF VETERANS AFFAIRS

Response: As a follow up to our prior correspondence to Senators Burr and Murray 

on September 12, 2102, VA provides the following update to its scheduling procurement efforts: 

VA will procure a scheduling solution in two phases. In the first phase, currently 

ongoing, VA is running a risk-reduction contest under the America Competes Act 

calling for scheduling application submissions. The purpose of this contest will be 

to reduce procurement and deployment risk. VA will offer up to three prizes for 

scheduling packages that demonstrate their compatibility with the Open Source 

version of VA’s electronic health record, VistA. Contest submissions are due in June, 

and VA is scheduled to announce winners in September. 

The second phase will include the actual procurement of a scheduling solution. As 

this risk-reduction activity proceeds, VA will continue working with the Department 

of Defense and the Interagency Program Office to determine joint requirements and 

a master development and acquisition plan. The master development and acquisition plan will be based upon an evaluation of contestant responses for proposed 

functionality and compliance with iEHR architecture. 

May 2013 

Chairman SANDERS. Senator Burr, thank you very much. 

Senator Rockefeller. 

7 

STATEMENT OF HON. JOHN D. ROCKEFELLER IV, 

U.S. SENATOR FROM WEST VIRGINIA 

Senator ROCKEFELLER. Thank you, Mr. Chairman; and I welcome 

General Shinseki and his staff, as we all do. 

I just want to recount to my colleagues that I spent a very, very 

long time last week talking with General Shinseki about how one 

takes a 220,000-person agency and gets it to be responsive on all 

kinds of different issues, many of which have been mentioned today 

and some more of which I will mention. 

The General actually has done a lot of work on management over 

the course of his life, and training, and he described how he broke 

the 220,000 down into blocks and then blocks within blocks, all of 

them to be held accountable, all evaluating themselves, and being 

evaluated. 

The reason I say this is because I really do not know of any job 

which has such a human poignancy in its work and yet has complexity and bulk at the level that the VA has. 

I think you are a superb General of that VA, and I just want to 

say that. We talked about claims and all the rest of it. I mean, you 

are really working at it, and I believe that. 

Does that give veterans enough comfort? No. But everything in 

life is a process and the process is either pushed from above or it 

is not. 

As you and I discussed, General, a number of years ago, all of 

a sudden the VA, medically, went from sort of a not really very, 

very good place to a really good place. And we both, at the same 

time, said Ken Kizer. 

Ken Kizer had been sitting here on that row for years. I knew 

his position. I had no idea until he left the effect that he had, 

which lasts today. 

I don’t want Johnny Isakson, who is my dear friend, to be mad 

at me if I say something nice about the President, but I am really 

struck, Mr. Chairman, by the specificity and directness of the budget increases which the President—with the entire rest of the world 

claiming every nickel that he doesn’t have in this government— 

what he has done to make your mission more amenable to your 

leadership, though not in all fields and not with all problems. But 

he has given a vote of confidence, and more importantly than that, 

he has spoken very strongly to the veterans. 

I do not usually say things like that at hearings, but I just wanted to in this case. 

A 10.2 increase percent is huge, you know. We throw those numbers around and soon forget them, but this will not be forgotten. 

Nevertheless, I am also very concerned about the persistent problems that have been addressed by the two speakers prior to me— 

the needs of the rapidly growing veterans community to the backlog in veterans’ claims. I am actually not sure whether it is 

600,000, or at one point, I heard it was 800,000. In one sense, it 

does not make any difference. It is too many. 

And, yes, you are attacking that crisis. You are bringing in more 

mental health clinicians. You are meant to have 1,600; I think you 

have over 1,200. People all over the country—hospitals—are 

screaming and yelling because you are taking some of their best 

8 

people. I say, well done. But the importance of that, as Chairman 

Sanders indicated, is so incredibly important. 

Mental health care is so needed and so recently, powerfully, on 

the minds of all of us. I think Americans in general, American families, and even Senators as policymakers are capable of seeing 

those kinds of things. 

There is no quick fix for health care, mental health care, claims, 

or anything else. There is the need for a persistent driving agenda—when the Secretary and his team come to work every day, determined as you are, sir, to make a difference as best you can. 

I am disturbed by the fact that this very promising DOD/VA joint 

effort on IT and other things, which was quite vibrant 7 or 8 years 

ago, has now kind of been called off. So I want to ask why and 

what price do we pay, and what can be done? 

I would just say to my friends on this Committee that we are 

very, very lucky to serve here. I’ve been on here every year that 

I’ve been in the Senate, which some may think is 1 or 2 but actually is 28 years. And it is a proud, proud service. 

You know, in West Virginia we have so many veterans; every 

State does. The work is powerful in its poignancy. 

I commend you for the work to be done, and I have more questions I want to ask. 

Thank you, Mr. Chairman. 

Chairman SANDERS. Thank you, Senator Rockefeller. 

Senator Johanns. 

STATEMENT OF HON. MIKE JOHANNS, 

U.S. SENATOR FROM NEVADA 

Senator JOHANNS. Mr. Chairman, thank you and thank you for 

calling this hearing on this budget request. 

Mr. Secretary, it is good to see you again. One of the things that 

I appreciate, and I know the other Members certainly do also, is 

your willingness to stop by our offices and talk to us about the 

issues that are of concern to us. 

I also want to indicate, as a former department head, I understand the complexities of putting together a budget that meets the 

priorities of the President of the United States. I also understand 

the challenges in trying to touch all of the bases. 

There are many challenges facing the VA. The Chairman and the 

Ranking Member went through those. I will not take up time this 

afternoon and go through them item-by-item myself. 

There are a couple of things that I did want to mention. The first 

one is one that I appreciate a great deal. As you know, for some 

period of time, a number of us have been working on a VA cemetery in the Omaha area. I do want to thank you for including that 

in the fiscal year 2014 budget request. 

There are about 112,000 veterans and their families who currently do not have a VA cemetery within 75 miles that will be very 

positively impacted. I did not want the start of this hearing to go 

by without me saying how much I appreciate that. 

In addition, I also wanted to mention on a more concerning note, 

though, is the issue of facilities. As I mentioned, I have gone 

through these budget efforts, where you are trying to put together 

the necessary funds and get it passed through OMB, et cetera, and 

9 

one of the things that always tends to slip is the capital improvements. It is just the reality of what we deal with. You have real 

human beings with real human needs that you need to find funding for. 

I think about the facility in Omaha, but I do not want this to be 

just about that facility because I know there are problems all over 

the country where we are dealing with 1950s-era buildings. Recently, in the Omaha VA they closed the operating suite for much 

needed repairs. I am sure there are stories that could be told about 

that kind of thing all across the country. 

So, as we go through the hearing this afternoon, I would like to 

spend a little bit of time on facility needs around the country and 

how you think we are doing in addressing that because I do believe 

it is an important issue and, again, I recognize it is an issue that 

I would suspect slips as the budget gets put together. 

With that, I do want to thank you for being here and look forward to your testimony. 

Thank you, Mr. Chairman. 

Chairman SANDERS. Well, thank you, Senator Johanns. 

Senator Tester. 

STATEMENT OF HON. JON TESTER, 

U.S. SENATOR FROM MONTANA 

Senator TESTER. Yes, thank you, Mr. Chairman. 

I want to thank each and every one of you for being here today. 

I have had a chance to work with, I think, every one of you pretty 

closely, and I appreciate that. 

A special thanks to the Secretary—thank you, General. Thank 

you for being here and thank you for the work you do. 

You have been saddled with a tough job, and you have received 

some criticism. I just want to say some of it has been pretty unfair 

criticism, and I think you have done a great job considering the 

conditions that you are faced with in this position. I appreciate 

your leadership, and I appreciate your service to the country very 

much. 

Now I will be the first to tell you—and you know this—I do not 

agree with everything you have done, and there is plenty to improve upon. Yet, I think we have made great strides under your 

leadership, working with some incredibly complex issues—the cost 

of war, the men and women coming back from Iraq and now Afghanistan, and the injuries, both seen and unseen, that you have 

to deal with and your staff has to deal with and everybody on the 

ground has to deal with. 

I can tell you that I have been on this Committee for 6 years and 

in this Senate for 6 years. I have had numerous meetings around 

the State of Montana, and I have found one—one—person that 

does not like VA health care. The rest of them love it. So I just 

want to say thank you for your work. 

This is a $152.7 billion budget. It is a fair chunk of change that 

invests significantly in our veterans, and we need to make sure 

that we spend it as effectively as possible. That is our job, and it 

is your job. We need to proceed in a way that honors our military 

folks’ service, and one that also makes the most sense for the taxpayers as we go forward. 

10 

This is an important discussion, whether we are talking mental 

health or local partnerships or vet vans or Vet Centers or vet cemeteries or homelessness or education. There are plenty of issues to 

talk about. How we make this budget work for our veterans is 

going to be critically important. 

I want to thank you for being here, and I look forward to the discussion today, Mr. Chairman. 

Chairman SANDERS. Thank you very much, Senator Tester. 

Now, Senator Isakson. 

STATEMENT OF HON. JOHNNY ISAKSON, 

U.S. SENATOR FROM GEORGIA 

Senator ISAKSON. Thank you, Mr. Chairman. 

So, as to not disappoint the distinguished Senator from West Virginia, not only do I acknowledge that the President’s budget is a 

10 percent increase, but it is $7 billion more than this Senate approved in its budget just a month ago. So he has topped us as well, 

as to what needs to be done. 

I will also point out the fact that unlike a lot of appropriations 

units that we do—whether it is the Department of Energy, the Department of Labor—we are talking about mandatory spending 

when we talk about veterans. When one of our soldiers comes back 

from serving overseas, we have a commitment to them that is going 

to drive how much we spend. 

We should never shortchange those benefits, or look at it as an 

efficiency or a savings. Instead, what we have got to do is make 

sure we run the Department as efficiently as it can be and find our 

savings there. 

So I commend the President and the Senate, and most of all, I 

am grateful and thankful to those soldiers who sacrificed and 

fought for us overseas. 

My interest is really in two things: suicide; and the benefit 

claims backlog. Those two things are terrible, protracted problems 

that I know you are facing. I acknowledge the compliments that everybody has given you, General Shinseki, because they are well deserved, but those are the two priorities that we have got to focus 

on if we are ever going to get the VA responding as it should respond to those who have come back from overseas and who have 

served this country. 

So, with that said, I will yield back the balance of my time so 

we can get to our questions. 

Chairman SANDERS. Senator Isakson, thank you very much. 

Senator Boozman. 

STATEMENT OF HON. JOHN BOOZMAN, 

U.S. SENATOR FROM ARKANSAS 

Senator BOOZMAN. Thank you, Mr. Chairman. 

Likewise, again, I do not have a lengthy statement at all. 

It is good to have you here. We appreciate you and appreciate 

your service, not only to the VA but in so many ways throughout 

your career, and the team that you have assembled to try to help 

us get this done. 

I think as you hear the mood of the comments so far I think it 

is important that the public understands that this is not a partisan 

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issue. This is something that I think both sides are very much committed to helping you here in the Senate and then also spending 

a lot of time in the House with Congressmen Michaud and Miller. 

I know that they also are totally dedicated to seeing if we can figure out how to solve some of these very, very difficult problems, as 

Senator Isakson said—the suicide issue, the benefits, and also just 

the ongoing. 

As was said by our Senator from West Virginia, we can be very 

proud of the VA system that we have. We are doing a lot of things 

really, really right. 

We have got two VA hospitals in Arkansas that are excellent. 

That has taken a lot of hard work to get to that outcome. So, again, 

we appreciate the efforts there. 

Clearly, we have to address these other things, but we do have 

some things that we can celebrate. 

Thank you. 

Chairman SANDERS. Senator Boozman, thank you very much. 

Senator Begich. 

STATEMENT OF HON. MARK BEGICH, 

U.S. SENATOR FROM ALASKA 

Senator BEGICH. Mr. Chairman, I really do not have an opening 

statement. I just want to first thank you for having this hearing. 

Thank you, General Shinseki—Secretary Shinseki—for all the 

work you have done. 

First, with Alaska and our rural vets that are moving forward 

in a relationship with the tribal community on delivery of health 

care, we really appreciate VA’s efforts there. We hope to see, as it 

moves forward, some good progress. 

Second, I know you have put some resources in this budget, 

which I will be anxious to hear about, regarding disability claims 

and how we move those forward. We had a hearing, and your staff 

was—they survived that last hearing, and we appreciate that—but 

a lot of effort is needed to make sure we move that forward. I know 

that is one of your priorities. 

Last, is the effort that you all are making regarding homeless 

vets. I know this is one of your top three priorities, within the top 

three. In Alaska, as you can imagine, homeless veteran issues are 

even more severe because of climatic conditions and other things 

that we have to deal with. 

So thank you for being here. I look forward to your budget, and 

I am anxious to hear the testimony. 

Thank you, Mr. Chairman. 

Chairman SANDERS. OK. It is now my pleasure to welcome VA 

Secretary Eric Shinseki. 

Thank you, General, for joining us today to give your perspective 

on the President’s fiscal year 2014 budget and the fiscal year 2015 

advanced appropriations request for the Department of Veterans 

Affairs. We look forward to hearing your testimony. 

Secretary Shinseki is accompanied by Steve Muro, Under Secretary for Memorial Affairs; Allison Hickey, Under Secretary for 

Benefits; and Dr. Robert Petzel, Under Secretary for Health. We 

also have Todd Grams, Executive in Charge for the Office of ManVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00015 Fmt 6633 Sfmt 6601 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
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agement and Chief Financial Officer, and Stephen Warren, Acting 

Assistant Secretary for the Office of Information and Technology. 

Your prepared remarks will be submitted for the record. 

Secretary Shinseki, please begin and thanks again for being with 

us 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, ACTING ASSISTANT 

SECRETARY FOR THE OFFICE OF INFORMATION AND TECHNOLOGY; AND W. TODD GRAMS, EXECUTIVE IN CHARGE FOR 

THE OFFICE OF MANAGEMENT AND CHIEF FINANCIAL OFFICER 

Secretary SHINSEKI. Chairman Sanders, Ranking Member Burr, 

distinguished Members of the Committee, thank you for this opportunity to present the President’s 2014 budget and 2015 advanced 

appropriations requests for VA. We deeply value your partnership 

and support in providing the resources needed to assure quality 

care and services for veterans. 

Let me also join you, Mr. Chairman, in acknowledging other 

partners here today—our veteran service organizations, whose insights and support make us much better at our mission of caring 

for veterans, their families and our survivors. 

Mr. Chairman, thank you for accepting my written statement for 

the record. 

The 2014 budget and 2015 advanced appropriations requests 

demonstrate the President’s steadfast commitment to our Nation’s 

veterans. And I thank the members for your resolute commitment 

as well to veterans and seek your support on these requests. 

The latest generation of veterans is enrolling at VA at a higher 

rate than previous generations. Sixty-two percent of those who deployed in support of operations in Afghanistan and Iraq have used 

at least one VA benefit or service. VA’s requirements are expected 

to continue growing for years to come. Our plans and resources 

must be robust enough to care for them all. 

The President’s 2014 budget for VA, as the Chairman outlined: 

$152.7 billion—$66.5 billion in discretionary funding and $86.1 billion in mandatory funding, an increase of $2.7 billion in discretionary funding, 4.3 percent above the 2013 level. 

This is a strong budget which enables us to continue building 

momentum for delivering three long-term goals we set for ourselves 

roughly 4 years ago—increase veterans’ access to VA benefits and 

services, eliminate the disability claims backlog in 2015, and end 

veterans’ homelessness in 2015. These were bold and ambitious 

goals then. They remain bold and ambitious today because veterans deserve a VA that advocates for them and then finds a way 

to put resources against its words, against those promises. 

Access. Of the roughly 22 million living veterans in the country 

today, more than 11 million now receive at least 1 benefit or service from VA—an increase of over a million veterans in the last 4 

years. We have achieved this by opening new facilities, renovating 

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others, increasing investments in telehealth and telemedicine, 

sending mobile clinics and Vet Centers to remote areas where veterans live, and using every means available, including the social 

media, to connect more veterans to VA. Increasing access is a success story at VA. 

The backlog. No question, too many veterans wait too long to receive benefits they deserve. We know this is unacceptable and no 

one wants to turn this situation around more than this Secretary, 

Under Secretary Hickey or the folks who come to work at VBA 

every day, 52 percent of whom are veterans themselves. 

We are resolved to eliminate the claims backlog in 2015 when 

claims will be processed in 125 days or less at a 98 percent accuracy level. Our efforts mandate investments in VBA’s people, processes and technology. Not just technology—people, processes and 

technology. 

In terms of people, more than 2,100 claims processors have completed training to improve the quality and productivity of claims 

decisions. More are being trained, and VBA’s new employees now 

complete more claims per day than their predecessors. 

Processes. Use of disability benefits questionnaires, DBQs, online 

forms for submitting medical evidence, have dropped average processing times of medical exams and improved accuracy. 

There are now three lanes for processing claims—an express lane 

for those that will, predictably, take less time; a special operations 

lane for unusual cases or those requiring special handling; and a 

core lane where roughly 60 percent of the claims will go, and that 

is the remainder. 

Technology is critical in ending the backlog. Our paperless processing system, VBMS—Veterans Benefits Management System— 

will be faster, improve access, drive automation and reduce variance. Thirty regional offices now use VBMS. All 56 will have it by 

the end of this year. 

Homelessness. The last of our three priority goals is to end veterans’ homelessness in 2015. Since 2009 we have reduced the estimated number of homeless veterans by more than 17 percent. The 

latest available estimate from January 2012 is 62,600. 

There is more work to be done here, but we have mobilized a national program that reaches into communities all across this country. Prevention of veterans’ homelessness is our follow-on main effort. The first phase to be completed by 2015 is the rescue of veterans currently on the street, and at the same time we are building 

a prevention program to keep others from ending up there. 

Mr. Chairman, we are committed to the responsible use of the resources Congress provides. 

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

we look forward to your questions. 

[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 2014 Budget and 2015 advance appropriations requests for the Department 

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

and strong budgetary support and will have a positive impact on the lives of VetVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00017 Fmt 6633 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
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erans, their families, and survivors. We value the unwavering support of the Congress in providing the resources and legislative authorities needed to care for our 

Veterans and recognize the sacrifices they have made for our Nation. 

The current generation of Veterans will help to grow our middle class and provide 

a return on the country’s investments in them. The President believes in Veterans 

and their families, believes in providing them the care and benefits they’ve earned, 

and knows that by their service, they and their families add strength to our Nation. 

Twenty-two million living Americans today have distinguished themselves by 

their service in uniform. After a decade of war, many Servicemembers are returning 

and making the transition to Veterans status. The President’s 2014 Budget for VA 

requests $152.7 billion—comprised of $66.5 billion in discretionary funds, including 

medical care collections, and $86.1 billion in mandatory funds. The discretionary request reflects an increase of $2.7 billion, 4.3 percent above the 2013 level. Our 2014 

budget will allow VA to operate the largest integrated healthcare system in the 

country, with more than 9.0 million Veterans enrolled to receive healthcare; the 

ninth largest life insurance provider, covering both active duty members as well as 

enrolled Veterans; an education assistance program serving over 1 million students; 

a home mortgage service that guarantees over 1.5 million Veterans’ home loans with 

the lowest foreclosure rate in the Nation; and the largest national cemetery system 

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

about 121,000 Veterans and family members in 2014. 

PRIORITY GOALS

Over the next few years, more than one million Veterans will leave military service and transition to civilian life. VA must be ready to care for them and their families. Our data shows that the newest of our country’s Veterans are relying on VA 

at unprecedented levels. Through January 31, 2012, of the approximately 1.58 million Veterans who returned from Operations Enduring Freedom, Iraqi Freedom, and 

New Dawn, at least 62 percent have used some VA benefit or service. 

VA’s top three priorities—increase access to VA benefits and services; eliminate 

the disability compensation claims backlog in in 2015; and end Veterans homelessness, also in 2015—anticipate these changes and identify the performance levels required to meet emerging needs. These ambitious goals will take steady focus and 

determination to see them through. As we enter the critical funding year for VA’s 

priority goals, this 2014 budget builds upon our multi-year effort to position the Department through effective, efficient, and accountable programming and budget execution for delivering claims and homeless priority goals. 

STEWARDSHIP OF RESOURCES

Safeguarding the resources—people, money, time—entrusted to us by the Congress, managing them effectively, and deploying them judiciously, is a fundamental 

duty. Effective stewardship requires an unflagging commitment to use resources efficiently with clear accounting rules and procedures, to safeguard, train, motivate, 

and hold our workforce accountable, and to assure the effective use of time in serving Veterans on behalf of the American people. Striving for excellence in stewardship of resources is a daily priority. At VA, we are ever attentive to areas in which 

we need to improve our operations, and are committed to taking swift corrective action to eliminate any financial management practice that does not deliver value for 

Veterans. 

VA’s stewardship of resources begins at headquarters. Recognizing the very difficult fiscal constraints facing our country, the 2014 request includes a 5.0 percent 

reduction in the Departmental Administration budget from the 2013 enacted level. 

This reduction follows a headquarters freeze in the 2013 President’s Budget—a twoyear commitment. 

Recent audits of the Department’s financial statements have certified VA’s success 

in remediating all three of our remaining material weaknesses in financial management, which had been carried forward for over a decade. In terms of internal controls and fiscal integrity, this was a major accomplishment. In the past four years, 

we have also dramatically reduced the number of significant financial deficiencies 

from 16 to 1. 

At VA, we believe that part of being responsible stewards is shutting down information technology (IT) projects that are no longer performing. Developed by our Office of Information and Technology, the Project Management Accountability System 

(PMAS) requires IT projects to establish milestones to deliver new functionality to 

its customers every 6 months. Now entering its third year, PMAS continues to instill accountability and discipline in our IT organization. Through PMAS, the cumulative, on-time delivery of IT functionality since its inception is 82 percent, a rate 

15 

unheard of in the industry where, by contrast, the average is 42 percent. By implementing PMAS, we have achieved at least $200 million in cost avoidance by shutting down or improving the management of 15 projects. 

Through the effective management of our acquisition resources, VA has achieved savings of over $200 million by participating in Federal strategic sourcing programs 

and establishing innovative IT acquisition contracts. In 2012, VA led the civilian 

agencies in contracting with Service-Disabled Veteran-Owned Small Businesses, 

which, at $3.4 billion, accounted for 19.3 percent of all VA procurement awards. In 

addition, we have reduced interest penalties for late payments by 19 percent (from 

$47 to $38 per million) over the past four years. 

Finally, VA’s stewardship achieved savings in several other areas across the Department. The National Cemetery Administration (NCA) assumed responsibility in 

2009 for processing First Notices of Death to terminate compensation benefits to deceased Veterans. Since taking on this responsibility, NCA has advised families of 

the burial benefits available to them, assisted in averting overpayments of some 

$142 million in benefit payments and, thereby, helped survivors avoid possible collections. In addition, we implemented the use of Medicare pricing methodologies at 

the Veterans Health Administration (VHA) to pay for fee-basis services, resulting 

in savings of over $528 million since 2012 without negatively impacting Veteran 

care and with improved consistency in billing and payment. 

TECHNOLOGY

To serve Veterans as well as they have served us, we are working on delivering 

a 21st century VA that provides medical care, benefits, and services through a digital infrastructure. Technology is integrated with everything we do for Veterans. 

Our hospitals use information technology to properly and accurately distribute and 

deliver prescriptions/medications to patients, track lab tests, process MRI and X-ray 

imaging, coordinate consults, and store medical records. VA IT systems supported 

over 1,300 VA points of healthcare in 2012: 152 medical centers, 107 domiciliary rehabilitation treatment programs, 821 community-based outpatient clinics, 300 Vet 

Centers, 6 independent outpatient clinics, 11 mobile outpatient clinics, and 70 mobile Vet Centers. Technology supports Veterans’ education and disability claims 

processing, claims payments, home loans, insurance, and memorial services. Our IT 

infrastructure consists of telephone lines, data networks, servers, workstations, 

printers, cell phones, and mobile applications. 

No Veteran should have to wait months or years for the benefits that they have 

earned. We will eliminate the disability claims backlog in 2015; technology is the 

critical component for achieving our goal. VA is deploying technology solutions to 

improve access, drive automation, reduce variance, and enable faster and more efficient operations. Building on the resources Congress has provided in recent years 

to expand our claims processing capacity, the 2014 budget requests $291 million for 

technology to eliminate the claims backlog? $155 million in Veterans Benefits management System (VBMS) for our new paperless processing system, and $136 million 

in the Veterans Benefits Administration (VBA) to support a Veterans Claims Intake 

Program, our new online application system that will allow for the conversion of 

paper to digital images for our new paperless processing system, the Veterans Benefits Management System (VBMS). Without these resources, VA will be unable to 

meet its goal to eliminate the disability claims backlog in 2015. 

Information Technology 

At VA, advances in technology—and the adoption of and reliance on IT in our 

daily commercial life—have been dramatic. Technology is integral to providing high 

quality healthcare and benefits. The 2014 budget requests $3.683 billion for IT, an 

increase of $359 million from the President’s 2013 Budget, reflecting the critical role 

technology plays in VA’s daily work in serving and caring for Veterans and their 

families. Of the total request, $2.2 billion will support the operation and maintenance of our digital infrastructure and $495 million is for IT development modernization and enhancement projects. 

The 2014 budget includes $32.8 million for development of VBMS, our new 

paperless processing system that enables VA to move from its current paper-based 

process to a digital operating environment that improves access, drives automation, 

reduces variance, and enables faster, more efficient operations. As we increase 

claims examiners’ use of VBMS version 4.2 to process rating disability claims, our 

major focus is on system performance, as we tune the system to be responsive and 

effective. VA will complete the rollout of VBMS in June 2013. 

In addition, the 2014 budget includes $120 million for development of the Veterans Relationship Management (VRM) initiative, which enhances Veterans’ access 

to comprehensive VA services and benefits, especially in the delivery of compensaVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00019 Fmt 6633 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
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tion and pension claims processing. The program gives Veterans secure, personalized access to benefits and information and allows a timely response to their inquiries. Recently, VRM released Veterans Online Application Direct Connect (VDC), 

which enables Veterans to apply for VBA benefits by answering guided interview 

questions through the security of the eBenefits portal. Claims filed through 

eBenefits use VDC to load information and data directly into VBMS. 

The Virtual Lifetime Electronic Record (VLER) is an overarching program which 

aims to share health, benefits, and administrative information, including personnel 

records and military history records, among DOD, VA, SSA, private healthcare providers, and other Federal, State and local government partners. eBenefits is already 

reaching 2 million Veterans and Servicemembers and 1 million active users with 

BlueButton. The 2014 budget requests $15.4 million for VLER to develop and support these functions as well as the Warrior Support Veterans Tracking Application; 

the Disability Benefits Questionnaires; a VA/DOD joint health information sharing 

project known as Bidirectional Health Information Exchange; and a storage interface known as Clinical Data Repository/Health Data Repository. All of these efforts 

are designed to enable the sharing of health, military personnel and personal information among VA, other Federal agencies, Veteran Service Organizations and private health care providers to expedite the award and processing of disability claims 

and other services such as education, training and job placement. 

ELIMINATING THE CLAIMS BACKLOG

Too many Veterans wait too long to receive benefits they have earned. This is unacceptable. Today’s claims backlog is the result of several factors, including: increased demand; over a decade of war with many Veterans returning with more severe, complex injuries; decisions on Agent Orange, Gulf War, and combat PTSD presumptions; and, successful outreach to Veterans informing them of their benefits. 

These facts, in no way, diminish the urgency that we all feel at VA to fix this problem which has been decades in the making. VA remains focused on eliminating the 

disability claims backlog in 2015 and processing all claims within 125 days at a 98- 

percent accuracy level. 

To deliver this goal, the Veterans Benefits Administration (VBA) is implementing 

a comprehensive transformation plan based on more than 40 targeted initiatives to 

boost productivity by over the next several years However, as VBA transforms its 

people, processes, and technologies, its claims demand is expected to exceed on million annually. From 2010 through 2012, for the first time in its history, VBA processed more than one million claims in three consecutive years. In 2013, VBA expects 

to receive another million claims and similar levels of demand are anticipated in 

2014. This is driven by successful outreach, claims growth not previously captured 

in VBA’s baseline, and new requirements. Included are mandatory Servicemember 

participation in VOW/VEI benefits briefings and an expected increase upon successful completion of a transition assistance program, revamped by the President as 

Transition: Goals, Plan, Success (GPS). As more than one million troops leave service over the next 5 years, we expect our claims workload to continue to rise. In addition, VBA is experiencing an unprecedented workload growth arising from the number and complexity of medical conditions in Veterans’ compensation claims. The average number of claimed conditions for our recently separated Servicemembers is 

now in the 12 to 16 range—roughly 5 times the number of disabilities claimed by 

Veterans of earlier eras. While the increase in compensation applications presents 

challenges, it is also an indication that we are being successful in our efforts to expand access to VA benefits. 

Investments in transformation of our people, processes, and technologies are already paying off in terms of improved performance. For example: 

• People: More than 2,100 claims processors have completed Challenge Training, 

which improves the quality and productivity of VBA compensation claims decisionmakers. As a result of Challenge Training, VBA’s new employees complete more 

claims per day than their predecessors—with a 30 percent increase in accuracy. 

VBA’s new standardized organizational model incorporates a case-management 

approach to claims processing that organizes its workforce into cross-functional 

teams that work together on one of three segmented lanes: express, special operations, or core. Claims that predictably can take less time will flow through an express lane (30 percent); those taking more time or requiring special handling will 

flow through a special operations lane (10 percent); and the rest of the claims flow 

through the core lane (60 percent). Initially planned for deployment throughout 

2013, VBA accelerated the implementation of the new organizational model by nine 

months due to early indications of its positive impact on performance. 

17 

VBA instituted Quality Review Teams (QRTs) in 2012 to improve employee training and accuracy while decreasing rework time. QRTs focus on improving performance on the most common sources of error in the claims processing cycle. Today, for 

example, QRTs are focused on the process by which proper physical examinations 

are ordered; incorrect or insufficient exams previously accounted for 30 percent of 

VBA’s error rate. As a result of this focus, VBA has seen a 23 percent improvement 

in this area. • Process: Disability Benefits Questionnaires (DBQs) are online forms used by 

non-VA physicians to submit medical evidence. Use of DBQs has improved timeliness and accuracy of VHA-provided exams—average processing time improved by 6 

days from June 2011 to October 2012 (from 32 to 26 days). 

Fully developed claims (FDCs) are critical to reducing ‘‘wait time’’ and ‘‘rework.’’ 

FDCs include all DOD service medical and personnel records, including entrance 

and exit exams, applicable DBQs, any private medical records, and a fully completed 

claim form. Today, VBA receives 4.5 percent of claims in fully developed form and 

completes them in 117 days, while a regular claim takes 262 days to process. Fulfilling the Veterans Claims Assistance Act, to search for potential evidence, is the 

greatest portion of the current 262-day process. The Veterans Benefit Act of 2003 

allows Veterans up to 365 days, from the date of VA notice for additional information or evidence, to provide documentation. Of the 262 days to complete a regular 

claim, approximately145 days are spent waiting for potential evidence to qualify the 

application as a fully developed claim. 

VBA built new decision-support tools to make our employees more efficient and 

their decisions more consistent and accurate. Rules-based calculators provide suggested evaluations for certain conditions using objective data and rules-based 

functionality. The Evaluation Builder uses a series of check boxes that are associated with the Veteran’s symptoms to help determine the proper diagnostic code of 

over 800 codes, as well as the appropriate level of compensation based on the Veteran’s symptoms. • Technology: The centerpiece of VBA’s transformation plan is VBMS—a new 

paperless electronic claims processing system that employs rules-based technology 

to improve decision speed and accuracy. For our Veterans, VBMS will mean faster, 

higher-quality, and more consistent decisions on claims. Our strategy includes active 

stakeholder participation (Veterans Service Officers, State Departments of Veterans 

Affairs, County Veterans Service Officers, and Department of Defense) to provide 

digital electronic files and claims pre-scanned through online claims submission via 

the eBenefits Web portal. • VBA recently established the Veterans Claims Intake Program (VCIP). This 

program will streamline processes for receiving records and data into VBMS and 

other VBA systems. Scanning operations and the transfer of Veteran data into 

VBMS are primary intake capabilities that are managed by VCIP. As VBMS is deployed to additional regional offices, document scanning becomes increasingly important as the main mechanism for transitioning from paper-based claim folders to the 

new electronic environment. 

There are other ways that VA is working to eliminate the claims backlog. VHA 

has implemented multiple initiatives to expedite timely and efficient delivery of 

medical evidence needed to process a disability claim by VBA. As a result, timeliness improved by nearly one-third, from an average of 38 days in January 2011 to 

26 days in October 2012. Recently, VA launched Acceptable Clinical Evidence (ACE), 

an initiative that allows clinicians to review existing medical evidence and determine whether they can use that evidence to complete a DBQ without requiring the 

Veteran to report for an in-person examination. This initiative was developed by 

both VHA and VBA in a joint effort to provide a Veteran-centric approach for disability examinations. Use of the ACE process opens the possibility of doing assessments without an in-person examination when there is sufficient information in the 

record. 

Another way to eliminate the claims backlog is by working closely with the DOD. 

The Integrated Disability Evaluation System (IDES) is a collaborative system to 

make disability evaluations seamless, simple, fast and fair. If the Servicemember is 

found medically unfit for duty, the IDES gives them a proposed VA disability rating 

before they leave the service. These ratings are normally based on VA examinations 

that are conducted using required IDES examination templates. In FY 2012, IDES 

participants were notified of VA benefit entitlement in an average of 54 days after 

discharge. This reflects an improvement from 67 days in May 2012 to 49 days in 

September 2012. 

The Benefits Delivery at Discharge (BDD) and Quick Start programs are two 

other collaborations for Servicemembers to file claims for service-connected disabilities. This can be done from 180 to 60 days prior to separation or retirement. BDD 

18 

claims are accepted at every VA Regional Office and at intake sites on military installations in the U.S., and at two intake site locations overseas. In 2012, BDD received more than 30,300 claims and completed 24,944—a 14% increase over 2011’s 

productivity (21,657). During this same period of time Quick Start decreased their 

rating inventory by over 44 percent. 

EXPANDING ACCESS TO BENEFITS AND SERVICES

VA remains committed to ensuring that Veterans are not only aware of the benefits and services that they are entitled to, but that they are able to access them. 

We are improving access to VA services by opening new or improved facilities closer 

to where Veterans live. Since 2009, we have added 57 community-based outpatient 

clinics (CBOCs), for a total of 840 CBOCs through 2013, and increased the number 

of mobile outpatient clinics and mobile Vet Centers, serving rural Veterans, to 81. 

Last August, we opened a state-of-the-art medical center in Las Vegas, the first new 

VAMC in 17 years. The 2014 medical care budget request includes $799 million to 

open new and renovated healthcare facilities and includes the authorization request 

for 28 new and replacement medical leases to increase Veteran access to services. 

Today, access is much more than the ability to walk into a VA medical facility; 

it also includes technology, and programs, as well as, facilities. Expanding access 

includes taking the facility to the Veteran—be it virtually through telehealth, by 

sending Mobile Vet Centers to rural areas where services are scarce, or by using 

social media sites like Facebook, Twitter, and YouTube to connect Veterans to VA 

benefits and facilities. Telehealth is a major breakthrough in healthcare delivery in 

21st century medicine, and is particularly important for Veterans who live in rural 

and remote areas. The 2014 budget requests $460 million for telehealth, an increase 

of $388 million, or 542 percent, since 2009. 

As more Veterans access our healthcare services, we recognize their unique needs 

and the needs of their families—many have been affected by multiple, lengthy deployments. VA provides a comprehensive system of high-quality mental health treatment and services to Veterans. We are using many tools to recruit and retain our 

large mental healthcare workforce to better serve Veterans by providing enhanced 

services, expanded access, longer clinic hours, and increased telemental health capabilities. In response to increased demand over the last four years, VA has enhanced 

its capacity to deliver needed mental health services and to improve the system of 

care so that Veterans can more readily access them. Since 2006, the number of Veterans receiving specialized mental health treatment has risen each year, from over 

927,000 to more than 1.3 million in 2012, partly due to proactive screening. Outpatient visits have increased from 14 million in 2009 to over 17 million in 2012. VA 

believes that mental healthcare must constantly evolve and improve as new knowledge becomes available through research. 

The 2014 budget includes $168.5 million for the Veterans Relationship Management (VRM) initiative, which is fundamentally transforming Veterans’ access to VA 

benefits and services by empowering VA clients with new self-service tools. VA has 

already made major strides under this initiative. Most recently, in November 2012, 

VRM added new features to eBenefits, a Web application that allows Veterans to 

access their VA benefits and submit some claims online. Veterans can now enroll 

in and manage their insurance policies, select reserve retirement benefits, and 

browse the Veterans Benefits Handbook from the eBenefits Website. With the help 

of Google mapping services, the update also enables Veterans to find VA representatives in their area and where they are located. Since its inception in 2009, eBenefits 

has added more than 45 features allowing Veterans easier, quicker, and more convenient access to their VA benefits and personal information. 

VBA has aggressively promoted eBenefits and the ease of enrolling into the system. We currently have over 2.5 million registered eBenefits users. Users can check 

the status of claims or appeals, review VA payment history, obtain military documents, and perform numerous other benefit actions through eBenefits. The Stakeholder Enterprise Portal (SEP) is a secure Web-based access point for VA’s business 

partners. This electronic portal provides the ability for VSOs and other external VA 

business partners to represent Veterans quickly and efficiently. 

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 

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 results in the most efficient use of resources to reach the greatest 

number of Veterans. 

19 

ENDING VETERAN HOMELESSNESS

The last of our three priority goals is to end homelessness among Veterans in 

2015. Since 2009, we have reduced the estimated number of homeless Veterans by 

more than 17 percent. The January 2012 Point-In-Time estimate, the latest available, is 62,619. We have also created a National Homeless Veterans Registry to 

track our known homeless and at-risk populations closely to ensure resources end 

up where they are needed. In 2012, over 240,000 homeless or at-risk Veterans 

accessed benefits or services through VA and 96,681 homeless or at-risk Veterans 

were assessed by VHA’s homeless programs. Over 31,000 homeless and at-risk Veterans and their families obtained permanent housing through VA specialized homeless programs. 

In the 2014 budget, VA is requesting $1.393 billion for programs to assist homeless Veterans, through programs such as Department of Housing and Urban Development-VA Supportive Housing (HUD-VASH), Grant and Per Diem, Homeless Registry, and Health Care for Homeless Veterans. This represents an increase of $41 

million, or 3 percent over the 2013 enacted level. This budget will support our longrange plan to end Veteran homelessness by emphasizing rescue and prevention— 

rescue for those who are homeless today, and prevention for those at risk of homelessness. 

Our prevention strategy includes close partnerships with some 150 community 

non-profits through the Supportive Services for Veteran Families (SSVF) program; 

SSVF grants promote housing stability among homeless and at-risk Veterans and 

their families. The grants can have an immediate impact, helping lift Veterans out 

of homelessness or providing aid in emergency situations that put Veterans and 

their families at risk of homelessness. In 2012, we awarded $100 million in Supportive Service grants to help Veterans and families avoid life on the streets. We 

are currently reviewing proposals for the $300 million in grants we will distribute 

later this year. In 2012, SSVF resources directly helped approximately 21,000 Veterans and over 35,000 household members, including nearly 9,000 children. This 

year’s grants will help up to 70,000 Veterans and family members avoid homelessness. The 2014 budget includes $300 million for SSVF. 

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. Family members and non-VA providers who call on behalf of homeless Veterans are provided with information on VA 

homeless programs and services. In 2012, the National Call Center for Homeless 

Veterans received 80,558 calls (123 percent increase) and the center made 50,608 

referrals to VA medical centers (133 percent increase). 

VA’s Homeless Patient Aligned Care Teams (H-PACTs) program provides a coordinated ‘‘medical home’’ specifically tailored to the needs of homeless Veterans. The 

program integrates clinical care with delivery of social services and enhanced access 

and community coordination. Implementation of this model is expected to address 

health disparity and equity issues facing the homeless population. Expected program outcomes include reduced emergency department use and hospitalizations, improved chronic disease management, and improved ‘‘housing readiness’’ with fewer 

Veterans returning to homelessness once housed. 

During 2012, 119,878 unique homeless Veterans were served by the Health Care 

for Homeless Veterans Program (HCHV), an increase of more than 21 percent from 

2011. At more than 135 sites, HCHV offers outreach, exams, treatment, referrals, 

and case management to Veterans who are homeless and dealing with mental 

health issues, including substance use. Initially serving as a mechanism to contract 

with providers for community-based residential treatment for homeless Veterans, 

many HCHV programs now serve as the hub for myriad housing and other services 

that provide VA with a way to outreach and assist homeless Veterans by offering 

them entry to VA medical care. 

VA’s Homeless Veterans Apprenticeship Program was established in 2012—a 1- 

year paid employment training program for Veterans who are homeless or at risk 

of homelessness. This program created paid employment positions as Cemetery 

Caretakers at five of our 131 national cemeteries. The initial class of 21 homeless 

Veterans is simultaneously enrolled in VHA’s Homeless Veterans Supported Employment program. Apprentices who successfully complete 12 months of competencybased training will be offered permanent full-time employment at a national cemetery. Successful participants will receive a Certificate of Competency which can also 

be used to support employment applications in the private sector. 

20 

Another avenue of assistance is through Veterans Treatment Courts, which were 

developed to avoid unnecessary incarceration of Veterans who have developed mental health problems. The goal of Veterans Treatment Courts is to divert those with 

mental health issues and homelessness from the traditional justice system and to 

give them treatment and tools for rehabilitation and readjustment. While each Veterans Treatment Court is part of the local community’s justice system, they form 

close working partnerships with VA and Veterans’ organizations. As of early 2012 

there are 88 Courts. 

The Veterans Justice Outreach (VJO) program exists to connect these justice-involved Veterans with the treatment and other services that can help prevent homelessness and facilitate recovery, whether or not they live in a community that has 

a Veterans Treatment Court. Each VA Medical Center has at least one designated 

justice outreach specialist who functions as a link between VA, Veterans, and the 

local justice system. Although VA cannot treat Veterans while they are incarcerated, 

these specialists provide outreach, assessment and linkage to VA and community 

treatment, and other services to both incarcerated Veterans and justice-involved 

Veterans who have not been incarcerated. 

MULTI-YEAR PLAN FOR MEDICAL CARE BUDGET

Under the Veterans Health Care Budget Reform and Transparency Act of 2009, 

which we are grateful to Congress for passing; VA submits its medical care budget 

that includes an advance appropriations request in each budget submission. The 

legislation requires VA to plan its medical care budget using a multi-year approach. 

This policy ensures that VA requirements are reviewed and updated based on the 

most recent data available and actual program experience. 

The 2014 budget request for VA medical care appropriations is $54.6 billion, an 

increase of 3.7 percent over the 2013 enacted level of $52.7 billion. The request is 

an increase of $157.5 million above the enacted 2014 advance appropriations level. 

Based on updated 2014 estimates largely derived from the Enrollee Health Care 

Projection Model, the requested amount would allow VA to increase funding in programs to eliminate Veteran homelessness; continue implementation of the Caregivers and Veterans Omnibus Health Services Act; fulfill multiple responsibilities 

under the Affordable Care Act; 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. Our multi-year budget plan assumes that VHA will carry over negligible unobligated balances from 2013 into 

2014—consistent with the 2013 budget submitted to Congress. 

The 2015 request for medical care advance appropriations is $55.6 billion, an increase of $1.1 billion, or 1.9 percent, over the 2014 budget request. Medical care 

funding levels for 2015, including funding for activations, non-recurring maintenance, and initiatives, will be revisited during the 2015 budget process, and could 

be revised to reflect updated information on known funding requirements and unobligated balances. 

MEDICAL CARE PROGRAM

The 2014 budget of $57.7 billion, including collections, provides for healthcare 

services to treat over 6.5 million unique patients, an increase of 1.3 percent over 

the 2013 estimate. Of those unique patients, 4.5 million Veterans are in Priority 

Groups 1–6, an increase of more than 71,000 or 1.6 percent. Additionally, VA anticipates treating over 674,000 Veterans from the conflicts in Iraq and Afghanistan, an 

increase of over 67,000 patients, or 11.1 percent, over the 2013 level. VA also provides medical care to non-Veterans through programs such the Civilian Health and 

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

Bifida Health Care Program; this population is expected to increase by over 17,000 

patients, 2.6 percent, during the same time period. 

The 2014 budget proposes to extend the Administration’s current policy to freeze 

Veterans’ pharmacy co-payments at the 2012 rates, until January 2015. Under this 

policy, which will be implemented in a future rulemaking, co-payments will continue 

at $8 for Veterans in Priority Groups 2 through 6 and at $9 for Priority Groups 7 

through 8. 

The 2014 budget requests $47 million to provide healthcare for Veterans who 

were potentially exposed to contaminated drinking water at Camp Lejeune as required by the Honoring America’s Veterans and Caring for Camp Lejeune Families 

Act of 2012, enacted last August. Since VA began implementation of the law and 

in January 2013, 1,400 Veterans have contacted us concerning Camp Lejeune. Of 

these, roughly 1,100 were already enrolled in VA healthcare. Veterans who are eligible for care under the Camp Lejeune authority, regardless of current enrollment staVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00024 Fmt 6633 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
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tus 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. In 2015, VA expects to start treating family members as authorized under the law and has included $25 million for this purpose within the 2015 

advance appropriations request. VA continues a robust outreach campaign to these 

Veterans and family members while we press forward with implementing this complex new law. 

Mental Healthcare and Suicide Prevention 

At VA, we have the opportunity and the responsibility to anticipate the needs of 

returning Veterans. Mental healthcare at VA is a system of comprehensive treatments and services to meet the individual mental health needs of Veterans. VA is 

expanding mental health programs and is integrating mental health services with 

primary and specialty care to provide better coordinated care for our Veteran patients. Our 2014 budget provides nearly $7.0 billion for mental healthcare, an increase of $469 million, or 7.2 percent, over 2013. Since 2009, VA has increased funding for mental health services by 56.9 percent. VA provided mental health services 

to 1,391,523 patients in 2012, 58,000 more than in 2011. 

To serve the growing number of Veterans seeking mental healthcare, VA has deployed significant resources and is increasing the number of staff in support of mental health services. Consistent with the President’s August 31, 2012 Executive 

Order, VHA is on target to complete the goal of hiring 1,600 additional mental 

health clinical providers and 300 administrative support staff by June 30, 2013 to 

meet the growing demand for mental health services. In addition, as part of VA’s 

efforts to implement the Caregivers and Veterans Omnibus Health Services Act of 

2010, VA has hired over 100 Peer Specialists in recent months, and is hiring and 

training nearly 700 more. Additionally, VA has awarded a contract to the Depression and Bipolar Support Alliance to provide certification training for Peer Specialists. This peer staff is expected to be hired by December 31, 2013, and will work 

as members of mental health teams. 

In addition to hiring more mental health workers, VA is developing electronic 

tools to help VA clinicians manage the mental health needs of their patients. 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 Veterans Crisis Line in Canandaigua, New York, 

has answered over 725,000 calls and responded to more than 80,000 chats and 5,000 

texts from Veterans in need. In the most serious calls, approximately 26,000 men 

and women have been rescued from a suicide in progress because of our intervention—the equivalent of two Army divisions. 

We recently completed a 2012 VA suicide data report, a result of the most comprehensive review of Veteran suicide rates ever undertaken by VA. We are working 

hard to understand this issue—and VA and DOD have jointly funded a $100 million 

suicide research project. We will be better informed about suicides, but while research is ongoing, we are taking immediate action and are not waiting 10 years for 

final study outcomes. These actions include Veterans Chat on the Veterans Crisis 

Line, local Suicide Prevention Coordinators’ for counseling and services, and availability of VA/DOD Suicide Outreach resources. 

The Affordable Care Act 

The Affordable Care Act (ACA) expands access to coverage, reins in health care 

costs, and improves the Nation’s health care delivery system. The Act has important 

implications for VA. Beginning in 2014, many uninsured Americans, including Veterans, will have access to quality, affordable health insurance choices through 

Health Insurance Marketplaces, also known as Exchanges, and may be eligible for 

premium tax credits and cost-sharing reductions to make coverage more affordable. 

The 2014 budget requests $85 million within the Medical Care request and $3.4 million within the Information Technology request to fulfill multiple responsibilities as 

a provider of Minimum Essential Coverage under the Affordable Care Act, including: (1) providing outreach and communication on ACA to Veterans related to VA 

health care; (2) reporting to Treasury on individuals who are enrolled in the VA 

healthcare system; and (3) providing a written statement to each enrolled Veteran 

about their coverage by January 2015. 

Medical Care in Rural Areas 

VA remains committed to the delivery of medical care in rural areas of our country. For that reason, in 2012, we obligated $248 million to support the efforts of the 

22 

Office of Rural Health to improve access and quality of care for enrolled Veterans 

who live in rural areas. Some 3.4 million Veterans enrolled in the VA healthcare 

system live in rural or highly rural areas of the country; this represents about 41 

percent of all enrolled Veterans. For that reason, VA will continue to emphasize 

rural health in our budget planning, including addressing the needs of American Indian and Alaska Native (AI/AN) Veterans. 

VA is committed to expanding access to the full range of VA programs to eligible 

AI/AN Veterans. Last year, VA signed a Memorandum of Agreement with the Indian Health Service (IHS), through which VA will reimburse IHS for direct care 

services provided to eligible American Indian and Alaska Native Veterans. While 

the national agreement applies only to VA and IHS, it will inform agreements negotiated between the VA and tribal health programs. 

This follows the agreement already in place between VA and IHS whereby nearly 

250,000 patients served by IHS have utilized a prescription program that allows 

IHS pharmacies to use VA’s Consolidated Mail Outpatient Pharmacy (CMOP) to 

process and mail prescription refills for IHS patients. By accessing the service, IHS 

patients can now have their prescriptions mailed to them, in many cases eliminating 

the need to pick them up at an IHS pharmacy. 

Women Veterans Medical Care 

Changing demographics are also driving change at VA. Today, we have over 2.2 

million women Veterans in our country; they are the fastest growing segment of our 

Veterans’ population. Since 2009, the number of women Veterans enrolled in VA 

healthcare increased by almost 22 percent, to 591,500. However, by 2022—less than 

a decade from now—their number is projected to spike to almost 2.5 million, and 

an estimated 900,000 will be enrolled in VA healthcare. 

The 2014 budget requests $422 million, an increase of 134 percent since 2009, for 

gender-specific medical care for women Veterans. Since 2009, we have invested 

$25.5 million in improvements to women Veterans’ clinics and opened 19 new ones. 

Today, nearly 50 percent of our facilities have comprehensive women’s clinics, and 

every VA healthcare system has designated women’s health primary care providers, 

and has a women Veteran’s program manager on staff. 

In 2012, VA awarded 32 grants totaling $2 million to VA facilities for projects 

that will improve emergency healthcare services for women Veterans, expand women’s health education programs for VA staff, and offer telehealth programs to female 

Veterans in rural areas. These new projects will improve access and quality of critical healthcare services for women. This is the largest number of one-year grants 

VA has ever awarded for enhancing women’s health services. 

MEDICAL RESEARCH

Medical Research is being supported with $586 million in direct appropriations in 

2014, with an additional $1.3 billion in funding support from VA’s medical care program and through Federal and non-Federal grants. VA Research and Development 

will support 2,224 projects during 2014. 

Projects funded in 2014 will be focused on supporting development of New Models 

of Care, 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 Post Traumatic Stress Disorder and mild Traumatic 

Brain Injury, and advancing genomic medicine. 

The 2014 budget continues support for the Million Veteran Program (MVP), an 

unprecedented research program that advances the promises of genomic science. 

The MVP will establish a database, used only by authorized researchers in a secure 

manner, to conduct health and wellness studies to determine which genetic variations are associated with particular health issues—potentially helping the health 

of America’s Veterans and the general public. MVP recently enrolled its 100,000th 

volunteer research participant, and by the end of 2013, the goal is to enroll at least 

150,000 participants in the program. 

VETERANS BENEFITS ADMINISTRATION

The 2014 budget request of $2.455 billion for VBA, an increase of $294 million 

in discretionary funds from the 2013 enacted level, is vital to the transformation 

strategy that drives our performance improvements focused most squarely on the 

backlog. 

Virtually all 860,000 claims in the VBA inventory, including the 600,000 claims 

that have been at VA for over 125 days and are considered backlogged, exist only 

in paper. Our transition to VBMS and electronic claims processing is a massive and 

23 

crucial phase in VBA transformation. VA awarded two VCIP contracts in 2012 to 

provide document conversion services that will populate the electronic claims folder, 

or eFolder, in VBMS with images and data extracted from paper and other source 

material. Without VCIP, we cannot populate the eFolder on which the VBMS system relies. The 2014 request for $136 million for our scanning services contracts will 

ensure that we remain on track to reach this key goal. In addition, the budget request includes $4.9 million for help desk support for Veterans using the Veterans 

On-Line Application/eBenefits system. VBA projects a beneficiary caseload of 4.6 million in 2014, with more than $70 

billion in compensation and pension benefits obligations. We expect to process 1.2 

million compensation claims in 2014, and we are pursuing improvements that will 

enable us to meet the emerging needs of Veterans and their families. 

Veterans Employment 

Under the leadership of President Obama, VA, DOD, the Department of Labor, 

and the entire Federal Government have made Veterans employment one of their 

highest priorities. In August 2011, the President announced his comprehensive plan 

to address this issue and 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. He created a new DOD/VA Employment Initiative Task Force 

that would develop a new training and services delivery model to help strengthen 

the transition of our Veteran Servicemembers from military to civilian life. VA has 

worked closely with other partners in the Task Force to identify its responsibilities 

and ensure delivery of the President’s vision. On November 21, 2012, the effective 

date of the VOW Act, VA began deployment of the enhanced VA benefits briefings 

under the revised Transition Assistance Program (TAP), called Transition GPS 

(Goals, Plans, Success). VA will also provide training for the optional Technical 

Training Track Curriculum and participate in the Capstone event, which will ensure 

that separating Servicemembers have the opportunity to verify that they have met 

Career Readiness Standards and are steered to the resources and benefits available 

to them as Veterans. Accordingly, the 2014 budget requests $104 million to support 

the implementation of Transition GPS and meet VA’s responsibilities under the 

VOW Act and the President’s Veterans Employment Initiative. 

Veterans Job Corps 

In his State of the Union address in 2012, President Obama called for a new Veterans Job Corps initiative to help our returning Veterans find pathways to civilian 

employment. The 2014 budget includes $1 billion in mandatory funding to develop 

a Veterans Job Corps conservation program that will put up to 20,000 Veterans back 

to work over the next five years protecting and rebuilding America. Jobs will include 

park maintenance projects, patrolling public lands, rehabilitating natural and recreational areas, and administrative, technical, 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 will have a particular focus on post-9/11 Veterans. 

Post-9/11 and other Education Programs 

Since 2009, VA has provided over $25 billion in Post-9/11 GI Bill benefits to cover 

the education and training of more than 893,000 Servicemembers, Veterans, family 

members, and survivors. We are now working with Student Veterans of America to 

track graduation and training completion rates. 

The Post-9/11 GI Bill continues to be a focus of VBA transformation as it implements the Long-Term Solution (LTS). At the end of February we had approximately 

60,000 education claims pending, 70 percent lower than the total claims pending the 

same time last year. The average days to process Post-9/11 GI Bill supplemental 

claims has decreased by 17 days, from 23 days in September 2012 to 6 days in February 2013. The average time to process initial Post-9/11 GI Bill original education 

benefit claims in February was 24 days. 

NATIONAL CEMETERY ADMINISTRATION

The 2014 budget includes $250 million in operations and maintenance funding for 

the National Cemetery Administration (NCA). As we move forward into the next fiscal year, NCA projects our workload numbers will continue to increase. For 2014, 

we anticipate conducting approximately 121,000 interments of Veterans or their 

family members, maintaining and providing perpetual care for approximately 3.4 

million gravesites. NCA will also maintain 9,000 developed acres and process approximately 345,000 headstone and marker applications. 

24 

Review of National Cemeteries 

For the first time in the 150-year history of national cemeteries, NCA has completed a self-initiated, comprehensive review of the entire inventory of 3.2 million 

headstones and markers within the 131 national cemeteries and 33 Soldiers’ Lots 

it maintains. The information gained was invaluable in validating current operations and ensuring a sustainment plan is in place to enhance our management 

practices. The review was part of NCA’s ongoing effort to ensure the full and accurate accounting of remains interred in VA national cemeteries. Families of those 

buried in our national shrines can be assured their loved ones will continue to be 

cared for into perpetuity. 

Veterans Employment 

NCA continues to maintain its commitment to hiring Veterans. Currently, Veterans comprise over 74 percent of its workforce. Since 2009, NCA has hired over 

400 returning Iraq and Afghanistan Veterans. In addition, 82 percent of contracts 

in 2012 were awarded 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 received the highest 

score—94 out of 100 possible—in the 2010 American Customer Satisfaction Index 

(ACSI) sponsored by the University of Michigan. This was the fourth time NCA participated and the fourth time it received the top rating in the Nation. 

Partnerships 

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). There are currently 88 operational 

state and tribal cemeteries in 43 states, Guam, and Saipan, with 6 more under construction. Since 1978, VCGS has awarded grants totaling more than $500 million 

to establish, expand, or improve Veterans’ cemeteries. In 2012, these cemeteries conducted over 31,000 burials for Veterans and family members. 

NCA works closely with funeral directors and private cemeteries, two significant 

stakeholder groups, who assist with the coordination of committal services and interments. Funeral directors may also help families in applying for headstones, 

markers, and other memorial benefits. NCA partners with private cemeteries by furnishing headstones and markers for Veterans’ gravesites in these private cemeteries. In January of this year, NCA announced the availability of a new online funeral directors resource kit that may be used by funeral directors nationwide when 

helping Veterans and their families make burial arrangements in VA national cemeteries. 

CAPITAL INFRASTRUCTURE

A total of $1.1 billion is requested in 2014 for VA’s major and minor construction 

programs. The capital asset budget reflects VA’s commitment 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 gap 

between our current status and the needs identified in our Strategic Capital Investment Planning (SCIP) process. 

Major Construction 

The major construction request in 2014 is $342 million for one medical facility 

project and three National Cemeteries. The request will fund the completion of a 

mental health building in Seattle, Washington, to replace the existing, seismically 

deficient building. It will also increase access to Veteran burial services by providing 

a National Cemetery in Central East Florida; Omaha, Nebraska; and Tallahassee, 

Florida. 

The 2014 budget includes $5 million for NCA for advance planning activities. VA 

is in the process of establishing two additional national cemeteries in Western New 

York and Southern Colorado, according to the burial access policies included in the 

2011 budget. These two new cemeteries, along with the three requested in 2014, will 

increase access to 550,000 Veterans. NCA has obligated approximately $16 million 

to acquire land in 2012 and 2013 for the planned new national cemeteries in Central East Florida; Tallahassee, Florida; and Omaha, Nebraska. 

Minor Construction 

In 2014, the minor construction request is $715 million, an increase of 17.8 percent from the 2013 enacted level. It would provide for constructing, renovating, expanding and improving VA facilities, including planning, assessment of needs, 

gravesite expansions, site acquisition, and disposition. VA is placing a funding priVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00028 Fmt 6633 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
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ority on minor construction projects in 2014 for two reasons. First, our aging infrastructure requires a focus on maintenance and repair of existing facilities. Second, 

the minor construction program can be implemented more quickly than the longterm major construction program to enhance Veterans’ services. 

In light of the difficult fiscal outlook for our Nation, it’s time to carefully consider VA’s footprint and our real property portfolio. In 2012, VA spent approximately $23 

million to maintain unneeded buildings. Achieving significant reduction in unneeded 

space is a priority for the Administration and VA. To support this priority, the 

President has proposed a Civilian Property Realignment Act (CPRA), which would 

allow agencies like VA to address the competing stakeholder interests, funding 

issues, and red tape that slows down or prevents the Federal Government from disposing of real estate. If enacted by Congress, this process would give VA more flexibility to dispose of property and improve the management of its inventory. 

LEGISLATION

Besides presenting VA’s resource requirements to meet our commitment to the 

Nation’s Veterans, the President’s Budget also requests legislative action that we 

believe will benefit Veterans. There are many worthwhile proposals for your consideration, but let me highlight a few. For improvements to Veterans healthcare, our 

budget includes a measure to allow VA to provide Veterans with alternatives to 

long-stay nursing homes, and enhance VA’s ability to provide transportation services to assist Veterans with accessing VA healthcare services. Our legislative 

proposasl also request that Congress make numerous improvements to VA’s critical 

homelessness programs, including allowing an increased focus on homeless Veterans 

with special needs, including women, those with minor dependents, the chronically 

mentally ill, and the terminally ill. 

We also are putting forward proposals aimed squarely at the disability claims 

backlog—such as establishing standard claims application forms—that are reasonable and thoughtful changes that go hand-in-hand with the ongoing transformation 

and modernization of our disability claims system. We are offering reforms to our 

Specially Adaptive Housing program that will remove rules that in some circumstances can arbitrarily limit the benefit. The budget’s legislative proposals also 

include ideas for expanding and improving services in our national cemeteries. 

Finally, this budget includes provisions that will benefit Veterans and taxpayers 

by allowing for efficiencies and cost savings in VA’s operations—for example, we are 

forwarding a proposal that would require that private health plans treat VA as a 

‘participating provider’—preventing those plans from limiting payments or excluding 

coverage for Veterans’ non-service-connected conditions. VA merits having this status, and the additional revenue will fund medical care for Veterans. We are also 

requesting spending flexibility so that we can more effectively partner with other 

Federal agencies, including DOD, in pursuit of collaborations that will benefit Veterans and Servicemembers and deliver healthcare more efficiently. 

SUMMARY

Veterans stand ready to help rebuild the American middle class and return every 

dollar invested in them by strengthening our Nation. And we, at VA, will continue 

to implement the President’s vision of a 21st century VA, worthy of those who, by 

their service and sacrifice, have kept our Nation free. Thanks to the President’s 

leadership and the solid support of Congress, we have made huge strides in our 

journey to provide all generations of Veterans the best possible care and benefits 

through improved technology that they earned through their selfless service. We are 

committed to continue that journey, even as the numbers of Veterans using VA 

services increase in the coming years, through the responsible use of the resources 

provided in the 2014 budget and 2015 advance appropriations requests. Again, 

thank you for the opportunity to appear before you today and for your steadfast support of our Nation’s Veterans. 

RESPONSE TO POSTHEARING QUESTIONS SUBMITTED BY HON. BERNARD SANDERS TO

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

BENEFITS AND BURIAL PROGRAMS

Question 1. Provide the current performance standards for employees involved 

with the processing of claims. 

Response. Please see attached documents, ‘‘Q1—PMC RVSR Performance Plan,’’ 

‘‘Q1—PMC VSR Performance Plan,’’ ‘‘Q1—RVSR Standard,’’ and ‘‘Q1—VSR Standard.’’ 

26 

[The referenced files, due to their volume, are not being reproduced here.] 

The current performance standards for Veterans Service Representatives (VSR) 

and Rating Veterans Service Representatives (RVSR) are attached. The performance 

standards are based on the employee’s General Schedule grade level. VSRs and 

RVSRs are evaluated based on quality of work, productivity, customer service, workload management, cooperation, and organizational support. Claims processors are 

awarded credit for actions taken to process a claim. 

Question 2. Provide the job titles, grade level and number of FTE assigned to each 

of the services and organizations within the Veterans Benefits Administration as of 

April 1, 2011 and April 1, 2013. 

Response. Please see attachment entitled ‘‘VBA-SVAC-PHQ2FTElist’’ 

[The referenced file, due to its volume, is not being reproduced here.] 

For the purposes of this response, the spreadsheet reflects Full-time Equivalent 

(FTE) rather than individual employees. One FTE is the equivalent of one employee 

working full time. For example, an employee who is scheduled for 80 hours per pay 

period is considered 1 FTE, an employee scheduled for 40 hours per pay period is 

considered .5 FTE, an employee scheduled for 20 hours is considered .25 FTE, and 

so on. It is also important to note that if an office has and is authorized 10 FTE, 

there could theoretically be 20 half time employees to meet the 10 FTE limit. In 

this example, when examining performance output or budget authorizations, it 

would be misleading to note the office has 20 employees since it may be assumed 

the office has 20 full time employees. This accounts for why whole numbers are not 

shown in the spreadsheet. 

Question 3. Provide the number of FTE at each VA regional office, separated by 

job tittle and grade as of April 1, 2011 and April 1, 2013. 

Response. Please see attachment entitled ‘‘VBA-SVAC-PHQ3FTElist’’ 

[The referenced file, due to its volume, is not being reproduced here.] 

For the purposes of this response, the spreadsheet reflects Full-time Equivalent 

(FTE) rather than individual employees. One FTE is the equivalent of one employee 

working full time. For example, an employee who is scheduled for 80 hours per pay 

period is considered 1 FTE, an employee scheduled for 40 hours per pay period is 

considered .5 FTE, an employee scheduled for 20 hours per pay period is considered 

.25 FTE, and so on. It is also important to note that if an office has and is authorized 10 FTE, there could theoretically be 20 half time employees to meet the 10 FTE 

limit. In this example, when examining performance output or budget authorizations, it would be misleading to note the office has 20 employees since it may be 

assumed the office has 20 full time employees. This accounts for why whole numbers are not shown in the spreadsheet. 

Question 4. Provide the methodology utilized to allocate personnel and resources 

to the regional offices. 

Response. Veterans Benefits Administration’s (VBA) Resource Allocation Model 

(RAM) is a systematic approach to distributing field resources each fiscal year. The 

RAM uses a weighted model to assign compensation and pension FTE resources 

based on regional office (RO) workload in rating receipts, rating inventory, non-rating receipts, and appeals receipts. VBA leaders use the model as a guide, making 

some adjustments for special circumstances or missions performed by individual 

ROs. Special missions include the Appeals Management Center, the Records Management Center, Day-One Brokering Centers, IDES processing sites, Benefits Delivery at Discharge sites, Quick Start processing locations, national call centers, fiduciary hubs, pension management centers, etc. Similar workload-based models are 

used for each VBA business line. 

Non-payroll and travel resources are allocated to each RO based on business need. 

RO need is driven by the number of FTE, benefits programs administered by the 

RO, and other factors that are unique to each RO, such as geographic location and 

jurisdiction, facility characteristics, security needs, and workload. 

VBA’s Office of Field Operations works with the Area Offices and ROs to determine resource needs. 

Question 5. As of 2009, VA started updating the VA Schedule for Rating Disabilities yet this budget request includes little information about the status or resources 

necessary to complete this effort. 

a. Provide an itemized list of funding expended in FY 2012 on the rating schedule 

modernization. 

Response. The Department of Veterans Affairs (VA) is in the process of updating 

the VA Schedule for Rating Disabilities (VASRD). As part of this process, members 

of Compensation Service, Regulations Staff hosted multiple public forums to gather 

scientific evidence regarding disabling conditions and their impact on the average 

27 

impairment of earnings capacity. These public forums have also been used as a platform to solicit public input regarding these deliberations. In addition, during these 

forums, working groups were formed to support the ongoing review process. For fiscal year (FY) 2012, the non-payroll expenditures for the VASRD modernization 

project totaled $366,139. The table below shows a breakdown: 

Event Date Expenses 

VASRD FORUM—NYC ............................................ October 11-20 $84,626 

VASRD Forum—NYC .............................................. January 17-26 $52,688 

Travel ..................................................................... FY 2012 $27,467 

Medical consultation contract ............................... FY 2012 $201,358 

TOTAL ................................................... $366,139 

The medical consultation contract provided subject matter expertise to assist with 

medical content relevant to rating disabilities, consult on policy issues and revisions 

to the disability benefits questionnaires, and various other responsibilities. 

b. Provide an itemized list of funding expended in FY 2013 on the rating schedule 

modernization? 

Response. So far in FY 2013, an event focused on mental health disorders was 

held on May 1 and 2, with expenses totaling $4,300, and a meeting focused on skin 

diseases was held from March 28 through April 5, with expenses totaling $2,000. 

VA plans to fund additional VASRD modernization project conferences this year. 

These conferences are needed for the body systems still pending final review and 

revision, which include the musculoskeletal system and mental disorders. The purpose of these work group conferences is to intensify the review process and to expedite research, development, and deliberations within these sections of the VASRD. 

The diverse work group includes medical doctors, psychologists, attorneys, Veterans 

Service Organization representatives, and VA adjudicators. The benefit of these conferences is the generation of more ideas and energizing of the collaborative process 

which is at the heart of the VASRD review. Each conference will require participants to travel, with estimated costs of $12,000 to $15,000. 

VBA medical officers responsible for drafting the VASRD regulations will also 

meet with subject matter experts (SME) to obtain clinical expertise and opinions 

useful in revising the VASRD regulations. The estimated cost for FY 2013 is 

$15,000. 

c. Provide an itemized list of the requested funding in FY 2014 for the rating 

schedule modernization? Also, include the number of FTE assigned to or supporting 

this modernization effort. 

VBA Response: It is anticipated that conferences, travel, and outside consultation 

will be completed in FY 2013. In FY 2014, it is expected that the remaining work 

will be accomplished by VA without travel or outside consultation. VA has $15,000 

in funding in FY 2014 to support any unforeseen travel or conferences. There are 

currently 5 FTE assigned to the VASRD modernization project. 

d. Provide the Project Management Plan, the VASRD Update Operating Plan and 

project schedule for the rating schedule modernization. 

Response. VA is currently expanding the Project Management Plan (PMP) to include a specific addendum that will include milestones, deliverables, and the designation of a sub-program manager who is dedicated to managing any earnings loss 

and validation studies VA undertakes. VA is currently exploring the option of engaging in research partnerships to conduct more than one earnings loss study at a 

time to increase our research capacity. A copy of the updated PMP and operating 

plan as well as the project schedule will be provided when completed. 

e. Provide an itemized list of any funding requested to support IT solutions to 

modernize the rating schedule. 

Response. The VASRD modernization project did not require any IT solutions. 

f. Does the FY 2014 request include any funding to support updates that will need 

to be made to IT solutions, including VBMS, disability benefit questionnaires, rules 

based calculators, or other initiatives based on 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 2014 request does not include funding changes to IT systems 

related to the VASRD modernization project, as Veterans Benefits Management System (VBMS) enhancements will incorporate any VASRD changes. VBMS will continue to be enhanced and additional system capabilities will be released in 3 future 

generations of VBMS that will be deployed over the next 2 years. 

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VA/DOD COLLABORATION

Question 6. According to the FY 2014 budget request, IDES now operates at 139 

military treatment facilities worldwide and is available to all servicemembers who 

are referred to Medical Evaluation Boards. The FY 2014 budget request also noted 

over 30,000 new referrals in 2012. 

a. Provide the amount of funding spent in FY 2012 (both mandatory and discretionary) and how many VA employees were dedicated to the IDES process. 

Response. During FY 2012, VA’s Office of Planning and Policy (OPP) spent ap- proximately $1,074,539, consisting of $467,081 for a program management support 

contract, $577,458 in salary for 5 full-time equivalent employees (FTE), and $30,000 

in travel costs. 

During FY 2012, the Veterans Benefits Administration (VBA) spent approximately $54.8 million for salaries and general operating expenses for 490 FTE dedicated to disability claims processing in the Integrated Disability Evaluation System 

(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. 

The FY 2012 IDES Supplemental Budget distributed to the operational field sites 

supporting IDES was $24.4 million. Staffs located at the VA medical centers 

(VAMC) are not solely dedicated to the IDES process. 

b. Provide the amount of funding spent in FY 2013 (both mandatory and discretionary) and how many VA employees were dedicated to the IDES process. 

Response. During FY 2013, OPP spent approximately $1,336,630 which is comprised of $570,630 for a program management support contract, $741,000 in salary 

for 5 FTE, and $25,000 in travel costs. 

During FY 2013, VBA estimates it will spend approximately $63 million for salaries and general operating expenses to support 580 FTE dedicated to disability 

claims processing in the IDES process. 

The FY 2013 IDES Supplemental budget was $21.6 million. These funds were distributed to the VAMCs in support of IDES. Staffs located at the VAMCs are not 

solely dedicated to the IDES process. 

c. Provide the amount of funding requested in FY 2014 (both mandatory and discretionary) and how many VA employees will be dedicated to the IDES process. 

Response. During FY 2014, OPP estimates it will spend $1,057,458, which is comprised of $450,000 for a program management support contract, $577,458 in salary 

for 5 FTE, and $30,000 in travel costs. 

During FY 2014, VBA estimates it will spend approximately $63.6 million for salaries and general operating expenses to support 580 FTE dedicated to disability 

claims processing in the IDES process. 

For FY 2014, the IDES Supplemental budget request is $18.6 million. Staff located at the VAMCs are not solely dedicated to the IDES process. 

d. What is the methodology used to predict workload for this joint program? Has 

DOD provided information on the anticipated number of referrals that VA can expect the program to receive in FY 2013 and FY14? 

Response. The IDES workload is based solely on the number of referrals made by 

the Military Services; therefore, IDES workload projections are made by DOD. We 

defer to DOD to explain the methodology used in workload predication. VA has requested a 5 year projection from DOD, and DOD is working on that request. The 

anticipated number of referrals for FY 2013 is 32,000 and for FY 2014 is 32,000. 

e. How many referrals has the program received in FY 2013 and how many are 

anticipated for FY14. 

Response. For FY 2013, 19,841 referrals have been received as of May 12, 2013, 

and the anticipated number of referrals for FY 2014 is 32,000. 

f. For each of the 139 military treatment facilities operating IDES, provide performance metrics to include enrollment, outcomes, VA exam utilization rate, timeliness, referred and total conditions, and timeliness for case processing by stage. 

Response. VA is at 116 sites throughout the United States and Puerto Rico. The 

remaining 23 sites are overseas locations. The attached spreadsheet shows the performance metrics for enrollment, referred and total conditions, and timeliness for 

case processing by stage. IDES outcomes are determined by the Military Services 

Physical Evaluation Boards. VBA defers to DOD to provide definitive IDES outcome 

metrics and the exam utilization rate, which is based on the outcome metrics. 

g. How many contract disability examinations were used to support IDES in FY 

2012 and FY 2013 and at which IDES locations? 

Response. In FY 2012, 11,616 VBA contract examinations were completed in support of IDES. In FY 2013 (through May 15, 2013), 7,426 VBA contract examinations 

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have been completed in support of IDES. The attached spreadsheet provides a 

breakdown by location of the contract disability examinations completed so far in 

FY13. 

The Veterans Health Administration (VHA), similar to VBA, has a contract—the 

Disability Examination Management (DEM) Contract, which is used by the VAMCs 

to supplement Compensation & Pension (C&P) examination services. No IDES 

exams were conducted using the DEM Contract in FY 2012. However, 1,116 IDES 

exams were conducted using this contract in FY 2013 through March 2013. Of these, 

661 exams were conducted to directly support IDES locations as described below. 

The remaining examinations were conducted by VAMCs Nation-wide in support of 

the IDES Reserve Component Exams Closest to Home initiative. 

IDES Location Number of Exams 

West Point .................................................................................... 44 

Ft. Bragg/Pope AFB/Camp Lejeune .............................................. 4 

Ft. Riley/Ft. Leavenworth/McConnell AFB/Whiteman ................... 32 

Ft. Hood ........................................................................................ 571 

Ft. Bliss ........................................................................................ 1 

Mountain Home AFB .................................................................... 9 

Total ........................................................................... 661 

Question 7. VA’s Office of VA/DOD Collaboration 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 2013 to streamline the process? 

Response. VA has made the following process improvements in streamlining the 

disability evaluation process: 

• Entry of Physical Evaluation Board (PEB) Decisions in the Veterans Tracking 

Application (VTA)—IDES cases that have completed Secretarial Review are missing 

Disposition and Combat Condition data in VTA. Consistent entry of timely PEB decision information into VTA will improve Benefits Notification process timeliness 

(Implemented). • Ensure cases are ‘‘Ready to Rate’’ before reaching the Disability Rating Activity 

Site (DRAS)—Current IDES case processing requires certain military information 

and/or documentation which ensure cases are ready to rate before forwarding them 

to the DRAS. At times, some of the required information and/or documentation were 

missing. DOD has provided 15 DOD personnel to perform DOD administrative procedures in development teams to assist in increasing the ready to rate inventory 

(Implemented). • Disability Benefits Questionnaire (DBQs)—Currently DBQ’s are used in processing regular disability claims. VA’s move to DBQ’s will increase the efficiency of 

the DRAS operations, assist in reducing the current IDES backlog, reduce the percentage of insufficient medical exams, and provide raters with needed clinical information to effectively complete disability ratings. 

Other identified initiatives in development are as follows: 

One Rating—Current IDES case processing procedures require the DRAS to prepare a rating decision for a case at two separate points in time—Proposed Rating 

and Benefits Notification. Resources expended to complete final rating could be devoted to proposed ratings which will enable timely Benefit Notification and additional resources (information technology changes will have to be made in the claims 

processing system, potential implementation in FY 2014). 

b. What is the status of electronic case file transfer capabilities within IDES? 

Response. Partial IDES case files, minus Service Treatment Records (STRs), are 

already being shared electronically between DOD and VA using DOD’s Safe Access 

File Exchange (SAFE) system. Moreover, DOD and VA have successfully tested a 

new system for electronically sharing IDES case files-to include portions of STRs 

and other non-medical case forms-using the Electronic Case File Transfer (eCFT) 

system, exchanging more than 3,000 case files since the pilot began in September 2012. The eCFT pilot was designed to demonstrate the ability of the Departments to jointly develop and electronically share files that execute various portions 

of the IDES process. 

In January 2013, VA identified additional requirements to establish interoperability between eCFT and VA IT via a data-exchange service. These will satisfy VA’s 

needs to (1) retain electronic copies of case files for legal purposes, and (2) maintain 

30 

the ability to track documents entered into case files on a per member, per document basis. Once these requirements are met, eCFT will replace SAFE. 

To this end, VA and DOD are working together to provide an automated file 

transfer capability that physically moves the files from eCFT to VA systems (i.e., 

the Veterans’ Benefits Management System or VBMS) by way of VA’s Virtual Lifetime Electronic Record Data Access Service (VLER DAS). 

MEDICAL PROGRAMS

Budget Request Assumptions 

Question 8. The President’s budget request includes an increase of 15.4 percent 

for mental health care since 2012, which is a 7.2 percent increase since last year’s 

enacted level. Please explain how VA arrived at this number. Specifically, did VA 

take into account an anticipated increase in enrollment and use of behavioral health 

services that may result from the return of troops from Afghanistan and the 

downsizing of the force? 

Response. The Veterans Health Administration (VHA) places a high priority on 

ensuring that all enrolled Veterans have access to needed mental health services. 

The VA Enrollee Health Care Projection Model (Model), with input from VHA’s Office of Mental Health Services, projected an increase in the utilization of mental 

health services by taking into account several techniques to forecast Veteran enrollee needs for VA mental health services. These techniques include incorporating 

the latest scientific evidence about effective mental health interventions, data analysis of Veteran demographics, access to care data, and trends in service utilization 

projections. The Model projects future demand for mental health services and accounts for the impact of enrollee age, gender, morbidity, the unique utilization patterns of specific cohorts such as Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND), events such as the return of troops from 

Afghanistan, and the downsizing of the force. 

Question 9. Given that VA saw an increase of nearly 150,000 patients between 

2010 and 2011, when the impact of the health insurance coverage requirement in 

the Affordable Care Act coupled with the drawdown of troops in Afghanistan was 

less of a factor, what led VA to estimate that only 100,000 new patients will come 

into VA between 2014 and 2015? 

Response. The year-to-year enrollment and patient projections presented in the 

President’s budget submission represent the net change in projected enrollment and 

patients over the prior fiscal year. VA recognizes that the additional options available under the Affordable Care Act (ACA) may lead some Veterans to choose nonVA providers while other Veterans may enroll with VA for the first time in order 

to satisfy the requirement to have minimum essential coverage. The VA Enrollee 

Health Care Projection Model (EHCPM) accounts for many factors affecting enrollment, such as the drawdown of troops in Afghanistan, mortality, change in demographic mix, morbidity, reliance on the VA health care system, and economic conditions. These factors will affect the net enrollment and patient growth differently 

each fiscal year. The extent to which ACA will impact VA will be closely monitored 

on an ongoing basis. 

Question 10. How did VA determine that an increase of 5.4 percent over the FY 

2013 level for medical services was sufficient? To what extent does this increase 

allow for an expansion of health care treatment options beyond what VA is currently providing? 

Response. VA’s medical care budget is based on an actuarial model (the Enrollee 

Health Care Projection Model) that reflects health care trends within VA and also 

considers health care trends in the broader health care industry. The estimate is 

informed by understanding the demographic changes in the enrolled Veteran population, which is a key factor for projecting future demand for health care services. 

VA’s budget also includes several initiatives for expanding services to Veterans such 

as addressing Veteran homelessness and new models of care, which include Patient 

Aligned Care Teams (PACT), Women’s Health, Special Care Team Based Models, 

and Connected Health. VA’s program offices are actively engaged to ensure that the 

actuarial model reflects continued evolution of VA’s health care delivery system and 

reflects VA’s vision for personalized, proactive, Veteran-centric health care. 

Complementary and Alternative Medicine 

Question 11. How has VA included complementary and alternative medicine 

(CAM) specialists into its health care delivery model? Are clinicians who provide 

these services integrated into VA’s Patient Aligned Care Teams? 

Response. As VHA does not have occupational codes that would allow the hiring 

of CAM providers, almost all CAM delivered within VHA is done by providers with 

31 

allopathic training who have an interest in CAM. Eighty-nine percent of VA facilities offer at least one form of CAM, and these therapies are integrated into traditional VA care. CAM is primarily used for the management of chronic pain and 

mental health disorders and for the promotion of general health and well-being. The 

principles of patient activation and self-management embodied by many CAM activities are very consistent with VA’s health care delivery model which advocates for 

proactive, personalized, and patient-driven care. The issue of chronic disease management, including management of mental health disorders and chronic pain, as 

well as the promotion of healthy lifestyle and behavior modification are a key part 

of the management of Veterans in PACTs. While the clinicians who deliver CAM 

services within VA are not physically part of the PACTs, many of the services they 

provide are ones that would be accessed through PACTs. The providers who deliver 

CAM would be considered part of the PACTs’ resources. 

Question 12. What are individual medical centers doing to promote CAM therapies 

among their patients, including those seeking treatment for behavioral health and 

pain management? 

Response. The main reason cited by individual medical centers for offering CAM 

therapies was to promote wellness, as an adjunct to chronic disease management, 

and because they believed it was consistent with patient preferences. The strategies 

of facilities regarding CAM are variable. Some facilities offer CAM services such as 

Yoga and Tai Chi, which may be accessed directly by Veterans, as well as other 

services which may be accessed via referral from a primary care provider or offered 

by a treating specialist as part of a comprehensive plan of care. According to a 2011 

VHA Survey of Complementary and Alternative Medicine conducted by VHA’s 

Healthcare Analysis and Information Group, the conditions most commonly treated 

with CAM in VA are mental health disorders and chronic pain. Within mental 

health, CAM therapies such as meditation, biofeedback, and guided imagery, while 

not a substitute for conventional therapies, are seen as potentially useful adjuncts 

to care. The potential benefits of CAM therapies as adjuncts to allopathic care are 

a consistent theme within VA. 

For the past 13 months, VHA Primary Care Services and the Office of Patient 

Centered Care and Cultural Transformation have hosted a monthly Integrative 

Medicine Community of Practice conference call. This call has served as a forum to 

spread information and education on Integrative Health and CAM and on the ways 

CAM is being used within VA as well as to create dialog on issues of policy and 

implementation. 

Question 13. Would CAM therapies be more readily available to veterans if clinicians could be hired solely to practice these therapies? 

Response. The lack of allopathic providers with training and expertise in CAM 

does pose a barrier to being able to offer CAM services, as does the lack of CAM 

providers. Further education of our allopathic providers regarding the evidence and 

integration of these practices, as well as the ability to hire CAM providers, would 

likely enhance VA’s ability to provide CAM services. In 2005, the Institute of Medicine published its national report on CAM, and one of the key recommendations was 

that ‘‘health profession schools should incorporate sufficient information about CAM 

into the standard curriculum at the undergraduate, graduate, and postgraduate levels to enable licensed professionals to competently advise their patients about 

CAM.’’ The scope of Integrative Health and CAM is vast, including whole systems 

of medicine and a diverse group of practices and products. As with conventional approaches, those that are best trained and most qualified should be the ones providing the services, which would also make these services more readily available. 

Medical Care Collections 

Question 14. How does VA plan to ensure it meets its budget projection of collecting nearly $3.1 billion for Fiscal Year 2014? 

Response. The Medical Care Collections budget can be broken out into three segments: Medical Care Collection Fund (MCCF) collections, other collections (including 

parking fees, enhanced-use revenue, compensation work therapy, compensation and 

living expenses and makes up $65 million of the FY 2014 budget), and collections 

tied to legislative proposals. The MCCF collections portion accounts for $2.870 billion of the $3.064 billion budget. VA’s plans to ensure that FY 2014 MCCF budget 

projections are met through the following: 

• Consolidated Patient Accounting Centers (CPAC): In FY 2012, VA completed the 

transition of revenue collection activities from individual VA medical centers to 

seven industry-best-practice CPACs. This transition was done one year earlier than 

required under Public Law 110–387. Most critically, CPACs have demonstrated success based on standardized business practices, enhanced employee training and 

32 

greater accountability for results. In order to ensure MCCF collection targets are 

met in FY 2014, VA will continue to focus on improving efficiencies using the CPAC 

model in areas related to people, process and technology. • Payer Relations Activities: VHA continues to aggressively pursue strategies to 

effectively manage relationships with third-party payers. In order to ensure that 

MCCF collection targets are met in FY 2014, VA plans to provide comprehensive 

training to payer relations staff located in each CPAC, implement enhanced denials 

management capabilities and deploy tools to monitor payments versus agreement 

terms and conditions. • Electronic Business Initiatives: In an effort to leverage the health care industry’s migration to national standard electronic data exchanges under the Health Insurance Portability and Accountability Act and to comply with other legal requirements, VHA has put in place electronic business initiatives to add efficiencies to the 

billing and collections processes. In order to meet FY 2014 MCCF collection targets, 

VHA will continue to enhance this capability through expanded utilization of Electronic Data Interchange tools related to insurance verification, electronic billing and 

electronic payments. 

Question 15. To what extent would VA be unable to meet its projected collections 

level if the legislation the Department proposed on this topic does not become law? 

Response. VA has submitted two legislative proposals in the FY 2014 President’s 

Budget that 1) allow for VA to release of patient information to bill health plans 

for non-service-connected care relating to drug abuse, alcoholism, or alcohol abuse 

and 2) require health plans to treat VA as a participating provider, whether or not 

an agreement is in place with the health plan. These two proposals account for $129 

million of the $3.064 billion FY 2014 budget (4%). VA does not anticipate being able 

to achieve this target without these proposals becoming law. 

Affordable Care Act 

Question 16. Veterans enrolled in VA health care are not eligible for tax credits 

established by the Affordable Care Act to assist individuals in paying for health care 

coverage through the Exchange. What is VA doing to inform veterans of this and 

how is VA working with the IRS to determine which veterans will be ineligible for 

the tax credit? 

Response. VA has developed a plan to inform, educate, and engage Veterans, eligible beneficiaries, and other stakeholders about ACA. This plan includes a set of key 

messages that have been incorporated into communications materials addressed to 

Veterans and other beneficiaries. One of these key messages is that enrollment in 

VA health care programs meets the ACA minimum essential coverage (MEC) requirement. VA and the Internal Revenue Service (IRS) collaborated to draft a special provision for Veterans. Under an IRS final rule, individuals who are enrolled 

in specified VA health care programs identified as MEC will not be eligible to receive premium tax credits (with respect to that individual) to purchase coverage 

through the Health Insurance Marketplace. 

VA will inform enrollees that individuals enrolled in specified VA health care programs (i.e., Veterans health care program, VA Civilian Health and Medical Program 

(CHAMPVA), and Spina Bifida health care benefits program) are not eligible for a 

tax credit to purchase additional health insurance coverage. Family members of enrolled Veterans who are not enrolled in specified VA health care programs may still 

be eligible for a tax credit (if they otherwise meet the applicable eligibility criteria) 

to purchase health insurance coverage through the Health Insurance Marketplace 

(formerly known as Health Insurance Exchanges). Similar information will also appear in documents such as fact sheets, frequently asked questions, and language for 

VA social media sites accessible to both enrolled and non-enrolled Veterans and 

other beneficiaries. 

Question 17. Please provide a justification for the amount the President requested 

for compliance with the Affordable Care Act. 

Response. VA has prepared for health reform by examining the key provisions of 

the law, identifying the implications for Veterans and VA, and conducting analyses 

to estimate the potential impact of the law on VA. The Fiscal Year 2014 President’s 

Budget submission reflects the estimated cost impacts due to the current assumption that VA will experience a modest net enrollment increase as a result of ACA. 

VA’s Fiscal Year 2014 budget request included $85 million for the care of the estimated 66,000 new Veterans that VA estimates may choose VA for their health care 

under ACA. VA believes that some Veterans may enroll with VA to satisfy the requirement to have MEC, and other Veterans may disenroll in order to take advantage of the premium tax credit. VA believes that those most likely to enroll or 

disenroll are those Veterans who will have low reliance on VA health care. In addition, the Fiscal Year 2014 VA Information Technology budget includes $3.4 million 

33 

to build functionality needed to deliver statements to enrolled Veterans and beneficiaries enrolled in CHAMPVA and Spina Bifida who maintain MEC through VA. 

This funding will also go toward building the tool to identify and report on individuals who are enrolled in VA health programs identified as MEC. 

Question 18. What is VA doing to address the expected increase in demand for 

primary care services that will be the result of expanded insurance coverage under 

the Affordable Care Act? 

Response. Since the Affordable Care Act’s enactment, VA has been proactive in 

working to understand the law’s impact on Veterans, other beneficiaries, and VA’s 

health care system, and in preparing for implementation of the law. VA will continue to provide eligible Veterans with high quality, comprehensive health care they 

have earned through their service. VA is preparing for ACA implementation with 

a focus on providing personalized, Veteran-centric health care. Ongoing efforts include, for example, developing data tools and coordinating directly with other Federal agencies, including the Department of Health and Human Services. 

Question 19. The President’s Budget requests an additional $19 million for the 

HHS Inspector General for new oversight efforts, including efforts related to the 

ACA. Do you anticipate VA’s Office of Inspector General will require any additional 

funds specific to ACA-related activities? 

Response. Until VA more clearly understands the impact of ACA on its programs 

and operations, it is not possible to determine what OIG efforts will be required. 

Additional funds may be needed when VA is able to provide the OIG with detailed 

plans on ACA’s impact. 

Homeless Veterans 

Question 20. As we pass the halfway point in the Secretary’s five-year plan to end 

homelessness among veterans, is any program realignment necessary to ensure that 

there are no unsheltered homeless veterans by the end of 2015? 

Response. VA’s successes thus far in reducing Veteran homelessness is in part due 

to ongoing program evaluation and realignment in two areas: services and resource 

investments. Finishing the job of ending Veteran homelessness and ensuring there 

are no unsheltered homeless Veterans on our streets will require continued realignment of program resources and continued investment in Veteran-centric permanent 

housing and health programs, including the widespread adoption of evidence-based 

best practices, such as Housing First and critical time intervention case management services. 

Already, VA has realigned its programs and instituted a number of Veteran-centric program innovations and transformations based on a guiding principle: the solution to homelessness is permanent housing with wrap-around supportive services. 

This commitment to permanent supportive housing is best captured by VA’s adherence to a Housing First model. Housing First is an evidence-based approach that 

focuses on helping individuals and families access and sustain permanent housing 

as quickly as possible while providing the necessary health care and other supports 

to help sustain permanent housing and improving the Veteran’s quality of life. VA’s 

service delivery system has become more accessible, community-based, and Veterancentric, with a focus on meeting Veterans where they are and helping them to move 

forward to improve their health and housing stability. Resources focused on rapid 

engagement and placement in permanent housing need to continue to grow to ensure there are no unsheltered Veterans on the street. VA has demonstrated its commitment to properly realigning program services and program investments through 

the Department of Housing and Urban Development-VA Supportive Housing (HUDVASH) Program, Supportive Services for Veteran Families (SSVF) Program, and the 

ongoing transformation of the Grant and Per Diem (GPD) Program. 

The HUD-VASH Program is concrete evidence of VA’s efforts to realign program 

services to successfully end Veteran homelessness. The HUD-VASH Program is 

jointly administered by HUD and VA to provide permanent supportive housing for 

eligible homeless Veterans. Veterans in the HUD-VASH Program receive a HUDprovided Section 8 Housing Choice voucher and VA-provided case management services. Since 2008, a total of 48,385 vouchers have been awarded, and 42,557 formerly 

homeless Veterans are currently in homes because of HUD-VASH. VA’s ongoing 

commitment to the HUD-VASH Program is in keeping with its efforts to realign 

program services under a Housing First permanent supportive housing model. 

The SSVF Program is further evidence of VA’s ongoing efforts to realign program 

services and investments to end Veteran homelessness. Although still a relatively 

new program, it is already clear that the SSVF Program has been an enormous success. The SSVF Program provides grants to private non-profit organizations and 

consumer cooperatives to help Veteran families rapidly exit homelessness or to assist Veterans at-risk of homelessness. The SSVF Program is unique in that it can 

34 

serve both the Veteran and his or her family member(s) and continues VA’s efforts 

to realign services under a Housing First permanent supportive housing model. In 

fiscal year (FY) 2012, during the SSVF Program’s first full year of operations, SSVF 

surpassed expectations, serving approximately 21,500 Veterans and a total of over 

35,000 persons. Of those served, 40 percent were at-risk for homelessness and seeking prevention services while the remaining 60 percent were provided rapid re-housing services to transition from homelessness into permanent housing. At the end of 

FY 2012, VA awarded 151 SSVF grants in 49 states and the District of Columbia 

for operations in FY 2013. In recognition that this community-based resource needed to be more geographically available to all communities assisting Veterans and 

their families, VA recently announced an FY 2013 SSVF Notice of Funding Availability (NOFA) for an additional $300 million to further grow this program. 

Additionally, VA’s recent efforts to transform the GPD Program provides further 

evidence of VA’s commitment to the realignment of program services and investments. As VA advances its realignment efforts focused on a community-based, Veteran-centric permanent supportive housing, VA expects that the demand for transitional housing will be less intense. In recognition of the decreased demand for transitional housing, the GPD Program is already working with a new model utilizing 

the principles of Housing First and focused on facilitating permanent supportive 

housing, GPD Transition in Place (TIP). In FY 2012, VA awarded approximately 

$28.4 million in grants to provide capital funding for transitional housing projects. 

Thirty-one of the funded projects were GPD TIP, which will provide time-limited 

wrap-around supportive services to homeless Veterans housed in apartment style 

housing, in which the services transition but the Veteran remains in the housing. 

GPD TIP provides an opportunity to realign traditional transitional housing services 

with VA’s preferred permanent supportive housing model. 

To increase and enhance efforts at housing unsheltered homeless, VA is working 

with community-based agencies to realign efforts at targeting vulnerable unsheltered homeless Veterans. For example, some local VA medical centers have started 

partnering with local homeless Continuums of Care (CoC) to conduct local ‘‘Registry 

Weeks.’’ A Registry Week is a concept used to develop an accurate registry of the 

needs of individuals/Veterans who are permanently, or frequently, living on the 

street. Volunteers are recruited and trained to reach out to unsheltered homeless 

individuals and survey them in an effort to collect valuable information that will 

help connect them to the appropriate housing and services. Those identified as the 

most vulnerable (physical and behavioral health conditions that are serious) are 

prioritized for available permanent housing and support. Local VA medical centers 

have also teamed with local homeless CoCs and other local community-based organizations to evaluate and realign system processes through Rapid Results Boot 

Camps. A Rapid Results Boot Camp is a full-day event designed to train service providers who are already helping homeless Veterans in their communities to learn 

new and more efficient ways to house Veterans and provide them with the services 

they need. Teams of representatives from VA, public housing authorities, local governments, and other agencies who work with homeless Veterans attend and participate in the Boot Camps. Boot Camps help communities to improve their processes 

in order to decrease the amount of time it takes a homeless Veteran to leave the 

streets and enter into permanent housing. 

VA has had significant and measurable success in VA’s Plan to End Veteran 

Homelessness. Based on HUD’s Point in Time (PIT) Count, from 2009 to 2012, the 

number of Veterans experiencing homelessness on a single night in January has decreased 17.2 percent (from 75,609 to 62,619). Furthermore, these reductions in Veteran homelessness took place in a challenging economic period. 

In conclusion, VA has made significant and measurable success in ending Veteran 

homelessness. VA must continue to focus its efforts on housing unsheltered homeless Veterans. The key to success is a continued and increased investment in the 

HUD-VASH and SSVF Programs, continued focus on the principles of Housing 

First, and effective and ongoing realignment of program services and resources nationally and at the local level. 

Question 21. While homelessness is generally an urban phenomenon, it is important to recognize that homelessness also occurs in rural areas, albeit generally in 

the form of overcrowding or substandard housing. What specific actions is VA taking 

to ensure that the housing needs of rural veterans are also being met? 

Response. VA has taken decisive action to eliminate Veteran homelessness in both 

urban and rural areas. VA’s ongoing prevention, transitional housing, and permanent supportive housing programs provide wide-ranging services in rural areas. VA 

realizes the importance of reaching the rural homeless Veteran population. Rural 

homeless persons are often referred to as the ‘‘hidden homeless’’ as many of these 

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ings not intended for human habitation. Much of the rural at-risk homeless population reside in substandard housing or are doubled up in temporary housing arrangements. Additionally, rural community-based homeless service providers often 

lack adequate capacity and infrastructure to address rural homelessness. 

The SSVF Program provides grant funding for private non-profit organizations 

and consumer cooperatives to assist Veterans and their families with preventive 

supportive services. Of those grants awarded in FY 2011 for operations conducted 

in FY 2012, approximately 5 percent of the SSVF grants serve Veteran families in 

rural areas exclusively while an additional 32 percent of grants serve a mix of rural 

and urban areas. In FY 2012, VA awarded funding for operations in FY 2013. Approximately 10 percent of the community agency grantees provide services exclusively in rural areas. Additionally, over 45 percent of these grantees included a 

rural component in their services. VA is expanding access to services both by increasing available resources and by specifically targeting rural areas. In the past 

year, VA has increased funding available through its SSVF grant program from 

$100 million to $300 million. Additionally, the FY 2013 SSVF NOFA lists ‘‘Veteran 

families located in a rural area’’ as one of the target populations for SSVF funding. 

Community agencies funded under VA’s Homeless Providers GPD Program provide transitional housing for Veterans who are homeless. In FY 2012, 16.8 percent 

of those GPD Programs were in rural areas. As of April 2013, 26.6 percent of those 

GPD Programs indicated that they provided transitional housing for Veterans in 

rural areas. 

VA’s HUD-VASH Program offers homeless Veterans permanent housing opportunities through Section 8 vouchers, linked with wrap-around VA case management 

services. Vouchers are distributed through Public Housing Authorities in both urban 

and rural areas. From FY 2008 to FY 2012, HUD allocated approximately 11 percent of the approximately 48,000 HUD-VASH vouchers to rural areas, awarding a 

total of 5,260 vouchers to rural areas. VA expects HUD to announce the allocation 

of an additional 10,000 vouchers for FY 2013 and expects a similar proportion of 

these additional vouchers to serve rural areas. 

Finally, VA understands that the rural homeless Veteran population has pressing 

and unique needs. To that end, VA continues to explore the potential use of videoteleconferencing and related technologies in the care of rural homeless Veterans. 

Connecting people through technology can reduce costly and inconvenient travel and 

prevent isolation for remote staff and Veterans. 

Question 22. The FY 2014 budget request notes that over 3,000 veterans were enrolled in H-PACTS in 2012 and that enrollment was associated with greater health 

outcomes. Please provide more specific data on what type of outcomes improved and 

how care improved. 

Response. The Homeless Patient Aligned Care Team (H-PACT) initiative is a pilot 

program that provides integrated homeless program support and primary care to 

homeless Veterans. Teams integrate a housing agenda with providing care for the 

ongoing and evolving medical, mental health, and substance abuse needs of homeless Veterans coming into the system. The goal is to create a ‘‘medical home’’ tailored to the needs of homeless Veterans that reduces unnecessary trips to the emergency department for care; assists in addressing chronic medical, mental health, and 

substance abuse treatment needs; and integrates homeless program staff to expedite 

housing placement and reduce recidivism. Enrollment in the H-PACT program has 

consistently been associated with high volume use of primary care, mental health, 

and specialty care outpatient services. Homeless Veterans enrolled in H-PACT have 

shown reductions in inpatient hospitalizations and emergency department visits. 

While national data is not available on H-PACT program clinical performance, published site-specific data (Providence VA Medical Center (VAMC): American Journal 

of Public Health 2010, American Journal of Public Heath 2013 (publication forthcoming)) has demonstrated improvements in chronic disease (diabetes, hypertension, 

hyperlipidemia) monitoring and management, as well as accelerated placement in 

permanent housing among Veterans enrolled in the H-PACT program. 

Through September 2012, approximately 3,549 Veterans were enrolled in an HPACT program. Of those enrolled, approximately 40.6 percent have shown a reduction in emergency department use and a 32.3 percent reduction in inpatient hospitalizations. Data from the Providence VAMC has shown 80.7 percent of homeless 

Veterans enrolled in an H-PACT program moved into transitional or permanent 

supportive housing within 6 months and demonstrated significant improvements in 

blood pressure and cholesterol management. 

The H-PACT model has already shown considerable promise with preliminary 

data from early May 2013 showing 5,691 enrolled H-PACT patients nationwide. HPACT sites average approximately 350 new patients each month with an 86 percent 

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ance of H-PACTs, VA is considering further resource realignment to fund additional 

H-PACT sites in FY 2014. 

Question 23. CRRCs are critical to ending homelessness among veterans. The FY 

2014 budget request states that ‘‘based on demonstrated positive contribution to the 

community, additional CRRC investment is anticipated in FY 2013 and FY 2014.’’ 

Please describe the level of additional investment anticipated in each fiscal year, 

and the locations that may be considered for placement of additional CRRCs. 

Response. Community Resource and Referral Centers (CRRC) are collaborative, 

multi-agency, multi-disciplinary programs that provide ‘‘one-stop shopping’’ access to 

housing, health care, job development programs, and other VA and non-VA benefits. 

In FY 2013, an additional 13 medical centers across the country were awarded funding to establish CRRCs. Two of these sites will become operational in FY 2014. The 

total funding for 28 of 30 CRRCs in FY 2013 will amount to approximately $23 million. All 28 sites will continue operations in FY 2014 along with two new sites that 

will activate in FY 2014. At an estimated annual cost of $1 million per site, the total 

estimated FY 2014 cost is $30 million. CRRC costs include lease, staffing costs, and 

supply costs. 

Although specific locations for future CRRCs have not been determined, additional 

sites for CRRCs may be selected as the budget allows in FY 2014. VA medical centers will be encouraged to apply for the placement of a CRRC upon announcement 

of a Request for Proposals. In the event funding is available, potential future sites 

will be chosen through selection criteria including: documentation of need, homeless 

Veteran population, services offered, support from the local VA medical center, and 

community support. 

Veterans Canteen Service 

Question 24. What is VA doing to ensure that everyone who is eligible to make 

purchases in person at Veterans Canteen Service (VCS) retail locations can do so 

via the VCS online exchange store? 

Response. Working with internal/external stakeholders, Veterans Canteen Service 

(VCS) has placed special emphasis on outreach initiatives to eligible patrons communicating the benefits of VCS services. VCS’ Online Exchange Catalog validates 

eligible patrons through VA’s enrolled Veterans and active employee database. 

Additional initiatives include: 

• VA’s Health Benefits Office Veterans Benefit Handbook includes VCS Online 

Exchange Catalog Program and 1–800 Special Order Program information. Since 

February 2013, approximately 1.5 million copies have been mailed to Veterans. The 

Veteran Identification Card (VIC) will include information about VCS shopping benefits, and Veterans will be able to directly access the VCS Web site from the Health 

Benefits Web site. 

• eBenefits will host a promotional graphic with the VCS Online Exchange Catalog Program on its homepage carousel. This will take place in September 2013. 

• Veterans Integrated Service Network (VISN) Newsletters and booklets include 

the VCS Online Shopping program. VISN newsletters are electronically sent to Veterans and VA employees. As an incentive, VCS provides coupons placed in newsletters and in some Community Living Centers’ (CLC) booklets to be used at the 

retail stores. 

• VCS conducts sale events at community-based outpatient clinics (CBOC) on a 

scheduled basis. These operations do not have traditional retail/food operations. VCS 

flyers and Exchange Catalogs are offered to patrons informing them of online shopping benefits and opportunities with VCS. 

• VCS uses ‘‘eBlasts’’ (e-mail) to send information periodically to patrons about 

new VCS programs and online shopping benefits. The list includes 97,000 VA employees and 2,000 Veterans. VCS ran a promotion through July 2013 to sign up Veterans to the eBlast program. VCS accumulated 6,870 new e-mail addresses to include in our national eBlast promotions schedule. Veterans that signed up for the 

promotion were also registered into a drawing to win prizes for their participation. 

Winners were notified and visited the VCS Patriot Store to claim their prize. In addition, VCS has increased the e-mail list for VA employees from 97,000 to 101,368 

since June 2013. 

Question 25. The FY 2014 budget details an anticipated increase of 50 FTE for 

the Veterans Canteen Service (VCS). Please describe how VCS plans to use these 

FTE, and where VA anticipates that they will be located. 

Response. Veterans Canteen service (VCS) will open 30 PatriotBrew Coffee Shops 

as well as eight food/retail combo operations located in CBOCs and VBA sites. Additional full-time employees (FTE) will be secured to operate and maintain services 

at these locations. 

37 

Question 26. How is VCS working to improve the profitability of underperforming 

locations? 

Response. VCS has initiated a ‘‘deep-dive’’ assessment of the underperforming operations. This will include analysis of current business models for small, class 4/5 

operations; business metrics assessment (gross margins, retail turns, personnel cost 

increase, FTE/productivity goals, supply chain, retail turns, retail/food/vending promotions, overhead costs, leadership skill sets and core competencies, etc.) to ascertain cause/effect correlations involving successful/unsuccessful operating canteens; 

and the development of aspirational goals and/or new business models to facilitate 

improved sales and earnings for these operations. This assessment and supporting 

action plans were completed in July 2013. Financial reports for August 2013 indicate that 70 percent of the targeted canteens showed improvement in operating income and other metrics. Monthly financial results are addressed directly with targeted operations to ascertain progress toward defined aspirational goals. 

Question 27. Is VA considering any expansion of the healthy vending initiative? 

Response. VCS currently provides healthy vending machines at 10 percent of VA 

medical centers. These units offer a variety of organic, gluten free, and healthy food/ 

beverage options. VCS expects to increase the presence of healthy vending machines 

by 60 percent by the end of fiscal year 2013. This will include VA medical centers, 

CBOCs, and Veterans Benefits Administration locations. 

In 2012, VCS increased the assortment of healthy vending snack options across 

the country. The assortment includes low fat and low calorie selections. These additions produced a 25-percent sales increase over the previous selections and have 

been well received by customers. This fiscal year, VCS will double its healthy choice 

options available from existing food and snack machines to include freshly prepared 

salads, sandwiches, fruits, and vegetables as well as organic and gluten free products. 

Miscellaneous 

Question 28. Given that VA generally pays for non-VA care at the Medicare rate, 

does VA have plans to reduce reimbursement rates, since Medicare is subject to a 

2 percent cut and has reduced repayment rates by that percentage? 

Response. If the services are under contract, VA will continue to honor the contractual reimbursement rate. Likewise, for services that VA reimburses under the 

applicable Medicare Fee Schedule when there is no contract, VA payments would 

continue to reflect Medicare Fee Schedule rates, as only Medicare final payment 

amounts—not Medicare Fee Schedule rates—are affected by the sequester. 

Question 29. Please provide documentation to illustrate the mental health staffing 

model that VA uses to determine the target number of mental health staff at each 

facility. 

Response. VA has developed and is implementing staffing guidance for general 

outpatient mental health programs per 1,000 Veterans using mental health services. 

VA does not yet have a staffing model that determines the target number of mental 

health staff for the whole facility. VA has previously developed a staffing model for 

the Residential Rehabilitation Programs that is based on the number of beds in the 

program. The general outpatient mental health model’s clinical staffing ratio is as 

follows: 

Employee Category FTEE for Mental Health (MH) Team 

Panel Size of 1,000 

Total MH Clinician: Licensed Independent Providers (LIP) ........................................................ 5.1–5.5 

Admin. Clerical Support ............................................................................................................. 0.5–1 

Non-LIPs ..................................................................................................................................... 1 

Total FTEE ................................................................................................................. 6.6–7.5 

The ‘‘Total MH Clinician’’ full-time equivalent employee (FTEE) refers primarily 

to LIPs (e.g., psychiatrists, psychologists, social workers, nurse practitioners, physician assistants, clinical nurse specialists, licensed marriage and family therapists, 

and licensed professional mental health counselors) and certain Doctors of Pharmacy (Pharm.D.) with residency and board certification in psychiatric pharmacy 

while the non-LIPs refer to providers such as Registered Nurses (RN), addiction 

therapists, and peer support staff. The ‘‘Admin. Clerical Support’’ is the administrative and/or clerical FTEE needed to support the mental health providers on the 

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mately 6.6–7.5 FTEE will be responsible for the mental health care of 1,000 Veterans. 

Under Section 729 of the National Defense Authorization Act for Fiscal Year 

2013, VA is currently developing guidance to determine the staffing level required 

for specialty mental health outpatient programs per 1,000 Veterans. Finally, VA will 

develop guidance for acute inpatient programs. Actual staffing at facilities will be 

based on the types of programs available at the facilities and adjusted for local factors such as use of telemental health programs and non-VA contracts. 

Question 30. To the extent that there has been a study completed within the last 

few years on the nutritional content of food available at VA medical centers, please 

provide a brief summary of the study’s findings as well as a copy of the report. 

Response. The automated version of the nutrient analysis data of VA medical center diets began in FY 2002 for Veteran patients. The total calories, fat, cholesterol, 

and sodium are decreasing. The sodium content of meals has decreased by 1500 milligrams since FY 2002 with the average FY 2012 content at approximately 3100 milligrams of sodium per day. VA medical centers offer modified diets to meet the 

needs of inpatient Veterans, including Diabetic/Carbohydrate Controlled, Renal, and 

others that are specific to our patient population. In 2010, VHA’s Nutrition and 

Food Services published VHA Directive 2010–007, Healthy Diet Guidelines, to improve the Regular Diet offered in all VA medical centers: www.va.gov/ 

vhapublications/ViewPublication.asp?pub—ID=2167. 

Subsequent to the release of VHA Directive 2010–007, Healthy Diet Guidelines, 

the sodium, fat, and cholesterol contents of our meals reached their lowest average 

since 2002. A copy of the data report is provided as an attachment below. 

Nutritional Analysis of Patient Hospital Menus 

FY 2005 FY 2006 FY 2007 FY 2008 FY 2009 FY 2010 FY 2011 FY 2012 

Average Calories ................................. 2442 2444 2427 2383 2433 2387 2304 2271 

Average Percentage Protein ................ 16.9 17 17.2 17.3 17 17.1 18 18.8 

Average Percentage Carbohydrate ...... 49.9 50.3 50.3 49.9 49.8 52.57 51 51.1 

Average Percentage Fat ...................... 33.3 33.5 32.5 32.7 32.3 32.3 31 30 

Average Milligrams Sodium ................ 4293 4167 3911 4068 4003 3688 3250 3165 

Average Milligrams Cholesterol .......... 377 369 358 364 386 378 308 361 

Question 31. Please provide the amount VA spent on outreach during fiscal year 

2012 and the estimate for how much will be spent during fiscal year 2013. 

Response. The Office of Public and Intergovernmental Affairs’ (OPIA) National 

Veterans Outreach Office (NVO) spent approximately $600,000.00 on outreach during Fiscal Year 2012. This amount was expended for message development and production of creative material for an integrated advertising campaign. The goal of this 

campaign was to inform and educate Veterans, their families, and other stakeholders about the health care, benefits and services VA provides and eligibility 

based on their service. 

During FY 2013, OPIA will spend approximately $1,600,000.00 on costs related 

to a national advertising campaign led by the Ad Council. Ad Council is collaborating with DDB, an award winning advertising agency, to produce the campaign. 

DDB is providing pro bono advertising services. By working with the Ad Council 

and DDB, VA is receiving advertising support from a world class advertising agency, 

which represents approximately $35,000,000.00 worth of savings for the government. These professional services will continue national VA outreach efforts to increase awareness among Veterans and family members regarding the breadth of VA 

benefits and services available to them and how to access them. 

CONSTRUCTION AND LONG RANGE CAPITAL PLAN

Question 32. Please provide a list of priority weights for the major criteria and 

sub criteria used to inform the FY 2014 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 FY 2014 Strategic Capital Investment Plan. 

39 

The decision criteria are Improve Safety and Security, Fixing What We Have; Increasing Access; Right-Sizing Inventory; Ensure Value of Investment; and Departmental Initiatives. 

The details of each major criterion are listed below: 

• Improve Safety and Security: VA is dedicated to ensuring its Clients (Veterans) 

and Customers (VA Staff) are being served and/or work in a safe and secure environment. Mitigating the destruction and injury caused by natural or manmade disasters (including seismic, hurricane, flooding, blast, etc.); improving compliance with 

safety and security laws, building codes, and regulations; mitigating threats to persons on a VA facility (physical security), and ensuring VA mission critical buildings 

are able to provide service in the wake of a catastrophic event, are of paramount 

importance. • Fixing What We Have (making the most of current infrastructure/extending useful life): VA is committed to managing its buildings in order minimize the extent 

to which deficiencies in infrastructure (including IT infrastructure) and other areas 

impact the delivery of benefits and services to Veterans. For infrastructure deficiencies, facility condition assessments (FCA) evaluate the condition of VA buildings. 

Mitigating other deficiencies (such as functional deficiencies and privacy deficiencies) also has a positive impact on the delivery of benefits and services. • Increasing Access: Serving Veterans is at the core of VA’s mission. VA strives 

to increase access for Veterans by reducing the time and distance a Veteran must 

travel to receive the best quality services and benefits; providing adequate supporting structures at VA facilities, such as gravesite locators; by increasing our ability to handle workload; and by enabling VA staff to work efficiently. 

• Right-Sizing Inventory: In order to provide the highest quality service to Veterans at the right time and in the right place, VA is managing its space inventory 

by reducing excess space, building new space, collocating (VHA, VBA, NCA, and 

Staff Offices using the vacant or underutilized space of another office), leasing new 

space, and converting underutilized space of one type to another type, to better suit 

its mission. 

• Ensure Value of Investment: As a steward of the public’s trust, VA is responsible 

for making capital investments in the most cost-effective way possible by ensuring 

new capital investments optimize operating and maintenance costs, in order to create the best value. 

• Departmental Initiatives: For improved management and performance across 

the Department, capital projects should contribute to key major (such as eliminating 

Veterans homelessness; improving Veterans mental health; enable 21st century benefits, etc.) and supporting initiatives (such as educating and empowering minority 


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and women Veterans; enabling 21st century vocational rehabilitation and employment; expanding Veterans access to burial options in National or State Veterans 

cemeteries) from the Department’s strategic plan, including DOD collaboration and 

complying with energy standards established in law and Executive Orders. 

Question 33. VA has identified over $9 billion in facility condition deficiencies to 

remediate, and a total of $54–66 billion in facility improvements that have been requested over the next ten years. In light of several successful partnerships to share 

space with community providers, what type of considerations are being made regarding the use of these means to close this gap with fewer appropriated dollars? 

Response. Generally speaking, assets that have significant conditions to remediate 

are often poor candidates for sharing of space. The risk associated with significant 

deficiencies must be mitigated prior to engaging with community partners or other 

Federal agencies to share such space. This mitigation falls on VA and would require 

appropriated funding. 

For assets that have some deficiencies, but are otherwise in usable condition, VA 

has had success using public-private partnerships. In these cases, VA is able to leverage non-appropriated funds to address the condition deficiencies of certain assets. 

VA has used its enhanced-use lease (EUL) authority to repurpose and restore unneeded assets, using private funding, in support of housing homeless Veterans and 

delivering complementary services at local VA medical centers. Since the EUL program was authorized in 1991, VA has awarded 100 projects. These projects include 

housing (57), special services for Veterans (3), consolidation/improved VA operations 

(14), energy (4), and mixed-use/community benefit (14). Eight of the 100 projects 

have been terminated. 

VA’s current EUL authority, a narrow version to that which existed before expiration on December 31, 2011, only allows re-purposing assets for supportive housing, 

which limits the type of partnerships and assets that can be pursued. A restoration 

of VA’s full EUL authority, as requested in the FY 2014 President’s Budget, would 

allow additional assets to be considered for re-purposing. 

Other VA authorities, such as sharing agreements or joint ventures with DOD 

have also assisted in meeting some of its condition or space needs. These arrangements, however, generally still require appropriated funding, although they may be 

shared across agencies. One example of this is the Captain James A. Lovell Federal 

Health Care Center in North Chicago, Illinois, where VA and DOD operate the center jointly. 

Question 34. The budget requests authorization to proceed with 27 major medical 

facility leases in 18 states. For each, please detail the following: 

a. When the existing facility will close, if the request is for a replacement, consolidation, or expansion lease. 

b. The number of unique veterans that will not be able to access care, if the request is for a replacement, consolidation, or expansion lease. 

c. The effect that pursuing each alternative to lease would have on the patient 

population or the ability to provide care. 

Response. The attached document contains information responsive to questions 34 

a–c for each of the 27 major medical facilities requiring Congressional authorization. 

The attached information was previously transmitted to the Committee on June 4, 

2013, and was current at the time of submission. 

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d. Tables analyzing the costs of alternatives to leasing that were considered. 

Response. In response to question 34.d, the Department provides tables [below] 

analyzing the total life cycle cost of the alternatives to the 2013 and 2014 major 

medical facility leases. 


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Question 35. Please provide national quantity and cost data for purchased utilities 

at VHA facilities, to include water, electricity, gas, and sewage for FY 2010 through 

FY12. 

Response. The below tables detail the cost and consumption data for purchased 

utilities at VHA facilities for FY 2010 through FY 2012. 

Question 36. Please provide national quantity and cost data for waste disposal, 

divided by category to include general, regulated medical, hazardous chemical, etc. 

for FY 2010 through FY12. 

Response. The following attachment is the Waste Management and Compliance 

data that provides the national quality and cost data for waste disposal, divided by 

category to include general, regulated medical, hazardous chemical, etc. for FY 2010 

and FY 2011. VHA is finalizing FY 2012 as part of our roll out and implementation 

of the new VHA real time waste management and cost avoidance web based tracking system developed by Practice GreenHealth (PGH). 


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Question 37. The FY 2014 budget request commits to improving the functionality 

of VA’s national utility metering data collection and analysis system. What type of 

improvements is the Department planning to make? 

Response. In FY 2014, VA will continue to build on its successful metering program by improving the functionality of its data reporting and analysis capability. 

Both electric and non-electric (water, natural gas, etc.) information will be more visible and useful across VA from facility managers to policymakers. System enhancements will help ensure the capture and display of key data from meters around the 

country, allowing better evaluation of facility performance to reduce energy use. 

VA’s capability to respond quickly and accurately to information requests and perform annual reporting will be improved. Additionally, VA will pursue avenues to 

more cost-effectively add, maintain, and modify meter installations across the Department. 

Specific areas of improvement include: 

• VA will add meters to fill gaps that have been identified or created since past 

meter installations 

• VA will begin linking meter data into local facility management systems 

• VA will create additional capacity to use historical information to guide current 

operations—currently VA has limited ways to use historical information 

• VA will develop new analysis capability on existing data to improve local, regional, and national decisionmaking 

INFORMATION TECHNOLOGY PROGRAMS

Question 38. The President’s Budget requests $344 million for the Interagency 

Program Office (IPO) to support the integrated electronic health record project. 

Please describe the assumptions used to arrive at this estimate, and how the IPO 

plans to use this funding, given that the Department of Defense is still making a 

decision regarding the core technology they will use for this initiative. 

Response. The budget request for FY 2014 is based on the Lifecycle Cost Estimate 

and will support the following major iEHR efforts: 

• Identify Management 

• Access Control Services 

• Immunization 

• Laboratory 

• Pharmacy 

• Presentation Services 

• Service-Oriented Architecture (SOA) Suite Enterprise Service Bus (ESB) 

Question 39. Please provide documentation to detail estimated savings through 

ideas generated by the Ruthless Reduction Task Force. 

OIT Response: The Ruthless Reduction Task Force (RRTF) was established to 

identify opportunities for cost avoidance and to help VA focus resources on access, 

benefits and homelessness. Over 60 projects have been identified under RRTF that 

would result in an estimated total cost avoidance of $2.5 billion. Below is a more 

in depth breakdown of the cost avoidance, inclusive of approximate cost avoidance 

for pending and active projects. 

• Total Estimated Cost Avoidance: $2.5 billion 

• Total Estimated Cost Avoidance for Pending Projects: $2.166 billion 

– Total Estimated Cost Avoidance to harmonize identity management and access control across VA: $1.7 billion 


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– Note: A ‘‘pending project’’ is defined as a project for which a plan of action 

and milestones (PoAM) idea scope is still being defined, or one that is awaiting 

development of the PoAM slide deck or else assignment of a project manager 

(PM.) • Total Estimated Cost Avoidance for Active Projects: $340 million 

– Note: An ‘‘active project’’ is defined as a project for which a PoAM has been 

developed and to which a PM has been assigned 

Question 40. In FY 2014, how much does VA anticipate spending to improve the 

Department’s Section 508 compliance? 

Response. Making VA accessible for all Veterans, beneficiaries, and employees is 

important not only because it is the law, but because it is the right thing to do. Previously, VA’s Section 508 IT compliance efforts were divided between OIT’s ‘‘Section 

508 Program Office’’ and VHA’s ‘‘Health 508 Office.’’ 

In FY 2014, all Section 508 efforts will be centralized within OIT. The combined 

Federal IT staff on this endeavor will amount to 11 FTE. 

The President’s FY 2014 budget request includes $11.9 million for VA’s Section 

508 program. This funding will cover: 

• Contracted resources to support the development and execution of Section 508- 

related training for developers, testers, and non-technical staff • Testing support services to (1) bring new software into compliance with Section 

508 requirements, and (2) audit existing Section 508-compliant software to ensure 

that it remains compliant • Maintenance of hardware and software that is used to test IT systems for Section 508 compliance • Development of an enterprise-wide approach to bringing all VA SharePoint repositories into compliance with Section 508 requirements 

RESPONSE TO POSTHEARING QUESTIONS SUBMITTED BY HON. RICHARD BURR TO

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

GENERAL

Question 41. In the Department of Veterans Affairs (VA) 2012 Performance and 

Accountability Report (PAR), VA indicated that it has ‘‘developed and executed a 

plan to reduce the cost associated with activities covered in [Executive Order 13589, 

Promoting Efficient Spending].’’ VA also indicated that, for 2012, it ‘‘exceeded its 

spending reduction target of $173.4 million by an additional $69 million.’’ 

A. Please provide the Committee with a copy of the plan that was developed in 

response to the Executive Order. 

[The referenced files, due to their volume, are not being reproduced here.] 

B. Please outline where those spending reductions were realized and what was 

done with the funds that were saved through those reductions. 

Response. Spending reductions were realized in the categories of travel, supplies 

and materials, printing, employee information technology (IT) devices, and management support contracts. Realized savings were used for: 

• Over-time hours for compensation claims processing staff to support the reduction of the benefits claim backlog; • Non-recurring maintenance projects to improve the health care environment; • Critical infrastructure and life cycle refresh for existing IT equipment to support current and new VA staff; and 

• Additional health care-related equipment purchases. 

Question 42. In response to questions about VA’s fiscal year 2013 budget request, 

VA indicated that, at the end of fiscal year 2011, there was $1.2 billion in outstanding delinquent debt owed to VA, of which $732 million was created in connection with VA benefit payments. VA also indicated that, during fiscal year 2011, VA 

wrote off or waived $247 million of debts to VA. 

A. What was the total amount of outstanding delinquent debt at the end of fiscal 

year 2012? 

Response. At the end of FY 2012, VA reported $3.7 billion in outstanding debt. 

B. What portion of that amount was debt created in connection with VA benefit 

payments? 

Response. At the end of FY 2012, VA reported $1.6 billion in outstanding benefit 

debt. 

C. What is the total value of debts for which VA waived recoupment during fiscal 

year 2012 and what is the total value of debts that were written off during fiscal 

year 2012? 

77 

Response. In FY 2012, VA waived debts totaling $116,167,896 and wrote-off debts totaling $85,194,153. 

D. During fiscal year 2013, how much new debt does VA project will be established? 

Response. For FY 2013, VA estimates new benefit debts of $1.2 billion. 

E. During fiscal year 2014, how much new debt does VA project will be established? 

Response. For FY 2014, VA estimates new benefit debts of $1.3 billion 

Question 43. In response to questions regarding VA’s fiscal year 2013 budget re- quest, VA indicated that approximately $305 million in mandatory funding would 

be used to pay for non-direct benefits. 

A. Does that figure include any amounts spent on contract vocational and educational counseling? Response. The $6 million from the Readjustments Benefits account authorized for 

contract vocational and educational counseling is a benefit to Veterans and is therefore not included in the $305 million total for non-direct benefits. The $305 million 

in mandatory funding used to pay for non-direct benefits includes funding for: equal 

access to Justice Act payments, medical examination payments, and income 

verification matching (38 United States Code (U.S.C.) § 5317) from the Compensation and Pensions (C&P) account. This also includes: reporting fees, State Approving 

Agencies, reimbursements to the General Operating Expense account as authorized 

under Public Laws (P.L.) 101–237 and 105–368, and reimbursements to the Office 

of Information Technology account as authorized under P.L.s 106–419, 108–454, and 

112–56 from the Readjustments Benefits account. 

B. For fiscal year 2014, please identify how much in mandatory funding will be 

spent on non-direct benefits and how those funds would be spent. Response. For FY 2014, VA expects to spend $285.3 million in mandatory funding 

on non-direct benefits. Below is a detailed breakdown of the requested funding: 

Compensation and Pension ($000s) 

Medical Exams ........................................................................... $231,376 

Equal Access to Justice Act ....................................................... $11,768 

Income Verification Matching .................................................... $9,232 

C&P Total .......................................................................... $252,376 

Readjustment Benefits ($000s) 

State Approving Agencies .......................................................... $19,000 

Reporting Fees ............................................................................ $13,308 

Reimbursement to GOE .............................................................. $568 

RB Total ...................................................................................... $32,876 

TOTAL ................................................................................. $285,252 

C. Are any mandatory funds expected to be spent to hire contractors? If so, please 

specify the amount(s) and purpose(s). 

Response. In accordance with Section 504 of the Veterans’ Benefits Improvement 

Act of 1996, Public Law 104–275, VA is authorized to pay for contracting of disability evaluation examinations from the C&P account. In FY 2014, VA estimates 

this amount to be $231.4 million. 

Also, section 3697 of title 38 U.S.C, authorizes VA to use $6 million from the Readjustment Benefits account to pay for educational or vocational counseling services 

obtained by VA by contract for Veterans applying for or receiving Education or Vocational Rehabilitation and Employment benefits. 

Additionally, under section 3674 of title 38 U.S.C., VA is authorized to reimburse 

State Approving Agencies up to $19 million from the Readjustment Benefits account. This funding is for the reasonable and necessary salary, travel, and administrative expenses incurred by employees of the State Approving Agencies in carrying 

out contracts or agreements entered into with VA for the purpose of ascertaining 

the qualifications of educational institutions for furnishing courses of education to 

eligible persons or Veterans. 

D. 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 VA to pay the expenses of carrying out certain income verification matching activities with the mandatory C&P 

78 

appropriation. Accordingly, the C&P appropriation reimburses the General Operating Expenses (GOE) account and the Office of Information Technology account for 

administrative costs associated with verification of eligibility for the pension program through income verification matching. The FY 2014 reimbursement to the 

GOE account is estimated to be $8.4 million, which will be used to support 97 FTE. 

Reimbursement to the Office of Information Technology in FY 2014 is estimated to 

be $110,000, which will be used to support 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. Historically, VA appropriations 

acts have provided that the mandatory C&P appropriation is the source of funding 

for the pilot program for disability examinations. Accordingly, the C&P appropriation has reimbursed the the GOE account for the purposes of conducting a pilot program to contract disability evaluation examinations of claimants for benefits administered through VBA. The FY 2014 reimbursement amount is estimated to be $2.1 

million, which will support 25 FTE. 

Question 44. This budget would cut VA central office (VACO) funding by 5 percent; however, the offices that comprise VACO would realize an increase of 106 fulltime equivalents (FTE) if this budget were adopted. During the budget rollout on 

April 10, 2013, VA responded to a question inquiring about the contradiction of an 

increase in FTE and a funding decrease 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 3,334 staff requested in the fiscal year 2014 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.). 

Response. The 3,334 staff represent the FTE level funded within the General Administration (GenAd) account in the President’s FY 2014 budget request. A total of 

76 GenAd FTE are reimbursed by the Supply Fund for services provided (62 FTE 

in the Office of General Counsel, 7 in the Office of Business Oversight, and 7 in 

the Office of Acquisitions, Logistics and Construction). None of the 3,334 FTE are 

direct Supply Fund or Franchise Fund employees. The 106 FTE increase reflected 

in GenAd represent staff being hired during the later stages of FY 2013 which will 

be fully annualized in FY 2014. The on-board FTE at the beginning of the fiscal 

year is not expected to change significantly over the course of the year. 

The 106 FTE consists of 31 FTE from budget authority (BA) and 75 FTE from 

reimbursable authority (RA). They are primarily funded through VA’s Human Capital Investment Plan (RA), VA’s Identify Credentials Management Program (RA), 

and VA’s enterprise-wide facilities transformation efforts (BA and RA). 

B. Please provide the Committee with a detailed description of the heading ‘‘reimbursement.’’ Please include 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. The reimbursement process for VA’s GenAd account occurs when one 

office provides a service that benefits another office, and the office receiving the 

service reimburses the providing office for the cost of that service. Authority to provide reimbursements is allowed under the Economy Act (31 United States Code 

(U.S.C.) § 1535), Account Adjustment Statute (31 U.S.C. § 1534), or other specific authority, including appropriations language. In many instances, these authorities are 

utilized to ‘‘pool’’ funds to pay for products or services that benefit more than one 

appropriation. VA charges the benefiting appropriations amounts that are commensurate with the value received by their staff office(s) and/or Administrations. 

Authorized reimbursements are requested through the Office of Management and 

Budget apportionment process. Of the 3,334 FTE requested in FY 2014, 1,067 are 

reimbursable FTE in the GenAd account. Of this total, 76 GenAd FTE are reimbursed by the Supply Fund for services provided directly to the Fund (62 FTE in 

the Office of General Counsel for legal services provided to the Fund; 7 FTE in the 

Office of Business Oversight for logistics reviews for the Fund; and 7 FTE in the 

Office of Acquisition, Logistics, and Construction for management oversight of the 

Fund). Below is a description of the reimbursable programs and FTE (if applicable) 

performed within the GenAd account. 

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OFFICE OF THE SECRETARY

Office of Employment Discrimination Complaint Adjudication (OEDCA)—FTE: 24 

OEDCA has statutory authority to collect reimbursements for costs incurred to 

carry out its operations. Historically, an administrative provision in the annual appropriations act has provided that VA customers may reimburse OEDCA for services provided, see, e.g., section 210 of title II of division E of section 2 of the Consolidated and Further Continuing Appropriations Act, 2013 (Public Law 113–6). 

OEDCA is an independent office responsible for issuing final agency decisions and 

orders on the merits of employment discrimination complaints filed by employees. 

OEDCA is also responsible for determining equitable relief and issuing final agency 

decisions on a complainant’s entitlement for compensatory damages and attorney’s 

fees if the complainant is the prevailing party. OEDCA collects funding from the 

customers it services. 

Leading Executives Driving Government Excellence (EDGE)—FTE: 3 

The President’s Management Council initiated Leading EDGE to: 1) inspire a 

seamless and powerful senior executive corps with shared governmentwide identity 

and vision; 2) craft solutions that have impact across agencies; and 3) reignite the 

highest ideals of public service. To achieve these objectives, Leading EDGE employs 

five integrated learning components: workshops, leadership assessments, government performance projects, executive coaching, and a Web portal for increased 

cross-agency networking and problem-solving. In FY 2012, the program’s first year, 

15 Federal Government departments (totaling over 150 individual bureaus) reimbursed VA to participate in Leading EDGE. 

OFFICE OF GENERAL COUNSEL (OGC)

OGC receives reimbursement for legal services it provides where authorized by 

statute. 

MSCA Medical Support and Compliance Account—FTE: 63 

Public Law 101–508 MSCA (formally Medical Care Collection Fund (MCCF)) 

The Budget Reconciliation Act of 1990, Public Law 101–508, established the Medical Care Cost Recovery Revolving Fund (MCCF). VA medical centers receive the 

funds collected through the MCCF program and may use those funds for direct patient care. The reimbursement OGC receives for its collection efforts, as authorized 

by 38 U.S.C. § 1729A(c)(1)(B), enables it to provide legal services related to the recovery of reasonable charges from third parties (health insurance companies, workers compensation plans, no-fault automobile insurance carriers, and third-party 

tortfeasors) that are legally responsible for paying for medical care and services provided to Veterans. In addition, the Medical Support and Compliance Appropriations 

Account has traditionally contained specific language that provides that the account 

is available to fund ‘‘legal expenses of the Department for collecting and recovering 

amounts owed the Department as authorized under chapter 17 of title 38, United 

States Code, and the Federal Medical Care Recovery Act.’’ See Public Law 113–6, 

the Consolidated and Further Continuing Appropriations Act, 2013. Through OGC’s 

services in this program, VA has collected over $260 million which it returned to 

VA medical centers for providing care to Veterans. 

Credit Reform—FTE: 41 

The Federal Credit Reform Act (FCRA) states that ‘‘[a]ll funding for an agency’s 

administration of a direct loan or loan guarantee program shall be displayed as distinct and separately identified subaccounts within the same budget account as the 

program’s cost’’ (emphasis added). Generally, the FCRA requires a fund established 

for a credit program to have two types of accounts. One is a program account that 

records administrative expenses and disburses the subsidy cost to the financing cost, 

and the other is a financing account that records all of the cash-flows resulting from 

direct loans or loan guarantees (It disburses loans, collects repayments and fees, 

makes claim payments, holds balances, borrows from Treasury, and earns or pays 

interest.). 

OGC provides legal services under the FCRA and receives reimbursement from 

the following two programs’ accounts as authorized by law: 

Veterans Housing Program: OGC provides legal services related to the origination 

and liquidation of guaranteed loans and to the acquisition and sale of properties acquired as a result of guaranteed loans that are foreclosed. 

Native American Housing Program: OGC provides legal services regarding the negotiation of memoranda of understanding with tribal governments, the origination 

80 

and liquidation of Native American Direct Loans (NADL), and the acquisition and 

sale of properties acquired as a result of NADL loans that are foreclosed. 

Supply Fund Contract Attorneys and Staff—FTE: 62 

OGC personnel provide direct contract support regarding all legal aspects of Supply Fund procurements, including defending the Department against protests, and 

are reimbursed by the Revolving Supply Fund. Section 8121 of title 38, U.S.C., authorizes VA to use the Supply Fund to cover ‘‘all expenses necessary’’ for the operation and maintenance of a supply system. 

Veterans Canteen Service (VCS)—FTE: 1 

The employee is under the supervision of the OGC Regional Counsel and the Assistant Regional Counsel in St. Louis, Missouri, where the VCS has its headquarters. The attorney provides advice and representation in administrative hearings and court proceedings as it pertains to employee/labor relations and Equal Employment Opportunity matters and acts as a liaison with personnel from other OGC 

regions who perform representational tasks involving VCS personnel and operations. Section 7804 of title 38, U.S.C., authorizes VA to use the Veterans Canteen 

Service Revolving Fund to cover administrative and operating expenses of the VCS. 

Veterans Administration Law Enforcement Training Center (LETC)—FTE: <1 

OGC provides reimbursable legal services from an attorney, part-time, to LETC 

to plan, coordinate, develop, and teach courses in legal aspects related to the field 

of law enforcement. LETC is a Franchise Fund entity that is authorized to collect 

fees for services provided and to use such fees to cover the total costs of providing 

such services. 

Enhanced-Use Lease (EUL)—FTE: <1 

OGC provides legal support to VA’s Office of Asset Enterprise Management 

(OAEM), which administers VA’s EUL program. VA’s EUL program, codified at 38 

U.S.C. §§ 8161–8169, authorizes VA to out-lease underutilized and vacant real property to lessees for terms of up to 75 years. In return, the lessees develop and operate 

the out-leased real property consistent with the EUL statute (which is currently 

limited to providing eligible Veterans and non-Veterans with ‘‘supportive housing,’’ 

as defined in 38 U.S.C. § 8161(3)) and provide VA with negotiated consideration (i.e., 

in-kind consideration and/or cash, depending upon when the underlying EUL was 

executed). VA’s EUL policy is contained in VA Directive and Handbook 7415. Section 8165 of title 38 U.S.C. authorizes the Secretary to use the proceeds from any 

EUL to reimburse applicable appropriations of the Department for any expenses incurred in the development of additional EULs. Notably, per Chapter 8, paragraph 

3 of the Handbook (copied below), OAEM may charge a ‘‘reimbursement fee’’ for 

EUL projects that involve VA receiving cash lease consideration. This fee is charged 

to reimburse OAEM and OGC for their direct and indirect project-related expenses 

associated with negotiating and administering the underlying EUL. 

EU Reimbursement Policy and Procedures. Each executed EU lease project managed by OAEM may be subject to a reimbursement fee to be charged against the 

proceeds from the project. This charge is designed to reimburse OGC and OAEM 

for direct and indirect project-related expenses associated with planning, developing, 

executing, managing and providing legal advice and services for the respective EU 

project, transactions and lease. This fee is not to exceed reasonable VA expenses. 

Construction Facility Management (CFM)—FTE: 6 

OGC attorneys review and comment on legal issues associated with the Office of 

Acquisition, Logistics, and Construction (OALC) and CFM major construction and 

real property projects located throughout the country. The attorneys are solely dedicated to OALC/CFM work and are supported through funding reprogrammed from 

CFM within the GenAd account. At least one will support OALC/CFM major leasing 

projects. The attorneys who will support the OALC/CFM major construction program will be assigned to the major projects in Denver, Colorado; Orlando, Florida; 

New Orleans, Louisiana; and Palo Alto, California. Additionally, the attorneys will 

assist with the remaining projects in the Western, Central, and Eastern Regions, 

as well as the National Region, which supports the National Cemetery Administration (NCA). OALC/CFM initiated this arrangement of direct legal support to assist 

in the expedient resolution of legal issues associated with major construction and 

leasing projects. 

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OFFICE OF MANAGEMENT

Defense Finance and Accounting Service (DFAS)—FTE: 0 

The Office of Finance within the Office of Management has an Inter-Agency 

Agreement with DFAS to process VA’s payroll and leave and earnings statements. 

Obligations are incurred and managed centrally, and VA offices reimburse the Office 

of Management for their share of the costs. No FTE are reimbursed. 

Office of Business Oversight (OBO)—Veterans Health Administration (VHA)—FTE: 

20 

OBO receives reimbursements from VHA to support OBO personnel in conducting 

expense and revenue reviews that ensure VHA field facilities comply with existing 

financial rules, regulations, and policies and assure the quality of VHA fiscal information. 

OBO—Supply Fund—FTE: 7 

OBO collects funding from the Supply Fund to cover expenses for OBO logistics 

reviews of the Supply Fund to ensure VHA field stations and VA Central Office organizations comply with existing rules, regulations, and policies. 

OBO—A–123—FTE: 4 

OBO personnel conduct and test reviews of internal controls of financial reporting 

as required by Office of Management and Budget Circular A–123 at VA facilities. 

The VA organizations that contribute funding toward these reviews are VHA, the 

Veterans Benefits Administration (VBA), NCA, and Office of Information and Technology. 

OAEM—Green Management—FTE: 5 

OAEM receives reimbursement from VHA for support of the VA Green Management Program at VHA field facilities. The portfolio managers support the Department’s initiative, Establish Enterprise Energy Cost Reduction and Implement VAwide Greenhouse Gas Initiative to Address VA’s Carbon Footprint—Greening VA. 

These professionals assist OAEM in managing the Green Management Program and 

meeting its performance and reporting mandates. 

OAEM—Building Utilization Review and Repurposing (BURR)—FTE: 3 

OAEM receives reimbursement from VHA for support it provides to eliminate Veteran homelessness through VA’s EUL program. Another initiative, BURR, uses VA’s 

EUL program through public/private partnerships to leverage VA’s vacant and underutilized buildings and land nationwide to provide housing for Veterans and their 

families who are homeless or at-risk of homelessness. 

Office of Management—VA Center of Innovation (VACI)—FTE: 0 

The VACI program taps the talent and expertise of individuals inside and outside 

of government to innovate and improve Veterans access to services, lower costs, improve quality, and enhance the performance of VA operations. The offices receiving 

the benefits and services provide reimbursement to support any contractual costs 

and operating expenses. 

OFFICE OF HUMAN RESOURCES AND ADMINISTRATION (HRA)

Human Capital Investment Plan (HCIP)—FTE: 298 

The HCIP includes VA’s Learning University and focuses on the development of 

VA’s workforce through enterprise-wide training. This is accomplished by leadership 

training, workforce competency training, Veteran hiring efforts, employee wellness, 

and the Corporate Senior Executive Management Office. HCIP program costs are 

funded by each program office through reimbursements to HRA on a pro-rata FTE 

basis. 

Office of Resolution Management (ORM)—FTE: 267 

Historically, an administrative provision in the annual appropriations act has provided that VA customers may reimburse ORM for services provided, see, e.g., section 210 of title II of division E of section 2 of the Consolidated and Further Continuing Appropriations Act, 2013 (Public Law 113–6). ORM promotes a discrimination-free work environment focused on serving Veterans by preventing, resolving, 

and processing Equal Employment Opportunity discrimination complaints and providing Alternative Dispute Resolution services as required by law. Each office’s costs 

are proportionate to the number of employees that use the services across the entire 

VA system. 

82 

VA Child Care Subsidy Program (CCSP)—FTE: 0 

VA CCSP is a nationwide program that assists lower income VA employees 

(household income of less than $59,999 per year) with the cost of child care. There 

are over 2,000 VA employee participants who receive child care services and receive 

a subsidy. Reimbursement is strictly for the costs of the program. 

VA Central Office Services—FTE: 20 

The Office of Administration (O/A) provides numerous services for the VA Central 

Office campus. O/A houses the simplified acquisitions staff which processes all procurement and acquisition requests for purchases under a threshold of $150,000 for 

VA organizations in 11 buildings throughout the National Capital Region. Funding 

supports acquisitions, labor support, and warehouse staff. O/A manages the National Transit Benefits Program Office which administers the transit benefits program for VA nationwide. Funds cover the salaries and benefits of the National Transit Benefits Program Office. O/A oversees the contract of the health units which provides health care services to VA Central Office employees in designated buildings 

and maintains the VA Central Office fitness center. The costs support the contract 

and personnel who manage the contract. O/A has a contract to transport VA Central 

Office employees across campus during duty hours. 

OFFICE OF POLICY AND PLANNING (OPP)

Enterprise Data Contracts—FTE: 0 

OPP requires three types of contract support to be the authoritative organization 

for data governance, Veterans’ statistics, statistical analysis, and modeling to manage the Department’s business intelligence tools and processes and to manage VA 

resources for developing interactive mapping tools and products. The three contracts 

will enhance data collection reporting and analysis capabilities while providing 

standards and guidelines for corporate-level business intelligence program management. A major contract for OPP is data-mining, which acquires Veteran demographics to supplement existing VA data sources. The integrated data will be used 

by VA to conduct statistical research and analysis, develop predictive models, and 

conduct outreach to Veterans. The offices that receive the data and analysis and 

benefit from these services reimburse OPP for these contracts. 

Secretary’s Carey Awards Program—FTE: 0 

The Secretary of Veterans Affairs’ Robert W. Carey Performance Excellence 

Award is an annual award that recognizes organizations within the Department 

that have implemented management approaches that result in sustained high levels 

of performance and service to the Veterans we serve. OPP’s Enterprise Program 

Management Office, executor of the Carey Awards Program, uses award criteria 

aligned with the Malcolm Baldrige Criteria for Performance Excellence. These criteria are nationally recognized as a framework and standard for organizational excellence. VHA, VBA, and NCA provide funding for contractor support to train personnel to understand the Baldrige criteria in order to develop application packages, 

provide support to Carey examiners during consensus week, provide technical editing support, and provide feedback to applicants for continuous improvement purposes. 

OFFICE OF OPERATIONS, SECURITY, AND PREPAREDNESS (OSP)

Identity, Credential and Access Management Program (ICAM)—FTE: 30 

A new program in FY 2014, ICAM, along with the ongoing transformation initiative of Continuous Readiness in Information Security (CRISP), will strengthen VA’s 

security by sharing information on the character and conduct of VA employees during the on-boarding, station code or inter-Department transfer, or off-boarding processes, consistent with Privacy Act requirements, VA Privacy Policy, and collective 

bargaining agreements where applicable. Each program office reimburses OSP for 

its share of the costs of this program. 

Personal Identity Verification (PIV) Card—FTE: 0 

Costs reflect procurement, distribution, and management support related to 

Homeland Security Presidential Directive—12 PIV cards and consumables for the 

Department. Each VA office reimburses OSP for its share of the PIV cards and 

consumables. 

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OFFICE OF PUBLIC AND INTERGOVERNMENTAL AFFAIRS (OPIA)

Homeless Veterans Initiative Office (HVIO)—FTE: 15 

OPIA’s HVIO provides policy development, interagency coordination, and public/ 

community engagement in collaboration with VHA, which is responsible for the operation and clinical implementation of eliminating homelessness among Veterans. 

VHA provides reimbursement to fund this initiative. 

OFFICE OF ACQUISITION, LOGISTICS, AND CONSTRUCTION (OALC)

Consistent with appropriation language (see, e.g., Public Law 113–6, the Consolidated and Further Continuing Appropriations Act, 2013), OALC receives funding 

from the Major Construction and VHA Medical Facilities appropriations to cover 

costs for resident engineers who provide on-site supervision of VA’s Major Construction projects and for VHA lease projects located throughout the country. 

OALC also receives reimbursement for FTE from NCA and the Supply Fund to 

cover the costs of the work and services related to those programs. In all circumstances, funding will cover employee costs including salary and benefits, training, travel, permanent change of station expenses, contracts, and other associated 

costs of these programs. Additional detail is below: 

• Reimbursement for on-site resident engineers—187 FTE from Major Construction, as authorized in appropriation language; 

• Reimbursement for proportionate share of OALC management support provided 

from the Supply Fund—7 FTE; and 

• Reimbursement for NCA Real Property Land Acquisitions/Actions support—2 

FTE. 

READJUSTMENT BENEFITS

Question 45. One item that VA pays for using mandatory funding is reporting fees 

provided to educational institutions. In response to questions about the fiscal year 

2013 budget request, VA indicated that information was not available for 2011 regarding the number of institutions that received reporting fees from VA or the size 

of those payments. 

A. Is that information now available regarding 2011 reporting fees? If so, please 

provide the number of institutions that received reporting fees, the 10 largest payments made to an institution, and the 10 smallest payments made to an institution. 

Response. VA paid 9,557 educational institutions a total of $9,370,303 in reporting 

fees in calendar year 2011. The tables below show the institutions with the 10 largest and 10 smallest total payment amounts. 

SCHOOL NAME 

Largest Reporting Fee Amounts 

for Calendar Year 2011 

(in $’s) 

University of Phoenix (Online) ........................................................................................................ 230,317 .00 

American Public University System (American Military University) ............................................... 109,697 .00 

University of Maryland University College ..................................................................................... 65,313 .00 

Grantham University ....................................................................................................................... 60,696 .00 

Kaplan University ........................................................................................................................... 58,707 .00 

Central Texas College ..................................................................................................................... 45,947 .00 

Columbia Southern University ........................................................................................................ 41,257 .00 

University of Phoenix (San Diego) .................................................................................................. 39,424 .00 

Florida State College at Jacksonville ............................................................................................. 39,085 .00 

DeVry University Online .................................................................................................................. 38,530 .00 

SCHOOL NAME 

Smallest Reporting Fee Amounts 

for Calendar Year 2011 

(in $’s) 

A and B Training Academy ............................................................................................................ 7.00 

A Head of Time Design Academy ................................................................................................... 7.00 

A Step Ahead Academy and Salon ................................................................................................ 7.00 

A T E of Texas Inc., DBA American Fly .......................................................................................... 7.00 

A.B. Training Center, LLC ............................................................................................................... 7.00 

Abrams College (CHAPTER 31) ...................................................................................................... 7.00 

Academy of Acadiana—New Iberia ............................................................................................... 7.00 

Academy of Cosmetology ................................................................................................................ 7.00 

84 

SCHOOL NAME 

Smallest Reporting Fee Amounts 

for Calendar Year 2011 

(in $’s) 

Academy of Equine Dentistry(CHAPTER 31) ................................................................................... 7.00 

Academy of Hair Design ................................................................................................................. 7.00 

1,046 other institutions ................................................................................................................. 7.00 

B. Is that information available regarding reporting fees paid in 2012? If so, 

please provide that information. 

Response. VA paid 10,578 educational institutions a total of $10,442,799 in reporting fees in calendar year 2012. The tables below show the institutions with the 10 

largest and 10 smallest total payment amounts. 

SCHOOL NAME 

Largest Gross Payments 

in Calendar Year 2012 (in $’s) 

University of Phoenix (Online) .................................................................................................................. 339,132 .00 

American Public University System (American Military University) ......................................................... 169,596 .00 

Ashford University (Online) ...................................................................................................................... 143,835 .00 

University of Maryland University College ............................................................................................... 91,740 .00 

Liberty University ...................................................................................................................................... 79,119 .00 

Grantham University ................................................................................................................................. 75,600 .00 

Kaplan University ..................................................................................................................................... 72,060 .00 

Columbia Southern University .................................................................................................................. 59,076 .00 

Central Texas College ............................................................................................................................... 55,752 .00 

University of Phoenix (San Diego) ............................................................................................................ 51,372 .00 

SCHOOL NAME 

Smallest Gross Payments 

in Calendar Year 2012 (in $’s) 

Louisiana Technical College—Shreveport ............................................................................................... 12.00 

YogaMotion—Center for Holistic Education ............................................................................................ 12.00 

Yoga Yoga Teacher Training .................................................................................................................... 12.00 

Yoga Connection, The ............................................................................................................................... 12.00 

Yale University School of Medicine—School of Public Health ................................................................ 12.00

Yale University School of Drama ............................................................................................................. 12.00 

Xtra-mile Driver Training, Inc. (CHAPTER 31 ONLY) ............................................................................... 12.00 

Xenon International Academy—Grand Island ......................................................................................... 12.00 

Xenon International Academy ................................................................................................................... 12.00 

Wyzsza Szkola Komunikacji I Zarzadania ................................................................................................ 12.00 

Question 46. The fiscal year 2014 budget request reflects that VA now expects to 

spend $4,764,000 from readjustment benefits in fiscal year 2013 for 

‘‘[r]eimbursement to [General Operating Expenses] and [Information and Technology],’’ which is $4,226,000 more than VA had originally projected would be spent 

in fiscal year 2013 for that purpose. The budget submission also reflects that, in fiscal year 2014, VA expects to spend $568,000 for that purpose. 

A. Please provide an itemized list of how that $4.8 million is now expected to be 

spent during fiscal year 2013. 

Response. Please see the following chart: 

Readjustment Benefits FY 2013 

($000s) Authority 

Reimbursements to GOE 

Information Pamphlets on Education Benefits ......................................................... $234 PL 101-237: sec 421 

Education Outreach Letters ...................................................................................... $304 PL 105-368: sec 206 

Reimbursements to IT 

Licensing and Certification System Start-Up Funds ................................................ $158 PL 106-419: sec 121 

Computer System Modifications for Apprenticeship and OJT .................................. $2,189 PL 108-454: sec 104 

Veterans Retraining Assistance Program (VRAP) IT Expenses ................................. $1,880 PL 112-56: sec 211 

85 

Readjustment Benefits FY 2013 

($000s) Authority 

Total Reimbursements .......................................................................................... $4,764 

B. Please explain the specific changes that led to this expected increase during 

fiscal year 2013. 

Response. The increases in the FY 2013 current estimate are a result of available 

funds carried over from FY 2012 to FY 2013 for reimbursements to the Office of 

Information and Technology. At the time the following laws were passed, $3 million 

was made available for Licensing and Certification systems under Pub. L. 106–419; 

$3 million was made available for Apprenticeship and on-job training (OJT) systems 

under Pub. L. 108–454; and $2 million was made available for VRAP systems under 

Pub. L. 112–56. Each fiscal year, the remaining unused funds are still available for 

the intended purpose identified in law. The increase for FY 2013 reflects the remaining funds being carried over for obligation during FY 2013. 

C. Please provide an itemized list of how these funds are expected to be spent during fiscal year 2014. 

Response. Please see the following chart: 

Readjustment Benefits FY 2014 

($000s) Authority 

Reimbursements to GOE 

Information Pamphlets on Education Benefits .......................................................... $248 PL 101-237: sec 421 

Education Outreach Letters ........................................................................................ $320 PL 105-368: sec 206 

Reimbursements to IT 

Licensing and Certification System Start-Up Funds .................................................. $0 PL 106-419: sec 121 

Computer System Modifications for Apprenticeship and OJT .................................... $0 PL 108-454: sec 104 

Veterans Retraining Assistance Program (VRAP) IT Expenses .................................. $0 PL 112-56: sec 211 

Total Reimbursements ............................................................................................ $568 * 

* Assuming funds associated with PL 106-419, PL 108-454, and PL 112-56 are obligated in FY 2013, the remaining $568 thousand is 

budgeted to carry out the authority provided by PL 101-237 and PL 105-368. 

Question 47. In the fiscal year 2014 budget request, VA proposes legislation to increase funding for ‘‘contract vocational and educational counseling’’ for certain veterans or members of the Armed Forces. 

A. In fiscal year 2012, how many individuals requested this type of counseling, 

how many individuals were provided with this type of counseling, and how much 

in total was spent to provide counseling to those individuals? 

Response. Please see table below showing FY 2012 data: 

Total Veteran 

Requests for Ch. 36 

Completed with 

Counseling 

Completed by 

Vocational Rehabilitation and 

Employment (VR&E) Staff 

Completed by 

Contractor 

Ed Voc Funding for 

Contractor Services 

15,513 5,341 271 5,070 $1,853,640.95 

* Requests which are not completed with counseling include those that are pending completion, as well as those that did not attend their 

required counseling appointments despite follow-up outreach attempts. 

B. In fiscal year 2013, how many individuals are expected to seek this type of 

counseling, how many individuals are expected to be provided with this counseling, 

and how much in total is expected to be spent on these counseling services? 

Response. Please see table below showing FY 2013 data: 

Total Veteran 

Requests for Ch. 36 Still Pending Completed with Counseling 

Completed by 

VR&E Staff 

Completed by 

Contractor 

Ed Voc Funding for 

Contractor Services 

14,322 1,193 5,585 279 5,306 $2,089,792.93 

FY 2013 estimates are based on the assumption that 60 percent of the year is 

complete, which equates to 60 percent of annual demand. Part of the decrease in 

Veteran requests is caused by the National Defense Authorization Act (NDAA) and 

VR&E counselors at Integrated Disability Evaluation System (IDES) installations 

accelerating Servicemembers into the Chapter 31 program. Veterans with serviceconnected disabilities who received Chapter 36 counseling often also became eligible 

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for and enrolled in the Chapter 31 program. As a result of NDAA accelerating eligibility and entitlement to Chapter 31 services, transitioning Servicemembers going 

through the IDES are receiving counseling under Chapter 31 instead of under Chapter 36. 

C. In fiscal year 2014, how many individuals are expected to seek this type of 

counseling? 

Response. In FY 2014, VA estimates there will be a total of 15,754 Veterans requesting Chapter 36 counseling. FY 2014 estimates are 10 percent above FY 2013 

projections due to anticipated increases in Veteran requests through mandatory 

TAP, increased outreach to eligible Veterans using Post-9/11 GI Bill, and VOW/VEI 

efforts. 

Question 48. In the fiscal year 2014 budget request, VA proposes legislation to 

permanently authorize work-study activities for which authorization is currently set 

to expire 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. 

A. During fiscal year 2012, how many individuals participated in each of those 

work-study activities. 

Response. The following table shows how many individuals participated in each 

of those work-study activities: 

Category Work-Study Students 

for FY 2012 

SAA Outreach ...................................................................... 11 

National Veteran Cemetery ................................................. 106 

State Veteran Cemetery ...................................................... 19 

VA State Homes .................................................................. 166 

Total .................................................................. 302 

B. To date, during fiscal year 2013, how many individuals have participated in 

each of those work-study activities? 

Response. Since VA collects work-study statistics at the end of each fiscal year, 

data for FY 2013 is not yet available. 

C. Please describe the resources required to administer this portion of the workstudy program. 

Response. VA does not anticipate any additional administrative costs associated 

with permanent authorization of this program. 

Question 49. The Honoring America’s Veterans and Caring for Camp Lejeune 

Families Act of 2012 provided a temporary expansion of eligibility for specially 

adapted housing for certain veterans with disabilities causing difficulty with ambulating. 

A. How many veterans have qualified for this expansion? 

Response. VA claims examiners are processing claims for benefits under Section 

202 of P.L. 112–154. VA does not track the status and disposition of claims for benefits under Section 202 of P.L. 112–154 separately from other claims. Also, due to 

the recent implementation of this law, VA has not yet compiled data related to this 

temporary expansion. 

VA notes that the law specifies that assistance under certain provisions of Section 

202 of P.L. 112–154 may only be furnished for applications approved on or before 

the sunset date (September 30, 2013). Because approval of a Specially Adapted 

Housing (SAH) grant is a two-step process, in order for a Veteran or Servicemember 

to be qualified for benefits under those provisions of Section 202, the individual 

must receive a medical rating from VA of eligibility for SAH grant benefits, as well 

as a determination of site feasibility and suitability by VA to ensure the home can 

be adapted to meet the individual’s needs. For a Veteran or Servicemember to receive benefits authorized by those provisions, both the medical rating and the site 

feasibility and suitability determination would need to be completed on or prior to 

the expiration date of the provisions (September 30, 2013). 

In the fourth quarter of FY 2013, VA will be conducting a manual count of Veterans and Servicemembers who have been medically rated eligible for Section 202 

benefits and who have begun the process of site feasibility and suitability to obtain 

actual data. VA will be happy to provide this information to SVAC upon conclusion 

of the count. VA is also researching options for a system enhancement to the Specially Adapted Housing/Special Housing Adaptation (SAHSHA) system, which would 

87 

allow SAH staff to flag and report on in-process grants associated with Section 202 

eligibility. 

B. How many houses have been adapted using this authority? 

Response. VA is unable to provide the requested figures at this time. Upon conclusion of the fourth quarter of FY 2013 manual count, VA will provide more information to the Committee. 

C. What is the average cost and the total cost per veteran of those who qualified 

and used the expansion? 

Response. VA is unable to provide the requested figures at this time; however, 

please note that each eligible Veteran may receive a grant of up to $63,780.00. Upon 

conclusion of the fourth quarter of FY 2013 manual count, VA will provide additional information to the Committee. 

VETERANS BENEFITS ADMINISTRATION

Disability Compensation 

Question 50. In January 2013, VA sent to Congress a strategic plan for eliminating the backlog that projected VA would decide 1.6 million claims in fiscal year 

2014. Less than three months later, VA submitted its budget request, which projects 

that VA will decide 1.3 million claims in fiscal year 2014. 

A. What specific performance metrics did VA assess in lowering this projection 

and what did they show? 

Response. The projections of received and completed claims in VA’s Strategic Plan 

to Eliminate the Compensation Claims Backlog, submitted to Congress on January 25, 2013, were based on assumptions made earlier in the budget cycle that included a higher level of claims receipts and FTE than is reflected in the 2014 VA 

Budget Submission. VA revised its projections prior to submission of the FY 2014 

budget to Congress based on FY 2013 actual experience to date that reflected a 

lower volume of claims receipts than previously projected. Projections are periodically updated based on recent experience, the impact of the transformation initiatives, and enhanced forecasting capabilities. 

B. Are there any on-going initiatives that are not having the impact on production 

that VA expected? If so, please explain. 

Response. VBA closely monitors the impact of initiatives on performance. All currently on-going initiatives have provided improvements to the disability claims process. A previous initiative called the Veterans Benefits Management Assistance Program (VBMAP) did not have an impact as expected and was not pursued further. 

VBMAP was a professional services contract for rapid development of claims for 

increased benefits, initial compensation claims, pension claims, and dependency 

verification claims. The VBMAP contract was awarded September 2011, requiring 

100% quality and 300,000 developed claims. The VBMAP vendor did not meet the 

quality or volume requirements of the contract. In June 2012, VA halted shipment 

of claims to allow the vendor to improve performance. The contract ended after the 

base period, September 12, 2012. 

Question 51. According to VA’s January 2013 backlog plan, VA expected that, in 

the first quarter of 2014, the number of claims VA decides would start to outpace 

the number of claims being received and that the total number of pending claims 

would be reduced in 2014. The fiscal year 2014 budget submission reflects that 

claims receipts will exceed production in 2014 and the number of pending claims 

will continue to grow. 

A. What specific information and metrics initially led VA to project that the first 

quarter of 2014 would be the point when output would start to exceed input? 

Response. The January 2013 strategic plan presented a worst case scenario in 

terms of a large number of incoming claims due primarily to the implementation 

of the Veterans Opportunity to Work (VOW) program for separating servicemembers. We anticipated that 200K+ additional claims might come in. Our belief 

was that if they did come in, they, and many other supplemental claims, would be 

submitted electronically, be fully-developed, and be simpler to process overall. Those 

assumptions led us to believe that if the large volume of new VOW-related claims 

occurred, we had a reasonable chance of turning them around very quickly; thus, 

we showed very large production increases in FY 2014 and especially FY 2015. In 

this worst case scenario, we believed that by not later than first quarter FY 2014 

we would see significant production improvements from Transformation. We understood the high risk that we would be assuming in production and that possible risk 

generated significant discussion about resource requirements. 

B. In revising this projection, what metrics did VA assess and what did they 

show? 

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Response. In revising the January 2013 projections for the FY 2014 budget submission, we had trend data showing that traditional receipts were moving downward but we were not yet ready to ignore the potential impact of additional VOWrelated claims. In reviewing the risk associated with the dramatic increase in production we postulated in the January plan, we concluded that with the resources 

requested we needed to adjust our production plan to reflect a less risky output projection. The combination of less projected production with the still very real possibility of a large influx of VOW-related claims turned FY 2014 into a year where we 

might see no significant reduction in the inventory. 

Since the FY 2014 budget was submitted, we have not seen any significant effect 

from VOW on total receipts in FY 2013 or the beginning of FY 2014. In addition, 

we achieved a significant increase in FY 2013 production. The net result was that 

we actually reached the point where production exceeded receipts on a consistent 

basis in the third quarter of FY 2013. 

Question 52. In the January 2013 backlog plan, VA noted that it did not take into 

account 774,000 claims that may be filed as a result of the VOW to Hire Heroes 

Act and the Honoring America’s Veterans and Caring for Camp Lejeune Families 

Act. 

A. Does VA still expect those laws to generate an additional 774,000 claims? 

Response. VA still expects that the VOW to Hire Heroes Act will result in an increase in claims between FY 2013 and FY 2015. VA will provide comprehensive benefits briefings at 250 sites worldwide. Together with the Veterans Employment Initiative, this could result in many additional claims as Servicemembers transition to 

civilian life. 

Estimates show that the population assigned to Camp Lejeune between 1957 and 

1987 was 630,000. Although the law provides health care to certain eligible Veterans and their eligible family members, it does not change the eligibility requirements for granting disability compensation. However, as a result of increased media 

exposure to the issue of contaminated water at Camp Lejeune, VA still expects that 

this law could generate additional claims between FY 2013 and FY 2015. 

B. What specific assumptions led VA to project in the fiscal year 2014 budget submission that less claims will be filed in 2013 and 2014 than VA projected in the 

backlog plan? 

Response. As previously mentioned, the projections of received claims VA’s Strategic Plan to Eliminate the Compensation Claims Backlog, submitted to Congress 

on January 25, 2013, were based on assumptions made earlier in the budget cycle 

that included a higher level of claims receipts and FTE than is reflected in the 2014 

VA Budget Submission. VA revised its projections prior to submission of the 2014 

budget to Congress based on FY 2013 actual experience to date that reflected a 

lower volume of claims receipts than previously projected. Projections are periodically updated based on recent experience, the impact of the transformation initiatives, and enhanced forecasting capabilities. 

Question 53. 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 about 

50,000 pending claims. 

A. For that workload, how many employees would be appropriate and how many 

are there currently? 

Response. Based on the RAM for FY 2012, the Winston-Salem RO compensation 

rating claims processing FTE ceiling was 605. Due to workload challenges, 25 additional FTE were approved in August 2012. As of April 30, 2013, the actual on board 

FTE was 621. 

B. What specific factors are considered in determining how claims processing staff 

are allocated among the regional offices? 

Response. The RAM is a systematic approach to distributing field resources each 

fiscal year. The RAM uses a weighted model to assign compensation and pension 

FTE resources based on RO workload in rating receipts, rating inventory, non-rating 

receipts, and appeals receipts. VBA leaders use the model as a guide, making some 

adjustments for special circumstances or missions performed by individual ROs. 

Special missions include the Appeals Management Center, the Records Management 

Center, Day-One Brokering Centers, IDES processing sites, Benefits Delivery at 

Discharge sites, Quick Start processing locations, national call centers, fiduciary 

hubs, pension management centers, etc. Similar, workload-based models are used 

for each VBA business line. 

C. When did VA last assess the staffing needs of each regional office and what 

did that assessment show? 

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Response. VBA assesses staffing needs in each RO at the beginning of each fiscal 

year based on the RAM. In FY 2013, VBA shifted to a RAM weighted more heavily 

on receipts and current workload, rather than the previous model which was 

weighted more on performance. As a result, some resources have been shifted to 

those ROs processing a greater portion of claims receipts and those currently carrying a greater portion of the claims inventory. The FY 2013 RAM has yet to be 

fully implemented, since rebalancing FTE resources is dependent upon attrition, 

and VBA must operate within its overall funding level. VBA anticipates continued 

use of this workload-driven RAM going forward. 

D. When is the next assessment scheduled to occur? Please share the results of 

that review with the Committee. 

Response. The RAM will be reviewed to ensure consistency with achieving VBA’s 

national mission and updated with current workload and performance metrics for 

each RO at the beginning of FY 2014. VA can share the results of the review with 

the Committee once it has been finalized. 

Question 54. 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 2012 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 2012 funding for three of the initiatives with the 

greatest impact on quality is provided below: 

• VBMS: $23.9 million (VBA GOE funding) • Challenge training: $9.5 million • Quality Review Teams: $51 million 

B. In total, how much is VA expecting to spend in fiscal year 2013 to carry out 

all of those quality initiatives, including the quality review teams at each regional 

office? 

Response. As previously noted, several initiatives will impact quality. A summary 

of FY 2013 funding for the primary initiative focused on improving quality is provided below: 

• VBMS: $20.8 million (VBA GOE funding) • Challenge training: $10.1 million • Quality Review Teams: $52 million • Station Enhancement Training: $925,000 

C. In total, how much is VA requesting for fiscal year 2014 to carry out all of 

those quality initiatives, including the quality review teams at each regional office? 

Response. For FY 2014, VBA has requested the following funding for these initiatives: 

• VBMS: $35.7 million 

• Challenge training: $9.9 million 

• Quality Review Teams: $53 million 

D. Nationwide, how many full-time equivalents are currently assigned to these 

quality review teams? 

Response. Currently, there are 583 Quality Review Specialists nationwide. 

E. If the fiscal year 2014 budget request is adopted, how many individuals Nationwide would be assigned to these teams? 

Response. During the development and piloting of the Quality Review Team 

(QRT) positions, analysis showed an appropriate staffing ratio of one Quality Review 

Specialist to 15 claims processors. VBA anticipates continuing to utilize this staffing 

ratio for QRT positions during FY 2014. Since RO staffing will remain consistent 

from FY 2013 to FY 2014, there will be no change to the number of Quality Review 

Specialists in FY 2014. 

Question 55. In the 2012 PAR, VA indicated that the use of Disability Benefits 

Questionnaires has ‘‘resulted in more timely rating decisions, fewer duplicated examinations, a reduced need for VA examinations, and a potential to improve rating 

accuracy.’’ 

A. Please provide any statistics on the timeliness of rating decisions in cases involving Disability Benefits Questionnaires compared to cases that do not. 

Response. All Veterans benefit from the efficiencies built into the Disability Benefits Questionnaires (DBQ) tools. Submitting a claim with a DBQ completed fully and 

accurately by a treating clinician can obviate the need to request a C&P examination, thus reducing the time required to obtain all the evidence necessary to decide 

the claim. Additionally, since DBQs are streamlined, condition-focused, and capture 

90 

the specific rating criteria needed to evaluate a medical condition, they elicit from 

the examiner responses to very specific questions that yield all necessary facts to 

evaluate a disability claim. Since the initiation of the DBQ process in 2012, VA has 

received just over 15,000 DBQs from treating clinicians and more than 2.54 million 

DBQs completed through the C&P exam process. 

At this time, there is insufficient data to compare the differences in timeliness of 

rating decisions in cases involving DBQs with those that do not as there are a limited number of cases in which DBQs are not used. Additionally, other factors may 

affect timeliness which are not related to DBQ use, such as requesting military and 

other Federal records. 

B. Please provide any statistics on the number of duplicated examinations that 

have been avoided as a result of the use of Disability Benefits Questionnaires and 

the cost savings associated with that reduction. 

Response. Because DBQs are streamlined, condition-focused, and capture the specific rating criteria needed to evaluate a medical condition, they elicit from the examiner responses to very specific questions that yield all necessary facts to evaluate 

a disability claim. Therefore, the DBQ examination report is less frequently found 

insufficient for rating purposes, reducing the number of additional exams on any 

given Veteran’s claim. However, there is insufficient data related to a measurable 

difference in the number of duplicate examinations requested. This is not because 

the value and efficiency of DBQs is not being seen, but because of other factors that 

held the national insufficiency rate steady since the implementation of DBQs. 

C. Please provide any statistics on the reduction of VA examinations attributable 

to the use of Disability Benefits Questionnaires and the cost savings associated with 

that reduction. 

Response. The data set of DBQs completed by treating clinicians is too small to 

allow for accurate measure of overall examination avoidance. However, conservatively assuming that half of the DBQs completed by a treating clinician avoided 

the need for a C&P examination, it is possible that 7,500 fewer examinations were 

ordered. With the average cost of an examination at $500, this equates to $3.75 million in cost savings. Again, these are estimates based on a non-statistically significant sample of DBQs. VBA anticipates that the examination avoidance figure will 

actually be higher once DBQs are fully automated and become the norm for use by 

treating clinicians. 

Question 56. In the fiscal year 2014 budget request, VA projects that VA will complete 1.1 million claims in fiscal year 2013 and 1.3 million claims in fiscal year 2014. 

A. If those projections are accurate, how many claims does VA expect would need 

to be completed in fiscal year 2015 in order to meet VA’s goal of eliminating the 

backlog by 2015? 

Response. Over the last 6 months, VBA has received a lower volume of claims 

than previously projected. From October 1, 2012, through June 3, 2013, VBA received 5.7 percent fewer receipts than last year at the same time. As a result, VA 

will revise its estimates of the number of completed claims needed through FY 2015 

in connection with developing the FY 2015 budget submission. Projections are periodically updated based on recent experience, the impact of the transformation initiatives, and enhanced forecasting capabilities. Eliminating the claims backlog in 2015 

remains VA’s goal. 

B. What specific performance outcomes suggest to VA that that level of output 

during 2015 is possible? 

Response. These increased levels of output are possible due to the implementation 

of VA’s comprehensive Transformation Plan, which is designed to eliminate the 

claims backlog and achieve our goal of processing all claims within 125 days at a 

98-percent accuracy level in 2015. This major transformation in claims processing 

includes a series of tightly integrated people, process, and technology initiatives that 

are being implemented according to a carefully developed multi-year timeline. The 

transformational initiatives are being rolled out in a progressive, intentional sequence that enables efficiency gains while minimizing risks to performance. We are 

confident that we will meet this goal as we continue to implement the Transformation Plan. It is important to note that the timeline for eliminating the claims 

backlog could be affected if policymakers establish new presumptive conditions, 

courts make new precedential decisions, or legislators make laws that establish new 

entitlements. VA continues to monitor the performance impact of transformation as 

well as other external factors that could potentially have an impact. 

VBA has increased its rating output in each of the past 3 months, and in 

May 2013, VBA set production history by processing more claims (109,097) than any 

previous month. Additionally, VA is eliminating the backlog by prioritizing claims 

for those Veterans who have been waiting the longest for a decision, including 

claims over 2 years old, followed by claims over 1 year old. From April 19, 2013, 

91 

through June 19, 2013, VBA successfully processed 65,507 2-year-old claims, and 

67,050 1-year-old claims. Over this same period, VBA reduced its backlog, defined 

as those claims pending for over 125 days, by over 58,000 claims, from 588,868 to 

530,104. 

Question 57. VA’s ‘‘appeals resolution time’’ in fiscal year 2012 was 866 days, an 

increase of 210 days since fiscal year 2010. 

A. How much in total is expected to be expended by the Veterans Benefits Administration (VBA) to process appeals during fiscal year 2013? 

Response. In FY 2013, VBA estimates that funding to process appeals will total $84.5 million, including $63 million for Decision Review Officers assigned at ROs 

and $21.5 million on Appeals Management Center staffing and operations. There 

are also VSRs and RVSRs assigned to Appeals Teams at ROs. However, VBA is unable to specifically identify the payroll costs associated with those employees. 

B. What level of funding is requested in total for fiscal year 2014 for purposes 

of processing appeals by VBA? Response. The FY 2014 budget includes $85.9 million for processing appeals, in- cluding $64 million for Decision Review Officers assigned at ROs and $21.9 million 

on Appeals Management Center staffing and operations. There are also VSRs and 

RVSRs assigned to Appeals Teams at ROs. However, VBA is unable to specifically 

identify the payroll costs associated with those employees. 

Question 58. In the fiscal year 2014 budget request, the discretionary request for the disability compensation program includes $526 million for Other Services. 

Please provide a detailed itemized list of how that funding would be utilized during 

fiscal year 2014. 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 $526 million contains funding of $420.6 

million for contracts that directly impact or support the delivery of disability compensation claims: 

• Contract Medical Examinations ($239.1 million) • Veterans Claims Intake Program (scanning) ($132.1 million) • Program management and systems engineering support services for the Vet- erans Benefits Management System ($32.3 million) • Development of instructional methodologies and systems that support the train- ing and skills development of the disability compensation workforce ($8.2 million) • Program management, scientific, technical, and engineering support for Com- pensation Service and the VBA Operations Center ($6.2 million) 

The request also includes $31.9 million for studies and analyses that support stra- tegic planning ($16.4 million) and innovation ($15.5 million). The remaining $73.5 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 59. In response to questions about VA’s fiscal year 2012 budget request, 

VA provided this prediction: ‘‘Investments in information technology will begin to 

pay dividends as deployment of the Veterans Benefits Management System (VBMS) 

begins in 2012, allowing for increased productivity and reduced operating costs in 

processing disability compensation claims.’’ Then, in response to questions about the 

fiscal year 2013 budget request, VA indicated that ‘‘VA will be able to better examine increases in productivity and reduction in costs once additional software releases 

are deployed in November 2012 and May 2013.’’ 

A. Please quantify any increased productivity or reduced costs realized during fiscal year 2012 and to date in fiscal year 2013 as a result of VBMS, in terms such 

as individual productivity of claims processing staff, cost per case, or overall operating costs. 

Response. VBA began deployment of VBMS Generation 1 in September 2012, concluding the calendar year with 18 stations on the system. It is important to note 

that early adopters of first generation technology participated heavily in the development and refinement of efficiencies and functionality of the system, which had a 

direct impact on productivity as a result of the live test environment. These stations 

paved the way for the accelerated deployment of VBMS, which will enable VBA to 

track and measure productivity outcomes in a consistent and accurate manner once 

all ROs are operating with the new technology and after a period of stabilization. 

The first 18 stations enabled VBA to also test business processes and functionality 

for the establishment of eFolders in VBMS and the model for tracking and shipping 

of paper-based claims with two scanning vendors. Under VBA’s accelerated VBMS 

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deployment schedule, all ROs have implemented VBMS as of June 10, 2013. However, nearly 557,000 paper claims in our current inventory remain to be processed. 

It is difficult to extract the impact of each transformation initiative from the combined people, process, and technology model to determine individual initiative’s contribution to productivity outcomes. At the end of April 2013, approximately 5,800 

claims have been fully processed in VBMS in an average of 121.1 days fiscal year 

to date. 

B. Please quantify the increased productivity and reduced costs now expected in 

fiscal year 2014 as a result of VBMS, in terms such as individual productivity of 

claims processing staff, cost per case, or overall operating costs. 

Response. VBMS is projected to provide a 20 percent increase in productivity in 

FY 2014. 

Question 60. In connection with VA’s fiscal year 2012 budget request, VA was 

asked to explain VA’s plan to bring down the backlog of disability claims by 2015. 

In part, VA responded that ‘‘productivity*** will rise from 89 annual claims per 

[compensation and pension] direct labor FTE in 2012 to 129 in 2015.’’ 

A. Now, how many claims are projected to be completed during fiscal year 2015 

per compensation and pension direct labor FTE? 

Response. Our current estimates suggest a productivity of 100 to 101 per direct 

FTE in FY 2015 and 90 to 91 per direct FTE in FY 2014, after finishing FY 2013 

at approximately 81 per direct FTE. The 81 figure reflects a slow first six months 

of FY 2013 as the integrated lanes and accelerated fielding of VBMS approached 

completion and a very robust productivity the final six months of FY 2013. 

B. What specific metrics or performance outcomes lead VA to conclude that that 

level of productivity per FTE is attainable? 

Response. As discussed in question 51, our assumptions for FY 2014 and FY 2015 

productivity in the January 2013 plan reflected a high risk assumption of our ability 

to deal with a large number of VOW-related claims relatively quickly in comparison 

to the traditional receipts we expected. The final six months of FY 2013 showed a 

sustained production per direct FTE of almost 93 claims due to Transformation. 

Continued Transformation is expected to permit achieving even higher levels of productivity per direct FTE in FY 2014 and FY 2015. 

Question 61. According to information provided in connection with the fiscal year 

2013 budget request, VBA planned to expend $46.9 million in fiscal year 2013 to 

pay for claims processing staff to work overtime. 

A. During fiscal year 2012, how much in total was actually expended to pay for 

overtime work by claims processing staff and what outcomes were achieved as a result of those overtime hours? 

Response. In FY 2012, $42.9 million was spent on overtime for C&P claims processing. Approximately 50,000 rating claims were completed during overtime. 

B. During fiscal year 2013, 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 recently reallocated an additional $32.9 million for mandatory 

overtime for C&P claims processing, bringing the total overtime for C&P claims 

processing in FY 2013 to $65.5 million. VBA anticipates approximately 80,500 

claims completed on overtime in FY 2013. 

C. For fiscal year 2014, 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. Of the $45 million budgeted for overtime, VBA anticipates using approximately $40 million to fund overtime for C&P claims processing. FTE productivity is expected to be higher during FY 2014, resulting in an estimated 53,000 

claims completed on overtime during FY 2014. 

Question 62. In VA’s testimony before the Committee on the fiscal year 2013 

budget request, the Secretary indicated that ‘‘VA plans an aggressive communications strategy surrounding the release of [additional Disability Benefits Questionnaires] that will promote the [fully-developed claims (FDC)] program.’’ VA’s responses to post-hearing questions also indicated that VA was ‘‘considering promoting the program by implementing an FDC training course for Veterans Service 

Officers*** and disseminating FDC program information, benefit applications, 

and marketing materials, such as an FDC program trifold brochure, to VSOs, Veterans, and other potential claimants.’’ 

A. How many fully-developed claims are expected to be filed during fiscal year 

2013 and during fiscal year 2014? 

Response. VA is on track to receive more than 80,000 fully developed claims 

(FDCs) in FY 2013, and projects to receive more than 200,000 FDCs in FY 2014. 

93 

B. To date in fiscal year 2013, how many days on average is it taking to complete 

fully-developed claims? 

Response. FDCs are taking an average of 121 days to complete as of September 17, 2013. 

C. For fiscal year 2014, how long is it projected to take to complete fully-developed 

claims? 

Response. In FY 2014, an FDC is projected to take an average of 100 days. 

D. For fiscal year 2013, how much is expected to be spent on FDC marketing materials and on an FDC training course? 

Response. In FY 2013, VBA’s Benefits Assistance Service has $450,000 allocated 

for FDC marketing materials and FDC training. 

E. For fiscal year 2014, what level of funding is requested for purposes of promoting the fully-developed claims program? Please specify the amounts, if any, requested for an FDC training course and for marketing materials. 

Response. In FY 2014, VBA’s Benefits Assistance Service has $450,000 allocated 

for FDC marketing materials and FDC training. 

Question 63. VA processes claims at 56 regional offices around the country and 

those offices vary in the quality and timeliness of their decisions. 

A. For fiscal year 2012, please identify the specific regional offices with the highest attrition rates for claims processing personnel. 

Response. 

Station* 2012 Attrition Rate** 

Fargo ........................................................................................... 17 .18% 

Honolulu ...................................................................................... 14 .87% 

Indianapolis ................................................................................ 13 .29% 

Wilmington .................................................................................. 13 .28% 

Chicago ....................................................................................... 12 .17% 

Albuquerque ................................................................................ 12 .12% 

Boston ......................................................................................... 11 .05% 

Anchorage ................................................................................... 10 .84% 

San Juan ..................................................................................... 10 .77% 

Denver ......................................................................................... 10 .65% 

Reno ............................................................................................ 10 .45% 

Baltimore .................................................................................... 10 .40% 

Oakland ....................................................................................... 9 .79% 

Newark ........................................................................................ 9 .23% 

* Stations with > 9% attrition for claims staff 

** VSRs, RVSRs and DROs only 

Attrition defined as employees who left VBA 

B. What are the expected attrition rates for claims processing positions during fiscal year 2013 and fiscal year 2014? 

VBA Response. Based on a 5-year average of 7.57 percent and a slight downward 

trend, we can estimate VBA-wide attrition to be 7 percent for each of the next 2 

years. Please note: We define attrition for the purposes of this response as employees who leave VBA. 

Question 64. In response to questions regarding the fiscal year 2013 budget request, VA indicated that it planned to provide disability examinations to veterans 

residing overseas using contractors as well as VA employees. 

A. How many examinations are expected to be provided through contractors during fiscal year 2013 and 2014 and how much would be expended for that purpose? 

Response. In FY 2013, $4.798 million was budgeted for disability exams and associated travel to support 1,500 Veterans in residing overseas, with $575,000 paid to 

VHA contractors for performance of these disability exams in supported locations 

(Germany and Japan). For FY 2014, $4.316 million was budgeted for disability 

exams and associated travel to support an estimated 1,550 Veterans. 

B. How many examinations are expected to be provided through VA employees 

during fiscal year 2013 and 2014 and how much would be expended for that purpose? 

Response. VHA employees have not conducted overseas examinations in FY 2013. 

There are no examinations scheduled for either the remainder of FY 2013 or FY 

2014. The Office of Disability and Medical Assessment (DMA) plans to use the Disability Examination Management contract to the greatest extent possible to provide 

examinations to Veterans residing at specific geographic locations overseas. DMA 

has executable plans to deploy a small contingent of internal staff, if necessary. 

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Question 65. In response to questions about the fiscal year 2013 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 2012 and 

what was the average time it took the contractors to obtain private medical records 

(or otherwise close out the development action)? 

Response. VBA spent $508K in FY 2012 on the private medical records initiative. 

The average time to obtain private medical records or acceptable responses (none 

available or destroyed) from medical providers was 11.5 days. 

B. How much is now expected to be spent on this initiative during fiscal year 2013 

and how long on average is it currently taking the contractors to obtain private 

medical records (or otherwise close out the development action)? 

Response. VBA obligated $2.1 million in FY 2013 to continue the private medical 

records pilots at the ten pilot ROs: Chicago, Indianapolis, Houston, Jackson, Portland, Phoenix, New York, St. Louis, New York, and Waco. The average time for contractors to obtain private records remains around 11.5 days. 

C. Is any funding requested with respect to this initiative for fiscal year 2014? 

If so, please specify the amount. 

Response. VA requested $10 million in FY 2014, the estimated annual cost to run 

the program nationally. 

Question 66. According to the 2012 PAR, VA plans to continue efforts to revise 

the disability rating schedule during fiscal year 2013. 

A. How much in total was actually expended during fiscal year 2012 to update 

the disability rating schedule? Please provide an itemized list of how that funding 

was expended and what results were achieved with that funding. 

Response. VA is in the process of updating the VASRD. As part of this process, 

members of Compensation Service, Regulations Staff hosted multiple public forums 

and gathered scientific evidence regarding disabling conditions and their impact on 

the average impairment of earnings capacity. These public forums were also used 

as a platform to solicit public input regarding these deliberations. In addition, during these forums, working groups were formed to support the ongoing review process. For FY 2012, the non-payroll expenditures for the VASRD modernization 

project totaled $366,139. The table below shows a breakdown. 

Event Date Expenses 

VASRD FORUM—NYC ............................................... October 11-20 $84,626 

VASRD Forum—NYC ................................................. January 17-26 $52,688 

Travel ........................................................................ FY 2012 $27,467 

Medical consultation contract .................................. FY 2012 $201,358 

TOTAL ...................................................... ......................... $366,139 

The medical consultation contract provided subject matter expertise to assist with 

medical content relevant to rating disabilities, consult on policy issues and revisions 

to the disability benefits questionnaires, and various other responsibilities. 

B. During fiscal year 2013, how much in total does VA currently plan to expend 

to revise the rating schedule? Please provide an itemized list of how that funding 

has been or will be expended and what results have been or are expected to be 

achieved with that funding. 

Response. So far in FY 2013, an event focused on mental health disorders was 

held on May 1 and 2, with expenses totaling $4,300, and a meeting focused on skin 

diseases was held from March 28 through April 5, with expenses totaling $2,000. 

VA plans to fund additional VASRD modernization project conferences this year. 

These conferences are needed for the body systems still pending final review and 

revision, which include the musculoskeletal system and mental disorders. The purpose of these work group conferences is to intensify the review process and to expedite research, development, and deliberations within these sections of the VASRD. 

The diverse work group includes medical doctors, psychologists, attorneys, Veterans 

Service Organization representatives, and VA adjudicators. The benefit of these conferences is the generation of more ideas and energizing of the collaborative process 

which is at the heart of the VASRD review. Each conference will require participants to travel, with estimated costs of $12,000 to $15,000. 

VBA medical officers responsible for drafting the VASRD regulations will also 

meet with SMEs to obtain clinical expertise and opinions useful in revising the 

VASRD regulations. The estimated cost for FY 2013 is $15,000. 

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C. What level of funding is requested for fiscal year 2014 for purposes of updating 

the rating schedule and how are those funds expected to be spent? What results are 

expected to be achieved with that funding? 

Response. It is anticipated that conferences, travel, and outside consultation will 

be completed in FY 2013. In FY 2014, remaining work including workgroup participation, regulation drafting, and internal and external concurrence, will be accomplished by VA without travel or outside consultation. VA has $15,000 in funding in 

FY 2014 to support any unforeseen travel or conferences. There are currently 5 FTE 

assigned to the VASRD modernization project. VA anticipates that two body systems 

(endocrine and hematologic/lymphatic) will progress through external concurrence 

during FY 2014, with final publication in FY 2015. For the remainder of the body 

sytems, VA anticipates that they will progress through the workgroup, drafting and 

internal concurrence phases during FY 2014. Final publication of all body systems 

is expected to be completed in 2016. A copy of the updated project management plan 

and operating plan, as well as the project schedule, will be provided when 

completed. 

Question 67. According to a September 2012 Government Accountability Office 

(GAO) report, VA has experienced delays and challenges in obtaining earnings loss 

studies needed to complete revisions to the disability rating schedule. The fiscal 

year 2014 budget request reflects that ‘‘VA is in the process of issuing a request 

for proposals for data-driven earnings loss studies.’’ 

A. Since 2009, how much has VA expended in relation to earnings loss studies 

and what results have been achieved with that funding? 

Response. Since 2009, VA has entered into two contracts for earnings loss studies. 

Both contracts were made with a single contractor and most of the work completed 

was in support of development of an earnings loss model. Other expected deliverables were not completed prior to the decision to terminate the contract, including 

the following: a database of comparison groups; a compilation of service-connected 

Veterans and comparison group(s); and a peer-reviewed final report. The contractor 

was also unable to apply the earnings loss model formula it had developed for data 

acquisition because the contract was terminated before the income data was supplied. VA has paid $158,820 with the last payment made on these contracts in FY 

2011. The Contracting Officer is currently in the process of making a final termination determination on the total amount that is due to the contract based on the 

partial work completed. VA estimates that the total payment for both contracts is 

approximately $663,000. From this contractor, VA gained insight regarding limitations on the scope of any future earnings loss study. For example, VA learned that 

due to statutory limitations, individualized earnings data cannot be obtained from 

the Internal Revenue Service and therefore, any future plans for an earnings loss 

study cannot aspire to use individualized data. Additionally, earnings loss models 

cannot be designed to forecast earnings loss for each available diagnostic code because there is insufficient data available to build a statistically competent and reliable model for each diagnostic code. 

B. In fiscal years 2013 and 2014, how will funding for earnings loss studies be 

expended and what results are expected to be achieved? 

Response. For FY 2013, VA anticipates no costs for the earnings loss studies. VA 

is currently preparing for earnings loss studies in FY 2014 and will seek bids from 

contractors with demonstrated experience in administering such studies for other 

government entities to yield an adequate analysis of earnings loss for each of the 

major diagnostic codes in the VASRD. VA estimates that $1.8 million will be spent 

on earnings loss studies in FY 2014. 

Question 68. In response to questions about VA’s fiscal year 2013 budget request, 

VA indicated that there were 15 full-time employees at the Louisville regional office 

dedicated to processing claims based on exposure to contaminated water at Camp 

Lejeune. 

A. Currently, how many employees at the Louisville regional office are dedicated 

to handling these claims? 

Response. There are currently 15 full-time employees at the Louisville RO dedicated to processing claims based on exposure to contaminated water at Camp 

Lejeune. 

B. If the fiscal year 2014 budget request is approved, how many employees would 

be dedicated to handling these claims at the Louisville regional office? 

Response. During fiscal year 2014, the number of full-time employees dedicated 

to processing Camp Lejeune claims will remain at 15. Adjustments will be made as 

necessary based on the number of claims received including those received in connection with the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012. While this law does not change the eligibility requirements for 

96 

granting entitlement to compensation, it could potentially drive an increased volume 

of claims related to Camp Lejeune, as new healthcare benefits are provided to certain eligible Veterans and their eligible family members. 

Question 69. As one strategy to deal with VA’s backlog of disability claims, VA 

has brokered claims between VA offices. In response to questions about the fiscal 

year 2013 budget request, VA indicated that it ‘‘has not completed an analysis on 

the cost-effectiveness of brokered work.’’ 

A. In total, during fiscal year 2012, how many paper-based claims were brokered 

by VA? 

Response. In support of its national priorities and workload management strategies, VBA brokers its claims processing workload among ROs and dedicated 

brokering sites as necessary. A total of 46,591 paper-based claims were completed 

as part of the national brokering strategy. This represents 4.5 percent of the 

1,044,207 claims completed during FY 2012. 

B. During fiscal year 2013 and fiscal year 2014, how many paper-based claims 

does VA expect to broker? 

Response. Through April 2013, a total of 25,558 paper-based claims have been 

brokered this fiscal year. Workload demands and other factors may affect the actual 

volume of paper-based claims that are brokered. National deployment of Generation 

One of VBMS (our baseline system) began in 2012, with 18 ROs operational as of 

the end of the calendar year. Deployment to the remaining stations, originally 

scheduled to be completed by the end of CY 2013, was accelerated and completed 

as of June 2013, likely reducing the number of paper claims that will be physically 

brokered in FY 2014. 

C. What is the status of efforts to determine the cost-effectiveness of brokering 

paper-based claims? 

Response. With the implementation of VBMS, a cost-effectiveness study is no 

longer warranted. As VBMS will allow for a completely electronic claims process, 

future brokering efforts will be conducted in a paperless environment, thus eliminating the need for the transfer of paper-based claims folders among ROs. 

Question 70. 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 2012, 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 2012, VBA spent approximately $54.8 million for salaries 

and GOE for 490 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 2013, 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 2013, VBA estimates it will spend approximately $63.0 million for salaries and GOE to support 580 FTE dedicated to disability claims processing in the IDES process. 

C. During fiscal year 2014, 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 2014, VBA estimates it will spend approximately $63.6 million for salaries and GOE to support 580 FTE dedicated to disability claims processing in the IDES process. 

Pension and Fiduciary Service 

Question 71. In response to questions about the fiscal year 2013 budget request, 

VA indicated that the Pension and Fiduciary Service was ‘‘working with VA’s Office 

of Enterprise Development (OED) to replace the current electronic workload management system, Fiduciary-Beneficiary System (FBS)’’ and that ‘‘[c]ompletion of the 

first phase is expected in the Fall of 2012.’’ Please provide an updated timeline for 

the replacement of FBS. 

Response. Pension and Fiduciary Service began its pilot of the replacement system, the Beneficiary Fiduciary Field System, on August 30, 2013. The fiduciary hubs 

at Louisville, KY and Lincoln, NE were selected as the initial sites to test the 

functionality and capability of this application. National deployment of the replacement system is scheduled for December 31, 2013. 

97 

Question 72. In response to questions about VA’s fiscal year 2012 budget request, 

VA provided this information: ‘‘The 2012 budget request does not include funds to 

develop an online training program for fiduciaries but we have conducted research 

to identify existing certification programs. We plan to develop a system in 2013.’’ 

Then, in response to questions about the fiscal year 2013 budget request, VA indicated that ‘‘[t]he online training program for fiduciaries is still in the initial stages 

of development.’’ 

A. Please provide an update on the status of this initiative. 

Response. The first phase of the fiduciary training initiative is publication of a 

new Fiduciary Guidebook for volunteer fiduciaries (92 percent of VA fiduciaries); 

most of whom are the relatives, caregivers, and friends of beneficiaries in VA’s fiduciary program and have a one-on-one relationship with the beneficiary. The Guidebook will instruct fiduciaries on their responsibilities, their duty to act independently to determine the beneficiary’s needs, the rights of beneficiaries, and the procedures for completing an accounting. The intent is to clarify the roles of VA, fiduciaries, and beneficiaries in the program, and improve communications. It will also 

provide helpful answers to frequently asked questions. The ‘‘Guidebook for VA Fiduciaries’’ is currently available online at: http://benefits.va.gov/fiduciary/Fid_ 

Guide.pdf. Hard copy guidebooks will be published by the end of the fiscal year. 

The second phase of the fiduciary training initiative will target paid and unpaid 

fiduciaries and will include web-based training, as well as self-certification of the 

training material. The second phase is expected to deploy in October 2014. 

B. Does the fiscal year 2014 budget request include any funding to advance this 

initiative? 

Response. Yes, current funding is available to advance the fiduciary training initiative into the second phase. 

Question 73. In response to questions about VA’s fiscal year 2013 budget request, 

VA indicated that the Pension and Fiduciary Service ‘‘entered into a contract with 

Accurint, which is a service of LexisNexis Risk Solutions, to provide instant criminal 

background checks on prospective fiduciaries.’’ 

A. How much is expected to be expended for this purpose during fiscal year 2013? 

Response. During FY 2013, Pension and Fiduciary Service expects to expend 

$82,565 for the purpose of contracting for instant criminal background checks on 

prospective fiduciaries. 

B. How much is requested for this purpose for fiscal year 2014? 

Response. Pension and Fiduciary Service does not anticipate an increase in the 

contract amount from FY 2013 to FY 2014. 

Question 74. In the fiscal year 2014 budget request, the discretionary request for 

the pension, dependency and indemnity compensation, burial, and fiduciary programs includes $17.5 million for Other Services for fiscal year 2014. Please provide 

a detailed itemized list of how that funding would be utilized during fiscal year 

2014. 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 $17.5 million contains funding of $11.7 

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 ($8.2 million) 

The remaining $5.8 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 75. The fiscal year 2014 budget submission reflects that VA ‘‘is in the 

process of developing fiduciary regulations.’’ What is the expected timeline for completion of these regulations? 

Response. The draft fiduciary regulations are among VA’s highest priority regulations. VA anticipates publication in the second quarter of FY 2014. 

Question 76. Between 2009 and 2012, there was a 128.2 percent increase in the 

average days to complete burial claims. From 2010 to 2012, there was a 3.2 percent 

decrease in the amount of initial burial claims submitted to VA, yet there was a 

4.6 percent decrease in the amount of claims processed. 

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A. What has led to the substantial increase in days to process burial claims even 

though the number of claims has decreased? 

Response. All burial claims are processed at the Pension Management Centers 

(PMC) in addition to Dependency and Indemnity Compensation (DIC) and pension 

claims. The PMCs have focused more resources on DIC and pension claims due to 

the dramatic growth in volume of incoming claims between FY 2010 and FY 2012. 

As a result, the average days to process burial claims has increased. VA recognizes 

that burial benefits are an important benefit and has reviewed the process for adjudicating burial claims to determine how to streamline the process and improve the 

timeliness of claims. To address these issues, VBA is working to simplify and automate the burial program. 

Current burial regulations require VA to obtain statements and receipts from 

claimants showing that funeral expenses were incurred. Upon receipt, VA calculates 

the precise payment, up to a statutory maximum, and reimburses claimants. The 

process is paper and time intensive and often requires claimants and service providers to cover some portion of burial and funeral costs until VA reimburses them 

for allowable costs. 

Because the average cost of a funeral far exceeds the available benefit and VA 

could pay certain burial benefits based on evidence in its records at the date of a 

Veteran’s death, VA is drafting proposed regulations that, if approved, would enable 

it to automatically pay certain burial benefits to eligible survivors upon a confirmed 

notice of death. Such automatic payments are only possible with regulatory or legislative authority for payment of burial benefits at a flat-rate and without a formal 

claim. VA will, to the extent possible, seek such authority through regulatory 

change. By establishing flat-rate payment of burial benefits and automating the 

processing of burial claims, VA will expedite the delivery of benefits to survivors and 

other claimants and free up resources for working claims in the backlog. 

B. The 2014 target for average days to complete burial claims is 90 days, while 

the strategic target is 21 days. What actions have been or will be taken to reduce 

the average days to complete a burial claim? 

Response. See answer provided in 76a, above. 

Appeals Management Center 

Question 77. Since 2003, certain cases remanded by the Board of Veterans’ Appeals have been handled at a centralized entity called the Appeals Management 

Center. 

A. During fiscal year 2012, how much was spent on the Appeals Management 

Center and what level of staffing did that funding support? 

Response. In FY 2012, $20.8 million was allocated to the Appeals Management 

Center (AMC) for payroll, non-payroll, and travel. This supported staffing of 249 

FTE, of which 235 were production FTE. 

B. During fiscal year 2013, how much is now expected to be spent on the Appeals 

Management Center and what level of staffing will that funding support? 

Response. Approximately $20.4 million will be allocated to the AMC for FY 2013 

to support staffing of 230, of which 222 are production FTE. 

C. In total, how much funding is requested for fiscal year 2014 for the Appeals 

Management Center and what level of staffing would that funding support? 

Response. Currently, estimated FY 2014 staffing levels are consistent with FY 

2013 levels, and consequently, funding is also consistent with FY 2013. 

D. For fiscal years 2013 and 2014, what are the key performance targets for the 

Appeals Management Center? 

Response. The FY 2013 AMC key performance targets consist of the following 

metrics and corresponding targets: 

• Average days pending for claims from homeless Veterans—70 days 

• Claims inventory—13,500 

• Average days pending—145 days 

• Average days to complete—270 days 

• Claims production—30,000 

• 12-month claims accuracy—90% 

FY 2014 targets will be set at the beginning of the next FY, and will consider 

actual performance in FY 2013 and VBA’s organizational goals for FY 2014. 

Education 

Question 78. According to the 2012 PAR, one reason that VA did not meet its 

timeliness goals for processing education claims is that ‘‘[o]vertime for claims processing was limited.’’ 

99 

A. How much was requested for overtime for fiscal year 2012, what amount was 

expended, and what amount would have been adequate to help prevent claims processing delays? Response. VBA initially allocated $8.8 million in overtime funds for education 

claims processing in FY 2012. In the second quarter of FY 2012, some funds were 

reallocated for overtime for disability compensation claims processors. As VBA identified degradation in performance metrics for education claims, additional funding 

was secured for overtime. By the end of FY 2012, a total of $9 million was spent 

on overtime for education claims processing. 

B. How much has been allocated for overtime for fiscal year 2013 and how much 

would be adequate? Response. VBA initially allocated $10 million in overtime funds for the processing of education claims in FY 2013. Through September 7, 2013, $7.2 million has been 

spent. VBA anticipates reaching $8 million in total expenses for FY 2013. This is 

lower than our initial allocation due to the efficiencies resulting from the Chapter 

33 Long-Term Solution (LTS). We will continue to monitor the performance metrics 

of education claims and adjust overtime spending in order to maintain the expected 

levels of performance. 

C. How much is requested for overtime for fiscal year 2014 and what amount is 

expected to be adequate? 

Response. With the improved functionality of LTS, VBA anticipates allocating be- tween $5 million and $7 million in overtime for education claims processing. VBA 

will monitor Education performance metrics and distribute additional overtime 

funding as needed in order to maintain performance. 

Question 79. According to the fiscal year 2014 budget request, the discretionary request for Education programs includes $16.6 million for Other Services. Please 

provide a detailed itemized list of how those funds would be utilized during fiscal 

year 2014. 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 $16.6 million request contains funding of $5.4 million for contracts 

that support Education Service, including: 

• Program management and systems engineering support services for the Post- 9/11 GI Bill ($4.4 million), • Development of instructional methodologies and systems the support the train- ing and skills development of the Education workforce ($600,000), • Publication and distribution of outreach pamphlets and letters to satisfy intent of Public Law 101–237 and Public Law 105–368 ($200,000), • National Student Clearinghouse Contract for degree attainment data ($100,000), and • State Approving Agency Contract to support development and implementation of a RAM ($100,000). 

The remaining $11.2 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. 

GENERAL ADMINISTRATION

Office of the Secretary 

Question 80. According to the fiscal year 2014 budget request, 88 FTE are requested for the Office of the Secretary, which is 1 less than VA requested for fiscal 

year 2013 (89 FTE) and 11 less than VA now expects for fiscal year 2013 (99 FTE). 

A. Please provide a list of what positions, including pay-grades, would be included 

in the Office of the Secretary and its subsidiary offices if the fiscal year 2014 budget 

is approved. 

Response. 

Grade #Positions 

SES ..................................................... 15 

15 ....................................................... 14 

14 ....................................................... 28 

13 ....................................................... 18 

12 ....................................................... 4 

11 ....................................................... 5 

9 ......................................................... 3 

100 

Grade #Positions 

8 ......................................................... 2 

7 ......................................................... 1 

6 ......................................................... 5 

B. Please provide a list of the 10 additional positions that were added in fiscal 

year 2013. 

Response. The positions identified in the 2014 budget reflect the proper staffing 

to support the VA leadership initiatives that will move the Department forward in 

achieving the Secretary’s stated goals to increase access, eliminate the claims backlog, and end homelessness for Veterans. Staff positions are added/deleted accordingly as emerging requirements develop from administration, Congressional, or 

other external sources. 

Grade #Positions 

15 ....................................................... 2 

14 ....................................................... 3 

13 ....................................................... 4 

4 ......................................................... 1 

C. If the fiscal year 2014 budget is adopted, what (if any) positions would be eliminated? 

Response. No positions would be eliminated. 

D. If the fiscal year 2014 budget is adopted, would any employees be transferred 

from the Office of the Secretary to other positions within VA? If so, please specify. 

Response. There would be no requirement to move employees. 

Question 81. According to the fiscal year 2014 budget request, the Office of the 

Secretary now expects to spend $4.3 million on Other Services during fiscal year 

2013, which is $4.2 million more than VA originally requested for fiscal year 2013 

for Other Services. Please provide an itemized list of how those additional funds 

($4.2 million) are expected to be spent. 

Response. In FY 2012 the Presidents Management Council approved and 

launched the Leading Executives Driving Government Excellence (Leading EDGE) 

program. Ninety-five percent of the $4.2 million reflected in the 2014 budget reflects 

the estimated cost to run this program. The program is funded through reimbursement funds provided from all Federal agencies including VA and any unused funds 

are returned to the appropriate organization. 

Question 82. The Office of the Secretary requests $3.7 million for Other Services 

for fiscal year 2014. Please provide an itemized list of how those funds are expected 

to be expended. 

Response. In FY 2012 the Presidents Management Council approved and 

launched the Leading Executives Driving Government Excellence (Leading EDGE) 

program. Ninety-five percent of the $4.2 million reflected in the 2014 budget reflects 

the estimated cost to run this program. The program is funded through reimbursement funds provided from all Federal agencies including VA and any unused funds 

are returned to the appropriate organization. 

Question 83. According to the fiscal year 2014 budget request, the Office of the 

Secretary now expects to spend $495,000 on travel during fiscal year 2013, which 

is $216,000 more than VA originally requested for fiscal year 2013. Please provide 

an itemized list of how those additional funds ($216,000) are expected to be spent. 

For example, how many additional trips will that funding support and what would 

be the expected purposes of those additional trips. 

Response. Based on past trends the average travel budget for OSVA is approximately $450k; OSVA was approved additional funds through remaining carryover 

dollars, which allowed them to request a more realistic travel budget sufficient to 

support Senior Leaders, and related necessary staff, in executing travel that supports initiatives that will move the Department forward in achieving the Secretary’s 

stated goals to increase access, eliminate the claims backlog, and end homelessness 

for Veterans. The additional funds also support travel to fulfill invitations from 

Members for constituent activities in their districts. 

Question 84. According to the fiscal year 2014 budget request, the Office of the 

Secretary now expects to spend $265,000 for supplies and materials during fiscal 

101 

year 2013, which is $165,000 more than VA originally requested for fiscal year 2013 

for that purpose. Please provide an itemized list of how those additional funds 

($165,000) are expected to be spent. 

Response. Based on past trends the average supplies and materials budget for OSVA is approximately $200k; OSVA was approved additional funds through remaining carryover dollars, which allowed them to request a more realistic budget 

for supplies and materials including expenditures for increase in administrative requirements that support initiatives that will move the Department forward in 

achieving the Secretary’s stated goals to increase access, eliminate the claims backlog, and end homelessness for Veterans. 

Question 85. According to the fiscal year 2014 budget request, the Office of the Secretary now expects to spend $43,000 for printing and reproduction during fiscal 

year 2013, which is $27,000 more than VA originally requested for fiscal year 2013 

for that purpose. Please provide an itemized list of how those additional funds 

($27,000) are expected to be spent. 

Response. The OSVA mission is support of the Secretary of Veterans Affairs, Deputy Secretary and Chief of Staff the execution of missions, goals, and priorities of 

the Administration to support our Nation’s Veterans. Increase in printing and reproduction costs support strategic messaging initiatives necessary to effectively support 

initiatives that will move the Department forward in achieving the Secretary’s stated goals to increase access, eliminate the claims backlog, and end homelessness for 

Veterans. 

Question 86. The Leading Executives Driving Government Excellence (Leading 

EDGE) Program is an executive level training and leadership program across the 

entire Federal Government and, according to the budget request, among one of its 

activities is ‘‘[a]rchiving program benefits to the taxpayer in terms of savings and 

cost avoidance.’’ 

A. For fiscal year 2012, how much savings and cost avoidance did Leading EDGE 

produce? 

B. For fiscal year 2013, how much savings and cost avoidance does Leading EDGE 

expect to produce? 

C. For fiscal year 2014, how much savings and cost avoidance does Leading EDGE 

expect to produce? 

D. For each fiscal year, please describe in detail the savings and cost avoidances 

Leading EDGE achieved or expects to achieve. 

Response for A-D: 

The President’s Management Council (PMC) initiated Leading EDGE (Executives 

Driving Government Excellence) to: 1) inspire a seamless and powerful senior executive corps with shared governmentwide identity and vision; 2) craft solutions that 

have impact across agencies; and 3) reignite the highest ideals of public service. To 

achieve these objectives, Leading EDGE employs five integrated learning components: workshops, leadership assessments, government performance projects (GPPs), 

executive coaching, and a web portal for increased cross-agency networking and 

problem-solving. In 2012, the program’s first year, fifteen Federal Government departments (totaling over 150 individual bureaus) reimbursed Veterans Affairs (VA) 

to participate in Leading EDGE. 

Five teams of program participants engaged in the learning component most 

linked to cost savings and avoidance when they developed solutions to seven significant, cross-government challenges, subsequently reviewed by the Office of Management and Budget and the Office of Performance Management. The following list details the estimated cost savings based on the proposals of the 2012 government performance projects (GPPs): 

• Review of Federal shared services procurement data suggests an annual possible savings of $5.5 billion (supported by Industry reports) through centralized acquisition 

• Establishment of centralized disability hiring in the Federal Government acts 

as a catalyst for better return on human capital investment and could yield 0.01 

percent in annual employment savings ($30 million) 

• Reduction of Federal employee attrition gained through enhanced leadership development efforts across government could reduce annual employment costs by 10 

percent ($30 billion) 

• Establishing interagency security clearance reciprocity and convenient access to 

all government buildings in Federal agencies for all employees could yield annual 

cost savings of $38 million 

• Establishment of a Grants Management University could yield $30 million in 

grant administration savings given the number of Federal employees engaged in 

grants management 

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• Establishment and monitoring of Do Not Pay performance metrics could substantially reduce the $115 billion in improper payments by the Federal Government 

• A ‘‘Shared-First’’ approach to IT shared service delivery could yield annual cost 

savings of $50 million and represent increased buying power for IT investments 

Some of the qualitative benefits represented in these projects, such as expedited 

procurement processes, improved employee morale, and strengthened senior executive leadership are just as valuable as more easily quantified cost savings. The calendar year 2013 Leading EDGE effort began only recently and specific GPPs are 

as yet undecided, so estimated costs savings and avoidance for the year is not possible at this time. 

Question 87. The VA Center for Innovation was established in 2010 to ‘‘identif[y], 

prioritize[], fund[], test[] and evaluate[] the most promising solutions to VA’s most 

important challenges to increase Veteran access to VA services, improve the quality 

of services delivered, enhance the performance of VA operations, and reduce or control the cost of delivering those services that Veterans, their families, and survivors 

receive.’’ 

A. Please provide the Committee with the number of staff assigned to the Center, 

the total cost for staff salaries, whether any of the staff is considered to be reimbursable and which office would be reimbursed, and whether any of the staff were 

reassigned from the Office of Information and Technology. 

Response. The VA Center for Innovation (VACI) is a matrixed organization, modeled on private sector best-practices to better ensure VA-wide collaboration and coordinated execution. Not all of the individuals who perform work associated with VA 

innovations are members of the Office of the Secretary staff. By design, only the Director and the Deputy Director function out of OSVA. Most members of the VACI 

team work full time on innovations while some contribute in an adjunct status as 

a collateral duty in addition to the work they perform for other parts of the Department. Ten staff are assigned to the Center, of which four are military Veterans. 

None are considered reimbursable and one is assigned from the Office of Information and Technology. The total cost for staff salaries is $742,774. 

B. Please provide the Committee with the amount of funding available for grants 

through Industry Competitions, Employee Competitions, Special Projects, and Prize 

Contests. 

Response. The VA Center for Innovation (VACI) uses contracts as opposed to 

grants to implement its work with private sector entities involved in the implementation of innovations. To further reduce risk to the government, VACI general requires use of firm fixed price contracts. For prize challenges, VACI uses cash prizes 

as authorized by the America COMPETES Act of 2010. 

Over 95% of the VACI annual budget is used for direct funding of innovations 

that increase access to healthcare and other services, reduce or control the cost of 

delivering those services, improve quality at VA, and enhance the Veteran experience with the services they receive from VA. VACI uses, among other things, the 

Industry Innovation Competition, Employee Innovation Competition, Special 

Projects, and Prize Contests to achieve this. To be responsive to Veteran needs 

across the VHA and VBA mission areas, VACI funding is contained in three appropriations. Annually, as much as $35 million in Medical Services, $11 million in IT, 

and $15 million in VBA General Operating Expenses (GOE) is budgeted to fund innovations through VACI. The amounts available in a given Fiscal Year for contracts 

through the Industry Innovation Competition, Employee Innovation Competition, or 

Special Projects varies depending on the specific focus areas for that operating year. 

C. How many proposals have been selected for implementation through the VA 

Center for Innovation and the VA Innovation Initiative? Of these proposals, how 

many have been fully implemented on a national scale? 

Response. Since its inception in mid-2010, the VA Center for Innovation (VACI) 

has selected and implemented 149 innovations. The Industry Innovation Competitions and Employee Innovation Competitions generate the vast majority of the selected innovations. Special Projects tend to target emergent opportunities and/or innovations that have a longer lifecycle than the typical 24-month period. 

VACI functions as a supplier of novel and innovative capabilities to the Department, principally VHA and VBA. VHA and VBA are responsible for selection and 

funding of completed innovation projects for implementation and deployment across 

their respective domains. The pace and extent of deployment depends on the availability of resources, project scope, and overall innovation maturity. 

Innovation projects execute over a period of performance of 12 to 24 months following the selection, pilot design, and contracting processes. A substantial part of 

the VACI portfolio is in either the period of performance phase or the design and 

contracting phase. As these projects mature over the coming months and years, they 

103 

move into the evaluation phase. Successful innovations compete for VHA and VBA 

resources required for adoption and wider implementation. 

20 innovation projects have already been or are being adopted by VHA and VBA 

or are operating independently of VA in service to the Department’s mission. These 

completed innovations include 7 industry innovations, 8 employee innovations and 

5 innovations from the prize competitions and special projects categories. 

The seven Industry Innovations adopted include a number of new Blue Button 

services that allow Veterans across the Nation to freely access their medical records 

in a format that is portable across health providers, projects that use technology to 

improve TBI care and mental health screening, and a cardiology mobile application 

that allows physicians to receive medical images on mobile devices for faster and 

better care for Veteran heart patients. 

Among the several successful Employee Innovations, eight projects have been selected for full implementation. These projects cover a wide range of clinical practices, such as radiology, patient safety, and novel approaches to caring for brain injuries and brain diseases affecting Veterans. 

The Special Project and prize competition category generated the first open source 

software community to lower costs and increase innovation rates for VA’s electronic 

health record, the first automated claims processing prototype, a mobile application 

to connect any local services that can help Veterans in need, and a new way for 

Veterans to have their military service experience count for private sector employment. 

Board of Veterans’ Appeals 

Question 88. The fiscal year 2014 budget request includes $75 million for the 

Board of Veterans’ Appeals (Board). 

A. With that funding and funding provided in Public Law 113–6, what FTE level 

is expected during fiscal year 2013 and 2014? 

Response. With the additional $8 million in funding provided, the Board of Veterans’ Appeals (BVA or Board) will be able to sustain 538 full-time equivalents 

(FTE) in fiscal year (FY) 2013 and 613 FTE in FY 2014. 

B. Please provide a breakdown of the positions that would be filled in fiscal year 

2014 and the number of staff for each type of position. 

Response. All 100 positions hired in FY 2013 & FY 2014 with the additional $8 

million in funding will be staff attorneys. 

C. With that funding and the funding provided in Public Law 113–6, what performance outcomes does the Board expect to achieve during fiscal years 2013 and 

2014? 

Response. BVA has initiated an aggressive hiring plan to execute the $8 million 

in additional funding in FY 2013. In parallel to this aggressive hiring plan, BVA 

has developed and implemented a robust new training program that is designed to 

handle the high volume of incoming staff to maximize efficiencies at the earliest 

point. All new FTE will undergo this training. BVA expects production gains based 

on these efforts to be realized beginning in FY 2014. There is direct correlation between the number of FTE and the number of decisions produced; looking at recent 

years, each FTE produces up to 90 decisions per year. 

D. Of that funding, how much will be used to pay for union representation/union 

time? 

Response. The Board pays for union representation/union time in two ways: 

(1) costs (salary and benefits) of union representatives; and 

(2) costs (salary and benefits) of BVA’s managers who work on labor relations 

matters, labor relations counsel, and other labor relations support staff. 

In total, the Board expects to pay approximately $2,011,926 for labor relations 

matters per annum. 

Question 89. According to the fiscal year 2014 budget request, the Board now expects to spend $2.3 million on Other Services during fiscal year 2013, which is 

$253,000 higher than the amount requested for fiscal year 2013, and the Board is 

requesting $2.3 million for Other Services for fiscal year 2014. 

A. Please provide an itemized list of how these funds are expected to be spent during fiscal year 2013. 

Response. The $2,253,000 for ‘‘Other Services’’ in FY 2013 will be allocated as follows: 

All Shred Document Shredding Contract for disposition of sensitive records .......................... $20,000.00 

Lean Six Sigma Study of the Board’s Operations for identification of possible efficiencies in 

processes ................................................................................................................................ 344,000.00 

104 

West Group Contract—On-line Access to the Westlaw Legal Database for legal research by 

the Board’s Veterans Law Judge and attorney staff ............................................................. 290,000.00 

Transit Benefits .......................................................................................................................... 555,000.00 

United Parcel Services (UPS) Appellant Records Shipment Contract ........................................ 70,000.00 

Transcription Service (2 Vendors) .............................................................................................. 663,000.00 

Board’s Share of VACO’s Human Capital Investment Plan (HCIP) Training Support ............... 130,000.00 

Financial Service Center (FSC) ................................................................................................... 123,000.00 

Defense Finance and Accounting Services (DFAS) ..................................................................... 50,000.00 

Security Investigation Service ..................................................................................................... 8,000.00 

Total Other Services ........................................................................................................... $2,253,000.00 

B. Please provide an itemized list of how these funds are expected to be spent during fiscal year 2014. 

Response. The $2,333,000 for ‘‘Other Services’’ in FY 2014 will be allocated as 

follows: 

All Shred Document Shredding Contract for disposition of sensitive records .......................... $20,800.00 

Public Key Infrastructure (PKI) Electronic Research Materials Service and Maintenance 

Contract .................................................................................................................................. 386,000.00 

West Group Contract—On-line Access to the Westlaw Legal Database for legal research by 

the Board’s Veterans Law Judge and attorney staff ............................................................. 298,000.00 

Transit Benefits .......................................................................................................................... 558,200.00 

United Parcel Services (UPS) Appellant Records Shipment Contract ........................................ 80,000.00 

Transcription Service (2 Vendors) .............................................................................................. 670,000.00 

Board’s Share of VACO’s Human Capital Investment Plan (HCIP) Training Support ............... 131,000.00 

Financial Service Center (FSC) ................................................................................................... 125,000.00 

DFAS ............................................................................................................................................ 51,000.00 

Security Investigation Service ..................................................................................................... 13,000.00 

Total Other Services ........................................................................................................... $2,333,000.00 

Office of General Counsel 

Question 90. According to the fiscal year 2014 budget request, VA is seeking total 

resources of $101 million for the Office of General Counsel and 701 FTE. 

A. Please provide a list of the positions that would be filled in fiscal year 2014 

with that level of funding and the number of staff for each position. 

Response. 

Supervisory Attorney ................................. 78 .0 

General Attorney ....................................... 400 .8 

Paralegal Specialist .................................. 86 .1 

Legal Assistant ......................................... 52 .1 

Other ......................................................... 84 .0 

Total ................................................. 701 .0 

B. For each regional counsel office, please identify the number and type of staff 

that would be located at the office during fiscal year 2014. 

Response: 

Region 1 

Supervisory Attorney ............................. 2 

General Attorney ................................... 14 .3 

Paralegal Specialist ............................. 1 

Legal Assistant .................................... 3 

Office Automation Clerk ....................... 0 .5 

Total ................................................. 20 .8 

105 

Region 2 

Supervisory Attorney ............................. 2 

General Attorney ................................... 12 .5 

Paralegal Specialist ............................. 1 .8 

Legal Assistant .................................... 1 

Total ................................................. 17 .3 

Region 3 

Supervisory Attorney ............................. 2 

General Attorney ................................... 8 

Paralegal Specialist ............................. 3 

Program Analyst ................................... 1 

Total ................................................. 14 

Region 4 

Supervisory Attorney ............................. 2 

General Attorney ................................... 9 

Paralegal Specialist ............................. 4 

Administrative Officer .......................... 1 

Total ................................................. 16 

Region 5 

Supervisory Attorney ............................. 2 

General Attorney ................................... 8 .4 

Paralegal Specialist ............................. 2 

Legal Assistant .................................... 4 

Total ................................................. 16 .4 

106 

Region 6 

Supervisory Attorney ............................. 2 

General Attorney ................................... 15 .63 

Paralegal Specialist ............................. 9 

Legal Assistant .................................... 3 

Total ................................................. 29 .63 

Region 7 

Supervisory Attorney ............................. 2 

General Attorney ................................... 11 

Paralegal Assistant .............................. 3 

Legal Assistant .................................... 3 

Program Assistant ................................ 1 

Administrative Officer .......................... 1 

Total ................................................. 21 

Region 8 

Supervisory Attorney ............................. 2 

General Attorney ................................... 8 

Paralegal Specialist ............................. 6 

Legal Assistant .................................... 0 

Total ................................................. 16 

Region 9 

Supervisory Attorney ............................. 2 

General Attorney ................................... 8 

Paralegal Specialist ............................. 2 

Legal Assistant .................................... 2 

Total ................................................. 14 

Region 10 

Supervisory Attorney ............................. 2 

General Attorney ................................... 12 

Paralegal Specialist ............................. 2 

Legal Assistant .................................... 3 

Total ................................................. 19 

Region 11 

Supervisory Attorney ............................. 2 

General Attorney ................................... 8 .5 

Paralegal Specialist ............................. 3 

Total ................................................. 13 .5 

Region 12 

Supervisory Attorney ............................. 2 

General Attorney ................................... 10 

Paralegal Specialist ............................. 7 

Legal Assistant .................................... 2 

Total ................................................. 21 

Region 13 

Supervisory Attorney ............................. 2 

General Attorney ................................... 10 

Paralegal Specialist ............................. 4 .8 

Legal Assistant .................................... 5 

Total ................................................. 21 .8 

107 

Region 14 

Supervisory Attorney ............................. 2 

General Attorney ................................... 13 

Paralegal Specialist ............................. 5 

Legal Assistant .................................... 3 

Total ................................................. 23 

Region 15 

Supervisory Attorney ............................. 2 

General Attorney ................................... 6 .75 

Paralegal Specialist ............................. 1 

Administrative Officer .......................... 1 

Total ................................................. 10 .75 

Region 16 

Supervisory Attorney ............................. 2 

General Attorney ................................... 8 

Paralegal Specialist ............................. 2 

Legal Assistant .................................... 1 

Total ................................................. 13 

Region 18 

Supervisory Attorney ............................. 4 

General Attorney ................................... 21 .483 

Paralegal Specialist ............................. 8 

Legal Assistant .................................... 1 .6875 

Secretary ............................................... 2 

Total ................................................. 37 .17 

Region 19 

Supervisory Attorney ............................. 2 

General Attorney ................................... 9 

Paralegal Specialist ............................. 2 

Legal Assistant .................................... 1 

Total ................................................. 14 

Region 20 

Supervisory Attorney ............................. 2 

General Attorney ................................... 10 .58 

Paralegal Specialist ............................. 2 .8 

Legal Assistant .................................... 2 

Total ................................................. 17 .38 

Region 21 

Supervisory Attorney ............................. 2 

General Attorney ................................... 8 

Paralegal Specialist ............................. 4 

Legal Assistant .................................... 0 .8 

Total ................................................. 14 .8 

Region 22 

Supervisory Attorney ............................. 2 

General Attorney ................................... 6 

Paralegal Specialist ............................. 1 

Legal Assistant .................................... 2 

Total ................................................. 11 

108 

Region 23 

Supervisory Attorney ............................. 2 

General Attorney ................................... 8 

Paralegal Specialist ............................. 4 

Legal Assistant .................................... 3 

Total ................................................. 17 

Grand Total 

Supervisory Attorney ............................. 46 .00 

General Attorney ................................... 226 .14 

Paralegal Specialist ............................. 78 .40 

Legal Assistant .................................... 40 .49 

Administrative Officer .......................... 3 

Secretary ............................................... 2 

Program Analyst ................................... 1 

Program Assistant ................................ 1 

Office Automation Clerk ....................... 0 .5 

Grand Total ...................................... 398 .53 

C. If the fiscal year 2014 budget request is adopted, what would be the expected 

total budget for each regional counsel office? 

Response. 

Grand Total Regions .................................................................................................. 398 .53 $54,386,322 

Front Office—VACO 101 ............................................................................................ 5 $883,170 

Regs Office—VACO 101 ............................................................................................ 9 1,267,152 

PSG I—VACO 101 ...................................................................................................... 19 .41 3,068,983 

PSG II—VACO 101 ..................................................................................................... 20 2,836,576 

PSG III—VACO 101 .................................................................................................... 23 3,778,669 

PSG IV—VACO 101 .................................................................................................... 19 .75 3,057,628 

PSG V—VACO 101 ..................................................................................................... 63 .8 8,843,661 

PSG VI—VACO 101 .................................................................................................... 41 6,891,740

PSG VII—VACO 101 ................................................................................................... 101 .5 14,486,378 

Grand Total VACO .................................................................................................. 302 .46 $45,113,957 

Funded Where Needed ........................................................................................... ........... $1,484,721 

Grand Total OGC ............................................................................................... 701 .0 $100,985,000 

Question 91. According to the fiscal year 2014 budget request, VA’s Office of General Counsel now expects to spend $1.3 million on Other Services during fiscal year 

2013, which is $169,000 higher than the amount requested for fiscal year 2013 ($1.1 

million). According to the budget request, that amount changed ‘‘due to the transfer 

of all [human resources (HR)] functions from the regions into VACO.’’ 

A. Please provide an itemized list of how these funds are expected to be spent during fiscal year 2013. 

Response. Refer to charts below. 

Notes: 

(1) Budget Object Classification (BOC) codes describe the ‘‘nature’’ of the service 

or article for which obligations are first incurred. 

(2) In executing the fiscal year (FY) 2013 budget, the Office of General Counsel 

(OGC) now plans to spend $1.6 million on Other Services. Due to an unanticipated 

increase in the number of retirements among its leadership, OGC has incurred more 

household goods storage costs and relocation expenses associated with hiring replacements for the retired personnel. OGC offset the increased spending from its 

planned expenditures on equipment. 

109 

BOC 2580/81 

Classification 2013 Budget 

Contracts—VACO—employee recognition, framing, 

moving furniture, court reporters, transcription 2580 $52,555 

Contracts—Regions—Notaries, Shredding ............ 2580 8,702 

Human Capital Investment Plan (HCIP) ................. 2580 178,000 

Security & Investigation (S&I) ................................ 2580 11,615 

Office of Resolution Management (ORM) ............... 2580 108,000 

Financial Service Center (FSC) ............................... 2580 177,654 

Record Center & Vault (RC&V) ............................... 2580 1,811 

Child Care Subsidy .................................................. 2580 — 

Defense Finance and Accounting Service (DFAS) ... 2580 69,264 

Financial Disclosure Management System (ARMY) 2580 10,000 

PIV Card .................................................................. 2580 12,960 

OA&L Contract Support ........................................... 2580 57,054 

eOPF Contract .......................................................... 2580 22,631 

USA Staffing Contract ............................................. 2580 17,534 

USA Jobs Contract ................................................... 2580 4,344 

Total ....................................................... 2580 $732,124 

B. Please explain what impact this transfer of H.R. functions had on the budget 

for each region. 

Response. The transfer of H.R. functions to Central Office did not impact the 

budgets of OGC’s regions, in past years; the VA facility providing local fiscal support 

for each of the 22 regions would process our payroll and pay the associated fees. 

After the transfer, OGC must now pay all associated payroll processing fees for its 

personnel, wherever located. As a result, our Service Level Agreement with VA’s FiVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00113 Fmt 6633 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN

415tab84a.eps 415tab84b.eps 415tab85.eps
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nancial Service Center (FSC) increased from $35K to $178K. FSC charges OGC for 

common and administrative services included in payroll processing, financial reporting and accounting services, Permanent Change of Station travel, processing W–2’s, 

and helpdesk support. 

Question 92. The Office of General Counsel is requesting $1.2 million for Other 

Services for fiscal year 2014. Please provide an itemized list of how these funds 

would be spent during fiscal year 2014. 

Response. See Chart below. 

111 

Question 93. In response to questions about the fiscal year 2013 budget request, 

VA indicated that the Office of General Counsel planned to spend $14,000 in 2012 


415tab86.eps
112 

on a ‘‘Tort training video.’’ What was the purpose of this video and how has it been 

utilized? 

Response. The actual cost of producing this video training module was $1,478.90, 

which represented the cost of transporting a VA Office of Information Technology 

(OIT) employee and his video equipment to a Federal building in St. Louis at which 

OGC personnel were conducting previously-scheduled face-to-face training on administrative tort claim adjudication procedures. Editing and polishing the raw digital recordings in-house saved the Department over $12,000 in professional services 

and travel. The purpose of taping that session was to provide a Web-based, on-demand, re-usable training resource for OGC personnel regarding the processes and 

procedures to be followed in investigating and adjudicating administrative tort 

claims filed against the VA pursuant to the Federal Tort Claims Act (FTCA). The 

overall goal of creating this Web-based training was to improve the quality and consistency of legal service relating to torts across all of OGC’s regions, thereby improving service to Veterans who avail themselves of the administrative tort adjudication 

process afforded by the FTCA. The project has not yet launched, as the editing work 

must be done as collateral duty and as other duties allow. OGC anticipates taking 

the training live in August 2013, at which point the training will be viewed by the 

approximately 150 OGC employees who are engaged in torts practice. VA anticipates cost savings will be realized by eliminating travel and other costs associated 

with bringing those employees together to receive this training. 

Question 94. 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 101.5 FTE onboard and 43 active cases per attorney, on average. An ‘‘active case’’ is one in which the Secretary 

has yet to file his dispositive pleading. 

B. For fiscal year 2014, 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 ............................................................ 101.5 $14,487,244 

C. Please provide a list of the positions that would be filled with that level of 

funding. 

Response. 

Supervisory Attorney ......................................................... 11 .0 

General Attorney ............................................................... 57 .0 

Paralegal Specialist ......................................................... 4 .5 

Legal Assistant ................................................................ 14 .0 

Clerks ............................................................................... 11 .0 

Management Analyst ........................................................ 1 .0 

Supervisory Program Specialist ....................................... 1 .0 

Support Services Specialist ............................................. 1 .0 

Supervisory Program Analyst ........................................... 1 .0 

Total ........................................................................ 101 .5 

D. With the requested funding level, what would be the expected average number 

of active cases per attorney during fiscal year 2014? 

Response. The average number of active cases per attorney will be maintained in 

the range between 45 and 50. 

E. How many motions for extension of time did Professional Group VII file during 

fiscal year 2012? 

Response. PSG VII filed a total of 2,129 extension motions in FY 2012. 

F. How many motions for extension of time has Professional Staff Group VII filed 

to date during fiscal year 2013? 

Response. During the period between October 1, 2012, and April 30, 2013, PSG 

VII filed approximately 1,053 extension motions. 

113 

Question 95. In response to questions about the fiscal year 2013 budget request, 

VA indicated that the Regulation Rewrite Project ‘‘is not expected to require additional resources, but the implementation of these rules will require more resources 

over time’’ for items such as ‘‘training program revisions, manuals and forms updating, skills certification materials, and [information technology] projects.’’ VA also indicated that ‘‘[i]mplementation budget planning will occur in 2013.’’ 

A. Has VA developed a comprehensive implementation plan for these regulations? 

If so, please provide a copy of that plan to the Committee. 

Response. VA’s implementation planning for the Regulation Rewrite Project has 

been deferred in order to avoid conflicts with VA’s highest priority effort to eliminate the claims backlog by 2015. The timing for publishing a final rule and the 

manner of implementation will be determined by the Secretary at a future date depending upon the progress being made on the claims backlog. In the meantime, VA 

is preparing to publish the comprehensive 21st proposed rule responding to comments from the public and Veterans Service Organizations submitted for the previous 20 proposed rules. This consolidated proposed rule encompasses all of the previous proposed rules and is expected to be published in 2013. 

B. Please provide the Committee with an updated timeline for completion of this 

project. 

Response. The Rewrite Project’s staff currently expects to seek a determination 

on implementation by the end of 2014 in order to afford the Veterans Benefits Administration time for the necessary advance implementation coordination and budget planning. This expectation could be delayed, however, depending upon the status 

of VA’s claims backlog. VA’s goal is to implement the Regulation Rewrite Project so 

that it does not conflict with VA’s claims transformation initiatives or impede VA’s 

progress in eliminating the claims backlog. 

Office of Management 

Question 96. According to the fiscal year 2014 budget request, the Office of Management plans to spend $53 million on Other Services during fiscal year 2013, 

which is $16.3 million more than VA had requested for that purpose for fiscal year 

2013. Please provide an itemized list of how those funds would be expended during 

fiscal year 2013 and identify expenditures that were not anticipated in the fiscal 

year 2013 budget request. 

Response. The majority of the $16.3 million increase in obligations is due to higher-than-expected requirements for the Defense Finance and Accounting Service 

(DFAS) payroll processing services, which are funded through reimbursements and 

Department-level initiatives funded from FY 2012 carryover. The following are details of how the funds will be expended. 

• $5 million to DFAS for VA payroll processing. The Office of Management pays 

for this Departmental cost and is reimbursed from other VA programs that pay for 

their share of the costs. 

• $3 million to fund activities for VA’s Financial Statement Audit, which includes 

audit remediation, policy updates support, and vendor follow-up. 

• $1.2 million to address Improper Payments Elimination Recovery Act requirements. 

• $1 million to conduct Office of Management and Budget (OMB) Circular A–123 

reviews under the Office of Business Oversight. 

• $400 thousand to support the VA Center of Innovation. 

VA expects to obligate other contracts this fiscal year including: 

• $2 million for enhanced data analysis capability to support better decisionmaking. 

• $1.2 million for budgetary analytical support and development of an automation 

module to provide real-time budget data to improve the budget process and 

strengthen the quality of analysis. 

In addition, $2.5 million in Department-level carryover has been re-allocated within General Administration for additional outreach to increase Veterans’ access to VA 

benefits and services. 

Question 97. According to the fiscal year 2014 budget request, the Office of Management requests $38 million for Other Services for fiscal year 2014. Please provide 

an itemized list of how those funds would be used. 

Response. The $38 million in ‘‘Other Services’’ includes: 

• $30 million for DFAS support to the Department. 

• $4 million for reviewing and testing internal controls over financial reporting, 

as required by Appendix A of OMB Circular A–123. 

114 

• $1 million for service level agreements for the Financial Services Center, Security Investigations Center, and other service and maintenance agreements to conduct regular operations. • $700 thousand for the Enterprise Risk Management program. • $400 thousand for VA Center for Innovation programs. • $350 thousand for training provided through the VA Learning University and 

the Human Capital Investment Plan. • The balance of the costs within Office of Management’s ‘Other Services’ are for 

Office of Personnel Management fees related to USAJobs, USA Staffing, e-Classification, and e-OPF support. 

Question 98. According to the fiscal year 2014 budget request, the Office of Finance within the Office of Management manages the Debt Management Center. 

A. For fiscal year 2014, 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 VA Debt Management Center (DMC) is an enterprise center under 

the VA Franchise Fund, providing common administrative support services to VA 

and other government agencies on a fee-for-service basis and receives no direct appropriated funding. Projected revenues in FY 2014 will support $20,943,647 in expenditures and a staffing level of 189 FTE. 

B. How many telephone lines does the Debt Management Center currently operate and how many would be operated during fiscal year 2014? 

Response. The DMC currently has 144 telephone lines (toll-free). In 2014, VA 

plans to continue to have 144 lines available unless Veterans’ demands increase. 

C. During fiscal year 2012, 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. During FY 2012, 667,524 debts valued at $1.3 billion were referred to the DMC. During the fiscal year, the DMC collected $1.1 billion. 

D. How many new debts are expected to be referred to the Debt Management 

Center during fiscal year 2013 and 2014? 

Response. During FY 2013, VA expects referral of approximately 795,000 new 

debts, and during FY 2014, VA projects referral of approximately 875,000 new 

debts. 

Question 99. According to the budget request for fiscal year 2014, the Office of Management is expected to spend $44.1 million and would have a staffing level of 

262 FTE, if this budget were adopted. This would be a $4 million, or 8 percent, decline in budget authority; however, the staffing level is expected to increase by 7 

percent. 

A. If the Office of Management’s budget is set to decrease by 8 percent, what accounts for a 7 percent increase in FTE? 

Response. The Office of Management is not requesting additional staff in FY 2014. 

The office is hiring additional personnel during the latter part of 2013, and these 

new hires will only account as partial FTE for this year. In FY 2014, these partial 

FTE will be annualized (i.e., a staff hired in June counts as one-fourth of an FTE 

in FY 2013 but a full FTE in FY 2014). Due to the late hiring in FY 2013, the FTE 

will be lower but the on-board staffing level at year-end will be similar to the FY 

2014 FTE request level. 

B. If the increase in staff is a result of reimbursable or detailed FTE, please describe the work performed by those FTE for the Office of Management and the office 

from which they are reimbursed or detailed. 

Response. The increase in staff is not related to reimbursable or detailed FTE and 

is explained in the response to 99A. 

Office of Human Resources and Administration 

Question 100. In response to questions regarding the fiscal year 2013 budget re- quest, VA indicated that it planned to spend $242.3 million on contract costs for 

‘‘Training and Transformation Initiatives.’’ Please provide an itemized list of the 

specific activities this funding has supported or will support, the amount expected 

to be spent on each activity, and the expected outcomes. 

Response. The initiatives included in the Human Capital Investment Plan (HCIP), 

are expected to have immediate, tangible, and measurable impact on the services 

provided to Veterans. HCIP expected outcomes are programs that increase staff productivity and allow VA to more quickly address the needs of Veterans. Training provided improves competencies in the areas of human resources, financial management, project management, acquisition and information technology (IT) certification 

enabling VA employees to provide an improved level of service to Veterans. Programs developed and administered by the Veterans Employment Services Office, 

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which includes the VA for VETS program, created to facilitate the reintegration, retention and hiring of Veteran employees at VA: http://vaforvets.va.gov/Pages/default.aspx, provide the means for Veterans to translate the skills acquired in military service to marketable skills for civilian employment. 

The revised cost estimate for FY 2013 is $217 million, which includes support and 

administrative fees. The reduction is primarily due to the realigning of contracts’ 

periods of performance. Below is a list of the initiatives supported in FY 2013. 

VA LEARNING UNIVERSITY—VALU 

Transformational Leadership 

Support the VA’s transformation into a leading 21st century organization by 

training managers, supervisors, and executives while providing tools to better 

serve veterans and their dependents. 

Supervisory and Management Training 

Design and deliver supervisor and management training, including the Leadership Development Programs, leadership portal, and the training delivery of 

commercial-off-the-shelf content. 

Training Evaluation 

Provide independent evaluation and quality assurance of the ADVANCE training Initiatives delivered by VALU training partners. Develop and deploy formative and summative evaluations to assess the learners during, at close, and 

post-training. Evaluate program and training effectiveness. 

Program-Based Training/Career Technical Training 

Provide training for cross cutting-career fields, in particular those that impact 

all of the Department’s administrations and multiple staff offices. The goals 

are to ensure training is: (1) competency based, (2) consistent in learning 

events and products offered across the Department, and (3) uses formative and 

summative evaluation in development, assessment of learners during, at the 

close, and post training. 

Leadership Competency Assessment and Certification 

Develop a competency-based leadership assessment and certification program. 

Establish a leadership certification which enables VA to send a clear message 

about the importance of leadership as a recognized professional discipline 

equal to the status of a technical discipline. 

VA Career Mapping 

The FY 2013 purpose of this project is to continue to expand the design, development, and implementation of an innovative Career Mapping and Development Program. The goal is to ensure that VA employees have access to the 

functional training, experience, and education necessary to enhance their job 

performance, career progression, and development as multifunctional leaders. 

Leadership Infusion 

The FY 2013 purpose of this project is to continue to provide an OPM catalogue of training courses. 

e-Content 

This Initiative provides support and required licenses for educational content 

for VA employees. The licenses allow access to online materials, books, and 

training on a wide variety of subjects at a very low cost per person. Support 

services include: importing the content into the VA Talent Management System, assigning VA defined core competencies to the courses, and creating and 

revising course catalog documents. 

Talent Management System (TMS) Upgrade Training 

Provides training on the infrastructure system that is at the core of education, 

training and learning at the VA. The capabilities of the VALU TMS support 

significant portions of the Initiatives enacted by VA, but the VALU TMS is a 

tool that requires care and management itself. This Initiative ensures VA has 

the resources necessary to support the tools that the Department relies upon 

for meeting its mission. 

Talent Management Support 

This Initiative provides resources to manage the TMS system and to support 

all aspects of the Directorate’s business responsibilities. 

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VA Acquisition Academy 

The VA Acquisition Academy (VAAA) was created to address the growing challenge facing the Department of Veterans Affairs and the Federal Government 

overall. This challenge is largely faced by the acquisition workforce, which has 

been strained to keep pace with the increased amount of and complexities associated with contracted work in support of the VA mission. 

NATIONAL CENTER FOR ORGANIZATION DEVELOPMENT

Evaluation Services 

This Initiative funds an Intra-Agency Agreement (IAA) to extend a partnership between Office of Human Resources & Administration (OHRA) and National Center for Organization Development (NCOD), part of Veterans Health 

Administration (VHA), in order to complete projects that achieve goals for 

HRA and NCOD related to VA’s organizational health and transformation and 

most efficient use of VA resources. 

Staff Office Memoranda Of Understanding 

This Initiative provides funding to execute training events for the VA staff offices in order to achieve transformational impact, increase effectiveness, supports mission, and has investment justification. 

OFFICE OF HUMAN RESOURCES MANAGEMENT—OHRM 

HR Academy 

HR Academy supports the professional growth of VA H.R. professionals nationwide by closing the competency gaps. 

Central Office Human Resources Services (COHRS) 

This Initiative provides professional services including: business process maps, 

workload tracking tool, staffing resources, and an on-boarding program designed to improve H.R. services enabling the COHRS to reduce hiring time. 

Workforce Planning 

This Initiative develops and implements a corporate Workforce Planning 

(WFP) capability and forms strategic partnerships with Program Offices and 

Administrations enabling VA to identify and address department-wide WFP 

needs, make data-driven decisions, and capitalize on leading practices. 

Knowledge Management 

This initiative helps transform organizations into a learning organization 

through a knowledge management culture by empowering employees to innovate and collaborate with peers. 

Health and Wellness 

This Initiative develops, implements, and manages a health and wellness program resulting in a healthier, more productive, and motivated workforce. 

HR Professional Services 

This Initiative provides H.R. and Project Management services using a variety 

of models and solutions to standardize position descriptions; improve training, 

and H.R. customer service, and increase efficiencies in H.R. processes across 

the VA. 

Reclassification 

This project provides HRA with a customized positions classification system 

through Monster Government Solutions. The system includes planning, coordination, implementation, training and communication. 

HR Line of Business (LOB) 

HR LOB enables efficient Human Resource Service delivery by providing personnel information management systems that meet Office of Personnel Management data requirements. 

VETERANS EMPLOYMENT SERVICE OFFICE—VESO 

Case Management System (CMS)/ Coaching 

Provides support to VESO thru Case Management System and development, 

providing the VA for Vets Help Desk, training Veterans and providing coaching call center. VESO’s goals are to: increase percentage of Veterans hired 

within VA, the Federal Government, and non-profit sectors; reduce voluntary 

Veteran turnover VA-wide; and, implement a supportive reintegration infrastructure. 

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STRATEGIC MANAGEMENT GROUP (SMG)

Oversight and Program Management 

This Initiative provides Program Management support to SMG within HRA 

with oversight and integrated management of HCIP portfolio processes. 

Contract Assistance 

This Initiative provides acquisition support to HCIP Program Offices within 

HRA to develop high-quality requirements packages. 

HRA Strategic Support 

This Initiative provides expert, strategic planning, program management, organizational transformation and communications support to HRA, its supporting programs and initiatives. Support includes planning and investment 

support designed to help HRA determine its strategic priorities. 

OFFICE OF ADMINISTRATION—OA 

Workers’ Compensation Interdisciplinary FTE Support, Training and Occupational Safety and Health Conference 

Provide training services and logistical support to improve the management of 

VA’s Federal Workers’ Compensation (WC) and Occupational Safety and 

Health (OSH) Programs. This ongoing effort aims to train more than 196 VA 

employees in the fundamentals of the WC interdisciplinary functions and OSH 

program management and helps drive cost avoidance. 

Centralized Workers’ Compensation (WC) Processing 

This initiative is a resource to support VA field locations reviewing WC cases. 

VA is seeking to continue contractor support providing WC case management 

services. 

All Employee Safety Perception Survey 

The VA contracted with the National Safety Council (NSC) to conduct an allemployee Safety Perception Survey. In FY 2013, NSC’s subject-matter experts 

provide training to improve lower scoring safety program management categories identified in the FY 2012 survey. 

Medical Case Review 

This Initiative request funds for a Veterans Health Administration (VHA) employee physician to review Workers Compensation (WC) cases. The pilot of the 

Medical Case Review program has demonstrated the potential to save costs related to WC cases, primarily related to questionable treatment and diagnoses. 

Agency Medical Exams 

This Initiative is to establish a centralized fund to be used by VA facilities nationwide for medical examinations to reduce unnecessary costs related to worker’s compensation, as well as enhancing the management of those cases. 

Administrative Investigations 

This Initiative establishes a central fund for field facilities to draw and issue 

small non-personal service contracts in accordance with micro-purchasing procedures to perform Administrative Investigations. Cases would be evaluated 

against a set of criteria to ensure that only the most deserving cases are included in this initiative. 

Warehouse Operations Support 

The Office of Administration (OA) ensures that VA facility (office space), computer (laptop/workstation) and access costs (badges, access cards, etc.) are 

identified if the ‘‘contract employee’’ requires them to perform their work assignments. 

Workspace Modifications 

A fund assisting organizations to redesign office space into smaller workstations, fewer offices, utilizing collaborative and touchdown spaces. 

Employee Accountability/Emergency Preparedness (Personnel Accountability System (VA-PAS) Project) 

The purpose of the VA-PAS is to identify the location of VA employees and 

contractors. An interagency agreement with Space and Naval Warfare Systems 

Center, Pacific delivers a VA enterprise-wide Capability to identify personnel 

during an emergency and determine whether employees are safe, willing, and 

able to work through a Personnel Assessment and Accountability System 

(PAAS) and a VA Notification System (VANS). 

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CORPORATE SENIOR EXECUTIVE MANAGEMENT OFFICE—CSEMO 

Executive Coaching 

Provides a one-on-one way to assist executives during their on-boarding experience to help identify and set clear goals, ways, and methods to make their 

transition process efficient and effective. Executive coaching supports the executive by offering personalized leadership development experience where coach, 

leader and key stakeholders collaborate over time to accelerate the executive’s 

development, achieving results that positively impact his/her organization and 

ultimately Veterans. 

SES Collaborative Website 

Continue development to content enhancement, implementation, and sustainment for CSEMO Connect, the collaborative Web site for senior executives 

across VA. 

Senior Executive Talent Management System (TMS) 

Senior Executive TMS is an automated system to recruit, develop, deploy, and 

support executives across the Department to achieve VA’s missions and support its transformational initiatives. The system contributes to analysis and 

improvement of VA’s executive life cycle management. 

Executive On-boarding Tool 

Establish an automated tool for all aspects of the executive on-boarding experience. CSEMO will be able to streamline processes, capitalize upon efficiencies 

in the process, and develop metrics and reporting capabilities by automating 

certain aspects of the on-boarding process through the use of a web-based 

automated system with dashboards. 

Corporate Performance Management Training System 

Ensure the entire Senior Executive workforce receives annual performance 

management training as required by Office of Personnel Management (OPM). 

Works with VA’s automated Performance Management System tool to (1) ensure the content is accurate and updated in a timely fashion, and (2) ensure 

newly appointed executives are trained on the use of the automated tool. 

Business Process/Systems Architect 

Develop, deliver, manage and maintain CSEMO’s Human Resources (HR) information systems. 

ASSISTANT SECRETARY FOR HRA—(AS)

Leading EDGE (Executives Driving Government Excellence) 

An executive-level training program that: (1) inspires a seamless and powerful 

senior executive corps with shared governmentwide identity and vision; (2) 

crafts solutions that have impact across agencies; and (3) reignites the highest 

ideals of public service. In 2012, 15 Federal departments participated in the 

program. 

LABOR MANAGEMENT RELATIONS—LMR 

Labor Management Relations (LMR) Training 

This initiative supports all five Unions with Master Agreement Training. The 

FY 2013 effort supports the unions with training products and training facilitation. 

OFFICE OF DIVERSITY AND INCLUSION—ODI 

National Diversity Internship Program 

Provide a centralized fund providing VA offices with the ability to pay the salary of summer interns. 

Reasonable Accommodations Centralized Fund 

Provide a centralized fund to reimburse VA offices required to provide reasonable accommodations (RA) for VA employees, such as those needing accommodations for disabilities. The secondary objective is to track the receipt and 

processing of the RA requests. 

Diversity and Inclusion Training 

Develop and provide comprehensive, continuing, coordinated diversity and inclusion training to all VA SES, Title 38 Equivalents, managers and supervisors at the GS–13 level and above. 

Workforce Recruitment Program 

Provide a centralized fund supporting VA offices with the resources to pay the 

salary of interns that may be converted to full-time VA employees. 

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OFFICE OF RESOLUTION MANAGEMENT—ORM 

Conflict Management Training 

Provide the VA with conflict management training for VA leadership, management and labor in an effort to reduce and resolve workplace conflict. 

Question 101. For fiscal year 2014, the Office of Human Resources and Administration is requesting $305 million for Other Services. Please provide a detailed 

itemized list of how those funds are expected to be spent, including any specific initiatives these funds would support. To the extent any of the funds will be spent on 

contracts, please explain the nature of the contract and the expected outcomes. 

Response. In addition to the ongoing initiatives provided through the Human Capital Investment Plan (HCIP), (initiatives listed in question 100), HRA requested 

funding in other services for Office of Resolution Management (ORM), Office of Administration, and Office of Human Resources Management (OHRM). The current estimate for FY 2014 has been reduced from the projected $305 to $236 million. 

HCIP is part of the Departmental effort to transform the VA workforce to better 

serve Veterans in the 21st century. Contracts are awarded to provide training in 

the areas of executive and leadership training, program and project management, 

human resources reform, IT certification and financial management. HCIP has been 

evaluated using industry standards for best practices by an external auditing firm 

(Deloitte) and VA’s National Center for Organizational Development. 

ORM contracts include ADR Mediations, IT equipment, FSC, SIC, VHA Services 

Center, Temporary Services for a Visually Impaired Employee. 

OHRM included funding for the Child Care Subsidy Program (CCSP). CCSP is a 

Nation-wide 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. Employees submit monthly invoices that must be processed timely and accurately. Payments are made directly via electronic funds transfer to child care providers. The 

Child Care Records Management System (CCRMS) includes a process for capturing 

documents of participants in the Child Care Subsidy Program in an electronic and 

database format. The CCRMS provides a methodology for classifying, identifying, 

tracking, filing, retrieving and storing of documents as well as data used for statistical and reporting purposes. The Child Care Subsidy Program is a reimbursement 

program. Each organization supports the cost of daycare for their participants in the 

program and OHRM maintains the funding for distribution to child to child care 

providers upon request. 

A breakdown of current estimated FY 2014 contract costs of $236 million follows: 

Office Contract Description Cost 

(in Millions) 

Human Capital Investment Program ......... Training and Transformation Initiatives ................................... $217 .5 

Office of Resolution Management (EEO 

complaint Processing).

Contracts for Investigation of EEO complaints, Court Transcription Services.$11 

Administration ........................................... Contracts with Other Government Agencies for Mailroom Operations, Employee Health Unit and Employee Fitness Center.$3 

Office of Human Resources Management Child Care Subsidies ................................................................. $4 

Miscellaneous ............................................ Individual training,copier and equipment maintenance and 

other contracts.

$ .4 

Total ......................................... .................................................................................................... $235 .9 

Question 102. According to the fiscal year 2014 budget request, the Office of 

Human Resources and Administration plans to spend $13 million on travel during 

fiscal year 2013 and requests $20 million for travel during fiscal year 2014. 

A. In total, how many employees are expected to travel during fiscal year 2013, 

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 102 B. 

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B. For fiscal year 2014, how many unique travel trips is the $20 million expected 

to support? 

Response. The travel budget identified in the HRA chapter in the budget is primarily for travel provided for Human Capital Improvement Plan (HCIP) programs. 

The current estimates for travel have been reduced from what was originally submitted in the budget. The HCIP was initiated to transform the VA workforce to better meet the needs of a changing Veteran population. 

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. 

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. 

Additional HCIP programs are also allocated funds for travel associated with special events such as Veterans Employment Hiring Fairs held at various locations 

throughout the country. 

Other travel not associated with HCIP, but included in the HRA budget is for the 

Office of Resolution Management, which handles the processing of discrimination allegations and conflict resolution for both field and VA Central Office Equal Employment Opportunity-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 2013 FY 2014 

VALU sponsored travel ..................................................................................................................................... $10.1 $10.3 

All other HRA travel not included in VALU totals ........................................................................................... $1.1 $2.4 

Total ........................................................................................................................................................ $11.2 $12.7 

# of Unique Trips 

FY 2013 FY 2014 

VALU sponsored travel ..................................................................................................................................... 6,631 6,405 

All other HRA travel not included in VALU totals ........................................................................................... 712 1,412 

Total ........................................................................................................................................................ 7,343 7,817 

Average Cost (whole $) 

FY 2013 FY 2014 

VALU sponsored travel ..................................................................................................................................... $1,520 $1,611 

All other HRA travel not included in VALU totals ........................................................................................... $1,513 $1,684 

Total ........................................................................................................................................................ $1,519 $1,624 

C. What steps have been taken to avoid questionable travel expenses since 

issuance of the September 2012 Inspector General report entitled ‘‘Administrative 

Investigation of VA’s FY 2011 H.R. Conferences in Orlando, FL?’’ 

Response. VA employs over 320,000 employees who provide high quality health 

care, benefits, and services to Veterans every day. VA is the Nation’s largest integrated health care system with nearly 1,300 centers of care serving 8.6 million Veterans across the country. A large number of VA doctors, nurses, claims processors 

and other employees directly benefit from training events every year. Continuous 

workforce training and development is essential to delivering timely and quality VA 

care and services our Veterans have earned and deserve. VA holds centralized training forums to enhance the delivery of health care, benefits, and memorial services 

unique to Veterans. This includes employee development through critical training 

to improve customer service and the timely delivery of benefits and services; clinical 

training, which includes post-deployment care, treatment of chronic conditions, mental health, suicide prevention; and strategies to eliminate Veteran homelessness. 

Our training events are designed to achieve our goals—better access, eliminate the 

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backlog, and end Veteran homelessness by training and developing our employees 

and empowering them to provide the best care and services possible for our Nation’s 

Servicemembers and Veterans. 

VA has implemented a comprehensive action plan to revise and strengthen policies and controls on the planning and execution of training conferences and events. 

These actions are consistent with the recommendations in the September 30, 2012 

Inspector General report and are reflected in VA policy issued on September 26, 

2012. 

Stringent internal controls for training conferences are in place and oversight is 

provided by the senior executives in the Department. Further, the newly established 

Training Support Office ensures consistency and the distribution of clear guidance 

regarding needed steps for adherence with all appropriate regulations and requirements as the Department balances critical training requirements to ensure achievement of stated goals and objectives while minimizing costs. 

Automating data collection is essential to provide accurate and timely information 

for senior leaders so they can execute their responsibilities and respond to queries 

for training related events from Congressional and other Federal oversight bodies. 

VA is currently engaged in developing and delivering an automated data collection 

tool to increase accountability, control training conference spending, and produce 

congressionally required reports. 

VA’s Conference Oversight Memorandum dated September 26, 2012, supersedes 

all previously issued conference guidance. 

The approval authorities: 

• A Senior Executive must approve any conference under $20,000. • Two Senior Executives, the Conference Certifying Official (CCO) and the Responsible Conference Executive (RCE), are appointed when a conference exceeds 

$20,000 to ensure adherence to all applicable statutes, regulations, and policies 

when planning and executing the approved conference. • An Under Secretary or Assistant Secretary must approve any conference within the threshold $20K to $100K. • The Deputy Secretary is responsible for approving conferences exceeding $100K to $500K. • Conferences exceeding $500K require a waiver by the Secretary. 

A Quarterly Conference Planning and Execution Briefing is now required at least 

120 days prior to the quarter of execution. This briefing outlines all the conferences 

planned for the targeted quarter to include cost, attendees, location, purpose and 

outcomes. 

The VA conference process has four phases: Concept, Development, Execution, 

and Reporting. 

• The Concept Phase is a disciplined conference authorization process. In October 2012, VA began our quarterly Concept Authorization Briefing as part of the 

quarterly Conference Planning and Execution Briefing Cycle where senior officials 

review all events to ensure the best value prior to being authorized to enter the Development Phase. 

• The Development Phase builds the business case for the event; provides the 

guidance for the planning and execution of the potential conferences; appoints a 

Senior Executive as the CCO and a Senior Executive as the RCE. The CCO certifies 

the event details are in compliance with all directives. The event plan is then submitted through the appropriate channels to the approving official for approval, disapproval or modification of the planned event. 

• The Execution Phase covers the period after the conference plan has been approved and the responsible organization begins to execute the approved plan. The 

RCE is responsible for executing the approved plan in accordance with laws, regulations, and policy. Additionally, the RCE oversees the spending and contract execution, approving any changes to contract agreements or increases in spending. 

• The Reporting Phase covers the period after the execution of the conference. 

The RCE submits an After Action Review (AAR) reflecting how the event was conducted; providing conference attendance and details on how the spending was 

tracked and reported in accordance with Public Law 112–154 and OMB M–12–12. 

The Administrations and Staff Offices leadership review the AAR to verify that the 

event was executed in accordance with the plan and all applicable policies and regulations. 

Question 103. In response to questions regarding VA’s fiscal year 2013 budget request, VA indicated that it planned to expend $6 million during fiscal year 2013 on 

a ‘‘Change Academy.’’ 

A. To date, how much has been expended on the Change Academy during fiscal 

year 2013, how many individuals have attended this training, and what outcomes 

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have been achieved? Are any of the individuals who attended this training no longer 

employed at VA? 

Response. Change Academies are customized programs designed to address specific interests, problem solving or strategic initiatives for any leadership team to 

bring transformational change to a VA facility, region or network. Change Academy 

provides a venue to leverage actual VA work scenarios to help clarify goals and action plans and to build momentum for organizational sustainment. Change Academies are more than training events; they are partnerships to facilitate solving 

problems affecting VA and the needs of our Veterans. As of June 30, 2014, three 

events have been approved and one event, costing $11,000 for attendance by 12 employees, was completed. There are currently 20 Change Academy sessions undergoing coordination for delivery for the remainder of the FY, reaching over 4100 VA 

employees. The expense associated with managing the program is $1.54 million 

through April, 2013. 

B. During fiscal year 2014, how much does VA expect to spend on the Change 

Academy, how many individuals are expected to attend this training, and what outcomes are expected to be achieved? 

Response. There is currently $2.8 million budgeted for Change Academies for FY 

2014. Task estimates are based on delivery of 12 small events of two or three day 

duration for up to 50 participants, 2 medium events of five day duration for up to 

80 participants, and 1 large multi-event program for up to 2000 participants. This 

year, Change Academies will be delivered on an indefinite delivery/indefinite quantity (ID/IQ) basis. Change Academies have been an extremely successful organizational training delivery and have received strong reviews from VA participants. The 

outcome brings together an entire facility or department to open dialog and identify 

solutions to address urgent organizational needs. 

Question 104. According to the fiscal year 2014 budget request, funding for VACO 

is expected to be reduced by 5 percent; however, the staffing level for the Office of 

Human Resources and Administration would add 50 FTE above the 2013 level and 

the number of FTE has grown by 72 percent since 2009. The Office of Resolution 

Management, which handles equal employment opportunity (EEO) complaints within the Office of Human Resources and Administration, would have the single largest 

increase in staffing with an additional 24 reimbursable FTE. Has VA seen a growth 

in EEO complaints in the last year? If not, what accounts for the growth of these 

positions? 

Response. The higher FY 2014 FTE in ORM is largely due to the annualization 

of ORM FTE hired late in fiscal year FY 2013. ORM FTE is expected to reach 267 

FTE in FY 2014, as a result, there is no FTE growth during FY 2014. 

Question 105. 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, 40 Senior Executive Service 

(SES) employees have completed SLC I and 476 SES employees have completed 

SLC II. 

A. For each training program (SLC I and SLC II), please provide the amount VA 

expects to spend in fiscal year 2014. 

Response. For SLC I—Core Training, the one-week senior executive onboarding 

course, VA projects holding three sessions (Cohorts 4, 5, and 6) in FY 2014 at a total 

cost of $127,578.84. For SLC II—Basic, the strategic decisionmaking course currently held at University of North Carolina-Chapel Hill, VA projects holding three 

sessions (Cohorts 20, 21, and 22) at a total maximum projected cost of $649,627.95. 

B. How much was spent on each training course (SLC I and SLC II) for fiscal year 

2009 through fiscal year 2013? Please breakdown by fiscal year, by category of 

spending (travel, facility rentals, course material, etc.), and by training program. 

Response. In 2012, VA Senior Executives called for a redesign of the VA’s Senior 

Executive On-boarding and Development Programs. Based on senior executive feedback, the Executive Forum was terminated because it was not providing new VA 

executives what they needed to be successful. The Department piloted a new onboarding program, the Senior Executive Strategic Leadership Course I—Core Training. This course was designed to acclimatize new senior executives to VA culture, 

highlight red lines or issues that posed a threat to new senior executives, set the 

conditions for a successful transition into the role of strategic leader, and promote 

corporate problem-solving through networking. About 80% of the program is delivered by VA Senior Executives. 

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The SLC I—Core Training course is followed by the Strategic Leadership Course 

II—Basic. This university-based course builds on SLC I by focusing on critical thinking skills, strategic decisionmaking, tools to facilitate leading and driving change, 

and networking opportunities to promote corporate problem-solving. Additionally, 

VA senior executives work VA Strategic Challenges during SLC II. These challenge 

questions provide the senior executives an opportunity to apply what they are learning at SLC II to real-world VA challenges. They then brief their analysis and recommendations to a VA senior leader on the final day of SLC II. Not only does the activity reinforce lessons learned at SLC II, but the VA gains from a fresh perspective 

on a VA program or policy. 

For SLC I—Core Training: 

Cohort Program Travel Total 

1 ..................................................................................................................... 58,728.96 32,938.28 91,667.24 

2 ..................................................................................................................... 53,464.35 25,436.23 78,900.58 

For SLC II—Basic: 

Cohort Program Contractor 

Support OPM Fee Travel Total 

1 .................................................................... 177,687.50 — 7,995.94 17,500.00 203,183.44 

2 .................................................................... 187,714.50 — 8,447.15 21,000.00 217,161.65 

3 .................................................................... 163,584.76 — 7,361.31 16,800.00 187,746.07 

4 .................................................................... 189,525.00 — 7,107.19 18,725.22 215,357.41 

5 .................................................................... 194,940.00 — 7,310.25 25,032.66 227,282.91 

6 .................................................................... 204,445.00 24,282.33 8,577.28 17,761.46 255,066.07 

7 .................................................................... 202,732.50 24,282.33 8,513.06 23,624.59 259,152.48 

8 .................................................................... 203,107.5 24,282.34 8,527.12 22,355.11 258,272.07 

9 .................................................................... 197,255.00 24,282.33 8,307.65 22,426.96 252,271.94 

10 .................................................................. 202,425.00 — 7,584.19 22,254.56 232,083.75 

11 .................................................................. 169,577.50 — 6,359.16 20,974.88 196,911.54 

12 .................................................................. 168,715.00 — 6,326.81 20,974.88 196,016.69 

13 .................................................................. 188,237.50 — 7,058.91 19,782.60 215,079.01 

14 .................................................................. 193,027.50 — 7,238.53 28,005.65 228,271.68 

15 .................................................................. 163,025.00 — 6,113.44 17,036.47 186,174.91 

16 .................................................................. 161,985.00 — 6,074.44 14,436.74 182,496.18 

17 .................................................................. 138,110.00 — 5,179.13 12,186.36 155,475.49 

18 .................................................................. 144,647.50 — 5,424.28 13,345.62 163,417.40 

19 .................................................................. TBD 0.00 TBD TBD TBD 

OPM Fee for use of contract vehicle in FY 2011 was 4.5%, then 3.75% in FY 2012. 

C. For training programs that are not conducted on VA property, please provide 

the dates and locations of each training program. 

Response. For SLC I—Core Training: Cohort 1 was conducted July 22–27, 2012 

and Cohort 2 during August 26–31, 2012, at the Bolger Center in Potomac, MD, 

which is a U.S. Postal Service facility. For SLC II—Basic: All cohorts were held at 

the Rizzo Conference Center, Kenan-Flagler Business School at the University of 

North Carolina, Chapel Hill, NC. 

Cohort dates follow: 

FY 2011 

Cohort Date 

1 March 20–25, 2011 

2 June 26–July 1, 2011 

3 September 18–23, 2011 

FY 2012 

Cohort Date 

4 October 2–7, 2011 

5 November 13–18, 2011 

124 

FY 2012—Continued 

Cohort Date 

6 December 4–9, 2011 

7 January 22–27, 2012 

8 February 12–17, 2012 

9 March 11–16, 2012 

10 April 22–27, 2012 

11 May 6–11, 2012 

12 May 13–18, 2012 

13 May 17–22, 2012 

14 July 15–20, 2012 

15 August 12–17, 2012 

16 September 9–14, 2012 

FY 2013 

Cohort Date 

17 October 14–19, 2012 

18 January 27–February 1, 2013 

19 June 16–21, 2013 

Question 106. The Veterans Employment Services Office, under the Office of 

Human Resources and Administration, oversees the VA for Vets initiative. The VA 

for Vets initiative includes a Web site with a skills translator that helps veterans 

find employment at VA and other Federal agencies. 

A. What Federal agencies have signed a memorandum of understanding (MOU) 

with VA to utilize the capabilities of VA for Vets? 

Response. To date, the U.S. Departments of Agriculture, State, Homeland Security, and Interior have signed MOUs with VA to utilize VA for Vets. The American 

Red Cross, a non-profit organization, also has a MOU in place with VA. An MOU 

is forthcoming with the Department of Commerce. The Departments of Labor and 

Health and Human Services, the National Credit Union Association, and the National Aeronautics and Space Administration have all met with VA to discuss the 

MOU process. 

B. How is VA reaching out to other agencies in order to expand the usage of VA 

for Vets through MOUs? 

Response. VA’s Veteran Employment Services Office (VESO) participates on the 

joint VA/DOD Veteran Employment Initiative Task Force to maximize the career 

readiness of all Servicemembers. The VESO Director serves as a co-chair for the 

Task Force’s Veterans Employment Working Group. The Task Force developed and 

submitted a list of recommendations to the President outlining the steps needed to 

ensure a successful transition for Military Servicemembers. 

The recommendations included the development of a single portal for Servicemembers and Veterans to gain access to resources on employment and transition 

services and for employers to post jobs for Veterans. 

VA supports this effort by providing access to the VA for Vets platform throughout the Federal Government through MOU’s. This access is at no additional cost to 

either the VA or other agencies that use VA4Vets. 

Specifically, VA is responsible for having MOUs in place by 2015 with 35 percent 

of all the 24 agencies that comprise the Veteran Employment Council. This number 

equates to 9 MOUs by 2015. VA is on track to meet or exceed the target using the 

Task Force and the Veteran Employment Council as the avenue to reach out to the 

agencies to reinforce the benefits and importance of signing the MOU 

C. Please describe the assistance provided to veterans through the program (i.e., 

career coaching and counseling). 

Response. VA for Vets provides a fully integrated, online job-search and careerbuilding platform, the VA for Vets Career Center, which allows Veterans to assess 

their talents and strengths, translate their military skills and training, build resumes, and identify and apply for Federal job opportunities. Career Coaches work 

one-on-one with Veterans and provide guidance on resume writing, job searches and 

interview preparation. The program further supports Veteran employees at VA by 

offering career development services and reintegration support for Military Servicemembers. 

125 

D. There are numerous veteran employment Web sites supported by various Federal agencies. Given the enhanced tools developed by VA for use by other Federal 

agencies, what efforts, if any, have been pursued by VA to establish one Federal 

Web site for veteran employment information and tools? 

Response. As mentioned in the response to subquestion 106 B above, the joint VA/ 

DOD Task Force recommended a single portal for Servicemembers and Veterans to 

gain access to employment and transition services and to determine the feasibility 

of deploying the VA for Vets platform across government. VA is also undertaking 

internal initiatives to work toward establishing one Federal portal for Veterans to 

access employment information and tools by integrating its private employment 

Web site (VetSuccess.gov) with its Federal employment Web site, VA for Vets. VA 

will be integrating these two Web sites into one platform to create a seamless and 

consistent experience for Veteran users. 

These combined efforts will give Veterans instant access to open Federal and private sector job listings as well as provide access to the enhanced VA for Vets services in a single source. 

E. Please provide the Committee with the number of unique veterans who have 

used the VA for Vets site, the number of veterans utilizing the job coaching and 

counseling, and the number of Federal jobs obtained through the program. 

Response. As of June 30, 2013, 944,127 unique visitors, both Veterans and civilians, have visited the Web site. As of June 30, 2013, 12,733 Veterans have utilized 

the job coaching and counseling. As of June 30, 2013, 1,921 Federal jobs have been 

obtained by Veterans through the program. 

Question 107. The Veterans Recruitment Appointment (VRA) is one of the hiring 

authorities that allow Federal agencies to hire eligible veterans. Veterans can be appointed to positions up to GS–11 or equivalent. Participating veterans are hired 

under excepted appointments to positions that would otherwise need to be competed. After 2 years of service, the veteran must be converted to a career position 

if they have performed satisfactorily. 

A. According to the fiscal year 2014 budget request, 35 percent of the VA workforce was comprised of veterans in 2013. Of those, how many veterans were hired 

using VRA, over the last five years? 

Response. Please see the chart provided in response to subquestion B. 

B. Please provide the Committee the number of veterans, during the last five 

years, hired under other hiring authorities, such as the Veterans Employment Opportunities Act (VEOA) or 30 percent or more disabled. 


415tab109a.eps
126 

C. Of those initially hired under VRA, how many (number and percentage) were 

converted to career or career-conditional appointments after two years? 

D. Of those hired in the last five years under other authorities, how many (number and percentage) are still employed at VA? Please detail, if employees are no 

longer with VA, whether their positions were terminated, the positions hired for 

were temporary, or they left for other reasons. 


415tab109b.eps 415tab109c.eps
127 

Office of Policy and Planning 

Question 108. The fiscal year 2014 budget request includes $11 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. See spreadsheet below. 


415tab110.eps
128 


415tab112a.eps
129 

Question 109. For fiscal year 2014, the budget request includes over $25 million 

for the Office of Policy and Planning and would support 114 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 2013 

and fiscal year 2014 and the number of contractors that are expected to be assigned 

to each such office. 

Response. 

2013 

Title Series Grade 

Office of the Assistant Secretary 

Assistant Secretary ................................................................................................................................... 301 SES 

Executive Assistant to the Assistant Secretary ....................................................................................... 301 GS 15 

Scheduler/Program Support to Assistant Secretary ................................................................................. 301 GS 11 


415tab112b.eps
130 

2013—Continued 

Title Series Grade 

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 VA/DOD Collaboration 

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 

Pathways Intern ........................................................................................................................................ 399 GS 9 

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 

Management Analyst ................................................................................................................................ 343 GS 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 GS 14 

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 

131 

2013—Continued 

Title Series Grade 

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 

Pathways Intern ........................................................................................................................................ 399 GS 9 

Management Analyst ................................................................................................................................ 343 GS 14 

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 

132 

2013—Continued 

Title Series Grade 

Operational Management Review 

Director ..................................................................................................................................................... 343 GS 15 

Management Analyst ................................................................................................................................ 343 GS 11 

Management Analyst ................................................................................................................................ 343 GS 13 

Management Analyst ................................................................................................................................ 343 GS 14 

Pathways Intern ........................................................................................................................................ 399 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 

Management Analyst ................................................................................................................................ 343 GS 11 

Management Analyst ................................................................................................................................ 343 GS 13 

Management Analyst ................................................................................................................................ 343 GS 14 

2014 

Title Series Grade 

Office of the Assistant Secretary 

Assistant Secretary ................................................................................................................................... 301 SES 

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 VA/DOD Collaboration 

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 

133 

2014—Continued 

Title Series Grade 

Operations Research Analyst ................................................................................................................... 1515 GS 14 

Management Analyst ................................................................................................................................ 343 GS 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 GS 14 

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 

134 

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’s employees assigned to OPP. 

Question 110. According to the fiscal year 2014 budget request, approximately 

$7.3 million is expected to be spent in ‘‘contract dollars’’ managed by offices within 

the Office of Policy and Planning. Please describe, in detail, the contracts for the 

Office of VA/DOD Collaboration, the Office of Corporate Analysis and Evaluation, 

the Office of Policy, the Office of Data Governance, and the Enterprise Program 

Management Office. Please include a description of the work performed under the 

contracts, the total number of on-site and offsite contracted employees working 

under the contract, the length of the contract, the metrics to be used to determine 

if the contract would be renewed, and the expected outcomes. 

Response. See spreadsheet below. 

135 


415tab112a.eps
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Office of Operations, Security, and Preparedness 

Question 111. For fiscal year 2014, the Office of Operations, Security, and Preparedness requests total resources of $31 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 of 

$31 million is the total fiscal year (FY) 2014 budget request for the Office. The personnel services portion of that request is $17.6 million to support 133 full-time employee equivalents. 


415tab112b.eps
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Grade TITLE Organization POSITION 

OSP Front Office 

Honorable Honorable ....... Assistant Secretary (A/S) .............................. OSP .................................................. Assistant Secretary 

GS-12 ............. Special Assistant to A/S ............................... OSP .................................................. Staff Assistant 

Office of Resource Management 

GS-15 ............. Director, Resource Management ................... 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) ........... Emergency Management ................. Support 

Planning, Exercise, Training, and Evaluation Service (PETE) 

GS-15 ............. Dir - Emergency Management Spec ............. OEM/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 ............................................ ................................................... 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 

138 

Grade TITLE Organization POSITION 

Operations & National Security 

GS-15 ............. Director (Supv.) RO 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 Spe ............................ 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) 

ES ................... 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, HSPD-12 ............................. PSIM ................................................ HSPD-12 

GS-13 ............. Physical Security Specialist .......................... PSIM ................................................ HSPD-12 

GS-13 ............. Program Analyst ............................................ PSIM ................................................ HSPD-12 

GS-11 ............. Director, 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 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 

Office of Security & Law Enforcement (OSLE) 

SES ................. Director for S&LE ........................................... 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 

.................. 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 

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Grade TITLE Organization POSITION 

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 

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 

Identity, Credentials, and Access Management (ICAM) 

ES ................... 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 

GS-15 ............. 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 

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-15 ............. 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-15 ............. Director-On-Board/Off-Board ......................... On-Board/Off-Board ........................ On-Board/Off-Board 

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Grade TITLE Organization POSITION 

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 

Question 112. For fiscal year 2014, the Office of Operations, Security, and Preparedness requests $10.6 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 the Government Services Administration leased spaces in the Capital Region ($3.2 million) and Program 

support for the Homeland Security Presidential Directive–12 (HSPD–12) program 

management office ($6 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 maintenance contracts. 

Question 113. According to the fiscal year 2014 budget request, the Office of Operations, Security, and Preparedness now expects to spend $10.2 million on Other 

Services during fiscal year 2013, which is $6.2 million higher than the amount originally requested for fiscal year 2013 ($4.1 million). 

A. Please explain what led to the expected increase in Other Services during fiscal 

year 2013. 

Response. Beginning in FY 2013, OSP assumed overall management responsibility for the VA Personal Identity Verification (PIV) card program, which had previously resided in the Office of Information and Technology (OI&T). This increase 

in Other Services ($6.2 million) is a direct result of that action. OSP is funding that 

program utilizing reimbursable funding from the other Offices and Administrations. 

B. Please provide an explanation of how these funds are expected to be expended 

during fiscal year 2013. 

Response. These funds ($6.2 million) will be used for contract support at the 200+ 

PIV card issuing stations across the Department as well as in the Project Management Office at headquarters. 

Question 114. According to the fiscal year 2014 budget request, the Office of Operations, Security, and Preparedness now expects to spend $1.8 million on supplies 

and materials in fiscal year 2013, which is $1.6 million higher than VA originally 

requested for fiscal year 2013. 

A. Please explain what led to the expected increase in supplies and materials during fiscal year 2013. 

Response. Beginning in FY 2013, OSP assumed overall management responsibility for the VA PIV card program, which had previously resided in OI&T. This increase in Supplies and Materials ($1.6 million) is a direct result of that action. OSP 

is funding that program utilizing reimbursable funding from the other Offices and 

Administrations. 

B. Please provide an explanation of how these funds are expected to be expended 

during fiscal year 2013. 

Response. This $1.6 million increase will be used to purchase consumable supplies 

for PIV card issuing stations across the agency. These supplies are mainly PIV card 

blanks that are centrally managed which are used to issue new or replacement 

cards to agency employees, contractors, and affiliates. 

Office of Public and Intergovernmental Affairs 

Question 115. For fiscal year 2014, the Office of Public and Intergovernmental Affairs requests total resources of $25.7 million and 101 employees. Please provide a 

list of the positions that would be filled with that funding and the pay-grades for 

those positions. 

141 

Question 116. For fiscal year 2014, the Office of Public and Intergovernmental Affairs requests $9.5 million for purposes of the Paralympics program. 

A. During fiscal year 2013, how much is expected to be dispersed through this 

grant program, what percentage of those funds are expected to be used to pay the 

salary costs for employees of the U.S. Olympic Committee/U.S. Paralympics, and 

how much is expected to be spent on non-salary administrative costs by the U.S. 

Olympic Committee? 

Response. For FY 2014, OPIA requests $9.5 million for purposes of the Paralympics program. During FY 2013, the Paralympic program is expected to disperse $7.5 

million through the Paralympic grant, with 13 percent expected to be used to pay 

the salary costs for employees of the U.S. Olympic Committee/U.S. Paralympics, and 

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pic Committee. The U.S. Olympic Committee does not intend to use Paralympic 

grant funds for the allowed 5 percent administrative costs and intends to use nongovernmental sources of funding for non-salary administrative costs. 

B. During fiscal year 2014, how much is expected to be dispersed through this 

grant program, what percentage of those funds are expected to be used to pay the 

salary costs for employees of the U.S. Olympic Committee/U.S. Paralympics, and 

how much is expected to be spent on non-salary administrative costs by the U.S. 

Olympic Committee? 

Response. During FY 2014, the Paralympic program is expected to disperse $7.5 

million through the Paralympic grant, with 13 percent expected to be used to pay 

the salary costs for employees of the U.S. Olympic Committee/U.S. Paralympics, and 

no funds expected to be spent on non-salary administrative costs by the U.S. Olympic Committee. The U.S. Olympic Committee does not intend to use Paralympic 

grant funds for the allowed 5 percent administrative costs and intends to use nongovernmental sources of funding for non-salary administrative costs. 

Question 117. According to the fiscal year 2014 budget request, the Office of Public and Intergovernmental Affairs now expects to spend $4.4 million on Other Services during fiscal year 2013, which is $2.9 million higher than the amount requested 

for fiscal year 2013 ($1.5 million), and that office requests $1.5 million for Other 

Services for fiscal year 2014. 

A. Please explain what led to the expected increase in Other Services during fiscal 

year 2013. 

Response. OPIA received $2.5 million to execute an outreach initiative known as 

‘‘VA-Outreach.’’ The goal of the initiative is to increase Veterans access to VA health 

care, benefits, and services. 

B. Please provide an itemized list of how these funds are expected to be expended 

during fiscal year 2013 and fiscal year 2014. To the extent any of these funds will 

be spent on contracts, please explain the nature of the contract and the expected 

outcomes. 

Response. 

FY 2013 Other Services $4.4 million 

Contracts/Name Amount 

(Est.) Description 

VA Outreach Initiative ............. $2,500,000 The goal of the initiative is to increase Veterans access to VA health care, 

benefits, and services. ‘‘VA Outreach’’ is a national marketing and advertising outreach campaign with the goal of bringing new Veterans to 

VA. 

Barbaricum LLC ...................... $231,000 To establish, maintain and distribute a customized executive daily news 

summary. 

Young & Rubicam Inc. ........... $166,000 Vendor to provide graphic design services, custom computer programming 

services and administrative and general management consulting services is support of VA’s Executive Order 13175, Consultation and Coordination with Indian Tribal Governments. 

Rhinegold ................................ $965,000 HVIO will have a continuing need for outreach support in FY 14. That support will include purchasing paid internet advertising, developing and 

distributing public service announcements (PSAs), partner development 

and support, and distribution of materials promoting awareness and use 

of the National Call Center for Homeless Veterans (NCCHV), and other 

communications and public relations support in support of the effort to 

end homelessness among Veterans by 2015. Part of the effort on this 

contract serves the VHA Homeless Office. 

VA History Office and Archives $300,000 DVA seeks to establish an agency-wide VA History Office and Archives to 

preserve its heritage and material culture and to develop history outreach programs to benefit VA, Veterans, Congress and other stakeholders, and the American public. 

Misc. Contracts ....................... $250,000 Rent, Transit Subsidy, UPS Service, Service Level Agreements, Copier 

Maintenances 

TOTAL ............................. $4,412,000 

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FY 2014 Other Services $1,506m 

Contracts Amount 

(Est.) Description 

Barbaricum LLC ...................... $238,000 To establish, maintain and distribute a customized executive daily news 

summary. 

Rhinegold ................................ $965,000 HVIO will have a continuing need for outreach support in FY 14. That support will include purchasing paid internet advertising, developing and 

distributing public service announcements (PSAs), partner development 

and support, and distribution of materials promoting awareness and use 

of the National Call Center for Homeless Veterans (NCCHV), and other 

communications and public relations support in support of the effort to 

end homelessness among Veterans by 2015. Part of the effort on this 

contract serves the VHA Homeless Office. 

Misc Contracts ........................ $250,000 Rent, Transit Subsidy, UPS Service, Service Level Agreements, Copier 

Maintenances 

TOTAL ............................. $1,453,000 

Question 118. According to the fiscal year 2014 budget request, the Office of Pub- lic and Intergovernmental Affairs requests $462,000 for travel for fiscal year 2014. 

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 $462,000 for travel in FY 2014 is expected to support an estimation of 270 trips with an average estimation of $1,702.00 cost per trip. 

Question 119. In response to a question for the record regarding the fiscal year 

2013 budget request, VA provided the Committee with information on advertising 

outreach activities for 2009 through 2013. For the five-year period ending in 2013, 

VA reported spending $83.7 million. Please provide the Committee with updated 

amounts for 2013 and how much is expected to be spent on advertising in fiscal year 

2014. 

Response. In FY 2013, OPIA received $15 million from VHA to support media 

buys for regional advertising and the development of an outreach Web site prior to 

the start of the national Ad Council advertising campaign that will be launched in 

October 2013. OPIA also received approval for $2.5 million in FY 2012 carry-over 

funds to support creative advertising development, and social media advertising. 

In FY 2014, the Ad Council campaign will be the lead advertising effort under 

OPIA. The budget for the campaign during FY 2014 is estimated at $1.3 million. 

[Note: All three VA administrations maintain separate advertising and outreach 

budget data on their efforts conducted in FY 2013.] 

Question 120. VA’s response to prehearing questions for the fiscal year 2013 budget hearing stated that one of the missions of the National Veterans Outreach Office 

(NVO) was to ‘‘evaluate and develop metrics to measure the effectiveness of outreach programs.’’ 

A. Please describe the metrics that have been developed by NVO for the purposes 

of evaluating VA outreach activities. 

Response. The metric established for outreach is new access to one or more of 

VA’s programs. ‘‘Access’’ is defined as a Veteran, family member, or a Servicemember who enrolls, registers, and/or uses one or more VA benefits and services. 

The access baseline is the number of unique individuals who accessed VA in FY 

2012. ‘‘New access’’ is defined as an individual accessing VA in FY 2013 who was 

not found in any VA database in FY 2012. FY 2012 baseline data and FY 2013 access data are both extracted from VBA, VHA, NCA and VA’s e-Benefits portal. 

In order to track and measure VA access, a reporting process was established and 

approved by the VA Chief of Staff in December 2012. On a monthly basis, VHA, 

VBA, and NCA provide data within their respective areas of responsibility to the 

VA Office of Policy and Planning (OPP) to process and determine new clients accessing VA. 

B. What metrics will VA use to determine whether programs are duplicative in 

nature? If that determination is made, what steps will be taken to change or terminate the outreach? 

Response. 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. 

144 

C. Have any outreach programs or campaigns been terminated early by VA because they have been deemed ineffective? 

Response. Thus far, NVO has not terminated any outreach programs or campaigns due to ineffectiveness. All of NVO’s outreach programs or campaigns have 

sufficient built-in flexibility to enable reinforcing efforts along a proven path of success and also have off-ramp capabilities to preclude following a path that is not producing the intended result(s) or effect(s). 

D. How does VA evaluate whether veteran participation in services offered by VA 

is a result of outreach activities undertaken by VA? 

Response. NVO presently uses the database tracking system discussed in Question 120 to determine how outreach is impacting new user access to VA benefits and 

services. Starting in October 2013, VA and the Ad Council are launching a national 

advertising campaign targeting Veterans and their families to increase their awareness and usage of all VA benefits, programs, and services. The campaign’s messaging will direct the targeted audience to access a specially-created web page for 

more information about VA. Access to this web page will be tracked as one method 

of measuring the effectiveness of the advertising campaign. 

Additionally, the Ad Council uses the leading monitoring, audience and valuation 

services available in the industry to capture the data pertaining to the markets 

where the public service announcements aired during the campaign. The donated 

media support will be monitored and reported to VA approximately two months 

after the close of each quarter across the following: 

• Local broadcast, network cable, and local cable television 

• Radio (traditional and streaming) 

• Print (magazine and newspaper) 

• Web banners 

• Outdoor 

• Public Relations 

The Ad Council will also provide preliminary monthly reports to VA to assist with 

directional analysis. This information will include reports from: 

• Local broadcast detections, dollar values, and specific placement 

• Network cable detections and specific placement 

• Banner placements and click-through rates 

Office of Congressional and Legislative Affairs 

Question 121. According to the 2012 PAR, during 2012 VA ‘‘[i]mproved relations 

with Congress by improving responsiveness and communicating more effectively.’’ 

A. Please explain the statistics or information that were the basis for this conclusion. 

Response. The Office of Congressional and Legislative Affairs (OCLA) is responsible for maintaining open communications with Congress through briefings, meetings, office calls, hearings, site visits, written communications, reports, and responses to Congressional Member offices and Congressional Committee requests for 

information. OCLA also supports Congressional offices’ Veterans constituent casework and is responsible for VA interaction with the U.S. Government Accountability 

Office (GAO). OCLA coordinates all VA-GAO meetings, correspondence, and reports. 

During FY 2012, OCLA supported 72 congressional hearings (57% increase over 

FY 2011), coordinated 688 briefings (52% increase over FY 2011), responded to 1,404 

questions for the record, processed over 19,703 constituent casework inquires, supported 43 GAO Entrance Conferences, 41 Exit Conferences (41% increase over FY 

2011), 65 Draft Reports (35% increase over FY 2011), and 72 Final Reports (53% 

increase over FY 2011). FY 2012 was the first year OCLA measured the number 

of formal responses to requests for information. In FY 2012, OCLA responded to 

2,750 congressional requests for information. 

B. During fiscal year 2012, what was the average time it took to fulfill briefing 

requests by the Senate Committee on Veterans’ Affairs? 

Response. During FY 2012, OCLA coordinated 688 briefs to Members of Congress 

and staff. This was a 52 percent increase over the 454 briefs conducted in FY 2011. 

Briefs were coordinated based on the priority set by the requesting committee and 

the Department. 

C. During fiscal year 2012, what was the average time it took to fulfill briefing 

requests by the House Committee on Veterans’ Affairs? 

Response. During FY 2012, OCLA coordinated 688 briefs to Members of Congress 

and staff. This was a 52 percent increase over the 454 briefs conducted in FY 2011. 

Briefs were coordinated based on the priority set by the requesting committee and 

the Department. 

145 

D. To date in fiscal year 2013, how many requests from the Senate or House Committees on Veterans’ Affairs have gone unfulfilled for more than 2 weeks and for 

more than 4 weeks? 

Response. During FY 2013, OCLA coordinated 999 briefings to Members of Congress, congressional committees, and staff. This was a 45 percent increase over FY 

2012. The priority for briefings was set by the requesting Member or congressional 

committee, and the Department. 

During FY 2013, OCLA developed and maintains a Workload Dashboard that 

identifies all of the congressional action items the office is currently working. 

As of October 17, 2013, the OCLA Dashboard listed the following outstanding 

items: 

• 133 Congressional Requests for Information 

• 86 Executive Congressional Correspondence items addressed to the Secretary 

• 732 Questions for the Record 

• 17 Hearing Deliverables 

• Additionally, OCLA is also working: 

– 427 Congressional Constituent Casework Inquires 

– 17 GAO actions 

– 20 Requests for Technical Assistance on Legislation 

– 35 Briefings within the next 30 days 

The total current daily volume of work constitutes over 1,400 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. 

Question 122. For fiscal year 2014, 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 

Director, Congressional Reports and Correspondence ................................................................. GS-15 

Special Assistant .......................................................................................................................... GS-15 

Special Assistant .......................................................................................................................... GS-15 

2 Administrative Officers .............................................................................................................. GS-14 

Executive Correspondence Analyst ................................................................................................ GS-14 

13 Congressional Relations Officers ............................................................................................ GS-12/13/14 

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 123. In connection with VA’s fiscal year 2013 budget request, the Office 

of Congressional and Legislative Affairs outlined the measures and metrics used to 

evaluate the performance of that office. 

A. In terms of those measures and metrics, please assess the performance of the 

Office of Congressional and Legislative Affairs during fiscal year 2012. 

Response. During FY 2012 OCLA continued to carry out its Strategic Plan to ‘‘Enhance relationships with Congress by improving responsiveness and communicating 

more effectively’’ though a pro-active strategy designed to provide accurate, relevant, 

and timely information to Congress. OCLA also achieved full operational capability 

146 

of its congressional knowledge management system that provides a database to 

catalog the Department’s congressional activities. 

OCLA’s workforce, of whom 50% are Veterans, accomplished the following in FY 

2012: 

• Supported 72 Hearings (57% increase over FY 2011) • Coordinated 688 Briefings (52% increase over FY 2011) • Coordinated responses to 1,404 Questions for the Record • Responded to 2,750 Requests for Information (first year for this performance 

measure) • Supported 57 Congressional oversight travel visits • Supported 43 GAO Entrance Conferences • Supported 41 GAO Exit Conferences (41% increase over FY 2011) • Coordinated the Department’s responses to 65 GAO Draft Reports (35% increase over FY 2011) • Supported 72 GAO Final Reports (53% increase over FY 2011) • Coordinated 19,703 Congressional Constituent Inquires • Submitted 75% of questions for the record on time (Target goal was 85%) • Submitted 88% of testimony on time (Target goal is 90%) • Submitted 68% of Title 38 reports on time (Target goal is 85%) 

B. In terms of those measures and metrics, what performance outcomes are expected during fiscal year 2013? 

Response. OCLA achieved the following outcomes in FY 2013: 

• Supported 62 Hearings • Coordinated 999 Briefings (45% increase over FY 2012) • Coordinated responses to 310 Questions for the Record • Responded to 3,544 Requests for Information (29% increase over FY 2012—first 

year this performance measure was kept) • Supported 63 Congressional oversight travel visits • Supported 51 GAO Entrance Conferences (19% increase over FY 2012) • Supported 36 GAO Exit Conferences • Coordinated the Department’s responses to 31 GAO Draft Reports • Supported 35 GAO Final Reports • Coordinated 24,949 Congressional Constituent Inquires (27% increase over FY 

2012) • Submitted 13% of questions for the record on time (Target goal was 85%) • Submitted 75% of testimony on time (Target goal is 90%) • Submitted 24% of Title 38 reports on time (Target goal is 85%) 

C. In terms of those measures and metrics, what performance outcomes are expected during fiscal year 2014 if the requested level of funding is provided? 

Response. OCLA will continue to advance responsive and effective congressional 

communications (i.e., proactive approach to briefings, meetings, hearings, site visits, 

and constituent service) to increase the information exchanged regarding the Department of Veterans Affairs among Members of Congress and staff. 

If the requested level of funding is provided, OCLA would look to efficiencies, 

technology, and effective prioritization to maintain its level of performance and 

achieve the following outcomes in FY 2014: 

• 100% Support of all Hearings set by Congress • Conduct approximately 700 Briefings • Respond to approximately 1,200 Questions for the Record • Respond to approximately 3,750 Requests for Information • Support 59 Congressional oversight travel visits • Support approximately 60 GAO Entrance Conferences • Support approximately 20 GAO Exit Conferences • Coordinate the Department’s response to approximately 60 GAO Draft Reports • Support approximately 25 GAO Final Reports • Coordinate approximately 19,000 Congressional Constituent Inquires • OCLA would strive to meet its target goals of: 

• 90% Percentage of questions for the record submitted on time • 90% Percentage of testimony submitted on time • 85% Percentage of Title 38 reports submitted on time 

Office of Acquisition, Logistics, and Construction 

Question 124. In response to questions about the fiscal year 2013 budget request, 

VA indicated that the Office of Acquisition, Logistics, and Construction planned to 

spend $5 million during fiscal year 2013 on an ‘‘Acquisition Improvement Initiative,’’ 

which was described as developing the acquisition workforce. 

A. How much has VA expended on that initiative to date? 

147 

Response. VA has spent $3,979,384 on the Acquisition Improvement Initiative as of August 31, 2013, and is spending an additional $916,000 in September 2013, for 

a total of $4,895,384. 

B. Please describe this initiative in more detail and outline any measureable outcomes that have resulted from this initiative. 

Response. The Office of Acquisition, Logistics and Construction (OALC) is committed to continuing the improvement of the acquisition process. To ensure that 

these improvements are sustainable, OALC embarked on an aggressive path to increase the capacity and capability of the acquisition workforce. OALC has begun to 

increase the size of the acquisition workforce and improve the training of all employees that have a significant impact to the process, to include the Major Construction and Leasing Program Managers and Resident Engineers. 

OALC increased the capacity of the acquisition workforce supporting major construction and leasing by hiring 19 contracting officers since fiscal year (FY) 2012. 

This represents an 80 percent increase in contracting expertise. OALC has also invested in training and technology to ensure sustained improvement. The legacy program management software is currently being replaced by a state-of-the-art system 

and nationwide training is ongoing. OALC has also invested in additional program 

management and coaching focused on the acquisition process. The table below details the distribution of the Acquisition Improvement Initiative funds: 

Program Management Software Services (TRIRIGA) ........................................................................ $2,310,000 

Program Management and Coaching Training ................................................................................ $1,185,384 

Salary & Benefits .............................................................................................................................. $1,425,000 

$4,920,384 

Question 125. For fiscal year 2014, the Office of Acquisition, Logistics, and Con- struction requests total resources of $87 million and 492 employees, an increase of 

146 FTE over the fiscal year 2012 level. 

A. Please provide a list of the positions added since fiscal year 2012. 

Response. 

Proposed Positions Over the FY 2012 Level 

Resident Engineers ............................................................... 42 

Project Managers/Program Managers .................................. 34 

Realty Specialists ................................................................. 3 

Planners ................................................................................ 18 

Contracting Specialists ........................................................ 23 

Architect/Engineers ............................................................... 3 

Management Support ........................................................... 23 

Total ............................................................................. 146 

B. Have those positions been and will those positions generally be filled through 

hiring new employees or transferring employees from other VA offices? 

Response. 

Actual Hired Positions 

Resident Engineers ............................................................... 20 

Planners ................................................................................ 4 

Contracting Specialists ........................................................ 19 

Total ............................................................................. 43 

To date, 43 positions have been hired with 77 percent of the positions being new 

hires from outside VA. The majority of the 106 open positions are currently projected to be filled from outside VA. 

Question 126. According to the fiscal year 2014 budget request, the Office Acquisition, Logistics, and Construction now expects to spend $19.6 million on Other Services during fiscal year 2013, which is $5.7 million higher than the amount requested 

148 

for fiscal year 2013 ($13.9 million), and that office requests $7 million for Other 

Services for fiscal year 2014. 

A. Please explain what led to the expected increase in Other Services during fiscal 

year 2013. 

Response. Updated hiring plans reduced the requirement for personal services 

funds in FY 2013. $5.6 million from personal services was moved to other services 

and is targeted for contract needs. In FY 2014, hiring is expected to reach planned 

levels, and other services funding will decrease proportionately. Due to delays in 

hiring, OALC will pursue contracts to support efforts of the Construction Review 

Council (CRC) and other improvements to address issues noted in the GAO report, 

GAO–13–556T. 

B. Please provide an itemized list of how these funds are expected to be expended 

during fiscal year 2013 and fiscal year 2014. To the extent any of these funds will 

be spent on contracts, please explain the nature of the contract and the expected 

outcomes. 

Response. See charts below. 

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151 

Question 127. According to the 2012 PAR, in April 2012 VA established a Construction Review Council (CRC). The stated purpose of the CRC is to ‘‘oversee the 

Department’s development and execution of its real property capital asset programs.’’ The PAR also notes that VA has started ‘‘initiatives to advance the timely 

delivery of first-rate facilities.’’ 

A. Please provide a list of the members of the CRC, including their positions and 

for which VA agency or department they work. If a member of the CRC is not an 

employee of VA, please include the agency, Cabinet level department, company, or 

association for which they work. 

Response. The following positions are members of the CRC and are VA employees: 

• Secretary, Department of Veterans Affairs 

• Deputy Secretary, Department of Veterans Affairs 

• Under Secretary of Health 

• Under Secretary of Memorial Affairs 

• Under Secretary of Benefits 

• Principal Executive Director, Office of Acquisitions, Logistics and Construction 

(OALC) 

• Executive Director, Construction and Facilities Management 

• Assistant Secretary for Management 

• Director, Office of Asset and Enterprise Management 

• Assistant Secretary for Human Resources and Administration 

• Assistant Secretary for Information Technology 

• Assistant Secretary for Policy and Planning 

• Assistant Secretary for Congressional and Legislative Affairs 

• General Counsel 

• Assistant Deputy Under Secretary for Health for Policy and Planning, Veterans 

Health Administration 

• The relevant Veterans Integrated Service Network and VA medical center Directors as well as relevant construction program executives and senior resident engineers will participate as required. 

B. What is the duration of the CRC, and for how long do the members of the CRC 

serve? 

Response. The CRC does not have a termination date. Members on the Council 

are by position; therefore, the incumbent will serve on the panel. 

C. Please describe, in detail, the initiatives (referenced above) VA has undertaken 

to improve or ‘‘advance timely delivery of first-rate facilities to better serve our Nation’s veterans.’’ 

Response. The CRC defined four areas of concentration in order to advance timely 

delivery of first-rate facilities to better serve our Nation’s Veterans. They are: 

• Requirements—Adequately develop requirements during the planning process of 

a construction project. 

• Design—Improve design quality to minimize added costs and/or delays during 

construction. 

• Budget—Effectively coordinate design, construction and activation costs 

• Project Management—Streamline program management and automation enterprise-wide tools. 

The OALC initiatives to address these areas include: 

• Develop policy to align with the Strategic Capital Investment Planning (SCIP) 

process and the move to a 35 percent design, to adequately develop requirements 

before requesting major construction funding. 

• Examine the current peer review process, adequacy of current design guide, errors and omission rates, and guide specifications, to ensure all are current and effective, increase quality of the design, and allow fewer changes during construction. 

• Establish mechanisms, such as activations funding, to coordinate the various 

funding streams required for major construction, to ensure funding for medical 

equipment and Office of Information and Technology equipment, to support the construction schedule. 

• Field the construction project management software package (TRIRIGA) across 

the enterprise. 

Question 128. The 2012 PAR indicates that VA has seen a ‘‘cost savings or avoidance’’ of $82 million through selling property, space management, and other initiatives. It also notes that VA has reduced its vacant buildings by 23 percent over the 

last five years. 

A. As of the start of fiscal year 2013, how many vacant or underutilized properties 

does VA have in its inventory? Please break this out by building or property type 

(hospital, clinic, office building, etc.). 

152 

Response. At the end of FY 2012/beginning of FY 2013, VA had approximately 974 

vacant or underutilized buildings, of which 418 (43%) were historic buildings. Of the 

974, approximately 228 were vacant and 746 were underutilized. 

The 974 buildings account for approximately 10.5 million Square Feet (SF) of 

space in vacant or underutilized buildings. Of that total, 4.1 million SF is located 

in vacant buildings and 6.4 million SF is located in underutilized buildings. 

End of FY 2012 Vacant/Underutilized Buildings 

Usage Type # Vacant 

Buildings 

Sq Ft 

Vacant 

Buildings 

# Underuti- lized 

Buildings 

Sq Ft Underutilized 

Buildings 

Total # 

Buildings Total Sq Ft 

Dormitories/Barracks .......................................... 2 110,200 0 0 2 110,200 

Hospital .............................................................. 14 1,315,299 32 706,071 46 2,021,370 

Housing ............................................................... 58 294,004 52 233,414 110 527,418 

Industrial ............................................................ 2 2,278 57 243,619 59 245,897 

Laboratories ........................................................ 1 133,730 10 223,307 11 357,037 

Office .................................................................. 26 469,980 89 1,137,132 115 1,607,112 

Other Institutional Uses ..................................... 8 168,282 56 823,400 64 991,682 

Outpatient Health care Facility .......................... 1 74,551 3 22,319 4 96,870 

Service ................................................................ 16 145,115 193 1,342,195 209 1,487,310 

Warehouses (Storage/Sheds) .............................. 21 177,237 143 787,358 164 964,595 

All Other ............................................................. 79 1,186,290 111 859,117 190 2,045,407 

Grand Total ................................................ 228 4,076,966 746 6,377,932 974 10,454,898 

B. In fiscal year 2014, how many vacant or underutilized properties does VA expect to have in its inventory? Please break this out by building or property type 

(hospital, clinic, office building, etc.). 

Response. VA projects it will have approximately 941 vacant or underutilized 

buildings at the end of FY 2013/beginning of FY 2014. Of the 941, approximately 

206 would be considered vacant and 735 underutilized. In terms of SF, there will 

be 3.8 million SF in vacant buildings and 6.2 million SF in underutilized buildings, 

for a total of 10.0 million SF in the portfolio. 

The reduction in vacant and underutilized buildings from end of FY 2012 is the 

result of disposing of un-needed assets;, however, there are challenges in further reducing VA inventory in this area. Of the projected 941 vacant or underutilized assets, 409 (44%) 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 a fully restored Enhanced-Use Lease (EUL) authority or Civilian 

Property Realignment Act (CPRA), as proposed by the President of the United 

States, would help overcome some of these challenges and allow VA to more effectively reduce its inventory of vacant and underutilized assets. 

Projected End of FY 2013 Vacant/Underutilized Buildings 

Usage Type # Vacant 

Buildings 

Sq Ft 

Vacant 

Buildings 

# Underutilized 

Buildings 

Sq Ft Underutilized 

Buildings 

Total # 

Buildings Total Sq Ft 

Dormitories/Barracks .......................................... 1 85,000 0 0 1 85,000 

Hospital .............................................................. 14 1,315,299 32 706,071 46 2,021,370 

Housing ............................................................... 55 283,430 52 233,414 107 516,844 

Industrial ............................................................ 1 555 56 241,019 57 241,574 

Laboratories ........................................................ 1 133,730 8 213,034 9 346,764 

Office .................................................................. 22 424,172 89 1,137,132 111 1,561,304 

Other Institutional Uses ..................................... 6 163,892 55 719,161 61 883,053 

Outpatient Health care Facility .......................... 1 74,551 3 22,319 4 96,870 

Service ................................................................ 15 129,055 190 1,309,696 205 1,438,751 

Warehouses (Storage/Sheds) .............................. 17 166,571 139 780,740 156 947,311 

All Other ............................................................. 73 1,050,377 111 859,117 184 1,909,494 

Grand Total ................................................ 206 3,826,632 735 6,221,703 941 10,048,335 

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C. For each of fiscal years 2012, 2013, and 2014, how much has VA spent or does 

VA expect to spend on maintenance of vacant or underutilized property? 

Response. VA does not track actual costs at the building level; however it does 

use a proration methodology to report building level costs to the Federal Real Property Profile (FRPP) annually. For FY 2012, VA estimates it spent approximately 

$23.4 million on the 974 vacant and underutilized assets in its portfolio. A further 

breakdown of those costs is an estimated $6 million on the 228 vacant buildings and 

$17 million on the 746 underutilized assets. 

The average cost for vacant buildings is $1.48/SF and is consistent with previous 

estimates on maintaining vacant assets. Underutilized buildings are still in use, 

therefore incur greater operating expenses than a purely vacant building. The average cost for maintaining underutilized buildings is $2.72/SF 

The average cost per SF to maintain a vacant or underutilized building would 

likely remain constant over the next several years. Given current disposal plans, the 

overall estimated cost to operate vacant and underutilized buildings would range 

from $22 to $24 million annually in FY 2013 and FY 2014. 

Question 129. Public Law 111–82 authorized VA to enter into leases for seven 

Health Care Centers (HCCs). The law provided $150 million to cover the startup 

costs and the first year’s rent; however, VA has only obligated $40 million for construction costs. 

A. How much in total will be needed to construct theses HCCs and when will they 

start treating veterans? Please breakdown this funding by individual HCC. 

Response. VA obligates the build-out funds and first year’s rent upon contract 

award. To date, four of the seven HCCs have been awarded and approximately 

$52.7 million has been obligated. Please see the table below for specific amounts related to each project. VA’s request for authorization and actual costs expended are 

linked to the medical build-out requirements along with the rent payments, not necessarily the developer’s cost to construct the facility. Please see below for a breakout 

of each HCC and anticipated or actual costs, which are dependent on the contract 

award (projects highlighted in gray have been awarded). Also included for each clinic is the anticipated date for first patient day. 

Butler, 

PA 

Charlotte, 

NC 

Fayetteville, 

NC 

Loma Linda, 

CA 

Monterey, 

CA 

Montgomery, 

AL 

WinstonSalem, NC 

Annual Lease Cost— 

Year 1($) ..................... 5,755,683 14,232,000 7,662,113 16,249,000 6,183,000 3,723,855 10,986,664 

Build-Out($) ..................... 2,813,953 16,225,000 8,936,545 14,905,000 5,445,000 3,214,237 9,604,089 

Size (in net usable 

square feet) ................. 168,000 295,000 259,600 271,000 99,000 111,407 280,000 

Date of Contract Award 

(Planned(P) & 

Actual(A)) .................... May-12(A) Aug-13(P) Sep-12(A) Aug-13(P) Aug-13(P) May-13(A) May-13(A) 

Anticipated Date to Start 

Treating Veterans ........ TBD* Jan-16 Aug-15 Feb-16 Jan-16 Nov-15 Nov-15 

* VA’s Office of the Inspector General (OIG) completed an investigation of Westar and its related companies and principals and found that 

Westar made fraudulent misrepresentations in its offer during the procurement process. Due to these findings, VA issued a stop work order on 

June 21, 2013, and a ‘‘Show Cause’’ letter to Westar on July 12, 2013. The lease was terminated for default effective as of August 9, 2013. 

VA reopened the Butler HCC lease procurement on September 30, 2013, and expects a new lease award by May 2014. 

B. What is VA doing to track costs of the HCCs to ensure there is effective management of and supervision over the HCC leasing project? 

Response. VA’s lease acquisition process utilized on the HCCs follows a number 

of methods to ensure effective cost management. Leases adhere to the Competition 

in Contracting Act to ensure that maximum competition is pursued, which yields 

the most competitive pricing possible on each contract. Each lease is conducted as 

a ‘‘best-value’’ procurement, meaning that both price and technical factors are evaluated and weighed prior to VA making the final award determination. In order to 

track and manage funds expended on the HCCs, VA is maintaining clear, consistent 

contract files that include spreadsheets of all obligations pertaining to each project. 

Each project is effectively managed by an acquisition team that includes a Real Estate Project Manager and Contracting Officer from OALC; representatives from 

leadership and engineering at the parent VA medical centers, and, as needed, technical support from architect and engineer firms and legal support from VA’s Office 

of General Counsel. VA also assigns two to three resident engineers for each of the 

HCCs to oversee the project during the post-award design and construction phases, 

to ensure that the contract is executed in a quality and timely manner. 

154 

Question 130. The 2012 PAR highlights the Warrior to Workforce Program implemented by the Office of Acquisition, Logistics, and Construction. The Warrior to 

Workforce Program is a three-year pilot program that trains service-connected disabled veterans to become contract specialists. 

A. What metrics will VA use to determine if this program will be expanded beyond the three-year pilot? 

Response. The Warriors to Workforce (W2W) program has garnered positive recognition for the great benefits derived by both the Veterans in the program as well 

as VA. The W2W program has earned both the Secretary’s Award and the Chief Acquisition Officer’s Council Award, for its innovative approach to training wounded 

Veterans. Many metrics have been collected and evaluated; below are some of the 

more meaningful outcomes: 

• 100 percent completion of the positive education requirement for the 1102 series; average college business course grade point average was 3.7 (4.0 scale) (Targeted metric was 95 percent). Peak performance training resulted in 154 percent improvement in attention; 58 percent brain speed improvement for working memory; 

32 percent improvement on short term memory recall, and many other notable 

achievements (Targeted metric was >30 percent improvement). 

• 22 percent of the cohort will receive a Bachelor’s of Science in Business by 

May 2013; 65 percent of the cohort will receive a Bachelor’s degree within the next 

year. 

• VA acquisition organizations have embraced the W2W program which is demonstrated by an overwhelming willingness to host a W2W intern during their first 

on-the-job training period (which falls within the 2-year Acquisition Intern Program). 

Additionally, the VA Acquisition Academy (VAAA) established a continuous improvement process for the W2W program to measure learning, validate program effectiveness and incorporate lessons learned. VAAA monitors 28 key program metrics 

to assess program success and measurable benefit to the organization. Notable 

metrics demonstrating results include: 

• W2W intern retention is 96 percent, as of May 14, 2013, compared to 90 percent 

retention for the overall VA acquisition workforce (Targeted metric was >80 percent). 

• W2W courses rate 4.3 out of 5.0 for overall effectiveness (Targeted metric was 

4.0 on a Lickert scale). 

• Interns receive an average of 96 percent on course exams for the Federal Acquisition Certification in Contracting (Targeted metric was >80 percent). 

• 100 percent of interns received at least 95 percent ‘‘Acceptable’’ and ‘‘Mastery’’ 

ratings for performance in training activities (Targeted metric was >90 percent). 

The W2W Program has a broad reaching impact on groups including the wounded 

Veteran participants and their families, Federal acquisition organizations and 

America’s Veteran population. The specific short and long-term impacts, including 

lasting effects, on each of these groups are outlined below: 

• The Veteran participant and their families: 

• Are provided a long-term professional career with valuable skills (Peak Performance Training) that will benefit them professionally and personally; and 

• Obtain a sense of purpose, pride, esteem, and stability to be passed on to 

spouses and children. 

• The Federal Acquisition Organizations: 

• Receive an influx of well-rounded professionals ready to hit the ground running; and 

• Benefit from succession planning efforts to supply a pipeline of acquisition 

professionals for VA and other government agencies. 

• America’s Veterans: 

• Receive world-class service by expertly training acquisition professionals 

who understand Veteran needs and issues; and 

• Are provided increased career opportunities through expanded programs for 

Veteran development. 

As a result of the positive results from the completion of the W2W program year 

one and the previously demonstrated success and metrics of the 2-year Acquisition 

Intern Program (AIP), OALC intends to launch additional intern cohorts as outlined 

in questions 2 and 3 below. The intention is to expand participation by other executive agencies (NOTE: GSA participated in the pilot program). Additionally, OALC 

is piloting a W2W cohort focused on a program management career track. This cohort, launched in January 2013, and sponsored and funded by VA’s Office of InforVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00158 Fmt 6633 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
155 

mation and Technology, uses the same successful program design and focuses on the 

competencies required to become a program manager. 

B. How much is expected to be spent on the Warrior to Workforce Program for 

fiscal year 2014? 

Response. Our budget forecasts $2.2 million for FY 2014; which includes one acquisition-focused, and one program management-focused cohort, for a total of 48 

W2W participants in the program for FY 2014. The funding covers staff cost, participants on-the-job training, curriculum delivery, contractual services, and administrative costs (supplies, printing, reproduction, materials, and equipment). 

Cost effectiveness is central to the design and delivery of the W2W program. Some 

examples include: 

• Participants utilize their Veteran benefits to fund the college courses received 

in the program, resulting in a significant cost savings for their training during program year one. 

• The program utilizes existing online courseware to supplement the interns’ development at no additional cost. 

• The program provides a supplement to existing proven career development programs (such as the VA Acquisition Internship School’s Acquisition Intern Program 

for the inaugural W2W cohort). 

C. Please describe the program in detail, including the number of veterans currently in or who have completed the program, the courses the veterans take, and 

any internships required. 

Response. Twenty-eight interns have completed their first year and have moved 

into the AIP. There are 20 interns currently in the first year of the program management career track. OALC anticipates hiring another acquisition W2W cohort in 

FY 2014, and is in discussions with VA’s Office of Information and Technology, to 

sponsor another FY 2014 program management cohort. Implementation of these additional acquisition and program management cohorts would train an additional 48 

Veterans. 

VA launched the W2W program on December 5, 2011, to integrate wounded Veterans into the acquisition workforce and uphold President Lincoln’s promise, ‘‘to 

care for him who shall have borne the battle, and for his widow, and his orphan’’ 

by serving and honoring the men and women who are America’s Veterans. The mission of the program, supporting Executive Order 13518—Employment of Veterans, 

is to assist in the reintegration of wounded Veterans by preparing them for a career 

as a Contract Specialist (GS–1102) or as a Program Manager (GS–0343). As President Obama said in his address to Congress and the Nation, ‘‘We ask these men 

and women to leave their careers, leave their families, and risk their lives to fight 

for our country. The last thing they should have to do is fight for a job when they 

come home.’’ Ideal candidates are Veterans who have: (1) service-connected disabilities and (2) little or no post high school education. The W2W program addresses 

both the employment challenges facing wounded Veterans and the workforce development challenges of the acquisition community. The program design allows for participation from other government agencies. 

The W2W program took an innovative approach to hiring the wounded Veterans 

(including one GSA participant). The program utilizes the Veteran’s Recruitment 

Authority to access and target Veterans most in need of career and development opportunities. VAAA also collaborated with VA Veterans Employment Coordination 

Service and Vocational Rehabilitation and Employment Program, DOD Wounded 

Warrior Transition Programs and Veterans Service Organizations in identifying 

wounded Veteran candidates. 

The W2W program is a 3-year holistic training program providing Veterans an 

opportunity to apply military experiences and skills to the contract specialist career 

field. In the program;’s first year, participants receive academic education, peak performance training, an introduction to acquisition or project/program management, 

and participate in mission service activities. Upon successful completion, participants transition to the 2-year Acquisition Intern or Program Management Fellows 

Programs. 

156 

The initial year consists of 4 main components: Business Education, Foundational 

Curriculum, Peak Performance Training, and Mission Service. The purpose of these 

components is to build on the skill sets imparted by the military, and prepare the 

W2W interns for either the 2-year AIP, or the 2-year Program Management Fellows 

Program. 

Business Education consists of accredited college-level courses to prepare the interns for either the contracting or project/program management career. The 

Foundational training consists of introductory technical courses to introduce the interns to the technical specialty of the career field and to prepare them in other office 

fundamentals (including Microsoft Office applications and essential business competencies). The Peak Performance training consists of highly intensive, customized 

workshops and one-on-one sessions with training coaches focused on mental and 

physiological conditioning to perform at peak levels under pressure and stress. The 

Mission Service component is designed to give the interns a chance to participate 

in efforts to serve Veterans and gain a better understanding of VA’s mission, vision, 

and core values. 

The courses within the Business Education component vary slightly by the participant’s track (acquisitions or project/program management): 

Acquisition 

(Business curriculum targeted to meet the positive education requirements of the 

1102 career field): 

• Business Writing 

• Business Mathematics 

• Introduction to Business and Decision-Making 

• Computer Applications for Business 

• Accounting Principles I 

• Business Management and Organization 

• Accounting Principles II 

• Corporate Finance I 

• Business Law I 

• Business Communications: Written and Oral 

Project/Program Management (PM) 

(Combination of Business and Information Technology curriculum): 

• Business Writing 

• Business Mathematics 

• Computer Applications for Business 

• Computer Programming I 

• Information Systems 

• Operating Environments 

• Intro to Business Decision Making 

• Principles of Accounting I 

• Data base Design 

• Business Law 

• Systems Analysis and Design 

• Corporate Finance 

Interns also have over 200 online courses to complete during the first year as 

foundational curriculum in many topic areas including technical and business competency, and computer skills. Examples of foundational curriculum experienced by 

W2W acquisition interns include: Negotiation Essentials, VA Contract Security, Performance Based Services Acquisition, Simplified Acquisition Procedures, Overview of 


415tab148.eps
157 

Acquisition Ethics, Influencing Key Decision Makers, Getting Started with Microsoft 

Word, Moving and Getting Around in Excel, Interpersonal Communications, Workplace Conflict, Business Etiquette and Customer Interactions. Examples of 

foundational curriculum experienced by W2W program management interns include: 

Introduction to Project Management Using Project, Monitoring Schedule, Building 

a Schedule with Project, Communicating Project Information with Project, Influencing Key Decision Makers, Getting Started with Microsoft Word, Moving and Getting Around in Excel, Interpersonal Communications, Workplace Conflict, Business 

Etiquette and Customer Interactions. 

Interns also participate in Peak Performance training that strengthens key mental skills (e.g., Goal Setting, Stress-Energy Management) to assist with challenges 

associated with Post Traumatic Stress Disorder and Traumatic Brain Injury. This 

approach boosts their attention, memory, flexibility, and problem solving to perform 

at a peak level under pressure and stress. 

The final component is Mission Service. The interns plan and participate in a 

wide range of Mission Service activities throughout the program in an effort to gain 

a better understanding of VA’s mission, vision, and core values. Mission Service activities expose the interns to the Veteran community through hands-on experience 

with VA services and fellow Veterans. Interns take an active role in selecting and 

coordinating Mission Service activities, providing a valuable opportunity for development of teamwork and leadership skills. 

The interns are hired as a GS–5 for their transition year, and placed on a career 

ladder to GS–11. Interns in both the Acquisition track and the Project/Program 

Management track complete the transition year and move into their respective 2- 

year technical training. The technical training delivers the training and experience 

for either the Federal Acquisition Certification—Contracting or the Federal Acquisition Certification—Project/Program Management. 

The main goal of the W2W program is to transition the Veteran into the business 

workplace and to provide training leading to a productive career within VA. It 

serves VA by providing a valuable source of VA-trained employees who bring valuable skills learned in the military (i.e. integrity, discipline, teamwork, etc). 

Question 131. The fiscal year 2014 budget request for Construction, Major 

Projects, includes a request of $44 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 the Veterans Health Administration, the National 

Cemetery Administration, the Veterans Benefits Administration, and VA central office staff offices. 

A. What is the unobligated balance of the Advanced Planning Fund? 

Response. The balance is $141. million as of the September 30, 2013. The table 

below reflects the anticipated balance in the Advanced Planning Fund at the end 

of FY 2014. 

Unobligated Balance as of September 30, 2013) ............... $141,106 

FY 2014 Request .................................................................. $44,000 

Subtotal of Available Funds ............................................ $185,106 

Less: Expected FY 2014 Obligations ............................... $182,042 

Balance Remaining .............................................................. $3,064 

B. For fiscal year 2012, please provide a detailed description and amount for each 

project funded through the Advanced Planning Fund. 

Response. See table for 2012 below. 

Location/Description FY 2012 

Obligations 

Alameda, CA—OPC .................................................................................................................................................. $694,963 

Biloxi, MS—Mental Health Ctr Renovations ............................................................................................................ $209,583 

Biloxi, MS—PM & RS /Prosthetics .......................................................................................................................... $209,583 

Bronx, NY—Spinal Cord Injury (SCI) ....................................................................................................................... $869,398 

Canandaigua, NY—New Construction CLC and Domiciliary ................................................................................... $380,180 

Dallas, TX—Clinical Expansion of Mental Health ................................................................................................... $402,033 

Dallas, TX—Long Term SCI ..................................................................................................................................... $901,173 

East Central Florida—New Cemetery (MP/SD/DD) .................................................................................................. $1,664,339 

158 

Location/Description FY 2012 

Obligations 

Fayetteville, AR—Parking Garage ............................................................................................................................ $261,258 

Ft. Sam Houston, TX—National Cemetery (Master Plan) ....................................................................................... $332,571 

Las Vegas, NV—New Adminstration Building ......................................................................................................... $865,480 

Lexington, KY (Leestown)—Clinical Campus Realignment (Master Plan) .............................................................. $610,409 

Livermore, CA—Realignment & Closure .................................................................................................................. $5,349,373 

Long Beach, CA—Seismic Corrections Buildings 7 and 126 ................................................................................. $694,012 

Los Angeles, CA (West LA)—Construct Essential Care Tower/B500 Seismic Correction ....................................... $574,000

Louisville, KY—New VAMC ....................................................................................................................................... $932,782 

Omaha, NE—New Clinical Addition ........................................................................................................................ $461,885 

Orlando, FL—SimLEARN (Medical Center) .............................................................................................................. $1,870,734 

Palo Alto, CA—80 Bed Psychiatric Facility ............................................................................................................. $300,000 

Palo Alto, CA—Ambulatory Care/Polytrauma Rehab ............................................................................................... $52,128 

Pittsburgh, PA—Research Building ......................................................................................................................... $32,924 

Portland, OR—Retrofit & Renovation Siesmic Studies ........................................................................................... $264,855 

Riverside NC Master Plan Environmental Studies ................................................................................................... $80,000 

Southern Colorado, NC (MP/SD/DD) ......................................................................................................................... $353,360 

St Louis, MO (JC Division)—Bed Tower Master Plan (NEPA and 106) .................................................................. $107,701 

Tallahasee—New Cemetery (MP/SD/DD) ................................................................................................................. $1,283,441 

Tampa, FL—Polytrauma Expansion ......................................................................................................................... $367,227 

Walla Walla, WA—Multispecialty Clinic .................................................................................................................. $158,099 

West LA—12 Bldgs Seismic Upgrade (B206 & 258) ............................................................................................. $384,862 

West LA—New Bed Tower & Bldg 500 Seismic Correction .................................................................................... $500,000 

Total ................................................................................................................................................................. $21,168,353 

Other: 

Various Planning/Design/Assessment Activities: ..................................................................................................... $19,250,859 

Updated Design Guides and Criteria .................................................................................................................. — 

Facility Condition Assessments ........................................................................................................................... — 

Peer Review .......................................................................................................................................................... — 

Master Planning ................................................................................................................................................... — 

Post Occupancy Evaluation ................................................................................................................................. — 

Transferred funds from APF to support: Miami, FL—Renovation-Surgical Suite & Operating Rooms .................. $14,000,000 

Grand Total ...................................................................................................................................................... $54,419,212 

C. For fiscal year 2013, please provide a detailed description and amount for each 

project expected to be funded through the Advanced Planning Fund. 

Response. See table for 2013 below. 

Location/Description FY 2013 

Obligations 

Alameda, CA—Outpatient Clinic (OPC) ................................................................................................................... $323,141 

Biloxi, MS—B1 & B2 Renovations & PM-RS/Prosthetics ........................................................................................ $306,347 

Bronx, NY—Spinal Cord Injury (SCI) ....................................................................................................................... $1,091,888 

Dallas, TX—Clinical Expansion of Mental Health ................................................................................................... $118,230 

Livermore, CA—Realignment & Closure .................................................................................................................. $26,117 

Long Beach, CA—Seismic Correction Buildings 7 & 126 Phase 2 ........................................................................ $141,108 

Los Angeles, CA (West LA)—Capital Improvement Plan (Master Plan) ................................................................. $1,788,441 

Louisville, KY—New VAMC ....................................................................................................................................... $15,940,404 

Manhattan, NY—Medical Center-Flood Recovery .................................................................................................... $5,815,299 

National Cemetery of the Alleghenies ...................................................................................................................... $866,854 

Omaha, NE—Replacement Facility .......................................................................................................................... $628,380 

Palo Alto, CA—80 Bed Psychiatric Facility ............................................................................................................. $433,180 

Palo Alto, CA—Ambulatory Care/Polytrauma Rehab ............................................................................................... $8,127,955 

Perry Point, MD—Replace Community Living Center .............................................................................................. $107,617 

Portland, OR—Retrofit & Renovation ...................................................................................................................... $11,068 

Reno, NV—Seismic & Life Safety Corrections B-1 ................................................................................................. $4,298,543 

San Juan, PR—Seismic Correction (Parking Structure) .......................................................................................... $16,455 

St Louis, MO (JC Division)—Bed Tower .................................................................................................................. $41,100 

Tallahasee—New Cemetery ..................................................................................................................................... $79,527 

Walla Walla, WA—Multispecialty Clinic .................................................................................................................. $335,661 

West LA—12 Bldgs Seismic Upgrade (B206 & 258) ............................................................................................. $1,788,441 

West LA—New Bed Tower & Bldg 500 Seismic Correction .................................................................................... $4,600,816 

159 

Location/Description FY 2013 

Obligations 

Total ................................................................................................................................................................. $46,886,572 

Other: 

Various Planning/Design/Assessment Activities: ..................................................................................................... $12,399,045 

Cost Estimating, Environmental & Historic Preservation Services ..................................................................... — 

Updated Design Guides and Criteria .................................................................................................................. — 

NCA Facility Condition Assessments ................................................................................................................... — 

Regional Strategic Master Plans ......................................................................................................................... — 

Post Occupancy Evaluations ................................................................................................................................ — 

Grand Total ...................................................................................................................................................... $59,285,617 

D. For fiscal year 2014, please provide a detailed description and amount for each 

project expected to be funded through the Advanced Planning Fund. 

Response. See table for 2014 below. 

Location/Description FY 2014 

Estimate 

Alameda, CA—Outpatient Clinic (OPC) ................................................................................................................. $5,000,000 

Dallas, TX—Clinical Expansion of Mental Health ................................................................................................. $548,387 

Dallas, TX—Long Term SCI ................................................................................................................................... $500,000 

Dallas/Ft. Worth—Gravesite Expansion ................................................................................................................. $2,000,000 

Livermore, CA—Realignment & Closure ................................................................................................................ $3,500,000 

Ft. Sam Houston, TX—National Cemetery ............................................................................................................. $1,800,000 

W. Los Angeles, CA—Seismic Corrections (blgs B156,B157,B258) ..................................................................... $4,700,000 

Louisville, KY—New VAMC ..................................................................................................................................... $19,475,000 

Manhattan, NY—Medical Center-Flood Recovery .................................................................................................. $1,350,000 

North Little Rock, AR—VBA Building Replacement Facility ................................................................................. $900,000 

Ohio Western Reserve, OH—National Cemetery .................................................................................................... $1,500,000 

Omaha—New Cemetery ......................................................................................................................................... $500,000 

Omaha, NE—Replacement Hospital ...................................................................................................................... $15,000,000 

Portland, OR—Retrofit & Renovation .................................................................................................................... $5,000,000 

Southern Colorado National Cemetery ................................................................................................................... $2,000,000 

Sacramento Valley, CA—NC .................................................................................................................................. $2,000,000 

Barrancas, FL—NC ................................................................................................................................................ $2,000,000 

Jacksonville, FL—NC .............................................................................................................................................. $2,000,000 

S.Florida, FL—NC ................................................................................................................................................... $2,000,000 

Palo Alto, CA—Building 6 Seismic Replacement ................................................................................................. $4,000,000 

Pittsburgh, PA—Bridge .......................................................................................................................................... $50,000 

Perry Point, MD—Replace Community Living Center ............................................................................................ $900,000 

Long Beach, CA—Buildings 128 & 133 ............................................................................................................... $100,000 

San Francisco, CA—Seismic Retrofit B 1, 6 & 8/Replace B12 ........................................................................... $350,000 

San Juan, PR—Seismic Correction (Parking Structure) ........................................................................................ $3,500,000 

Seattle, WA—B101 Mental Health Services—Request for Equit Adj ................................................................... $450,000 

Puerto Rico, PR—Gravesite Expansion .................................................................................................................. $2,000,000 

Reno, NV—Seismic & Life Safety Corrections B-1 ............................................................................................... $4,300,000 

St Louis, MO (JC Division)—Bed Tower ................................................................................................................ $8,218,525 

Tampa, FL—New Bed Tower Schematics & DDs (Polytrauma Expansion) ........................................................... $4,600,000 

West LA—New Bed Tower & Bldg 500 Seismic Correction .................................................................................. $19,000,000 

Williamette, OR—NC Columbarium Expansion ..................................................................................................... $2,000,000 

Western New York—New Cemetery ........................................................................................................................ $800,000 

Total ............................................................................................................................................................... $122,041,912 

Other: 

Various Planning/Design/Assessment Activities: ................................................................................................... $60,000,000 

Cost Estimating, Environmental & Historic Preservation Services ................................................................... — 

Updated Design Guides and Criteria ................................................................................................................ — 

NCA Facility Condition Assessments ................................................................................................................. — 

Regional Strategic Master Plans ....................................................................................................................... — 

Post Occupancy Evaluations .............................................................................................................................. — 

Grand Total .................................................................................................................................................... $182,041,912 

160 

Question 132. The Office of Small and Disadvantaged Business Utilization’s 

(OSDBU) stated mission ‘‘is to advocate for the maximum practicable participation 

of small business in VA acquisitions, with special emphasis on service-disabled veteran-owned (SDVOSB) and veteran-owned small business (VOSB).’’ Within OSDBU 

is the Center for Veterans Enterprise (CVE) that is charged with verifying veteran 

businesses looking to take advantage of veteran specific VA contracting preferences. 

A. Many veterans have expressed the opinion that CVE’s mission of approving or 

denying eligibility for veteran set asides is in direct conflict with the OSDBU mission of advocating for VOSBs and SDVOSBs. How does VA respond to that charge? 

Response. VA has unique legislation in support of meeting Veteran-owned small 

business and service-disabled Veteran-owned small business procurement goals. 

This legislation is found in section 8127 of title 38. The Executive Director is not 

the manager of the Center for Veterans Enterprise (CVE). He has direct supervisory 

authority over the Director of CVE. 

The Executive Director, OSDBU implements and executes all of the functions and 

duties of the office under section 644 and 637 of title 15 of the United States Code 

with respect to VA. Of particular note, are the responsibilities of developing strategies to assure that a fair proportion of the total purchases and contracts for property 

and services for VA in each industry category are placed with small-business concerns pursuant to sections 637(d)(1) and 644(a)(3). One avenue to increase the number of awards to small businesses, specifically SDVOSBs/VOSBs, is the verification 

program established by 38 U.S.C. § 8127. Section 8127 directs the Secretary to verify 

the Veteran status, ownership and control of all SDVOSBs/VOSBs to participate in 

the unique contracting program created in the legislation. The Secretary has directed that the Executive Director, OSDBU oversee CVE as a part of his duties 

under sections 637(d)(1) and 644(a)(3). 

The VA VOSB Verification program provides VOSBs with access to VA procurement opportunities they would not have if they are not verified. VA contends that 

there is no conflict between advocating for Veterans and enabling VOSBs to participate in the Veterans First contracting program. 

B. In order to avoid the appearance of competing missions within OSDBU, has 

VA looked at whether CVE should be moved to another office or established as a 

standalone office under the Secretary? Please explain. 

Response. VA believes that the missions of verification and acquisition support 

are not competing missions, rather they are complementary missions. As such, VA 

has not explored moving CVE to either another office nor as a standalone office 

under the Secretary. The verification mission fits best with the mission of OSDBU, 

and VA believes it is best suited to be under the supervision of the Executive Director of OSDBU. 

Question 133. The chart ‘‘Summary of Employment and Obligations’’ for the Office 

of Acquisitions and Logistics Supply Fund does not include FTE information for 

OSDBU. 

A. Please provide the Committee with the FTE requirements for OSDBU for fiscal 

year 2014 and the preceding three years. 

Response. OSDBU has a standing authorization of 42 FTE since FY 2012. Prior 

to that, the authorization was for 40 FTE. 

B. Please provide the Committee with a detailed budget for OSDBU and CVE. 

Response. Due to the nature of OSDBU’s source of funding in the Supply Fund, 

OSDBU has traditionally negotiated its budget based on the current year’s funding 

level and adjusted the request for the rapidly changing circumstances. The flexibility of the Supply Fund has been beneficial to Veterans, as the OSDBU needs can 

be quickly addressed, and more accurate projections made with the request coming 

much closer to the need. 

OSDBU FY 2012 Expenditures 

FTE .............................................................................................................................................. 42 

Obligations: 

Personal services .................................................................................................................... $4,252,488 

Travel ...................................................................................................................................... $64,752 

Transportation of things ........................................................................................................ — 

Rents, communications and utilities ..................................................................................... $359,492 

Printing and reproduction ...................................................................................................... $4,594 

Other services ......................................................................................................................... $15,604,719 * 

Supplies and materials .......................................................................................................... $196,988 

161 

OSDBU FY 2012 Expenditures—Continued 

Equipment .............................................................................................................................. $5,640 

Total obligations ................................................................................................................ $20,488,672 ** 

Total budget ....................................................................................................................... $33,000,000 

* See breakdown of other services on page 5. 

** $12,511,328 carried over to FY 2013. 

OSDBU expects that the FY 2013 budget will be approved by July 31, 2013. 

Question 134. Last year, CVE announced the creation of a pre-decisional letter to 

better assist veterans make the necessary changes to their businesses prior to receiving full verification decisions. The goal was to decrease the number of veterans 

who entered the appeals process after an initial denial. 

A. Since its creation, how many veterans have taken advantage of the predecisional letter to make the necessary changes? 

Response. The Pre-Decisional Findings (PDF) program was piloted from February 

to April 2013, and launched at full scale on May 1, 2013. Data on the program is 

very limited, due to the fact that it is a brand new program. It is important to note 

that not all businesses are eligible for the program. Those businesses, whose compliance issues are categorized among the list of correctible issues, not requiring full 

re-evaluation, are allowed to clarify their issues and/or make adjustments to their 

documentation within a specified time period with the intent to avoid denial. Those 

with more complex issues that would require a complete re-evaluation are offered 

the option to withdraw their application rather than to receive a denial letter. This 

allows them to take the time that they need to address the issues and resubmit, 

rather than receiving a determination, and then having only the 30 days allowed 

by regulation to submit the request for reconsideration. 

In the first 27 days from the full scale launch on May 1, 2013, 31 Veterans have 

taken advantage of the program. Pulling in all results from both the pilot and the 

launch, 80 firms have taken advantage of the program through May 27, 2013. Of 

those firms, 71 percent were approved, ten percent were denied, and 19 percent 

withdrew their applications. 

B. What metrics have been established to determine whether the new process has 

been effective in decreasing the number of veteran businesses entering the appeal 

process? 

Response. The PDF process has helped to decrease the number of Veteran businesses entering the request for reconsideration (R4R) process. This process enables 

applicants to correct non-compliant aspects of their businesses established by the 

initial determination. CVE has developed a number of metrics to gage the program. 

One of the objectives of the PDF program is to reduce the number of requests for 

reconsideration and the time required to process them. The average number of R4Rs 

submitted monthly has declined from 92 in January 2013 to 40 in May (as of 

May 28, 2013). The average time to process R4Rs has declined from 146 days in 

January to 66 days in May. 

Fewer denials directly affects the number of requests for reconsideration submitted, shortening the average processing time. At the end of FY 2012, the initial 

determination approval rate was 58 percent. At the end of May 2013, the initial approval rate is 83 percent. It is important to note that prior to the introduction of 

PDF, all of the firms that are now participating would have received an initial denial. Note that because the sample size is so small (about three percent of all initial 

determinations made in FY 2013 to date), the impact on the overall approval rate 

will become more significant over time. 

OSDBU FY 2012 Expenditures (+ breakdown of other services) 

FTE .............................................................................................................................................. 42 

Obligations: 

Personal services .................................................................................................................... $4,252,488 

Travel ...................................................................................................................................... $64,752 

Transportation of things ........................................................................................................ — 

Rents, communications and utilities ..................................................................................... $359,492 

Printing and reproduction ...................................................................................................... $4,594 

Other services ......................................................................................................................... $15,604,719 * 

Supplies and materials .......................................................................................................... $196,988 

162 

OSDBU FY 2012 Expenditures (+ breakdown of other services)—Continued 

Equipment .............................................................................................................................. $5,640 

Total obligations ................................................................................................................ $20,488,672 ** 

Total budget ....................................................................................................................... $33,000,000 

* Breakdown of other services: 

Verification support ........................................................................................................... $9,925,585 

Outreach Support ............................................................................................................... $5,263,156 

Acquisition Support ............................................................................................................ $365,607 

Training and security ......................................................................................................... $50,371 

** $12,511,328 carried over to FY 2013. 

OFFICE OF INSPECTOR GENERAL

Question 135. For fiscal year 2014, the Office of Inspector General requests $11 

million for Other Services. Please provide an itemized list of how those funds would 

be utilized. 

Response. The fiscal year (FY) 2014) request for Other Services includes the following contractual services, interagency agreements, employee training, VA crosscutting services, and other procured services: 

• Contract for the Consolidated Financial Statement Audit. 

• Interagency Agreement for Human Resources/Payroll Processing Services—Department of Treasury and Department of Agriculture. 

• Contract for the Federal Information Security Management Act Review. 

• Employee Training. 

• VA Franchise Fund Services—IT processing, financial services, background investigations, and records storage. 

• Employee Relocation Services. 

• Annual assessment for Council of the Inspectors General for Integrity and Efficiency. 

• Building Security Services—Department of Homeland Security and VA. 

• Investigative Data Base Access, Forensic Services, Communications Agreements. 

• Other VA Administrative Services, including workers compensation, unemployment compensation, and EEO services. 

Question 136. With the requested level of resources for fiscal year 2014, how many 

benefits inspections would the Office of Inspector General plan to conduct? 

Response. The Office of Inspector General (OIG) will conduct 18 inspections of VA 

Regional Office operations in FY 2014. Our independent inspections provide recurring oversight focused on disability compensation claims processing and the performance of Veterans Service Center operations. 

We also plan to conduct the following two national reviews of key Veteran Benefits Administration (VBA) initiatives in meeting the VA Secretary’s goals of processing claims in an average of 125 days and with 98 percent accuracy by FY 2015: 

• Review of VBA’s Statistical Technical Accuracy Review (STAR) Program—We 

will sample claims reviewed by STAR to determine the effectiveness of the program 

in assessing disability claims processing accuracy and identifying areas for improvement. The STAR program is VBA’s quality assurance program. In our March 2009 

report, Audit of Veterans Benefits Administration Compensation Rating Accuracy 

and Consistency Reviews, we found that while VBA identified a national compensation claim rating accuracy of 87 percent for the 12-month period ending February 2008, we projected that VBA officials understated the error rate by about 10 

percent. This difference equated to approximately 88,000 additional claims where 

veterans’ monthly benefits may be incorrect. In FY 2013, the risk of increased inaccurate ratings could occur due to VBA’s reliance on Disability Benefits Questionnaires and provisional decisions on the oldest disability compensation claims in 

VBA’s inventory. 

• Review of the Veterans Benefits Management System (VBMS)—We plan to 

audit claims processed using VBMS to determine whether the automated system is 

resulting in higher quality and more consistent disability benefits decisions. This review is expected to complement the results of a current ongoing audit of cost, schedule, performance, and information security in VBMS development. 

163 

VETERANS HEALTH ADMINISTRATION

Question 137. If VA cannot provide care for a veteran at a VA Medical Center 

(VAMC), the VAMC will provide that care to the veteran in the veteran’s local community through purchased care. In fiscal year 2014, VA is expected to spend $1.1 

billion on purchased care. However, there are several Inspector General (IG) reports 

that have criticized various aspects of the Veterans Health Administration’s (VHA) 

purchased care program, such as improper payments and some facilities having 

problems with managing purchased care. 

A. How much does VA expect to be spent on purchased care in fiscal year 2015? 

Response. In 2015, VHA estimates spending $6,177,600,000 on Non-VA care. 

B. What actions has VHA taken to meet the requirements of the Improper Payments Elimination and Recovery Act of 2010? 

Response. The VHA Chief Business Office (CBO) has implemented multiple corrective actions to reduce improper payments and meet Improper Payments Elimination and Recovery Act requirements. Improvements to reduce improper payments 

include: 

• Implementation of the Quality Corrective Action Program (QCAP) was completed in December 2012. This internal program is designed to identify quality initiatives through various audit findings and reviews. The QCAP facilitates the development of appropriate corrective action teams and processes and tracks and trends 

results with the use of an automated tool. 

• Implementation of the Fee Basis Claims System (FBCS) was completed in 

March 2012. FBCS is a graphical user interface based system that is layered on top 

of the VistA Fee system. The national implementation of FBCS included an initial 

3-week training course on FBCS procedures that was provided to site Non-VA Care 

Fee staff during rollout. Supplemental online training was also provided. Ongoing 

FBCS training has been incorporated to share any recently installed patches and 

updates to process changes. 

• National rollout of the FBCS Optimization launched in August 2012. FBCS Optimization is the next stage in a nationwide effort to improve and standardize the 

processes associated with the use of FBCS for claims processing across VHA in support of the Non-VA Care Program Offices in the field. 

• Establishment of a Field Assistance Program in 2011 was expanded in 2012 to 

provide enhanced site visits designed to improve local operations by assessing site 

Non-VA Care claims processes and assisting with the development of effective internal controls. Findings are tracked at all sites to measure trends and identify lessons 

learned to share with all sites for training course development. 

• The VHA Chief Business Office developed a duplicate payment report, accessed 

through a user-friendly tool called SnapWeb, which identifies potential improper duplicate payments. The report was available beginning in April 2012. 

• The Non-VA Care Program Academy is the primary training program provided 

to VISN and VA medical center Fee employees nationwide. The Non-VA Care Program Academy is organized into a four-tiered, progressive level of curriculums designed to improve performance, enhance internal controls, and be in compliance 

with program policies. 

• The National Non-VA Care Program Office Intranet site was expanded in December 2012 to include updated training materials, procedure guides, notices, and 

FBCS alerts. This information is available to the field to alert staff to any changes 

and provide status of multiple projects related to Non-VA Care. 

• In January 2011, a contract was awarded to assist VA in establishing an enhanced program integrity function to reduce fraud, waste, and abuse through implementation of industry standard applications and processes. 

C. How much did VHA pay in duplicate payments in the last fiscal year and how 

much of those duplicate payments did VHA recover? 

Response. 

Duplicate Payments FY 2012 = $1,213,070 

Duplicate Payments Recovered in FY 2012 = $776,450 

D. Some VAMCs have inappropriately authorized millions in non-VA care but did 

not have sufficient funding to pay for those services. Why, after several IG investigations on this matter, does this continue? What is VHA’s plan to address this? 

VHA Response: The Chief Business Office Purchased Care (CBOPC) has instituted a comprehensive in-house auditing capability to cost-effectively audit claims 

for all CBOPC programs and ensure compliance with applicable regulations and 

other guidance. We will also be focusing on improving processes within the financial 

management of the Non-VA Medical Care program to improve the financial integrity 

of the program throughout its lifecycle. Additionally, CBOPC provides guidance to 

164 

the field concerning the need to obligate funds prior to authorizing care on an ongoing basis through several venues to include: 

• Policy and Procedure Guides 

• Recorded training sessions on the use of estimation tools 

• National conference call announcements 

• Field Assistance Site Visits 

• On-going audits to reduce improper payments 

In addition, guidance to the field is provided in Fiscal regulations published by 

the Office of Finance, available on-line and at local Finance offices. 

Sections of the NNPO Web site contain links to cost estimation and obligation of 

funds guidance to include: 

• 1601F Program Guide series Authorizations outlining the need to obligate the 

funds prior to issuance of the authorizations and a specific section titled, Fee Basis 

Obligations. 

• Fee Internal controls and Continuous Monitors, Internal Controls and Continuous Monitors Attachment A. 

• Obligation of Funds is outlined in M–1 Part 1, Chapter 18 and in M–1 Part 1 

Chapter 21. 

• FBCS training modules outline the authorization and obligation process. 

• An outpatient and inpatient cost estimation tool was developed and training 

provided to field staff. 

• Routine National Conference calls update the field on regulatory changes, training events and review procedures related to obligation of funds prior to services 

rendered. 

If a facility requires additional funding in support of Non-VA Medical Care activities, this is addressed at the local level, where additional funds are secured from 

the respective VISN Office and/or the Office of Finance, VA Central Office as per 

the Office of Finance guidance. 

Question 138. An IG report, titled Audit of Non-VA Inpatient Fee Care Program, 

suggested VHA could find potential cost savings, about $134 million over five years, 

by consolidating the Fee Programs claim processing system. The Under Secretary 

for Health, Dr. Petzel, agreed there would be potential savings if the claims processing systems were consolidated. 

A. Has VHA consolidated its fee processing system into regional centers, similar 

to how VHA manages medical revenue collections? 

Response. No, VA has not regionalized in a similar fashion to the revenue centers; 

however, work on a centralized claims processing system, known as HCP, or Health 

Claims Processing has begun. The system is currently under development. VHAwide implementation is expected to be complete in Fall 2015. Additionally, we have 

initiated an Improvement Roadmap (as of Sept 2012) that is focused on reducing 

improper payments, training, communications, and other programmatic fixes over a 

6–12 month timeframe. The larger effort to consolidate fee processing systems and 

personnel will be approached through the completion of the HCP system and the 

design and implementation of a new organizational model that consolidates that 

claims processing from the present 140+ locations to 3–5 centers. 

B. If not, why has this consolidation not been completed and when does VA expect 

to complete the consolidation? 

Response. The effort is not completed because of the current focus on completing 

the Improvement Roadmap, which builds a solid foundation for the new organizational model. Due to the anticipated size and scope of the reorganization effort, it 

is expected that the planning and implementation will be spread over several years. 

There are over 140+ processing sites currently with over 2,500 personnel involved 

across those sites. Consolidating these sites must take a well-planned and implemented approach to prevent disruption to the critical services that this program provides to our Veterans. Implementing the Improvement Roadmap is a key first step 

in standardizing business process and reducing improper payments before the consolidation begins. 

Question 139. Staffing at VAMCs make up a large portion of VHA’s funding obligations. However, VHA did not develop a mental health staffing plan until after several IG Combined Assessment Program and Community Based Outpatient Clinic reviews indicated problems with nurse staffing and the Committee requested that 

VHA develop one. 

A. Does VA have a staffing model in place for all clinical providers? 

Response. VHA continues to develop a staffing model for all clinical providers. In 

June 2012, the Under Secretary for Health established the Specialty Care Physician 

Productivity and Staffing Plan Task Force to develop a methodology for VHA speVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00168 Fmt 6633 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
165 

cialty care physician staffing and productivity. Productivity coupled with access 

measures provide a framework for determining specialty physician staffing. This 

model was prototyped for the seven specialties of Cardiology, Gastroenterology, Dermatology, Neurology, Orthopedics, Urology, and Ophthalmology. VHA will establish 

productivity standards for five specialties in FY 2013 and the remaining specialties 

by the end of FY 2015. 

B. Has VHA sought guidance from DOD Health Affairs or private health care providers, such as Kaiser Permanente, regarding how they developed their staffing 

models? If so, how did that guidance influence the development of VHA’s staffing 

model. 

Response. VA recently established a partnership with DOD and is leading a joint 

study to better understand physician productivity and how to effectively design and 

implement staffing plans to improve clinical outcomes. 

C. Of the funding VHA is appropriated for staffing, how much will be used to pay 

for union representation/union time? 

Response. VHA does not have a tracking mechanism to provide this data. 

Question 140. The Committee has held several hearings highlighting the problem 

veterans have accessing mental health care at VHA. In response to an IG report 

that found VHA’s measures for access to care are unreliable, VHA announced an 

increase of 1,900 mental health provider and administrative staff positions to address the problem. According to testimony VA submitted for the Committee’s 

March 20, 2013, mental health hearing, as of March 5, 2013, a total of 1,089 new 

providers and 230 administrative staff have been hired. 

A. How will VHA ensure that these new providers are deployed where veterans’ 

needs are the greatest? 

Response. As part of an ongoing comprehensive review of mental health operations, VA considered a number of factors to determine additional staffing levels distributed across the system, including: 

• Veteran population in the service area, • Mental health needs of Veterans in that population, and • Range and complexity of mental health services provided in the service area. 

VHA’s Mental Health Operations collaborated with VISNs and facilities to distribute the additional staffing based on this review and with the goal of ensuring 

that facilities had sufficient mental health staff to meet Veteran needs. In some 

areas, however, because of recruitment challenges, sites elected to develop regional 

telemental health programs or to develop Non-VA contracts to supplement staffing 

levels. VA continues to review the adequacy of staffing levels based on timeliness 

of care, quality of care, and patient and provider satisfaction. 

B. What changes has VHA made to make sure the metrics used to measure access 

provide an accurate picture? 

Response. VA has developed two new measures of Veterans’ waiting times: (1) a 

new patient metric based on ‘‘create’’ date, and (2) an established patient metric 

using the prospective waiting time and based on the Agreed Upon Date (AUD). The 

data is currently being reported for these two new metrics as of December 31, 2012. 

VA is also developing internal metrics based on measuring the time from the date 

of referral to mental health care to the time of the completed appointment. These 

metrics will be piloted in late FY 2013 for deployment in FY 2014. In addition, VA 

identified several metrics to assist clinic managers with reviewing access issues 

within their clinics. A ‘‘Clinic Access Index’’ group identified and defined key data 

elements needed by mid-level managers to improve the function of clinic operations. 

The database has been built and is available for use by all VA staff. Educational 

efforts are being developed to teach managers how to use the database. VA has also 

developed a Veteran survey to assess Veterans’ perceptions of access barriers. The 

survey is currently being mailed to Veterans with results expected by the mid-fall 

of 2013. 

Question 141. This budget request would provide a 92 percent, or $3.6 billion, increase for mental health care since fiscal year 2008. However, even with this significant spending increase, veterans have had significant problems with accessing care 

they need and deserve. 

A. How does VHA measure success of this program to ensure the significant increase in funding is spent wisely? 

Response. In September 2008, VA published the Uniform Mental Health Services 

(UMHS) VHA Handbook 1160.01 in VA medical centers and clinics. The handbook 

specified the range of services that must be available nationally to ensure that Veterans have access to a consistent set of services regardless of where they are seeking care. As a result of the handbook, the number and types of required services 

expanded and ensured that VA would provide outreach to Veterans in non-tradiVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00169 Fmt 6633 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
166 

tional clinics such as medical settings, primary care, and geriatric settings. VA has 

measured the success of this program in a number of ways including evaluating the 

increase in numbers of Veterans served across programs and by each service, the 

increase in the number of services provided, as well as the number of staff hired 

and trained in evidenced based therapies. 

In FY 2012, VA developed the Mental Health Information System in partnership 

with the mental health site visit protocol to comprehensively evaluate implementation of the UMHS handbook using administrative data, performance measure data, 

interviews with Veterans, mental health staff, facility/VISN leadership, and other 

stakeholders, as well as observations and other data to assess the status of implementation. As a result, VA developed quality improvement initiatives for areas that 

were not functioning as intended and developed a best practice SharePoint to allow 

facilities to share successful initiatives. In FY 2013, VHA is continuing the site visit 

process on a 3-year cycle while continuing to develop additional metrics including 

outcome metrics for leadership and mental health staff to use in evaluating the efficacy of mental health programs. 

B. To what extent does VHA consider patient outcomes as part of its metrics in 

evaluating VHA’s mental health care program? 

Response. VA has committed to developing and using outcome metrics for use in 

evaluating its mental health program in FY 2013. The initial set of measures is currently being validated, as the measures are based on administrative data. VA will 

collect symptom improvement and functional measures for new patients to mental 

health starting in fiscal year 2014. 

Question 142. Recently, VHA has changed the way it delivers care with the development of the Patient Aligned Care Team (PACT) model. This model of care uses 

a team of professionals that includes doctors, nurses, medical assistants, and clerks. 

The intent of this team approach is to provide a more comprehensive model of care 

to veterans. These care team professionals are to be physically located close together 

to be able to consult easily with each other. More recently, VHA has included mental health professionals within the PACT. 

A. The budget request provides a limited list of metrics VHA uses to ‘‘measure 

the progress toward the goals that we have set for these teams.’’ Please submit to 

the Committee the complete list of metrics and the goals PACTs must meet. 

Response. The metrics and goals (targets) for PACT are listed below: 

1. Continuity with Veterans assigned to a primary care provider: Veterans are 

able to see their own primary care provider for regularly scheduled or urgent visits. 

Target >=77% 

2. Same day access with primary care provider: Veterans are able to see their primary care provider the same day they call for an appointment and want the appointment that day. Target >=70% 

3. Appointment in Primary Care within 7 days of desired date: Veterans can 

schedule an appointment within 7 days of the date they choose to be seen. Target 

>=92% 

4. Ratio of non-traditional primary care encounters: Ratio of the combination of 

shared medical appointments, telephone encounters, and secure messaging for the 

assigned panel of primary care patients. Target >=20% 

5. Primary care patients enrolled in home telehealth. Ratio of primary care patients for the assigned panel of patients enrolled in home telehealth for chronic disease management. Target >=1.6% 

6. Primary Care staffing ratio. Ratio of support staff FTE assigned to a primary 

care provider FTE to care for the assigned panel of primary care patients. Target 

>=3.0 

B. The budget request indicates that half of all PACTs will be trained by the end 

of this year. Which sites have fully trained PACTs and when will all of the PACTs 

be trained? 

Response. The attachment below contains the current training numbers of PACT 

team members to date. During FY 2012–13, there have been 9,855 total participants 

attending one of the training sessions although VHA calculated only those who either completed, or are currently active, somewhere along the longitudinal training 

continuum. Three Networks (4, 10, and 23) opted out of the Learning Center training and are managing their own training activities. For example, VISN 4 conducted 

a PACT Collaborative with the participation of all their PACTs in FY 2012. 

167 

Limitations and other considerations related to this data include: 

• Numbers do not reflect special population PACTs, specific extended team members, or mental health integration team members. 

• Support staff numbers are available as FTEs (not reflecting the number of parttime employees). 

Conclusions: 

• The actual number of targeted participants is higher than reflected in the table. 

• The total of those needing training is a constantly moving target due to turnover and introduction of new members throughout the multi-year training roll-out. 

• The longitudinal model and participant caps require more time to reach all 

PACT members. 

• We will train a significant majority of all PACTs by the end of FY 2014. 

C. With the recent inclusion of mental health into the PACT, what has VHA done 

to ensure mental health providers assigned to a PACT are physically located with 

the rest of the PACT? Please provide a list of sites where a mental health provider 

is embedded with the PACT. 

Response. All VA medical centers and CBOCs with more than 5,000 enrolled Veterans are required to have co-located mental health providers embedded within and 

collaborating with other members of PACT as members of the interdisciplinary 

team. Implementation is assessed with three related mechanisms: 

1. Self report in the quarterly UMHS Handbook survey. 


415tab163.eps
168 

2. Self report in the annual Primary Care-Mental Health Integration survey with 

a subset of facilities visited to validate self-reports. 

3. During Office of Mental Health Operations site visits, leadership and front line 

staff are asked about co-located mental health staff presence in primary care. 

The attachment below contains a list of sites currently reporting mental health 

providers embedded within the PACT. 

Question 143. The President’s budget includes $85 million in medical services in 

both fiscal years 2014 and 2015 to cover costs associated with the Affordable Care 

Act’s (ACA) mandate that all Americans have health insurance by 2014. 

A. Please describe the metrics used to determine the amount of funding needed 

to cover the costs of ACA. 

Response. VA has conducted an analysis of the number of Veterans thought to be 

leaving the VA health care system, the number of Veterans to be accrued to the system, and the estimated costs for providing their care. The metrics used to estimate 

the amount of funding needed to cover ACA costs were: the health care utilization 

profiles designed to identify and sort Veteran enrollees into a spectrum of high users 

of VA health care services down to non-users of VA health care services; the resulting utilization rate; the disenrollment rate by profile; the expected utilization pattern for Veterans joining VA; and the average cost associated with their utilization. 

B. For each of fiscal years 2014 and 2015, how many veterans does VA estimate 

will leave VA for other options of care? 


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169 

Response. The Affordable Care Act (ACA) expands affordable, comprehensive 

health care coverage options for some Veterans, both through the Health Insurance 

Marketplaces and through expansion of Medicaid in states that choose to expand 

their programs to all individuals below 138 percent of the poverty level. VA assumes 

that currently enrolled Veterans who become eligible for Medicaid will generally 

choose to stay with VA. VA also assumes that some Veterans who would have enrolled in VA (under current Medicaid eligibility rules) and live in a state that expands its Medicaid program may choose to enroll in Medicaid instead of VA. ACA 

also provides premium tax credits for eligible individuals to purchase health care 

coverage through the Health Insurance Marketplaces. However, in order to receive 

the premium tax credit, a Veteran may not be enrolled in the VA health care 

system. 

C. For each of fiscal years 2014 and 2015, how many veterans does VA estimate 

will enroll in VHA to satisfy the individual mandate in ACA? 

Response. Starting in FY 2014, the individual shared responsibility provision 

under ACA calls for each individual to have minimum essential coverage (MEC), 

qualify for an exemption, or make a payment when filing his or her Federal income 

tax return. Under the law, VA health care benefits meet the definition of MEC. Additionally, under ACA, states have the option to expand their Medicaid programs 

but are not required to do so. VA continues to monitor state decisions to determine 

the impact on VA beneficiaries in each of these locations. VA anticipates a modest 

net increase in enrollment as a result of ACA. As previously stated, VA expects that 

there will be some increase in enrollment; VA also expects that there will be some 

people who will leave VA’s system. VA has conducted an analysis of how many Veterans may enroll in VHA to satisfy the individual mandate in ACA. The estimated 

net number of Veterans projected to enroll with VA as a result of ACA is 66,000 

for FY 2014. 

Question 144. Under the medical services account, VHA estimates it will spend 

$582 million in fiscal year 2014 and $95 million in fiscal year 2015 to activate facilities. And, within the Medical Facilities account, VHA projects it will spend $160 

million in fiscal year 2014 and $26 million in fiscal year 2015 to activate facilities. 

A. 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. The final 2015 funding level for this activity will 

be determined during the 2015 budget process when updated data and metrics on 

this program’s funding needs are available. 

Fiscal Year 2014 

VISN Location State Description Project Recurring Non-Recurring Total 

1 Boston ............. MA Outpatient Clinic ......................... Lease $17,320,522 $457,026 $17,777,548 

2 Syracuse .......... NY Addition For SCI Center (Overview - OV).528-708 $349,158 $5,988,729 $6,337,887 

4 Butler ............... PA Health Care Center ..................... Lease $536,294 $10,817,135 $11,353,429 

4 Pittsburgh ........ PA Medical Center Consolidation 

(OV).

646-500 $0 $2,672,993 $2,672,993 

6 Wilmington ...... NC Outpatient Clinic ......................... Lease $2,554,203 $1,574,230 $4,128,433 

6 Greenville ......... NC Outpatient Clinic ......................... Lease $3,209,783 $4,724,993 $7,934,775 

6 Fayetteville ...... NC Health Care Center ..................... Lease $4,576,215 $21,859,321 $26,435,536 

6 Winston-Salem NC Health Care Center ..................... Lease $0 $17,497,991 $17,497,991 

6 Charlotte .......... NC Health Care Center ..................... Lease $0 $18,112,576 $18,112,576 

7 Greenville ......... SC Outpatient Clinic ......................... Lease $0 $824,282 $824,282 

7 Hinesville ......... SC Community-Based Outpatient 

Clinic.

Lease $3,452,265 $805,961 $4,258,226 

7 Savannah ........ GA Community-Based Outpatient 

Clinic.

Lease $3,261,329 $1,713,770 $4,975,099 

7 Anderson .......... SC Outpatient Clinic ......................... Lease $0 $729,953 $729,953 

7 Montgomery ..... AL Health Care Center ..................... Lease $0 $5,908,871 $5,908,871 

7 Atlanta ............. GA Specialty Care ............................. Lease $0 $2,081,864 $2,081,864 

7 Huntsville ........ AL Outpatient Clinic ......................... Lease $0 $1,922,599 $1,922,599 

7 Birmingham ..... AL Clinical Annex/Outpatient Clinic Lease $0 $1,931,412 $1,931,412 

7 Atlanta ............. GA Modernize Patient Wards (OV) .... 508-057 $35,277,925 $1,206,019 $36,483,944 

8 Jacksonville ..... FL Satellite Outpatient Clinic .......... Lease $2,442,952 $9,900,225 $12,343,177 

8 Mayaguez ......... PR Satellite Outpatient Clinic .......... Lease $0 $4,764,179 $4,764,179 

8 Tampa ............. FL Primary Care Annex .................... Lease $1,763,264 $2,898,748 $4,662,012 

8 Tallahassee ..... FL Outpatient Clinic ......................... Lease $0 $9,814,345 $9,814,345 

170 

Fiscal Year 2014—Continued 

VISN Location State Description Project Recurring Non-Recurring Total 

8 Orlando ............ FL New Medical Facility (OV) ........... 673-950 $39,160,665 $38,741,513 $77,902,178 

8 Lee County ....... FL Outpatient Clinic (Bay Pines) ..... 516-400 $262,829 $7,501,365 $7,764,194 

8 Bay Pines ........ FL Inpatient/Outpatient Improvements.516-005 $91,716 $0 $91,716 

8 Gainesville ....... FL Correct Patient Privacy Deficiencies.573-070 $27,054,777 $2,021,224 $29,076,002 

8 Tampa ............. FL Polytrauma and Bed Tower (OV) 673-900 $2,004,046 $4,923,043 $6,927,089 

8 San Juan ......... PR Seismic Corrections Bldg. 1 (OV) 672-085 $0 $517,532 $517,532 

10 Mansfield ......... OH Satellite Outpatient Clinic .......... Lease $2,172,849 $1,091,263 $3,264,111 

11 Fort Wayne ....... IN Community Based Outpatient 

Clinic.

Lease $1,077,374 $1,777,600 $2,854,974 

11 Peoria .............. IL Community Based Outpatient 

Clinic.

Lease $783,178 $492,343 $1,275,521 

11 Toledo .............. OH Community Based Outpatient 

Clinic.

Lease $1,068,704 $3,066,828 $4,135,533 

11 Grand Rapids .. MI Community Based Outpatient 

Clinic.

Lease $2,611,478 $7,601,926 $10,213,404 

11 South Bend ...... IN Community Based Outpatient 

Clinic.

Lease $0 $4,652,872 $4,652,872 

12 Crown Point ..... IN Outpatient Clinic ......................... Lease $0 $4,134,828 $4,134,828 

12 Green Bay ........ WI Outpatient Clinic ......................... Lease $63,594,064 $12,429,484 $76,023,548 

15 Columbia ......... MO Operating Suite Replacement ..... 589-006 $182,127 $381,606 $563,734 

15 St. Louis (JB) ... MO Med Facility Improv & Cem Expansion (OV).657-313 $284,297 $4,229,655 $4,513,952 

16 Lafayette .......... LA Community Based Outpatient 

Clinic.

Lease $3,463,671 $2,689,598 $6,153,269 

16 Lake Charles ... LA Community Based Outpatient 

Clinic.

Lease $2,292,328 $2,286,639 $4,578,967 

16 Fayetteville ...... AR Clinical Addition ......................... 564-302 $1,786,503 $11,212,702 $12,999,205 

16 Biloxi ................ MS Restoration Of Hospital/Consolidation (OV).520-317 $24,587,218 $9,480,317 $34,067,536 

16 New Orleans .... LA Restoration/Replacement Medical 

Facility (OV).

629-401 $9,434,412 $45,842,871 $55,277,284 

17 San Antonio ..... TX Ward Upgrades And Expansion 

(OV).

671-047 $0 $709,106 $709,106 

17 Temple ............. TX IT Building .................................. 674-117 $0 $297,744 $297,744 

17 Corpus Christi TX Outpatient Clinic ......................... Lease $107,978 $1,302,693 $1,410,671 

17 McAllen ............ TX Outpatient Clinic ......................... Lease $237,414 $1,069,566 $1,306,980 

17 Fort Worth ........ TX Outpatient Clinic ......................... Lease $727,239 $10,724,819 $11,452,058 

17 Harlingen ......... TX Outpatient Clinic ......................... Lease $425,635 $0 $425,635 

17 Austin .............. TX Outpatient Clinic ......................... Lease $14,586,597 $5,937,983 $20,524,580 

17 San Antonio ..... TX Polytrauma Center, & Renovation 

of Exist Bldg. 1.

671-048 $5,988,569 $2,378,476 $8,367,045 

18 Mesa ................ AZ Satellite Outpatient Clinic .......... Lease $13,356,817 $1,448,934 $14,805,751 

19 Colorado 

Springs.

CO Community-Based Outpatient 

Clinic Relocation.

Lease $1,731,810 $7,264,216 $8,996,027 

19 Billings ............ MT Satellite Outpatient Clinic .......... Lease $4,127,973 $3,830,120 $7,958,093 

19 Denver ............. CO Replacement Medical Center Facility (OV).554-501 $7,735,419 $54,455,961 $62,191,381 

20 Salem .............. OR Community-Based Outpatient 

Clinic.

Lease $5,486,592 $1,623,365 $7,109,957 

20 Eugene ............. OR Community-Based Outpatient 

Clinic.

Lease $15,156,885 $4,470,620 $19,627,505 

20 Seattle ............. WA Correct Seismic Deficiencies 

B100, NT & NHCU.

663-406 $8,742,076 $8,495,652 $17,237,728 

20 Walla Walla ..... WA Multi Specialty Care (Overview) 687-400 $610,045 $1,093,449 $1,703,494 

21 San Francisco .. CA Research Lease ........................... Lease $0 $1,798,163 $1,798,163 

21 Palo Alto .......... CA Seismic Corrections, Bldg. 2 ...... 640-413 $30,980 $79,303 $110,283 

21 Palo Alto .......... CA Centers for Ambulatory Care and 

Polytrauma Rehabilitation 

(OV).

640-424 $0 $6,256,052 $6,256,052 

22 Los Angeles ..... CA Seismic Corrections - 12 Bldgs. 691-406 $0 $2,918,298 $2,918,298 

22 Las Vegas ........ NV Primary Care Clinic #1 ............... Lease $86,161 $369,431 $455,591 

22 Las Vegas ........ NV Primary Care Clinic #2 ............... Lease $86,161 $332,488 $418,648 

171 

Fiscal Year 2014—Continued 

VISN Location State Description Project Recurring Non-Recurring Total 

22 Las Vegas ........ NV Primary Care Clinic #3 ............... Lease $86,161 $332,488 $418,648 

22 Las Vegas ........ NV Primary Care Clinic #4 ............... Lease $86,161 $465,317 $551,478 

22 Bakersfield ...... CA Community-Based Outpatient 

Clinic.

Lease $0 $696,990 $696,990 

22 Loma Linda ..... CA Health Care Center ..................... Lease $0 $13,690,064 $13,690,064 

22 Las Vegas ........ NV New Medical Facility (OV) ........... 593-202 $32,248,745 $1,407,631 $33,656,376 

22 Long Beach ..... CA Seismic Corrections/Clinical, B-7 

& 126.

600-402 $1,360,206 $2,157,870 $3,518,076 

Total ............................................ $369,661,768 $428,889,232 $798,551,000 

Fiscal Year 2015 

VISN Location State Description Project Recurring Non-Recurring Total 

2 Rochester ........ NY Outpatient Clinic ............................. Lease $0 $2,594,855 $2,594,855 

4 Butler .............. PA Health Care Center ......................... Lease $345,228 $0 $345,228 

6 Greenville ........ NC Outpatient Clinic ............................. Lease $1,540,621 $0 $1,540,621 

6 Fayetteville ...... NC Health Care Center ......................... Lease $2,629,763 $0 $2,629,763 

6 Winston-Salem NC Health Care Center ......................... Lease $1,220,410 $4,718,419 $5,938,828 

6 Charlotte ......... NC Health Care Center ......................... Lease $1,787,028 $4,884,145 $6,671,173 

7 Hinesville ......... SC Community-Based Outpatient Clinic Lease $1,175,860 $0 $1,175,860 

7 Savannah ........ GA Community-Based Outpatient Clinic Lease $1,120,466 $0 $1,120,466 

7 Anderson ......... SC Outpatient Clinic ............................. Lease $297,703 $196,835 $494,538 

7 Montgomery ..... AL Health Care Center ......................... Lease $1,049,303 $1,593,356 $2,642,659 

7 Atlanta ............ GA Specialty Care ................................. Lease $1,785,517 $561,385 $2,346,901 

7 Huntsville ........ AL Outpatient Clinic ............................. Lease $3,464,333 $518,438 $3,982,771 

7 Birmingham .... AL Clinical Annex/Outpatient Clinic ..... Lease $3,912,878 $520,815 $4,433,693 

8 Tampa ............. FL Primary Care Annex ......................... Lease $730,925 $0 $730,925 

8 Tallahassee ..... FL Outpatient Clinic ............................. Lease $580,497 $2,646,486 $3,226,983 

8 Bay Pines ........ FL Inpatient/Outpatient Improvements 516-005 $47,574 $0 $47,574 

8 Tampa ............. FL Polytrauma and Bed Tower (OV) .... 673-900 $1,204,469 $443,826 $1,648,295 

8 San Juan ......... PR Seismic Corrections Bldg. 1 (OV) ... 672-085 $0 $418,665 $418,665 

11 Fort Wayne ...... IN Community Based Outpatient Clinic Lease $290,519 $0 $290,519 

11 Grand Rapids .. MI Community Based Outpatient Clinic Lease $1,128,712 $0 $1,128,712 

11 South Bend ..... IN Community Based Outpatient Clinic Lease $3,031,720 $1,254,670 $4,286,390 

15 St. Louis (JB) .. MO Med Facility Improv & Cem Expansion (OV).657-313 $299,499 $1,414,548 $1,714,046 

16 Lafayette ......... LA Community Based Outpatient Clinic Lease $933,996 $0 $933,996 

16 Lake Charles ... LA Community Based Outpatient Clinic Lease $618,137 $0 $618,137 

16 Biloxi ............... MS Restoration Of Hospital/Consolidation (OV).520-317 $7,051,589 $0 $7,051,589 

16 New Orleans .... LA Restoration/Replacement Medical 

Facility (OV).

629-401 $9,795,425 $13,599,164 $23,394,589 

18 Mesa ................ AZ Satellite Outpatient Clinic .............. Lease $4,721,649 $0 $4,721,649 

19 Colorado 

Springs.

CO Community-Based Outpatient Clinic 

Relocation.

Lease $847,931 $0 $847,931 

19 Billings ............ MT Satellite Outpatient Clinic .............. Lease $1,708,731 $0 $1,708,731 

19 Denver ............. CO Replacement Medical Center Facility (OV).554-501 $8,982,484 $832,040 $9,814,525 

20 Salem .............. OR Community-Based Outpatient Clinic Lease $1,479,486 $0 $1,479,486 

20 Eugene ............ OR Community-Based Outpatient Clinic Lease $5,765,526 $0 $5,765,526 

20 Seattle ............. WA Correct Seismic Deficiencies B100, 

NT & NHCU.

663-406 $9,945,330 $127,171 $10,072,500 

20 Walla Walla ..... WA Multi Specialty Care (Overview) ..... 687-400 $685,808 $351,214 $1,037,022 

21 Monterey .......... CA Health Care Center ......................... Lease $0 $1,136,277 $1,136,277 

21 Palo Alto .......... CA Centers for Ambulatory Care and 

Polytrauma Rehabilitation (OV).

640-424 $100,875 $5,060,925 $5,161,800 

22 Bakersfield ...... CA Community-Based Outpatient Clinic Lease $264,985 $187,947 $452,932 

22 Loma Linda ..... CA Health Care Center ......................... Lease $2,079,918 $3,691,593 $5,771,511 

22 Long Beach ..... CA Seismic Corrections/Clinical, B-7 & 

126.

600-402 $622,331 $0 $622,331 

172 

Fiscal Year 2015—Continued 

VISN Location State Description Project Recurring Non-Recurring Total 

Total ................................................ $83,247,227 $46,752,773 $130,000,000 

B. Please describe the activation costs that fall within the Medical Services account and those costs that fall within the Medical Facilities account. 

Response. Activation costs are funded by the two appropriations based upon what 

those appropriations are used to purchase. For example, if the activation cost was 

the result of purchasing medical equipment or hiring new clinical staff, the Medical 

Services appropriation would be required. If the activation cost was to expand a 

sidewalk and install a wheelchair ramp to make the facility more accessible to Veterans with limited mobility, the Medical Facilities appropriation would be required. 

Question 145. The Medical Support and Compliance account contains funding for 

VHA central office, Veterans Integrated Service Networks (VISN) headquarters offices, and management of the medical centers. However, unlike last year’s budget 

request, this year’s request does not display funding for these three accounts separately. 

a. How much does VA expect to spend in fiscal years 2014 and 2015 for VISN 

headquarters functions? 

Response. In the 2014 Congressional submission, VA anticipated spending $308 

million in 2014 and $297.1 million in 2015. In the 2015 Congressional submission, 

the 2014 estimate is revised to $291.6 million and the 2015 estimate remains at 

$297.1 million. 

b. How much funding will be saved as a result of implementing VHA’s staffing 

reorganization of VISN headquarters? 

Response. VA’s 21 Veterans Integrated Service Networks (VISNs) are being restructured around a standard staffing structure for each VISN. As the result of this 

initiative, VA estimates savings of $25 million each in FY 2014 and FY 2015 in the 

Medical Support and Compliance account. 

c. When does VHA plan to start the second part of the reorganization, a review 

of the number of VISNs? Please provide a detailed description of the criteria VHA 

will use to evaluate whether 21 VISNs are needed. 

Response. The Under Secretary for Health convened a workgroup on April 4, 

2013, chartered with reviewing the number and composition of VISNs that currently 

comprise make up the Veterans Health Administration. As part of that charter, the 

workgroup was responsible for developing the criteria and methodology that would 

be used to review the size and composition of the VISNs. A copy of the workgroup 

charter follows. 

173 


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174 

Question 146. Section 111 of Honoring America’s Veterans and Caring for Camp 

Lejeune Families Act directs VA to develop a plan for recovery and collection of 

amounts for the Department of Veterans Affairs Medical Care Collections Fund 

(MCCF). This section provides a method to develop and implement a better process 

and system of controls to ensure accurate and full collections by VHA. Please provide details on VHA’s efforts to implement section 111. 

Response. Public Law 112–154, Section 111 requires the VA to develop and implement a plan no later than 270 days after the date of enactment to ensure recovery 

and collection from Veterans’ health insurance for medical care and services provided through VA’s Fee Basis authorities. VA has completed all actions associated 

with the requirements of Section 111 as described below: 

• Improved identification of billable fee claims: The VHA Chief Business Office 

chartered a workgroup to reengineer business processes that support maximizing 

the cost recovery of billable fee services. The team implemented Standard Operating 

Procedures to improve identification of billable fee claims as part of this effort. 

• Training: Training on the identification of billable Fee claims was provided to 

Fee and revenue operations staff using both written guidebooks and fact sheets. 

• Fee Revenue Goals: Utilizing VA’s Integrated Collections Forecasting Model 

(ICFM), goals for Fee revenue were established beginning in FY 2012. 

• Monitors: Comprehensive monitoring to benchmark performance and outcomes 

was deployed in FY 2012. 

• Policies and Procedures for MCCF Recovery: Deployment of seven industry best 

practice Consolidated Patient Account Centers is the cornerstone of ensuring long 

term success in MCCF Recovery. As part of this effort, policies and procedures were 

implemented for all revenue cycle functional areas and are continually monitored 

for updates. 

Question 147. The issue of third party payers and MCCF have been the subject 

of a number of government reports over the years. These reports were critical of 

VHA’s third party billing and collection practices. Because funds deposited in MCCF 

are retained by the medical centers and can be used to treat veterans, it is critical 

that VHA is able to collect all that is owed by third parties. 

A. Please provide the Committee with the total amount VA sought in third party 

billings and the total amount collected from third parties for the last six fiscal years. 

Response. 

Fiscal Year Total Third Party 

Billings 

2007 ................................................ $3,325,052,175 

2008 ................................................ $4,107,259,321 

2009 ................................................ $5,290,964,587 

2010 ................................................ $5,490,122,279 

2011 ................................................ $5,775,314,495 

2012 ................................................ $5,556,546,698 

B. Please provide the Committee with the percentage increase in billings and collections for each fiscal year compared to the previous fiscal year’s billing. 

Response. 


415q3Bur145c2.eps
175 

Fiscal Year 

Total Third Party 

Billings 

Percent (%) 

Change from Prior Fiscal Year 

Total Third Party 

Collections 

Percent (%) 

Change from Prior Fiscal Year 

2007 ................................................................... $3,325,052,175 — $1,261,345,593 — 

2008 ................................................................... $4,107,259,321 23.52 % $1,497,448,632 18.7 % 

2009 ................................................................... $5,290,964,587 28.82 % $1,843,201,251 23.1 % 

2010 ................................................................... $5,490,122,279 3.76 % $1,904,031,955 3.3 % 

2011 ................................................................... $5,775,314,495 5.19 % $1,799,951,647 -5.5 % 

2012 ................................................................... $5,556,546,698 -3.79 % $1,847,530,762 2.6 % 

C. Please provide the Committee with the collection rate for claims over $1,000 

for the last six fiscal years. 

Response. 

Fiscal Year 

Collection rate 

for Claims 

over $1000 

2007 ................................................ 44.5% 

2008 ................................................ 42.2% 

2009 ................................................ 40.9% 

2010 ................................................ 39.2% 

2011 ................................................ 35.8% 

2012 ................................................ 36.5% 

D. Please provide the Committee with the collection rate for claims under $1,000 

for the last six fiscal years. 

Response. 

Fiscal Year 

Collection rate 

for Claims 

under $1000 

2007 ................................................ 50.3% 

2008 ................................................ 45.1% 

2009 ................................................ 41.3% 

2010 ................................................ 39.5% 

2011 ................................................ 35.5% 

2012 ................................................ 35.5% 

Question 148. In an explanation of health care benefits provided by the Honoring 

America’s Veterans and Caring for Camp Lejeune Families Act, VA’s budget request 

indicates ‘‘[i]n 2015 [VA] expects to start treating family members’’ and this budget, 

if adopted, would provide $25 million to treat Camp Lejeune families. The fiscal 

year 2013 Continuing Resolution (CR), signed into law on March 26, 2013, included 

the appropriations and legislative language needed for VHA to treat Camp Lejeune 

family members in fiscal year 2014. 

A. Given that the CR provides the funding and language necessary to treat Camp 

Lejeune families, will VA be able to provide benefits earlier than fiscal year 2015? 

If not, please describe the barriers to providing treatment earlier than fiscal year 

2015. 

Response. The earliest VA will be able to reimburse family members for hospital 

care or a medical service is dependent on the publication of an effective rule to implement the statute 

The family member regulations are currently going through Departmental review. 

Once completed, they will follow the regulatory development process established 

under the Administrative Procedure Act and will be submitted to the Office of Management and Budget (OMB) for review and approval. Concurrent with the finalization of regulations, VA will need to hire additional personnel to administer the family member program. VA anticipates that personnel will be hired and that other resources needed to implement this program will be in place when the regulations are 

published. 

B. Please describe the regulation drafting process as it pertains to providing treatment to Camp Lejeune families, including a timeline of when VHA began the draftVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00179 Fmt 6633 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
176 

ing process, the stages of the process, when the regulations are expected to be final, 

and what stage in the current regulation process are those regulations. 

Response. For family members, VA is expediting its own internal regulatory process. The very earliest VA anticipates being able to provide benefits to family members is by the start of FY 2015. Immediately after enactment of the law, VA assembled a Steering Committee, including subject matter and policy experts from the entire organization, which made policy decisions regarding providing treatment to 

Camp Lejeune family members. 

The U.S. Marine Corps is preparing a memo to clarify the support it and DOD 

will provide to VA to determine administrative eligibility for Veterans and family 

members. VA has used subject matter expert briefings, Internet, social media, and 

traditional media to proactively reach out to stakeholders. Briefings and information 

papers have been provided to members of the Camp Lejeune Community Action 

Panel, concerned Veterans and their family members, Veterans Service Organizations, congressional staff, and the media. 

Homelessness 

Question 149. A letter from VA, dated February 1, 2012, included a timeline of 

the ‘‘VA Homelessness Reduction Strategy: 2009–2015.’’ This timeline included decisions regarding increasing or decreasing budget requests, reallocating funding, and 

a decision whether to extend the timeline. 

A. When does VA expect to make a decision regarding reallocating funding and 

whether to extend the timeline? 

Response. The January 2013 PIT counts, projected to be released by HUD during 

quarter one of FY 2014, will provide an important snapshot of the Administration’s 

progress in ending veteran homelessness. 

Reallocating resources, however, is an ongoing process. VA’s success in moving toward ending Veteran homelessness is in part due to ongoing program evaluation 

and realignment. VA’s ongoing program realignment has been a two-pronged approach of focused service adjustments and a realignment of resource investment. 

The SSVF Program, for example, is evidence of VA’s ongoing efforts to realign program services and investments to end Veteran homelessness. Although still a relatively new program, it is already clear that the SSVF Program has been successful, 

which warrants continued, if not enhanced, investments. The SSVF Program provides grants to private non-profit organizations and consumer cooperatives to help 

Veteran families rapidly exit homelessness or to prevent at-risk Veterans from becoming homelessness. The SSVF Program is unique in that it can serve both the 

Veteran and his or her family member(s). The SSVF Program continues VA’s efforts 

to realign services under a Housing First permanent supportive housing model. 

In FY 2012, during the SSVF Program’s first full year of operations, the program 

surpassed expectations, serving approximately 21,500 Veterans and over 35,000 persons. Of those served, 40 percent were at?risk for homelessness and seeking prevention services while the remaining 60 percent were provided rapid re?housing services to transition from homelessness into permanent housing. At the end of FY 2012, 

VA awarded 151 SSVF grants in 49 states and the District of Columbia for operations in FY 2013. 

In recognition that this community-based resource needed to be more geographically available to all communities assisting Veterans and their families, VA announced a SSVF NOFA for an additional $300 million to further grow this program. 

B. What criteria will VA use to determine whether to decrease budget requests, 

reallocate funding, and make a decision whether to extend the timeline? 

Response. VA’s budget focuses on preserving funding for mission-critical and cost 

effective services that directly benefit Veterans, their families, and Survivors, 

prioritizing programs shown to be effective in ending Veteran homelessness. Decisions regarding future prioritization will continue to be informed by data from the 

PIT Count in addition to data from VA homeless programs. 

Question 150. In fiscal year 2012, Congress appropriated $1.023 billion for homeless veterans programs. Please provide the Committee a detailed breakdown of how 

this funding was utilized within these programs and the number of veterans who 

accessed these programs. 

Response. VA operates the largest system of homeless medical, treatment, and assistance programs in the Nation. The hallmark of VA’s programs for homeless Veterans is the provision of comprehensive care and benefits including medical, psychiatric, substance use, rehabilitation, dental care, and expedited claims processing 

for these Veterans. The following represent many programs included in VA’s homeless continuum of care. All programs in this continuum are part of VA’s plan to 

eliminate homelessness and contribute to the overall reduction of the homeless Veteran population. 

177 

Supportive Services for Veteran Families (SSVF) Program: In FY 2012, VA obligated approximately $100 million in funding for the SSVF Program for operations 

occurring in FY 2013. In FY 2012, the SSVF Program served over 35,000 Veterans 

and their family members based on $60 million in SSVF grants awarded in FY 

2011. The SSVF Program makes available grant funds for private non-profit organizations and consumer cooperatives to help very low-income Veteran families rapidly 

exit homelessness or to assist Veteran families at-risk for homelessness. In addition 

to providing linkage to VA health care and other services, grantee organizations 

have the ability to directly address the type of emergent needs that, if unmet, can 

be deciding factors in a family’s struggle to remain stably housed. Funds for emergency rental assistance, security and utility deposits, food and other household supplies, child care, one-time car repairs, and other needs will help to keep Veterans 

and their families housed—as families. In 2011, VA awarded the first SSVF grants, 

awarding approximately $60 million to 85 grantees in 40 states and the District of 

Columbia for operations in FY 2012. In FY 2012, SSVF grantees served over 35,000 

Veterans and their family members, placing nearly 86 percent in permanent housing. In FY 2012, $100 million was awarded in SSVF grants to 151 community agencies in 49 states, Puerto Rico, and the District of Columbia for operations in FY 

2013. In FY 2013, the SSVF Program anticipates serving at least 42,000 Veterans 

and their family members. In early FY 2013, a SSVF NOFA was published in the 

Federal Register, announcing the availability of $300 million for FY 2013. The application period closed on February 1, 2013, and VA is currently reviewing applications. 

Veterans Homelessness Prevention Demonstration (VHPD) Program: In FY 2012, 

VA obligated $1.39 million in funding for VHPD and, during this time, VHPD provided services to over 730 Veteran families, of which 26 percent were female and 

37 percent were OIF/OEF/OND Veterans. VHPD (also referred to as the HUD-VA 

Pilot Program) is designed to explore ways for the Federal Government to offer early 

intervention homeless prevention, primarily to Veterans returning from wars in Iraq 

and Afghanistan. This demonstration program provides an opportunity to understand the unique needs of a new cohort of Veterans and will support efforts to identify, provide outreach to, and assist them in regaining and maintaining housing stability. This 3-year HUD-VA prevention pilot is a partnership among VA, HUD, the 

Department of Labor (DOL), and local community agencies. VHPD will serve the following locations: MacDill Air Force Base in Tampa, Florida; Camp Pendleton in San 

Diego, California; Fort Hood in Killeen, Texas; Fort Drum in Watertown, New York; 

and Joint Base Lewis-McChord near Tacoma, Washington. As the lead agency, HUD 

is awarding grants for the provision of housing assistance and supportive services 

to prevent Veterans and their families from becoming homeless or to reduce the 

length of time Veterans and their families are homeless. In February 2011, grant 

agreements were signed by five Continuums of Care—regional or local planning bodies that coordinate housing and services funding for homeless families and individuals. VHPD sites began serving Veterans in March 2011. 

The National Call Center for Homeless Veterans (NCCHV): In FY 2012, VA obligated $3.9 million in funding for the NCCHV. The NCCHV received 80,558 total 

calls in FY 2012, representing an increase of 123 percent over the same time period 

in FY 2011. The NCCHV was founded to ensure that homeless Veterans or Veterans 

at risk for homelessness have free, 24/7 access to trained counselors. The hotline 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. The NCCHV (877–4AID-VET) was fully implemented on March 1, 

2010. The NCCHV received 80,558 total calls in FY 2012. Of the calls received, 

14,386 callers identified as being homeless. The NCCHV made 50,608 referrals to 

VA medical center points of contact in FY 2012, representing an increase of 133 percent over the same period in FY 2011. 

Veterans Justice Programs: In FY 2012, VA obligated $18.3 million for Veterans 

Justice Programs. As part of VA’s Plan to End Veteran Homelessness, VA is focused 

on serving Veterans involved with the criminal justice system, who may be homeless 

or at-risk for homelessness. Studies have shown that for adult males, incarceration 

is the most powerful predictor of homelessness. The Health Care for Reentry Veterans (HCRV) Program provides outreach and linkage to post-release services for 

Veterans in state and Federal prisons. In FY 2012, 10,572 Veterans were served 

through the HCRV Program. The Veterans Justice Outreach (VJO) Program focuses 

on Veterans in contact with law enforcement, jails, and courts, including the rapidly 

expanding Veterans Treatment Courts. In FY 2012, 27,251 Veterans were served in 

the VJO program. 

Grant and Per Diem (GPD) Program: In FY 2012, VA obligated over $208 million 

in operating funds for the GPD Program and over $26 million in funding for VA 

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GPD liaisons, who provide services and oversight of GPD-funded programs. During 

this time, over 41,000 Veterans accessed GPD services. Under the GPD Program, 

VA offers GPD payments to public or non-profit private entities to develop transitional housing and supportive services for homeless Veterans. The goal of the program is to help homeless Veterans achieve residential stability, increase their skill 

levels and/or income, and obtain greater self-determination. VA awarded approximately $28.4 million in grants to fund transitional housing projects. Thirty-one of 

the funded projects are a TIP Housing Model, which will provide time-limited supportive services to homeless Veterans in which the services transition but the Veteran remains in the housing. During this fiscal year, VA activated 34 new transitional housing projects that can house up to 890 homeless Veterans. 

Over 41,000 Veterans utilized GPD services in FY 2012. There were 22,148 discharges from GPD in FY 2012 with an average length of stay of approximately 183 

days. The average cost per admission in GPD was $6,465. Approximately 56 percent 

(12,464) of homeless Veterans discharged from GPD moved into independent housing, and approximately 17 percent were discharged to another treatment setting. 

Twenty-six percent of Veterans discharged were employed at least part-time or were 

participating in VA’s Compensated Work Therapy (CWT) Program. 

Health Care for Homeless Veterans (HCHV) Program: In FY 2012, VA obligated approximately $119 million in funding for all programs funded through the HCHV 

Program. The HCHV Program is a three-pronged approach to eliminating homelessness among Veterans, consisting of contract transitional housing services, outreach, 

and case management. The HCHV Program is critical to VA’s efforts to reach homeless Veterans living on the streets and in need of housing services. The program 

provides a means to contract with community-based residential treatment service 

providers to provide emergency housing and same-day placement of homeless Veterans identified in their outreach efforts. HCHV funds assist in supporting 16 

CRRCs, which provide ‘‘one stop services’’ to assist homeless Veterans and Veterans 

and their families at-risk for homelessness. In FY 2012, HCHV outreach staff provided services to 119,878 homeless Veterans. The Contract Residential Treatment 

component of the HCHV Program ensures that Veterans with serious mental health 

diagnoses can be placed in community-based residential treatment programs which 

provide quality housing and services. The HCHV Program provides ‘‘in place’’ residential treatment beds through contracts with community partners and VA outreach and clinical assessments to homeless Veterans who have serious psychiatric 

and substance use disorders. In FY 2012, the HCHV Program contracted residential 

programs provided transitional housing to over 11,500 homeless Veterans. The Veterans were supported in 3,399 operational beds at 299 sites, system-wide. 

Domiciliary Care for Homeless Veterans (DCHV): In FY 2012, VA obligated $19.98 

million to the development of five new DCHV programs. The DCHV mission is to 

provide time-limited, state-of-the-art, high quality residential rehabilitation and 

treatment services for homeless and at-risk of homeless Veterans with multiple and 

severe medical conditions, mental illness, addiction, or psychosocial deficits. DCHVs 

provide a 24/7 structured and supportive residential environment as part of the rehabilitative treatment process. In FY 2012, there were 2,342 DCHV beds dedicated 

to the treatment of homeless Veterans, an increase of 41 beds from FY 2011. The 

DCHV programs served 8,389 unique Veterans in FY 2012. In FY 2012, 54.8 percent 

of Veterans were discharged to permanent housing. An additional 25 percent of Veterans were discharged to another Mental Health Residential Rehabilitation and 

Treatment Program (MH-RRTP), health care institution, or transitional housing. 

Between FY 2007 and FY 2012, the number of homeless Veterans served yearly in 

all MH-RRTP programs increased by 68 percent from 14,112 to 23,835. In FY 2012, 

VHA will develop five new DCHV programs in Philadelphia, Atlanta, West Palm 

Beach, Denver, and San Diego. The Denver DCHV opened at the end of May 2013. 

The Atlanta DCHV and the Philadelphia DCHV are scheduled to open in November 2013. The San Diego DCHV is scheduled to open by May 2014. The West Palm 

Beach DCHV is scheduled to open in 2016 after the construction of a new on-station 

building. VHA has also approved the development of a DCHV in San Juan, Puerto 

Rico, which is scheduled to open in 2015. 

Substance Use Disorder (SUD) Treatment Enhancement Initiative for VA Homeless 

Programs: In FY 2012, VA obligated approximately $3.5 million for the SUD Treatment Enhancement. VHA’s SUD Treatment Enhancement Initiative created community-based Homeless SUD Specialist positions designed to provide case management 

and referral services to homeless Veterans with SUDs. These specialists assist Veterans in obtaining and maintaining housing, increasing access to substance abuse 

treatment, and enhancing opportunities for recovery. In FY 2012, this initiative 

funded a total of 47 SUD Specialists at targeted sites around the country, providing 

critical services to 8,390 homeless Veterans. 

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HUD-VASH Program: VA obligated $169.9 million for the HUD-VASH program 

during FY 2012, housing over 37,000 Veterans in this program. HUD-VASH is a collaborative program between HUD and VA for eligible homeless Veterans to receive 

a HUD-provided Housing Choice voucher and VA-provided case management and 

supportive services to support stability and recovery from homelessness. Case management services ensure the Veteran is able to obtain and sustain in permanent 

housing, thus exiting from homelessness. These case management services also ensure a wide menu of choices so the Veteran may care for his or her physical and 

mental health and SUDs as well as promote integration into the Veteran’s chosen 

community. As of September 30, 2012, 44,020 HUD-VASH vouchers were in use and 

37,591 Veterans were housed through this program. 

Homeless Veterans Dental Initiative (HVDI): In FY 2012, 119 participating VA facilities reported that 14,114 Veterans received dental care through the HVDI’s total 

FY 2012 obligations of $27.3 million. HVDI is jointly funded by VHA Homeless Programs and the Office of Dentistry. This initiative enhances the accessibility of quality dental care to homeless Veteran patients to help ensure success in VHA-sponsored and VA partnership homeless rehabilitation programs. The HVDI facilitates 

the provision of limited outpatient benefits for a one-time course of dental care for 

VA health care eligible Veterans who are enrolled for at least 60 days in the following programs: GPD, DCHV, CWT—Transitional Residence (CWT-TR), 

Healthcare for Homeless Veterans Contract Residential Treatment, and Community 

Residential Care. 

Homeless Veteran Supported Employment Program (HVSEP): In FY 2012, VA obligated approximately $25 million for HVSEP and provided employment services to 

12,815 Veterans. Homeless and at-risk Veterans need access to employment opportunities to support their housing needs, improve the quality of their lives, and assist 

in their community reintegration efforts. VA has committed to supporting this critical component to eliminating homelessness through HVSEP. HVSEP, jointly operated by CWT and VHA Homeless Programs, provides vocational assistance, job development, job placement, and ongoing employment supports to improve employment outcomes among homeless Veterans. Vocational and employment services are 

based on rapid engagement, customized job development, and competitive community placement with ongoing supports for maintaining employment. 

National Homeless Registry: In FY 2012, VA obligated $7.2 million in funding for 

the National Homeless Registry. Although not a program itself, VA’s comprehensive 

National Homeless Registry is intended to track and monitor treatment outcomes 

in homeless program expansion and prevention initiatives. The Registry serves as 

a data warehouse and enhances VA’s capability to monitor program effectiveness 

and the long-term outcomes of Veterans who have utilized VA-funded homeless 

services. The Registry is currently populated with over 500,000 names of current 

and formerly homeless Veterans who have utilized VA’s homeless programs. VHA 

will continue to refine its Registry to fully capture the scope of the homeless Veteran population, monitor treatment outcomes, and access to VA services. 

Question 151. The fiscal year 2013 budget request included $21 million for 200 

additional FTE to be Homeless Veterans Outreach Coordinators (HVOC) in VBA. 

Please provide the Committee with an update on the hiring status of the additional 

200 HVOCs, where the additional HVOCs will be located, and when VA expects to 

have completed the hiring of additional HVOCs. 

Response. The FY 2013 President’s Budget, submitted to Congress in February 2012, included a request for an increase of $21 million and 200 FTE to serve 

as Homeless Veterans Outreach Coordinators (HVOCs) at the ROs. Homeless Veterans Outreach is one of several integrated programs woven into the Department’s 

six strategies outlined in its 5-year plan to end homelessness among Veterans—outreach/education, treatment, prevention, housing/supportive services, income/employment/benefits, and community partnership—that encompass a wide continuum of 

interventions and services. 

By the summer of 2012, assessments of the Department’s homelessness program 

indicated that existing outreach efforts were proving successful, as evidenced by a 

58 percent increase in the number of claims received from homeless or at-risk Veterans. Concurrently, the C&P inventory pending more than 125 days was increasing 

rather than diminishing. As a result of this combination of factors, the Secretary 

decided in the Fall of 2012 to reprioritize the HVOC resources and allow them to 

be invested toward reducing the claims backlog. 

Question 152. The fiscal year 2014 budget request includes $1.393 billion for fiscal 

year 2014 and $1.0 billion for fiscal year 2015 for homeless veterans programs. The 

fiscal year 2015 advance appropriation request includes the funding of several programs being eliminated, including Domiciliary Care for Homeless Vets-Initiative, 

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Substance Abuse/Mental Health Enhancement, Expansion of Homeless Dental Initiative, Homeless Veterans Supported Employment Program, and Homeless Therapy 

Employment, Compensated Work Thearpy (CWT) & CWT/TR-Sustainment. 

A. What metrics were used to determine that these programs were no longer 

needed in fiscal year 2015? 

Response. As VA’s plan to end Veteran homelessness nears 2015, VA is gradually 

reducing funding for certain programs, moving other programs to sustainment, and 

generally realigning resources to preserve key homeless services for the long term. 

To this end, funding for several programs will be eliminated from VA’s homeless 

programs budget in FY 2015. The programs and services are still being provided 

through local VA medical centers and funded through different mechanisms than 

specific program budget line items. VA’s homeless programs budget focuses on preserving funding for absolutely necessary and mission-critical services, prioritizing 

programs shown to be effective in ending Veteran homelessness. The rationale behind these budget decisions is outlined below. As VA considered these budget decisions, VA chose to fund many of these eliminated programs through the Veterans 

Equitable Resource Allocation (VERA) model. VA funds each VISN using the VERA 

model, a capitated funding model that allows equitable distribution of patient care, 

education, and research funding based on patient workload with an adjustment factor for geographic location. In summary, the decision to eliminate these program 

line items from VA’s homeless programs budget was functional and fiscal in nature 

rather than performance/metrics-driven. The rationale behind these decisions are as 

follows: 

• DCHV: Currently, there are 42 DCHV programs across the country. VA’s plan 

to end Veteran homelessness called for the implementation of five new DCHV programs in Philadelphia, Atlanta, West Palm Beach, Denver, and San Diego. By design, DCHV programs throughout the country are funded primarily through VA’s 

VERA model. The funding eliminated in FY 2015 specifically supported the implementation of these five new DCHV programs. It is expected that development and 

implementation efforts will be completed by FY 2015 and that ongoing operations 

can be funded through VERA along with all the other DCHV programs. 

• Substance Abuse/Mental Health Enhancement: This initiative supported the 

creation of 47 Homeless Program Substance Use Disorder Specialists nationally. 

Since the inception of the enhancement, VA intended that funding for these positions would be shifted to VERA, consistent with the majority of SUD services offered 

by VA. These positions theoretically join the existing pool of SUD service providers 

in VA’s system, thus ensuring the sustainability of such services for homeless Veterans. 

• Homeless Dental Initiative: Homeless Dental Initiative funding is an enhancement to existing VA dental programs serving homeless Veterans. During a time of 

budget constraints, VA decided to eliminate this funding enhancement because dental services do not in and of themselves end homelessness. In order to preserve 

funding for and focus on the absolutely necessary and mission-critical services, VA 

eliminated enhanced dental funding in VA’s homeless program budget. Currently, 

VHA Dental Services allocates approximately $17 million for the dental care of eligible Veterans who are enrolled for at least 60 days in the following programs: GPD, 

DCHV, CWT-TR, HCHV Contract Residential Treatment, and Community Residential Care. 

• HVSEP: From its inception, HVSEP was intended to transition from an initiative funded through VA homeless programs to the VERA system by its fourth year 

of operation. This transition is a strategic decision and is not a reflection on its 

value as a program. In fact, VHA Homeless Programs Office is currently working 

on ways to expand employment services to homeless Veterans through its ongoing 

programs as well as through non-homeless programs such as CWT and through enhanced use of community-based employment resources. This expanded focus on employment is in recognition of the critical role employment plays in helping Veterans’ 

exit or preventing homelessness. 

• CWT and CWT/TR—Sustainment: CWT and CWT/TR are funded through 

VERA and, thus, these services will be sustained despite any changes in funding 

within the VHA Homeless Programs Office. 

B. If VA does not meet its goal of reducing the number of homeless veterans from 

62,619 in 2012 to 47,000 in 2013, how will this impact the funding requested for 

fiscal year 2015? 

Response. VA has already had significant and measurable success in ending Veteran homelessness. Based on HUD PIT Count, as available at the time of the FY 

2014 Budget hearing, from January 2009 to January 2012, the number of Veterans 

experiencing homelessness on a single night has decreased 17.2 percent (from 

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75,609 to 62,619), a reduction that occurred in a particularly challenging economic 

environment. The PIT Count is a count of sheltered and unsheltered homeless persons on a single night in January and is intended to be a snap shot in time. Consequently, it is important to note that in the event VA does not meet the PIT Count 

benchmark reduction to 47,000 homeless Veterans in FY 2013 (as measured in the 

January 2014 PIT Count), this does not mean VA is not on track to end Veteran 

homelessness. 

VA and HUD data sources inform the resource allocation and investment process 

for VA’s homelessness programs. Programs such as SSVF and HUD-VASH, which 

are focused on both homeless prevention and permanent supportive housing, are 

critical to accelerating VA’s progress in connecting Veterans to permanent supportive housing and providing crucial supportive services. For example, VA sees an 

urgent need for continued reinvestment in the HUD-VASH Program. To achieve 

more rapid engagement with chronically homeless Veterans, an additional 10,000 

vouchers with funding for long term case management services in FY 2015 will likely be needed to serve the most vulnerable homeless Veterans. Finishing the job of 

ending Veteran homelessness will require continued investment in Veteran-centric 

housing and health programs, the widespread adoption of evidence-based best practices such as Housing First, and resources that ensure that Veterans receive the 

proper treatment to achieve the best housing, income, and treatment outcomes. 

Finally, despite the comprehensive array of services and programs already proposed in VA’s budget, VA cannot directly address all the needs of homeless Veterans 

and their dependents. If VA is to end Veteran homelessness, VA must continue to 

cultivate strong and productive relationships within the community. Veterans, their 

partners, and their dependent children have a number of unmet health care needs 

directly related to their housing instability, including: emergency cash assistance, 

temporary housing for family members separate from the Veteran, transportation, 

affordable housing, move in kits and supplies, and legal services. These are all essential resources that in many cases, VA cannot directly provide to homeless Veterans and their families. Continued coordination with Federal, state, local, faithbased, philanthropic, and Veterans Service Organizations is vital for connecting all 

Veterans and their families with the housing and supports needed to prevent and 

end Veteran homelessness. 

Question 153. 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 (BURR) initiative, VA identified unused or underutilized property which would create an additional 4,100 housing units. 

A. How many additional units of housing were available through this program in 

fiscal year 2012 and how many will be available by the end of fiscal year 2013? 

Response. The 38 enhanced-use lease (EUL) agreements signed in December 2011 

as part of the BURR initiative created public/private partnerships whereby EUL lessee/developers, in exchange for a long-term leasehold interest in underutilized or vacant VA land and/or buildings, are responsible for the design, construction, operation, and on-going maintenance of supportive housing for homeless or at-risk Veterans. During FY 2012, all 38 projects were still in the design and/or construction 

phase; as a result, no new units went into operations during FY 2012. 

VA currently anticipates that 135 units will be placed into operations by the close 

of FY 2013 as a result of BURR EUL agreements. In addition, 258 units of supportive housing have or will become operational during FY 2013 as a result of three 

recent EUL agreements signed independently of the BURR initiative. 

B. What are the lessons learned from the leases that were executed in 2011 and 

how will these lessons learned be implemented to improve this program in the future? 

Response. The chief lesson learned from the BURR initiative concerns the interdependency between capital and operational financing. In many cases, state housing 

finance agencies (the entities responsible for dispersing Federal low-income housing 

tax credits (LIHTCs)) and investors (e.g., LIHTC syndicators) are unwilling to close 

on capital financing until developers have secured commitments of operational financing (e.g., rental subsidies like project-based HUD-VASH or Section 8 vouchers). 

Capital financing must be finalized before construction can begin, and construction 

on these facilities typically takes a minimum of twelve months—often longer. However, the entities responsible for dispersing operational financing and subsidies (e.g., 

local Public Housing Authorities) are often unable to make commitments of operational support this far in advance. This creates a ‘Catch–22’ of sorts for developers 

(like the BURR EUL lessees) who are attempting to leverage LIHTCs to create permanent affordable supportive housing for highly-vulnerable individuals, such as 

homeless Veterans. 

182 

VA has been coordinating with HUD in an effort to identify solutions to this 

‘‘Catch–22’’; currently, both agencies are hopeful that some mitigating measures 

have been identified. Going forward, VA will continue to coordinate with HUD, in 

an effort to identify these sorts of issues in advance, and to proactively generate solutions. 

C. What are the barriers identified that caused delays in these projects moving 

forward? 

Response. While the factors that have caused delays to some of the BURR 

projects’ schedules are ultimately unique to each project, it is possible to categorize 

most of these sources of delays under three broad headings: (i) financing, (ii) local 

opposition, and (iii) unforeseen environmental/historical conditions. (i) Financing 

delays sometimes take the form of the Catch–22 described in response to Question 

153(B) above, but other types of financing-related delays have impacted the BURR 

EUL projects as well. For instance: two states (Maine and Massachusetts) suspended housing finance programs during 2012, causing developers on three projects 

to have to await at least a year longer to apply for financing. In other cases, developers submitted applications for competitively-awarded tax credits, and simply were 

not awarded any—thereby requiring the developers to apply in the following year’s 

cycle. (ii) Due to the nature of the contemplated housing facilities, EUL developer/ 

lessees frequently face ‘Not In My Backyard’ (‘NIMBY’) opposition from local residents and municipalities.. (iii) Finally, the consultation processes required pursuant 

to Federal environmental and historic preservation regulations, for example (the 

National Environmental Protection Act and the National Historic Preservation Act 

(NHPA), respectively) can uncover unforeseen issues which result in delays. For example: compliance with Section 106 of the NHPA often requires VA to perform archaeological surveys at EUL sites before construction can begin. These surveys can 

be lengthy, and furthermore they sometimes recommend follow-up studies or mitigation measures which are themselves costly and time-consuming. 

Veterans Transportation Service 

Question 154. The Dignified Burial and Other Veterans’ Benefits Improvement 

Act of 2012 provides VA with authority to transport veterans to or from a VA facility or other locations that provide other services, such as vocational rehabilitation, 

counseling, and health services. 

A. Please provide the Committee with which VA medical facilities are providing 

transportation through this authority. 

Response. Please see table below. 

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415tab179a.eps
184 

B. Please provide any analyses conducted to determine the need for this program. 

Response: 

Challenges 

VTS was conceived with the goal of providing safe, reliable, and efficient transportation for Veterans to VA health care, especially those who are mobility impaired; 

suffered a Traumatic Brain Injury; severe PTSD, or other medical and mental 

health problems which make self-arranged transportation difficult or who reside in 

rural areas which lack public transportation. In the two years since, its inception, 

Veterans have increasingly relied on VTS transportation services. With almost 75% 

of the VTS sites depending on paid drivers for over 50% of Veterans’ rides. 

Volunteer Drivers 

While 48% of VTS facilities rely exclusively on VA staff to transport Veterans, 

most facilities use a combination of paid and volunteer drivers. The Disabled AmerVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00188 Fmt 6633 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN

415tab179b.eps
185 

ican Veterans organization (DAV) has long been a very positive contributor to Veterans receiving needed health care. In 2011, through the Volunteer Transportation 

Network (VTN) 702,867 Veterans were provided transportation to and from VA 

health care facilities. However, with increasing numbers of transportation disadvantaged Veterans, the number of volunteer drivers at most VA medical centers does 

not meet Veterans’ transportation needs. Volunteer drivers are generally precluded 

from transporting Veterans who are not ambulatory, require portable oxygen or 

have significant medical issues. Additionally, some volunteers, for valid reasons, are 

reluctant to transport non-ambulatory or very ill Veterans. Across the country, VTS 

transportation requests surpass the capacity of the VTN. 

Beneficiary Travel Program 

VA’s Beneficiary Travel (BT)Program, as part of VA Medical Care Benefits, provides mileage reimbursement at $0.415 per mile, common carrier (plane, boat, taxi, 

bus etc.) transportation, and when medically indicated special mode (ambulance, 

wheelchair van etc.) transport to low-income or disabled Veterans for travel to receive treatment, care or services at VA or VA authorized medical facilities. VA may 

also provide or reimburse for the actual cost of bridge tolls, road and tunnel tolls, 

parking, and authorized luggage fees when supported by a receipt. BT eligibility is 

based upon receipt of VA service connection and/or low income (VA pension thresholds). Approximately 3.3 million of 5.5 million current VHA users are eligible for BT; 

however, only 1.3 million of those utilize the benefit. Some eligible Veterans choose 

not to use the benefit for personal reasons; however, others have noted inability to 

drive to appointments, limited or no local (common carrier) transportation services 

meeting their needs, and not meeting medical need for special mode transport at 

VA expense. Veterans without BT eligibility have noted similar issues. VTS allows 

access for many of these Veterans and anecdotal evidence indicates BT mileage 

costs are reduced when veterans are transported on a VTS vehicle or use a common 

carrier. Additional anecdotal evidence indicates BT special mode costs are also reduced when VTS provides transportation rather than VA purchased community special mode transport services. A decrease in available VTS services will likely require 

a return of many BT eligible Veterans to some form of that program. 

Community Transportation Resources 

The VTS Program has funded Mobility Manager positions at facilities to identify 

available community transportation resources and to create partnerships among 

transportation providers in their region, so as to expand the range of viable options 

that Veterans have for transportation. To date, VA has trained 47 Mobility Managers. Additional training sessions have been scheduled for July and August 2012; 

however, 18 facilities have not yet filled their Mobility Manager positions. 

Coordination of transportation services is challenging due to differences in local, 

state, and Federal program requirements. Often, program rules are unclear about 

coordination of transportation services between different entities. 

Programs may also have statutory or regulatory barriers related to sharing costs 

or have differences in service requirements and eligibility. For example, VA only has 

authority to provide transportation at VA expense to certain qualifying Veterans 

and non-Veterans in relation to VA health care: not all beneficiaries are eligible and 

there is no authority for transport of non-beneficiaries. HHS’s Medicaid program is 

the largest source of Federal funds for non-emergency medical transportation for 

qualified low-income beneficiaries; however, barriers to transportation coordination 

for Medicaid grantees exists due to concerns about commingling Federal program 

funds and the potential for fraud. In addition, local community providers often have 

policies that impose income criteria or limit transportation to certain geographic 

areas, such as within county lines. 

VTS analysis comprised environmental surveys which yielded the following results: 

Canceled appointments and missed opportunities are a high cost to the system: 

• Resource utilization 

• Lack of timely care causes health complication and spiraling costs 

Targeted VTS toward clinics with high Missed Opportunities: 

• Temple TX demonstrated over 4% reduction in tracked clinics 

VTS Veteran Survey results: 

• Veterans using VTS indicate they have previously missed health care appointments due to transportation problems 

• 25% of respondents (397/1591) indicated VTS was responsible for meeting appointment time 

186 

Readjustment Counseling Service 

Question 155. Public Law 111–163, the Caregivers and Veterans Omnibus Health 

Services Act of 2010, provided VA with the authority to provide services through 

the Readjustment Counseling Service (Vet Center) Program to members of the 

Armed Forces and members of the Guard and Reserve who served in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn. 

A. What is the status of implementing this provision? What are the barriers VA 

is facing to providing services to members of the Armed Forces under this law? 

Response. VA and DOD are currently in the final stages of the joint regulatory 

process that was required in Section 401 of Public Law 111–163. Implementation 

is expected immediately after OMB’s approval of the proposed rule, public comment, 

and the publishing of the final rule. 

B. Once this provision is fully implemented, does VA anticipate an increase in 

funding will be needed due to the program expansion? 

Response. In anticipation of the implementation of section 401 of Public Law 111– 

163, VA has requested an increase in FY 2014 funding to Readjustment Counseling 

Service for expansion of Vet Center services to certain active duty Servicemembers. 

Question 156. The fiscal year 2013 National Defense Authorization Act (NDAA) 

included the Mental Health ACCESS provision, which expands the eligibility criteria for those who are eligible to receive services at Vet Centers. Does the fiscal 

year 2014 budget request take into consideration the costs associated with the implementation of the Mental Health ACCESS provision within the 2013 NDAA regarding the expansion of the Vet Center program? 

Response. Yes, VA’s budget request includes resources to support this provision, 

estimated at $4.8 million in FY 2014. 

Medical and Prosthetic Research 

Question 157. According to VA, in 2011, 89 percent of VA facilities offered Complementary and Alternative Medicine to address physical and mental health conditions. 

A. Please provide the Committee with a list of facilities that currently provide 

Complementary and Alternative Medicine and what facilities offer these treatments 

for mental health conditions. 

Response. The attachment below contains a list of VHA facilities that currently 

provide CAM services. 

COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) MODALITIES PROVIDED AT VA 

BY VA STAFF OR NON-VA STAFF * 

as Noted in the Healthcare Analysis & Information Group (HAIG) 2011 

Complementary and Alternative Medicine Report 

http://shfwire.com/files/pdfs/2011CAM_FinalReport.pdf 

Bedford, MA 518 

Manchester, NH 608 

Northampton, MA 631 

Providence, RI 650 

Togus, ME 402 

White River Junction, VT 405 

VA Boston HCS 523 

VA Connecticut HCS 689 

Albany, NY 528A8 

Bath, NY** 528A6 

Canandaigua, NY 528A5 

Syracuse, NY 528A7 

Batavia, NY (VA Western New York 

HCS)*** 528A4 

Buffalo, NY (VA Western New York 

HCS) 528 

Bronx, NY 526 

Northport, NY 632 

VA Hudson Valley HCS 620 

VA New Jersey HCS 561 

Brooklyn, NY (VA New York Harbor 

HCS)** 630A4 

New York, NY (VA New York Harbor 

HCS) 630 

St. Albans-Queens, NY (VA New York 

Harbor HCS)** 630A5 

Altoona, PA** 503 

Butler, PA*** 529 

Clarksburg, WV*** 540 

Coatesville, PA 542 

Erie, PA 562 

Lebanon, PA** 595 

Philadelphia, PA 642 

Wilkes-Barre, PA* 693 

Wilmington, DE 460 

VA Pittsburgh HCS 646 

Martinsburg, WV* 613 

Washington, DC 688 

Baltimore, MD (VA Maryland HCS)* 512 

Fort Howard, MD (VA Maryland HCS)** 

512A4 

Perry Point, MD (VA Maryland HCS)*** 

512A5 

Asheville, NC 637 

Beckley, WV** 517 

Durham, NC 558 

Fayetteville, NC 565 

Hampton, VA 590 

Richmond, VA 652 

187 

Salem, VA 658 

Salisbury, NC 659 

Atlanta, GA 508 

Augusta, GA 509 

Birmingham, AL 521 

Charleston, SC 534 

Columbia, SC 544 

Dublin, GA 557 

Tuscaloosa, AL 679 

VA Central Alabama HCS* 619 

Bay Pines, FL 516 

Miami, FL 546 

Orlando, FL* 675 

San Juan, PR 672 

Tampa, FL 673 

West Palm Beach, FL 548 

VA N. FL/S. GA Veterans HCS 573 

Huntington, WV 581 

Louisville, KY* 603 

Lexington (Leestown), KY*** 596 

Lexington (Cooper Dr.), KY* 596A4 

Memphis, TN 614 

Mountain Home, TN 621 

VA Tennessee Valley HCS 626 

Chillicothe, OH 538 

Cincinnati, OH 539 

Cleveland (Wade Park), OH* 541 

Cleveland (Brecksville), OH** 541A0 

Columbus, OH /OC/ 757 

Dayton, OH 552 

Battle Creek, MI 515 

Detroit, MI 553 

Indianapolis, IN 583 

Saginaw, MI* 655 

VA Ann Arbor HCS 506 

VA Illiana HCS 550 

VA Northern Indiana HCS 610 

Hines, IL 578 

Iron Mountain, MI** 585 

Madison, WI* 607 

Milwaukee, WI 695 

North Chicago, IL 556 

Tomah, WI 676 

VA Chicago HCS 537 

Columbia, MO* 589A4 

Kansas City, MO 589 

Marion, IL** 657A5 

Poplar Bluff, MO* 657A4 

St. Louis, MO* 657 

Wichita, KS 589A7 

VA Eastern Kansas HCS 589A5 

Alexandria, LA 502 

Fayetteville, AR 564 X X X X X X X X 

X X X X 

Houston, TX 580 X X X X X X X X X X 

X 

Jackson, MS 586 X X X X X X X X X 

Muskogee, OK 623 X X X X X X X X X 

New Orleans, LA* 629 X X X X X X X 

X X 

Oklahoma City, OK* 635 X X X X X X 

X X 

Shreveport, LA 667 X X X X X X X X X 

X X X 

VA Central Arkansas HCS 598 X X X X 

X X X X X X X X X X X X X X X X 

VA Gulf Coast HCS* 520 

VA Central Texas HCS* 674 

Bonham, TX (VA North Texas HCS)** 

549A4 

Dallas, TX (VA North Texas HCS) 549 

VA South Texas HCS 671 

Phoenix, AZ 644 

El Paso VA HCS** 756 

VA Amarillo HCS 504 

VA New Mexico HCS 501 

VA Northern Arizona HCS 649 

VA Southern Arizona HCS 678 

VA TX Valley Coastal Bend* 740 

VA West Texas HCS* 519 

Cheyenne, WY 442 

Grand Junction, CO* 575 

Sheridan, WY 666 

VA Salt Lake City HCS 660 

VA Sourhern Colorado HCS*** 554GD 

Denver, CO (VA Eastern Colorado HCS) 

554 

VA Montana HCS*** 436 

Boise, ID 531 

Portland, OR 648 

Spokane, WA*** 668 

Walla Walla, WA 687 

White City, OR /Ind Dom/* 692 

VA Alaska HCS* 463 

VA Roseburg HCS 653 

VA Puget Sound HCS 663 

Honolulu, HI 459 

Manila, PI*** 358 

San Francisco, CA 662 

VA Central California HCS 570 

VA Northern California HCS 612 

VA Sierra Nevada HCS 654 

Livermore, CA (VA Palo Alto HCS)** 

640A4 

Palo Alto, CA (VA Palo Alto HCS) 

Loma Linda, CA 605 

VA San Diego HCS 664 

VA Southern Nevada HCS 593 

VA Greater Los Angeles HCS 691 

VA Long Beach HCS* 600 

Fargo, ND** 437 

Iowa City, IA 636A8 

Minneapolis, MN 618 

Sioux Falls, SD** 438 

St. Cloud, MN 656 

VA Black Hills HCS 568 

VA Central Iowa HCS 636A6 

VA Nebraska-W Iowa HCS*** 636 

[References to *, **, and *** were not provided with this worksheet.] 

B. Please provide the Committee with a list of current and completed research 

studies on the efficacy of Complementary and Alternative Medicine for treatment 

of mental health conditions. 

Response. See attached CAM Studies spreadsheet. 

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Question 158. For the last few years, VA has been transforming the way health 

care is provided to veterans. A part of this transformation is the Patient-Center 

Care (PCC) model that VA is currently implementing. This ‘‘approach to 

healthcare*** prioritizes the Veteran and his/her values, and partners with him/ 

her to create a personalized strategy to optimize their health, healing, and wellbeing.’’ 

A. Please provide the Committee with a list of research studies that were used 

to define the PCC model. 

Response. Patient Centered Care (PCC) is a fundamental shift in the U.S. medical 

model and a cultural transformation in the way health care is delivered. There is 

not one single, specific model, but rather this approach is based on significant research from both within and outside VA. VHA charged the Universal Services 

Taskforce to review the evidence supporting the PCC Model. These findings were 

described in the 2009 Universal Services Taskforce Report, ‘‘Veterans Health Care: 

Leading the Way to Excellence.’’ Consultation was obtained from the Institute of 

Medicine (IOM), Booz Allen Hamilton, Kaiser Permanente, the Samueli Institute, 

the American Nurses Credentialing Center (ANCC), and most recently the 

Planetree Organization has worked VHA. Notably, the Task Force reported that 

‘‘Numerous organizations have constructed supporting evidence and/or PCC delivery 

models.’’ Among those Planetree, Picker, and the Institute for Family-Centered Care 

have surfaced as leaders in PCC through research and publication. Although each 

of these organization’s models have distinctions, meta-analysis notes important 

areas of equivalence among leading organizations in their definitions, guiding principles and common themes (Shaller, 2007), which are consistent with the approaches 

utilized by VHA. 

In addition, the Institute of Medicine (IOM) was established by the National 

Academy of Sciences to secure services of eminent members of appropriate professions to examine policy matters pertaining to the health of the public. IOM also 

serves as an advisor to Federal agencies and released two seminal reports informing 

the VHA PCC approach. The elements of the PCC approach, however, are rooted 

in the research and recommendations of the 2001 IOM Report, ‘‘Crossing the Quality Chasm: A New Health System for the 21st Century,’’ at http://iom.edu/∼/media/ 

Files/Report%20Files/2001/Crossing-the-Quality-Chasm/Quality%20Chasm%202001 

%20%20report%20brief.pdf. 

In this report, IOM called for health care to transform from care based on visits, 

where professional autonomy drives variability and the professionals control care to 

one that is based on ‘‘continuous healing relationships,’’ ‘‘care that is customized according to patient needs and values,’’ and care where ‘‘the patient is the source of 

control.’’ These recommendations, as well as those of the IOM ‘‘Summit on Integrative Medicine & the Health of the Public: Issue Background & Overview,’’ have informed the key elements of the VHA PCC approach. (The IOM Summit report can 

be found at http://www.iom.edu/∼/media/Files/Activity%20Files/Quality/Integrative 

Med/IM20Summit20Background20Paper20Weisfeld2022309.pdf.) The specific ways 

in which these key elements can and should be delivered are varied and are being 

developed and piloted in many different settings. Evidence continues to emerge supporting the PCC model as described by the Nuka System of Care (Gottlieb, 2013) 

and the Group Health Cooperative (Greene, 2012). 

B. What performance measurements are being used to determine the effectiveness 

of the PCC model and whether any improvements are needed to the model? 

Response. Given that this is a shift in the overall approach to health and health 

care, which truly constitutes a cultural transformation and not a specific model, the 

true outcomes will ultimately be improvement in the health and well-being of our 

Veterans. VA is committed to ongoing evaluation and adaption of these approaches 

and, as such, has several research initiatives underway. 

Since 2006, VA has used the Survey of Healthcare Experiences of Patients 

(SHEP) to track patient satisfaction. Currently, VA has 6 composites within SHEP 

as it relates to this model (see attachment below). Since this tool does not sufficiently capture the impact of this new medical model, VA is in the process of developing and validating measurement tools to accurately reflect outcomes of patient 

centered care. The frameworks were reviewed by an expert panel of researchers and 

administrators involved in the development and adoption of patient-centered care 

across the organization. Measurement experts will determine which elements within 

each framework will be measured at the level of patients, providers, and/or facilities. 

It is expected that the measurement tool will be developed by September 2013 and 

that patient, provider, and facility level data will be obtained in 2014. Data from 

these tools will be analyzed to further refine the tools and serve as initial assessments of the implementation and outcomes associated with PCC. 

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Question 159. One of VA’s major goals for VA Research and Development is the 

Million Veteran Program; this program collects genetic samples and general health 

information of veterans. How much does VA expect to spend on this research project 

in fiscal year 2014? 

Response. As of April 23, 2013, 153,803 Veterans have enrolled. They accomplished this by signing consent and Health Insurance Portability and Accountability 

Act (HIPAA) forms and providing a blood sample. Another 213,180 Veterans have 

completed the Baseline Survey and are awaiting appointments to fill out consent paperwork and conduct a blood draw. The FY 2014 Million Veteran Program (MVP) 

spending is projected to be $23.214 million. 

Our initial projections were that it would take 5 to 7 years to enroll 1,000,000 

Veterans, reaching a maximum enrollment of 225,000 per year by the end of the 


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study. Overall, we have found that enrolling younger Veterans at VA medical centers is more difficult than expected, and there are other administrative considerations as well. For this reason, we are currently exploring alternative methods such 

as Web-enrollment. Further, in order to make enrollment possible for all Veterans 

nationwide, including those in rural areas, we are exploring mechanisms that do not 

require a visit to a VA hospital to donate a blood specimen. 

All MVP enrollees sign an informed consent form and a HIPAA authorization 

form. They agree to allow access to their medical records on an ongoing basis and 

add that information to the VA Central Research Data base so that approved MVP 

researchers can follow their health and care for as long as they are alive. If the 

MVP enrollee participates or has participated in any other VA studies, he or she 

gives permission to access data from these studies and add that data to the VA Central Research Data base. MVP enrollees also agree to donate a blood sample that 

will be used for future studies related to characteristics of health or any disease, 

illness, or condition. MVP enrollees also agree to future contact by MVP staff. 

The samples and/or medical information will be available to approved researchers 

in a coded manner at VA, other Federal health agencies, and academic institutions 

within the United States for research projects approved by appropriate VA oversight 

committees. VA takes precautions to protect this data, consistent both within VA 

and during any approved sharing with other Federal entities or approved academic 

institutions. 

Rural Health 

Question 160. In fiscal year 2012, the Office of Rural Health was appropriated approximately $248 million; please provide the Committee with a detailed description 

of how this funding was utilized. 

Response. In FY 2012, the Office of Rural Health funds were distributed to VISNs 

and VA Central Office program offices to support new projects, sustain existing 

projects, and expand existing projects. Over 400 projects were funded and were allocated to the following activities: 

Project ARCH Fee Care Pilot* ..............................................................................$26.8M 

Access and Quality: transportation, outreach clinics, mobile clinics .................$34.3M 

Community Based Outpatient Clinics ..................................................................$77.8M 

Collaboration and Outreach: rural Veteran outreach program, mobile ............

Veteran centers, education of rural clergy ...........................................................$11.6M 

Geriatrics: stroke, caregivers support for demented Veterans ...........................$43.5M 

Homelessness ......................................................................................................... $0.6M 

Mental Health: Post Traumatic Stress Disorder, Traumatic Brain Injury .......$13.2M 

Specialty Care: Cardiology, Audiology, Prosthetics, Optometry, Radiology, 

Dermatology ........................................................................................................ $7.6M 

Telehealth and New Models of Care ....................................................................$28.8M 

Training and Education ........................................................................................ $3.1M 

Women Veterans .................................................................................................... $1.2M 

Total .................................................................................................................$248.5M 

* Project Access Received Closer to Home (ARCH) is a 3-year pilot program in five of the 

VISNs designed to provide Veterans with health care services closer to where they live. It implements Section 403 of P.L. 110–387: The Veterans’ Mental Health and Other Care Improvements 

Act of 2008 and was amended by Section 308 of P.L. 111–163, the Caregivers and Veterans Omnibus Health Services Act of 2010. Each of the five pilot sites identified services that are most 

needed by the VHA-enrolled Veterans in that region. Through Project ARCH, two sites provide 

primary care services (VISN 6—Farmville, Virginia, and VISN 15—Pratt, Kansas) and three 

sites offer specialty care services (VISN 1—Northern Maine; VISN 18—Flagstaff, Arizona; and 

VISN 19—Billings, Montana). 

Women Veterans 

Question 161. In a question for the record regarding the fiscal year 2013 budget 

request, VA provided a list of women’s projects from the fiscal year 2013 Strategic 

Capital Investment Process. Please provide the Committee with an updated list of 

construction projects relating to correcting patient privacy deficiencies. 

Response. Please see attached. 

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[Table continued.] 


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OFFICE OF INFORMATION AND TECHNOLOGY

Question 162. In response to the fiscal year 2013 budget questions for the record 

regarding VA’s scheduling package, VA stated that it would not be able to determine the timeline of deliverables and costs associated with the scheduling package 

until after the completion of the Concept Exploration and Life Cycle Cost Anaylsis 

in January 2013. 

A. Has the Concept Exploration and Life Cycle Cost Analysis been completed? If 

so, please provide the Committee with the expected total cost of a new scheduling 

package and the timeline associated with the project. 

Response. VA will procure a scheduling solution in two phases. In the first phase, 

which is now ongoing, VA is running a risk-reduction contest under the America 

Competes Act, with a call for scheduling application submissions. The purpose of 

this contest is to reduce procurement and deployment risk. VA will award up to 

three prizes for scheduling packages that demonstrate their compatibility with the 

Open Source version of VA’s electronic health record, VistA. The contest had 41 contestants registered and closed the week of June 17, 2013. The submissions are currently under review with a target of announcing a winner at the end of the current 

fiscal year. 

The second phase will involve the actual procurement of a scheduling solution. As 

this risk-reduction activity proceeds, VA will continue working with DOD and the 

VA/DOD Interagency Program Office (IPO) to determine joint requirements and a 

master development and acquisition plan. This plan will be based upon an evaluation of contestant responses for proposed functionality and compliance with integrated Electronic Health Record (iEHR) architecture. 

B. The fiscal year 2014 budget request expects VA to spend $30 million for the 

development of a new scheduling package. Please provide the Committee with an 

outline of how VA expects to utilize that funding. 

Response. The purpose of conducting the contest described in question 162 A is 

to inform the process for procuring an actual scheduling replacement solution. For 

FY 2014, VA plans to use what it has learned through the contest and to spend approximately $4 million on pre-planning and acquisition activities. These activities 

center on two basic areas: (1) defining business needs, and (2) mapping technical 

and architectural requirements to meet those needs. 

The remaining $26 million of the $30 million mentioned in the question will be 

spent on initial schedule package development efforts, which are anticipated to 

begin in mid-FY 2014. Specifically, these funds will be used to acquire commercial 

off-the-shelf (COTS) software and configure it to the VA environment. 

Question 163. The fiscal year 2014 request includes $15.8 million for the Virtual 

Lifetime Electronic Record (VLER), Health. Currently, VLER is deployed at only 13 

VA medical facilities across the country. GAO testimony provided to the House Committee on Veterans’ Affairs on February 27, 2013, stated that both Departments had 

the ‘‘goal of deploying VLER nationwide at or before the end of 2012.’’ 

A. It is clear that both Departments have missed this goal of achieving a national 

rollout of VLER by the end of 2012. Does VA plan to expand VLER out to additional 

sites in 2013? 

Response. The Virtual Lifetime Electronic Record (VLER) is the broad umbrella 

of information sharing. VLER will allow VA, DOD, and others to easily share information on Servicemembers and Veterans and will enable VA to provide proactive 

care and benefits to Veterans that they have earned and deserve. VA believes the 

question refers more specifically to the VLER Health Exchange capability, which 

provides health information exchange between VA, DOD, and private-sector facilities. 

VLER Health is currently deployed to 16 sites, with several more in the queue. 

As of April 30, 2013, VLER Health Exchange partner sites were added at: 

• Boise, Idaho, with the Idaho Health Information Exchange (HIE) 

• Biloxi, Mississippi Department of Veteran Affairs Medical Center (VAMC) 

(which includes the Joint Ambulatory Care Clinic in Pensacola, Florida), with the 

Pensacola HIE. 

Full deployment of the VLER Health Exchange capability is dependent on upgrading the technology to accommodate enterprise-wide deployment, and on gaining HIE 

private partners who are approved to exchange health information through the 

eHealth Exchange (formerly referred to as the Nationwide Health Information Network or NwHIN). 

The Department of Veterans Affairs (VA) can begin to add new HIE partners and 

develop a schedule for full deployment once HIE and Partner Integration contracts 

are in place. 

201 

B. If so, what costs are associated with implementing VLER at these additional 

sites? Please provide the Committee with a detailed timeline of the rollout, including the additional sites and costs associated with implementation. 

Response. As of July 9, 2013, the actual costs for these two deployments are not 

available because contracts to support enterprise-wide deployment activity are still 

pending award. The two existing deployments involved minimal costs, as they were 

accomplished by VLER Health Federal staff. 

C. Have the Departments developed a plan for VLER that includes the scope, cost 

and schedule estimation, and project planning documents? If so, please provide 

those documents to the Committee. 

Response. Again, VA assumes the question refers to the VLER Health activities 

within the larger VLER initiative. The VA/DOD Interagency Program Office (IPO) 

is responsible for VLER Health Program Management, including VLER Health systems, capabilities, and initiatives. IPO’s VLER Health program focuses on a portfolio of programs that manage the electronic exchange of clinically relevant health 

information between DOD, VA, and other Federal and non-Federal health exchange 

partners. 

VLER Health is now working on an FY 2014 plan to present to the DOD/VA Joint 

Executive Council (JEC) in September 2013, which will include details on further 

scope, to include cost planning estimates of the national rollout. VA will provide this 

plan to the Committee when it becomes available. 

For VLER initiatives outside of VLER Health, the VLER Enterprise Program 

Management Office publishes all of their documents on their public Web site at 

http://www.va.gov/vler/. 

Question 164. According to GAO’s testimony from the February 27, 2013, House 

hearing, in 2001 the VHA began to ‘‘modernize VistA by standardizing patient data 

and modernizing the health information software applications.’’ To modernize VistA, 

VA decided to use an incremental approach based on six phases which was to be 

completed in 2018. Between 2001 and 2007, VA spent $600 million on eight projects 

related to modernizing VistA. In April 2008, VA estimated that it would cost roughly 

$11 billion to complete the modernization of VistA by 2018. However, in August 2010, this project was terminated. 

A. Since August 2010, how much has VA spent on upgrades to VistA? 

Response. The chart below shows the VistA DME obligations from FY 2010 to 

YTD FY 13. 

FY VistA Total 

Obligations* 

FY 10 ...................................................................... $350 .948 

FY 11 ...................................................................... $320 .654 

FY 12 ...................................................................... $227 .567 

FY 13 YTD .............................................................. $65 .739 

Totals ............................................................. $964 .908 

* Total amounts VA obligated for upgrades to VistA, by fiscal year. 

B. Were these upgrades similar to the ones identified in VA’s attempt to modernize VistA by 2018? 

Response. The chart below shows the subset of DME obligations (seen above) for 

projects that VA determined to be ‘‘similar to the ones identified in VA’s attempt 

to modernize VistA by 2018.’’ 

FY 

Subtotal Similar to VistA Modernization** 

FY 10 ............................................................... $211 .217 

FY 11 ............................................................... $122 .665 

FY 12 ............................................................... $87 .282 

FY 13 YTD ........................................................ $28 .080 

Totals ...................................................... $449 .244 

** The projects that are similar to the ones previously identified in 

VA’s ‘‘attempt to modernize VistA by 2018’’ are those that fall under 

HealtheVet VistA. 

202 

C. How much in the fiscal year 2014 budget will be allocated to upgrade VistA? 

Response. $25 million will be allocated to upgrade VistA in fiscal year 2014. 

Question 165. According to the DOD and VA press conference on February 5, 

2013, Secretary Shinseki stated that the Departments planned to expand the use 

of the graphical user interface (GUI) to seven additional VA sites and two additional 

DOD sites no later than July 2013. 

A. What is the anticipated cost of implementing the GUI at these additional nine 

sites? 

Response. The Janus Joint Legacy Viewer is a web-based application hosted at 

VA’s Austin Information Technology Center and at the Military Health System Enterprise Service Operations Center. The cost to implement Janus includes hosting 

facility expenses as well as funds to support program contracts, including: 

WebSphere application licenses; MedWeb appliance server and licenses; and 

TRICARE Management Activity Cyber Security risk assessments. The total cost to 

implement this enterprise version of Janus is approximately $5.3 million. 

Since Janus is a web-based application, and no additional hardware is required 

at the nine pilot sites, these costs should be considered as enterprise-wide expenses, 

not attributable to the nine sites specifically. 

For the pilot deployment, a small team will be visiting each site to provide training and to ensure a smooth transition to Janus. Additionally, VA is developing a 

training video and has put together detailed guides to facilitate virtual delivery of 

future deployments and training. 

B. Do DOD and VA plan to implement the GUI at additional sites after 

July 2013? If so, what are the additional costs associated with the implementation 

of the GUI at the additional sites? 

Response. VA is developing a plan to expand Janus beyond the pilot sites. Since 

Janus is a web-based application, and hardware is not required at the local sites, 

we project decreasing marginal costs as Janus expands to more sites. Moreover, as 

virtual training will be available, it would be unnecessary to have a team visit each 

site. 

However, before expanding Janus to a larger enterprise base, performance and 

load testing—as well as analysis of feedback from the pilot sites—must occur. This 

will help determine requirements and costs in order to scale the system for enterprise-wide use. 

C. In addition, at the press conference, VA also stated that DOD and VA would 

select ‘‘a core set of integrated Electronic Health Record (iEHR) capabilities no later 

than March 2013.’’ Have DOD and VA selected the core set of iEHR capabilities? 

If so, please provide the Committee with the core set of iEHR capabilities. 

Response. The Interagency Clinical Informatics Board (ICIB)—a joint VA and 

DOD board established to oversee the functional aspects of interagency clinical information systems throughout the development and acquisition lifecycle—has identified 7 capabilities that are the core functions of an EHR. 

The iEHR Core is a foundational set of clinical and supporting functionality necessary to deliver health care that leverages IT capabilities and supports an electronic health record. 

Offering the Core functionality as a single set provides a stable foundation, supports integration integrity and reduces interface complexity when identifying the remaining medical capability selections. 

The Core provides the clinical capabilities of creating and managing orders; entering, analyzing and reviewing the patient’s health record and other clinically relevant 

information; supporting the provider in decisionmaking and situational awareness. 

The 7 functions that have been identified as the iEHR Core are: 

1. Orders Service 

2. Documentation 

3. Document Management 

4. Clinical Decision Support/Alerts 

5. Access Control 

6. Information Management/Terminology Services 

7. Federal Data Repository/Data Warehouse 

VA has decided to deploy an iEHR Core based on VistA. DOD has decided to obtain their core functions through a competitive acquisition. 

Question 166. According to the fiscal year 2014 Budget Fast Facts information 

sheet, VA has allocated $344 million for the iEHR, including $252 million for the 

development, modernization, and enhancement of iEHR and VLER. 

A. Please provide the Committee with a detailed breakdown of the sustainment 

cost associated with iEHR and VLER for fiscal year 2014 and any licensing agreements that are associated with these projects. 

203 

Response. The following table highlights iEHR and VLER Health sustainment 

funds for FY 2014. 

FY 2014 

(PB) 

iEHR Sustainment ..................................................... $87 .5 

VLER Health Sustainment ........................................ $4 .2 

Total ................................................................. $91 .7 

B. Please provide the Committee with an estimated sustainment cost associated 

with iEHR and VLER over the next five years. 

Response. The following table highlights iEHR enacted funds and estimated costs 

for sustainment for FY’s 2013 through 2018. Funding beyond FY 2014 has not been 

formally developed. 

FY 2013 FY 2014 FY 2015 FY 2016 FY 2017 FY 2018 

iEHR Sustainment ............................................................ $65 .0 $87 .5 $153 .1 $275 .6 $231 .6 $268 .1 

VLER Health Sustainment ................................................ $0 .8 $4 .2 $7 .7 $13 .9 $11 .7 $13 .5 

Total ......................................................................... $65 .8 $91 .7 $160 .8 $289 .5 $243 .3 $281 .6 

C. Please provide the Committee with a detailed breakdown of the $252 million 

for the development, modernization, and enhancement of iEHR and VLER and any 

deliverables associated with the development, modernization, and enhancement of 

iEHR and VLER. 

Response. The following amounts have been allocated to VLER Benefits, VLER 

Core, and VLER Memorials: 

VLER Benefits ................................ $8,500,000 

VLER Core ...................................... $27,056,666 

VLER Memorials ............................ $10,000,000 

The following spreadsheet provides the details for each project at the acquisition/ 

increment level. 

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The $252 million in development, modernization, and enhancement (DME) funds 

will support the following major iEHR programs: 

• Identify Management 

• Access Control Services 

• Immunization 

• Laboratory 

• Pharmacy 

• Presentation Services 

• VistA Modernization 

• Service-Oriented Architecture (SOA) Suite Enterprise Service Bus (ESB) 

Question 167. According to the fiscal year 2014 Budget Fast Facts information 

sheet, VA has allocated $155 million for the total development and implementation 

of VBMS, which included $32.8 million for the development costs. 

A. Please provide the Committee with a detailed breakdown of the sustainment 

cost associated with VBMS for fiscal year 2014 and any licensing agreements that 

are associated with VBMS. 

Response. Sustainment funds support maintenance and operations for OIT systems and applications at the existing capability and performance level. Sustainment 

does not support new functionality or enhancements. In addition to maintenance or 

replacement of infrastructure on an as-needed basis, sustainment involves correcting critical software defects that have an immediate, adverse impact on OIT’s 

as well as our business partners’ capability to support VA’s daily mission critical 

objectives. 

There are two types of sustainment: mandatory and marginal. Mandatory 

sustainment funds existing systems and applications. Marginal sustainment funds 

newly deployed applications or systems from the point of deployment until the end 

of the fiscal year. 

For FY 2013, VBMS funding supported: 

Marginal Sustainment: $50.582 million 

Mandatory Sustainment: $28.476 million 

The cost of VBMS licenses are explained in the table below, which is broken out 

by fiscal year. Some licenses support development work, and some support 

sustainment. 

FY 2011: $18,000 

FY 2012: $2.334 million 

FY 2013: $1.532 million 

FY 2014: $1.692 million 

B. Please provide the Committee with an estimated sustainment cost associated 

with VBMS over the next five years. 

Response. Please see the spreadsheet below. 

208 

Question 168. The fiscal year 2014 budget request indicates the $32.8 million associated with the development of VBMS will allow VA to ‘‘retire legacy software applications.’’ Please provide the Committee with a list of which legacy software applications will be retired, the anticipated timeline, and any costs associated with the 

retirement of the legacy software. 

Response. The FY 2014 budget request of $32.8 million includes Development, 

Maintenance and Enhancement (DME) funding for both VBMS ($20.7 million) and 

VETSNET ($12.1 million). 

FY 2014 VBMS DME will support the development of VBMS ‘‘Generation 3,’’ 

which will focus on achieving the following goals: 

• Improving electronic claims processing by providing increased system functionality and more complex automation capabilities for all VBMS end-users; 

• Making enhancements to VBMS that will reduce dependency on legacy systems 

for claims establishment, development, and rating; 

• Developing capability to accept electronic Servicemember Treatment Records 

(STRs) and Personnel Records from DOD, in general and to support the Veterans 

Opportunity to Work (VOW) legislation; and 

• Enabling end-users to leverage enhanced system functionality to perform their 

work more efficiently and accurately. 

The VBMS Project Management Office (PMO), together with VBA Compensation 

Services, has initiated the process to retire the legacy application ‘‘RBA2000’’ in FY 

2014. RBA2000 is the VETSNET application that assists VBA decisionmakers with 

the preparation of disability and ancillary ratings. Upon the retirement of RBA2000, 

all RBA2000 functionality will be replaced by the rating tool within the VBMS application. 

Because the effort to retire RBA2000 is still in a planning state, the exact cost 

and timeframe have yet to be determined. A timeline will be developed for complete 

retirement of RBA2000 as soon as business requirements have been identified. 

The retirement of legacy systems is an active objective of all IT projects. RBA2000 

is the only legacy application that VA will be able to retire in the near term. VA 

anticipates that future enhancements to VBMS and other projects will enable it to 

further reduce legacy systems. 

Question 169. In fiscal year 2012, VA undertook a pilot project to determine the 

feasibility of using a cloud email system, which placed a number VA email users 

into the cloud system. Depending on successful outcomes, the project would be expanded to additional users. 

A. How many VA email users were originally placed in the cloud email system? 


415tab192.eps
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Response. At this point, no production users have been placed in the cloud email 

system. Test mailboxes have been migrated successfully. 

B. Please provide the Committee with the metrics VA will use to determine the 

success of cloud email systems. 

Response. The goal of this project is to procure and implement a cloud-based, software-as-a-service (SAAS) e-mail system that will deliver cloud e-mail capabilities for 

up to 15,000 VA mailboxes while meeting VA functional and security requirements. 

The system will also be capable of scaling up to support a user base of 600,000 mailboxes. 

Upon completion of the project, recommendations and findings will be compiled 

and presented to VA’s CIO to help him make an informed decision on the migration 

of the remaining VA mailboxes to the cloud e-mail system. 

Overall success of this project will be determined according to three metrics: 

1. Success Factor: SaaS costs less than current e-mail systems 

Metric: Cost of Microsoft Exchange Server and associated maintenance compared to cost per-seat offered by the new SaaS vendor 

2. Success Factor: SaaS is secure 

Metric: Federal Information Security Management Act (FISMA) and Federal 

Risk and Authorization Management Program (FedRAMP) certifications are obtained for the SaaS solution 

3. Success Factor: Transition is seamless 

Metric: Results of project 

C. What is the timeline to determine whether this pilot project will be expanded? 

Response. Per the contract’s period of performance, the project expansion will 

occur on or before September 27, 2013. 

Question 170. The Interagency Program Office (IPO), established in the fiscal year 

2008 National Defense Authorization Act, serves as the ‘‘single point of accountability for DOD and VA in the rapid development and implementation of Electronic 

Health Record (EHR) systems and VLER Health capabilities.’’ 

a. Since the change in strategy regarding the iEHR, has the role and accountability of the IPO changed? If so, please provide the Committee with any changes 

that have taken place due to changes in the development of the iEHR. 

Response. VA and DOD remain committed to the IPO as the single point of accountability for achieving interoperability between the Departments’ EHR systems. 

The Departments recently signed a charter outlining the IPO’s responsibility for 

managing the interagency processes, having authority over dedicated resources and 

to ensuring those resources adequately support all IPO requirements. These responsibilities include overseeing, identifying, and approving health, domain, and messaging standards for the Departments to implement in their EHRs. VA delivered the 

new charter to the House and Senate Veterans’ Affairs Committees on December 20, 

2013. 

b. Please provide the Committee with a detailed staff organization chart and a 

breakdown of staff that are assigned to the IPO including VA, DOD, and any contract employees. 

Response. See the chart that follows. 

210 

Question 171. As part of the iEHR strategy, VA agreed to consolidate and move 

VistA systems into DOD-Defense Information System Agency (DISA) data centers. 

VA anticipates the complete migration for Regions 2 and 3 during fiscal year 2013 

and complete migration for Regions 1 and 4 during fiscal year 2014. The migration 

of Regions 1, 2, 3, and 4 will ‘‘enabl[e] full iEHR connectivity with DOD systems.’’ 

A. What are the costs associated with the migration of Regions 2 and 3 and with 

the migration Regions 1 and 4? 

Response. Approximately $15 million was spent on Region 2 and 3 migrations in 

FY 2012, with $31.3 million planned for execution in FY 2013. Migration costs for 

Regions 1 and 4 are being estimated for the out-year budgets (migrations will take 

place in 2016/2017). 


415q3Bur170b.eps
211 

B. What are the cost savings associated with the complete migration of VistA into 

DOD-DISA data centers? 

Response. VA leveraged the VistA migration projects to accomplish multiple objectives: 

1. Data Center Consolidation 

2. Pre-standardization of networks, hardware, platforms, and applications in anticipation of VA/DOD Health Record System Merging 

3. Security hardening for mission critical health record systems (implementation 

of high availability, disaster recovery, and continuation-of-operations capabilities for 

mission critical systems) 

The individual costs of these objectives cannot be differentiated, and do not lend 

themselves to standard Total Cost of Operations modeling used for estimating savings and cost avoidance for pure consolidations. Because VA leveraged the three 

mandates in one effort, short-term cost savings are not expected. However, over the 

longer term, VA will avoid the cost of constructing space for security hardening at 

multiple existing facilities that do not have capacity for the required redundant 

equipment. VA also expects significant long-term operational cost savings stemming 

from use of more efficient ‘‘commodity hardware’’ for both existing production systems and security hardening efforts. 

Question 172. Currently, VA is nationally implementing VA Point of Service (VPS) 

kiosks allowing veterans, who are seeking services at VA medical facilities, to use 

these kiosks to check into their appointments, update or confirm contact and demographic information, and review insurance information. 

A. Please provide the Committee with a list of: which VA facilities currently have 

these kiosks; how many kiosks are at each facility; a timeline of what additional 

facilities will receive a kiosk; and how many kiosks these additional facilities will 

receive. 

Response. Please see table below for kiosk data. 

Current State: Kiosk Deployed by Facility 

VISN Facility Kiosks 

Deployed VISN Facility Kiosks Deployed 

1 Maine ................................................... 32 6 Richmond ............................................. 78 

2 Syracuse .............................................. 39 7 Atlanta ................................................. 55 

3 North Port ............................................ 32 7 Atlanta—Carrollton ............................. 6 

4 Altoona ................................................. 44 8 Gainesville ........................................... 62 

4 Butler ................................................... 27 10 Dayton .................................................. 41 

4 Clarksburg ........................................... 21 16 Oklahoma City ..................................... 28 

4 Coatesville ........................................... 33 17 Central Texas ....................................... 47 

4 Erie ...................................................... 20 19 Salt Lake City Health Care System .... 60 

4 Lebanon ............................................... 29 20 Anchorage ............................................ 33 

4 Philadelphia ......................................... 89 20 Portland ............................................... 63 

4 Pittsburgh ............................................ 72 21 Hawaii .................................................. 39 

4 Wilkes-Barre ........................................ 35 22 Las Vegas ............................................ 40 

4 Wilmington ........................................... 39 Test Devices* ...................................... 58 

5 Martinsburg ......................................... 43 

Total deployed ................................. 1165 

* [There is no footnote for the asterisk above.] 

Response: Future State: National Deployment will be accomplished in WAVEs 

The schedule is provided below: 

Wave VISN Site Projected 

Kiosks Projected Deployment Start Date 

1 1 Bedford ............................................................................. 22 8/5/2013 

1 1 Boston HCS ...................................................................... 69 8/5/2013 

1 1 Central MA HCS ............................................................... 38 8/5/2013 

1 1 Connecticut HCS .............................................................. 56 8/5/2013 

1 1 Manchester ....................................................................... 26 8/5/2013 

1 1 Providence ........................................................................ 29 8/5/2013 

1 1 White River Junction ........................................................ 43 8/5/2013 

1 6 Asheville ........................................................................... 30 8/5/2013 

1 6 Beckley ............................................................................. 27 8/5/2013 

212 

Wave VISN Site Projected 

Kiosks 

Projected Deployment 

Start Date 

1 6 Durham ............................................................................. 61 8/5/2013 

1 6 Fayetteville ....................................................................... 56 8/5/2013 

1 6 Hampton ........................................................................... 32 8/5/2013 

1 6 Salem ............................................................................... 48 8/5/2013 

1 6 Salisbury ........................................................................... 47 8/5/2013 

1 16 Little Rock ........................................................................ 57 8/5/2013 

1 16 Muskogee .......................................................................... 35 8/5/2013 

1 16 New Orleans ..................................................................... 31 8/5/2013 

1 16 Shreveport ........................................................................ 41 8/5/2013 

1 16 Alexandria ......................................................................... 21 8/5/2013 

1 16 Biloxi ................................................................................. 30 8/5/2013 

1 16 Fayetteville ....................................................................... 35 8/5/2013 

1 16 Houston ............................................................................ 50 8/5/2013 

1 16 Jackson ............................................................................. 28 8/5/2013 

1 20 Boise ................................................................................. 48 8/5/2013 

1 20 Puget Sound ..................................................................... 52 8/5/2013 

1 20 Roseburg .......................................................................... 33 8/5/2013 

1 20 Spokane ............................................................................ 26 8/5/2013 

1 20 Walla Walla ...................................................................... 41 8/5/2013 

1 20 White city ......................................................................... 17 8/5/2013 

2 2 Albany ............................................................................... 34 8/5/2013 

2 2 Bath .................................................................................. 15 8/5/2013 

2 2 Canandaigua .................................................................... 27 8/5/2013 

2 2 WNY HCS .......................................................................... 24 8/5/2013 

2 3 Bronx ................................................................................ 52 8/5/2013 

2 3 Brooklyn ............................................................................ 24 8/5/2013 

2 3 Castle Point ...................................................................... 7 8/5/2013 

2 3 East Orange ..................................................................... 37 8/5/2013 

2 3 Lyons ................................................................................ 11 8/5/2013 

2 3 Manhattan ........................................................................ 30 8/5/2013 

2 3 Montrose ........................................................................... 10 8/5/2013 

2 3 St. Albans ......................................................................... 8 8/5/2013 

2 21 Fresno ............................................................................... 37 8/5/2013 

2 21 Palo Alto ........................................................................... 66 8/5/2013 

2 21 Reno ................................................................................. 22 8/5/2013 

2 21 Sacramento ...................................................................... 74 8/5/2013 

2 21 San Francisco ................................................................... 70 8/5/2013 

2 22 Greater Los Angeles ......................................................... 97 8/5/2013 

2 22 Loma Linda ...................................................................... 78 8/5/2013 

2 22 Long Beach ...................................................................... 67 8/5/2013 

2 22 San Diego ......................................................................... 54 8/5/2013 

3 7 Augusta ............................................................................ 99 1/20/2014 

3 7 Birmingham ...................................................................... 72 1/20/2014 

3 7 CAVHCS ............................................................................ 68 1/20/2014 

3 7 Charleston ........................................................................ 57 1/20/2014 

3 7 Columbia .......................................................................... 87 1/20/2014 

3 7 Dublin ............................................................................... 22 1/20/2014 

3 7 Tuscaloosa ........................................................................ 16 1/20/2014 

3 10 Chillicothe ........................................................................ 28 1/20/2014 

3 10 Cincinnati ......................................................................... 34 1/20/2014 

3 10 Cleveland .......................................................................... 65 1/20/2014 

3 10 Columbus ......................................................................... 38 1/20/2014 

3 11 Indianapolis ...................................................................... 33 1/20/2014 

3 11 Danville ............................................................................ 33 1/20/2014 

3 11 Marion IN .......................................................................... 9 1/20/2014 

3 11 Fort Wayne ........................................................................ 7 1/20/2014 

3 11 Detroit ............................................................................... 20 1/20/2014 

3 11 Ann Arbor ......................................................................... 21 1/20/2014 

3 11 Battle Creek ..................................................................... 20 1/20/2014 

3 11 Saginaw ............................................................................ 31 1/20/2014 

3 12 Lovell FHCC ...................................................................... 29 1/20/2014 

3 12 Jesse Brown ...................................................................... 50 1/20/2014 

3 12 Hines Jr VAH ..................................................................... 38 1/20/2014 

3 12 Middleton .......................................................................... 28 1/20/2014 

213 

Wave VISN Site Projected 

Kiosks 

Projected Deployment 

Start Date 

3 12 Tomah ............................................................................... 28 1/20/2014 

3 12 Milwaukee ......................................................................... 39 1/20/2014 

3 12 Iron Mountain ................................................................... 15 1/20/2014 

4 8 Bay Pines VA HCS ............................................................ 44 1/20/2014 

4 8 Miami ............................................................................... 21 1/20/2014 

4 8 Orlando ............................................................................. 31 1/20/2014 

4 8 San Juan .......................................................................... 48 1/20/2014 

4 8 Tampa .............................................................................. 20 1/20/2014 

4 8 West Palm Beach ............................................................. 25 1/20/2014 

4 15 Eastern Kansas City ......................................................... 48 1/20/2014 

4 15 Harry S. Truman ............................................................... 10 1/20/2014 

4 15 St. Louis ........................................................................... 51 1/20/2014 

4 15 John J. Pershing ............................................................... 13 1/20/2014 

4 15 Kansas City ...................................................................... 19 1/20/2014 

4 15 Marion .............................................................................. 36 1/20/2014 

4 15 Robert J. Dole ................................................................... 22 1/20/2014 

4 17 North Texas ...................................................................... 93 1/20/2014 

4 17 South Texas ...................................................................... 61 1/20/2014 

4 17 Texas Valley Coastal ........................................................ 50 1/20/2014 

4 17 Austin CBOC ..................................................................... 19 1/20/2014 

4 19 Cheyenne .......................................................................... 22 1/20/2014 

4 19 Denver (ECHCS) ................................................................ 36 1/20/2014 

4 19 VA Montana HS ................................................................ 44 1/20/2014 

4 19 Grand Junction ................................................................. 18 1/20/2014 

4 19 Sheridan ........................................................................... 25 1/20/2014 

5 5 Maryland HCS ................................................................... 29 1/20/2014 

5 5 Washington DC ................................................................. 20 1/20/2014 

5 9 Huntington ........................................................................ 32 1/20/2014 

5 9 Lexington .......................................................................... 30 1/20/2014 

5 9 Mountain Home ................................................................ 47 1/20/2014 

5 9 Tennessee ......................................................................... 50 1/20/2014 

5 9 Louisville .......................................................................... 34 1/20/2014 

5 9 Memphis ........................................................................... 32 1/20/2014 

5 18 Tucson .............................................................................. 49 1/20/2014 

5 18 Phoenix ............................................................................. 46 1/20/2014 

5 18 Prescott ............................................................................ 19 1/20/2014 

5 18 Amarillo ............................................................................ 22 1/20/2014 

5 18 West Texas ....................................................................... 21 1/20/2014 

5 18 El Paso ............................................................................. 17 1/20/2014 

5 18 Albuquerque ..................................................................... 52 1/20/2014 

5 23 Black Hills ........................................................................ 16 1/20/2014 

5 23 Fargo ................................................................................ 42 1/20/2014 

5 23 Minneapolis ...................................................................... 77 1/20/2014 

5 23 Sioux Falls ........................................................................ 25 1/20/2014 

5 23 Central Iowa ..................................................................... 22 1/20/2014 

5 23 Iowa City .......................................................................... 23 1/20/2014 

5 23 Nebraska .......................................................................... 52 1/20/2014 

5 23 St. Cloud .......................................................................... 17 1/20/2014 

Total ........................................................................ 4524 

B. Please provide the Committee with a detailed breakdown of costs associated 

with either leasing or purchasing these kiosks. 

Response. Please see table below. 

Kiosk devices and Accessories 

Equipment Price 

Free Standing Kiosk .................................................... $4,308 .80 

Free Standing Headphone Jack ................................... $30 .00 

Free Standing Surge Protector .................................... $20 .00 

Free Standing Card Scanner ....................................... $856 .00 

214 

Kiosk devices and Accessories—Continued 

Equipment Price 

Free Standing Kiosk Total .................................. $5,214 .80 

Desk Top Kiosk ............................................................ $2,998 .40 

Desk Top Headphone Jack .......................................... $30 .00 

Desk Top Surge Protector ............................................ $20 .00 

Desk Top Card Scanner .............................................. $856 .00 

Desk Top Kiosk Total .......................................... $3,904 .40 

Wall Mount Kiosk ........................................................ $2,998 .40 

Wall Mount Headphone Jack ....................................... $30 .00 

Wall Mount Surge Protector ........................................ $20 .00 

Wall Mount Card Scanner ........................................... $856 .00 

Wall Mount Kiosk Total ...................................... $3,904 .40 

C. What is the cost associated with the maintenance and sustainment of these kiosks? 

Response. Kiosk 2 year warranty (renewal): $235 (per kiosk). Three tier service 

desk support: $3,223,936 for 12 months ($415/kiosk annually). 

D. Please provide the Committee with a timeline of when additional functionality 

is expected to be delivered to these kiosks. 

Response. Kiosks Future Releases and Functionality 

Software Release 5.3 New Functionality (scheduled release August 2013): 

Release of Information submission 

Patient Queuing (appointment-based pilot) 

Notification verbiage and categorization overhaul 

Software Release 5.4 New Functionality (scheduled release September 2013): 

Beneficiary-Travel Application with optional queuing 

MVP Phase B 

Staff Patient Queue Improvements 

Alternative Patient Lookup (Last 5 or name lookup) 

Patient Queue Filter overhaul 

Notification filtering 

Additional Optional Workflow offerings 

Allergy Review (dependent upon VPS*1*3 VistA patch approval) 

VetLink 5.4 aligns with VPS*1*2 VistA patch 

Pilot testing expected to begin FY14Q1 

Software Release 5.5 New Functionality: (scheduled release February 2014): 

Staff-facing application improvements and redesign 

Approve Patient Update 

Patient Queue 

Bill pay 

Patient Question Queue 

Predictive update recommendations based on patient actions 

Improved Queuing functionality and integration 

Question 173. The fiscal year 2014 budget request proposes to realign funding between the medical care and Information Technology Systems appropriations, which 

would fund 80 FTE at a cost of $4.495 million out of the medical care appropriations. 

A. What metrics were used to determine that these 80 FTE should be funded 

through medical care instead of IT appropriations? 

Response. OIT and VHA propose to realign personnel in FY 2014 as follows: 

VHA/OIT Realignment 

(FTE Change Analysis) FTE Obligations ($M) 

Medical 

Services 

Medical 

Support & 

Compliance 

Information 

Technology 

Medical 

Services 

Medical 

Support & 

Compliance 

Information 

Technology 

Austin Human Resources Support Services .... +53 –53 +$6.346 –$6.346 

Clinical Applications Coordinator .................... +53 –53 +$6.138 –$6.138 

Information Technology Support Staff ............ –26 +26 –$7.989 +$7.989 

215 

VHA/OIT Realignment 

(FTE Change Analysis) FTE Obligations ($M) 

Medical 

Services 

Medical 

Support & 

Compliance 

Information 

Technology 

Medical 

Services 

Medical 

Support & 

Compliance 

Information 

Technology 

Total ........................................................ +53 +27 –80 +$6.138 –$1.643 –$4.495 

• The FY 2014 budget request realigns 53 FTE and $6.346 million to Austin 

Human Resources Support Services. These FTEs and funds are being moved from 

the IT appropriation to the Medical Support and Compliance (MS&C) appropriation. 

Note that certain human resource specialists that perform functions more appropriately aligned with the Veterans Health Administration (VHA) are still located 

within OIT. In FY’s 2012 and 2013, following a reassignment effective as of December 2011, these staff were supported by OIT on a reimbursable basis. 

• Clinical Application Coordinators (CACs) were assigned to OIT when the separate IT Appropriation was created in FY 2006. CACs provide direct support to clinical services, and coordinate facility efforts in support of VHA’s Medical Center 

Management. Due to the nature of their functions, VA’s intent now is to realign 

them back to VHA. 

• In addition to the above realignments, 26 FTE and $7.989 million were moved 

to OIT from VHA’s Office of Informatics and Analytics. The functions corresponding 

to these FTEs are better aligned under OIT. 

B. Please provide a list of positions and pay-grades for the 80 FTE staff that 

would be affected by the realignment? 

Response. The following is a list of positions and pay-grades for the 79 FTEs that 

are proposed for realignment. 

Austin HR Transfer (from OIT to VHA) 

Human Resource Management 

(HR Specialists/HR Assistants) 

FTE 

GS-13 ......................................................................................... 3 

GS-12 ......................................................................................... 7 

GS-11 ......................................................................................... 26 

GS-9 ........................................................................................... 7 

GS-7 ........................................................................................... 9 

GS-6 ........................................................................................... 1 

Total ...................................................................................... 53 

subject to change based on requirements 

CAC Transfer (from OIT to VHA) 

Information Technology Management 

(IT Specialists/Program Managers) 

FTE 

GS-13 ......................................................................................... 3 

GS-12 ......................................................................................... 31 

GS-11 ......................................................................................... 15 

GS-9 ........................................................................................... 4 

Total ...................................................................................... 53 

subject to change based on requirements 

216 

IT Support Staff Transfer (from VHA to OIT) 

General Administrative, Clerical and Office Services 

(Management & Program Analysts/Program Managers) 

FTE 

GS-15 ......................................................................................... 1 

GS-14 ......................................................................................... 12 

GS-13 ......................................................................................... 13 

Total .................................................................................. 26 

subject to change based on requirements 

NATIONAL CEMETERY ADMINISTRATION

Question 174. The fiscal year 2014 budget request for the National Cemetery Administration (NCA) is $5.1 million below the amount provided by the fiscal year 

2013 Continuing Resolution. The chart entitled ‘‘Analysis of Increases and Decreases—Obligations’’ shows a reduction of $15.4 million for change in contracts, 

other services and travel. 

a. Please provide the Committee with details on what is included in the ‘‘[c]hange 

in contracts, others service and travel’’ and what led to the expected reduction? 

Response. The reduction of $15.4 million shown in the fiscal year 2014 budget request column for this line item is due to a decrease in funding for national shrine 

and other repair projects. The reduction of funds in these lines had to be used for 

workload increases, operating cost increases, and the initial activations of three new 

cemeteries, two urban cemeteries, and two National Veterans Burial Grounds in 

rural areas. 

b. What other factors or assumptions contributed to the $5.1 million reduction in 

the fiscal year 2014 request? 

Response. American Recovery and Reinvestment Act (ARRA) funds ($26.3 million) 

for national shrine projects were used to address the most immediate shrine needs 

that would have otherwise been accomplished through annual appropriations. In addition, increased use of beam system foundations that maintain the height and 

alignment of headstones and markers for longer periods of time will decrease the 

need for follow-up national shrine projects. 

Question 175. According to the fiscal year 2014 budget request, in 2012, 82 percent of headstones, markers, and niche covers were clean and free of debris or objectionable accumulations; 69 percent of headstones and/or markers in national cemeteries were at the proper height and alignment; and 93 percent of gravesites had 

grades that were level and blend with adjacent grade levels. For fiscal year 2014, 

the annual target for these three metrics are 80 percent, 70 percent, and 84 percent, 

respectively. 

a. All three annual targets in 2014, for the metrics mentioned, are lower than the 

2012 and well below the strategic target. Why are the three annual targets below 

2013 actual percent? 

Response. Projected increases in the number of gravesites in national cemeteries, 

along with expected flat or decreased national funding beginning in 2012, will lead 

to a short term projected decrease in performance in 2014 for these measures. 

b. Given the low percentages versus those stated in the strategic targets, what 

steps is NCA taking to meet the strategic targets? 

Response. NCA is implementing new operational techniques designed to produce 

more lasting results in the repair and appearance of gravesites. One example is the 

increased use of beam system foundations that maintain the height and alignment 

of headstones and markers for longer periods of time, thereby decreasing the need 

for follow-up national shrine projects. 

Question 176. Public Law 113–2, the Disaster Relief Appropriations Act of 2013, 

included $2.1 million for NCA to make necessary repairs as a result of Hurricane 

Sandy in October 2012. 

a. Please provide the Committee with a list of projects undertaken with funds 

from Public Law 113–2. 

Response. The funding was used to repair tree damage caused by Hurricane 

Sandy at three VA national cemeteries: Beverly National Cemetery in New Jersey, 

and Long Island National Cemetery and Cypress Hills National Cemetery in New 

York. The funding was used to remove or prune damaged trees and clean up debris. 

b. Has all of the additional $2.1 million been spent or obligated? 

217 

Response. NCA has obligated $876,119 for damages caused by Hurricane Sandy. 

All damage has been repaired and no additional repair projects have been identified 

where these specific purpose funds could be used. Per Public Law 113–2, the funding was designated ‘‘for necessary expenses related to the consequences of Hurricane 

Sandy.’’ Accordingly, NCA cannot realign the funds for another purpose. 

Question 177. On February 7, 2013, the IG issued a report entitled ‘‘Audit of Internal Gravesite Review of Headstone and Marker Placement.’’ The audit found that 

NCA’s internal review of the placement of headstones and markers did not identify 

and report all misplaced headstones and unmarked gravesites. Specifically, at four 

of the 12 audited cemeteries, the IG found seven errors not previously reported. 

After revising its procedures, NCA identified an additional 146 errors at four of the 

12 cemeteries the IG audited. 

a. Given the findings of the IG audit, does NCA believe the information provided 

to Congress on its internal audit is valid? 

Response. Yes, the information provided to Congress is valid. NCA accepted the 

Department of Veterans Affairs (VA) Office of Inspector General’s (OIG) recommendations made in a July 2012 Management Advisory Memorandum, which preceded 

OIG’s final audit report. NCA immediately adjusted its methodologies to increase 

the accuracy of the headstone and marker review. As a result of OIG’s recommendations, Memorial Service Network (MSN) executive leaders conducted independent 

gravesite reviews at every national cemetery and soldiers’ lot administered by VA 

after the cemetery directors had completed reviews of their entire cemeteries. MSN 

senior leaders conducted these reviews either through statistically valid random 

sampling of gravesites or complete cemetery re-audits. With these reviews by independent MSN teams, NCA gained reasonable assurance that the audit results reported to Congress were valid in terms of the discrepancies reported at 147 of 164 

national cemeteries and soldiers’ lots administered by VA. Additionally, the NCA 

Headstone and Marker audit provided actionable data on which NCA is prioritizing 

efforts to ensure the accountability of remains at all national cemeteries now and 

in the future. These efforts will include full audit reviews at 17 cemeteries to 

achieve reasonable assurance that all gravesites are accurately marked at those facilities. 

b. How many additional errors were found using the revised procedures at other 

NCA cemeteries? 

Response. At four of the 12 cemeteries that OIG reviewed as part of its Phase 

I audit, NCA independent review teams reported 111 additional discrepancies. (The 

main differences between this number and the 146 errors noted in the question are 

explained in Under Secretary Muro’s January 15, 2013, response to OIG’s draft 

audit report. This letter is Appendix F of OIG’s final report; specific references 

about differences reported for Winchester and Philadelphia National Cemeteries are 

on page 23 of the final report.) NCA included these and other findings of the independent review teams in the Phase II report to Congress. NCA did not separately 

tabulate for all cemeteries the discrepancies identified by the independent review 

teams from those reported by cemetery directors in the Phase II report. 

c. Please provide a list of all errors identified by both phase one and phase two 

of the audit by cemetery and the difference in errors from what was originally reported and those discovered after the IG audit. 

Response. Phase I results reported to Congress on April 3, 2012, included a total 

of 251 corrective actions (243 headstone/marker errors and 8 reburials—see Attachment). The Phase I review was limited to sections of cemeteries that had undergone 

‘‘raise and realign’’ projects. In July 2012, during OIG’s audit which focused on 

NCA’s administration of Phase I, OIG issued a Management Advisory Memorandum 

which preceded OIG’s final audit report. NCA immediately adjusted its methodologies to increase the accuracy of the NCA headstone and marker review. As a result 

of OIG recommendations, Memorial Service Network executive leaders conducted 

independent gravesite reviews at every national cemetery and soldiers’ lot administered by VA, that is, all cemeteries and all sections that cemetery directors reviewed 

under both Phase I and Phase II. NCA reported these findings with the Phase II 

report to Congress on February 6, 2013. The Phase II results included 527 corrective 

actions: 520 headstone/marker errors, and seven potential reburials. (Phase II summary findings are attached. NCA later determined that two of the potential burials 

identified in the Phase II review were not necessary.) NCA did not categorize the 

findings of the independent review teams according to different sections reviewed 

under Phase I or Phase II. 

d. What personnel actions were taken by NCA in response to cemetery directors 

who did not accurately audit their cemeteries? 

Response. NCA is in the process of taking appropriate actions in response to the 

results of our gravesite review. In addition to looking at which cemetery directors 

218 

did not accurately audit their cemeteries, NCA is also investigating whether, and 

which, employees can be held accountable for gravesites which were mismarked or 

unmarked. NCA is reviewing the circumstances of each case to ensure consistency 

in responses across the organization. Although the process is not complete, one of 

the cemetery directors whose audit results were called into question by OIG has voluntarily left NCA. Another cemetery director has been removed from the position 

of director and demoted—actions related to the audit formed part of the basis for 

that personnel action. 

Question 178. The fiscal year 2014 budget request for Grants for Construction of 

Veterans Cemeteries includes $1.6 million less for fiscal year 2014 compared to the 

fiscal year 2013 Continuing Resolution. 

a. How many states have pending requests for state veterans cemeteries grants? 

Please list the grant applications by state and location. 

Response. As of July 29, 2013, there are 31 states, 11 tribal organizations, and 

the territories of Guam, the U.S. Virgin Islands, and the Commonwealth of the 

Northern Mariana Islands with pending requests. 

Grant Applications by State and Location 

State Location Date Received Estimated 

Amount Description Priority 

AK Fairbanks ............................ 3/23/2009 $6,468,231 .11 establishment ........................................... 2 

AR North Little Rock ................ 4/19/2010 $753,495 .00 operations and maintenance .................... 4 

AR North Little Rock ................ 6/29/2010 $600,000 .00 expansion .................................................. 3 

AZ Flagstaff ............................. 4/20/2009 $7,450,000 .00 establishment ........................................... 2 

AZ Yuma .................................. 4/20/2009 $6,800,000 .00 establishment ........................................... 2 

AZ Kingman ............................. 4/20/2009 $6,800,000 .00 establishment ........................................... 2 

AZ Chinle (tribal) ..................... 4/20/2009 $9,600,000 .00 establishment ........................................... 2 

AZ Northern Tucson ................. 6/24/2009 $5,300,000 .00 establishment ........................................... 2 

AZ San Carlos (tribal) ............. 6/28/2013 $3,483,102 .00 establishment ........................................... 2 

CA Rancheria (tribal) ............... 6/30/2008 $57,000 .00 expansion Toulmne Band .......................... 3 

CA Monterey ............................. 2/25/2009 $15,944,487 .00 establishment ........................................... 2 

CA Yountville ............................ 6/26/2009 $4,695,760 .00 improvement ............................................. 4 

CA Auberry (tribal) ................... 6/7/2012 $1,143,000 .00 establishment ........................................... 2 

CA Igo ....................................... 6/28/2013 $95,377 .00 improvement ............................................. 4 

CT Middletown ......................... 6/17/2013 $3,626,500 .00 expansion .................................................. 1 

DE Millsboro ............................. 4/12/2010 $74,250 .00 operations and maintenance .................... 4 

DE Millsboro ............................. 6/28/2013 $1,008,000 .00 expansion .................................................. 1 

GU Agatna Heights ................... 5/25/2011 $3,952,500 .00 expansion .................................................. 1 

GU Agatna Heights ................... 5/25/2011 $175,000 .00 operations and maintenance .................... 4 

HI Hilo ..................................... 6/29/2010 $312,291 .00 improvement ............................................. 4 

HI Lanai ................................... 6/29/2010 $88,287 .00 improvement ............................................. 4 

HI Kauai .................................. 6/29/2010 $1,477,381 .00 improvement ............................................. 4 

HI Hoolehua ............................. 6/29/2010 $438,408 .00 improvement ............................................. 4 

HI Kauai .................................. 6/29/2010 $26,478 .00 operations and maintenance .................... 4 

HI Kaneohe .............................. 6/29/2010 $3,092,939 .00 operations and maintenance .................... 4 

HI Makawao ............................. 6/29/2010 $1,119,667 .00 operations and maintenance .................... 4 

HI Hilo ..................................... 6/29/2010 $563,434 .00 operations and maintenance .................... 4 

HI Hilo ..................................... 6/29/2010 $2,829,703 .00 operations and maintenance .................... 4 

HI Kailua-Kona ........................ 6/29/2012 $795,459 .00 improvement ............................................. 4 

HI Makawao ............................. 6/29/2012 $6,556,200 .00 expansion .................................................. 1 

HI Kaneohe .............................. 6/27/2013 $12,168,000 .00 expansion .................................................. 1 

ID Southeastern ....................... 8/13/2012 $11,150,100 .00 establishment ........................................... 2 

IN West Lafayette .................... 7/1/2010 $0 .00 operations and maintenance .................... 4 

KY South Eastern ..................... 4/7/1999 $7,255,000 .00 establishment ........................................... 2 

KY Hopkinsville ........................ 7/1/2010 $149,048 .00 operations and maintenance .................... 4 

LA Rayville ............................... 12/21/2006 $6,800,000 .00 establishment ........................................... 2 

LA Jennings .............................. 12/21/2006 $6,800,000 .00 establishment ........................................... 2 

MA Agawam .............................. 7/1/2013 $2,173,025 .00 expansion .................................................. 1 

MD Owings Mills ....................... 6/30/2010 $2,500,000 .00 operations and maintenance .................... 4 

MD Hurlock ................................ 6/30/2010 $1,250,000 .00 operations and maintenance .................... 4 

MD Flintstone ............................ 6/30/2010 $1,250,000 .00 operations and maintenance .................... 4 

MD Crownsville ......................... 6/30/2010 $1,630,000 .00 operations and maintenance .................... 4 

MD Crownsville ......................... 6/24/2011 $4,000,000 .00 expansion .................................................. 3 

MD Cheltenham ........................ 6/25/2011 $3,773,450 .00 expansion .................................................. 3 

MD Flintstone ............................ 6/24/2013 $2,600,000 .00 expansion .................................................. 1 

MD Hurlock ................................ 6/24/2013 $2,240,000 .00 expansion .................................................. 1

ME Augusta-Civic Center ......... 4/6/2012 $430,000 .00 improvement ............................................. 4 

219 

Grant Applications by State and Location—Continued 

State Location Date Received Estimated 

Amount Description Priority 

ME Augusta-Civic Center ......... 2/20/2013 $1,763,250 .00 expansion .................................................. 1 

ME Augusta-Mt. Vernon Rd ...... 2/21/2013 $1,852,500 .00 expansion .................................................. 1 

MI Grand Rapids ..................... 6/30/2010 $100,100 .00 operations and maintenance .................... 4 

MN Duluth ................................. 6/30/2008 $8,350,000 .00 establishment ........................................... 2 

MN Southwest Minnesota ......... 6/4/2009 $7,900,000 .00 establishment ........................................... 2 

MN SE Minnesota ...................... 6/29/2010 $7,900,000 .00 establishment ........................................... 2 

MN Little Falls .......................... 6/28/2013 $475,000 .00 expansion .................................................. 1 

MO St. James ............................ 4/13/2010 $368,065 .00 improvement ............................................. 4 

MP Rota .................................... 6/30/2013 $500,000 .00 establishment ........................................... 2 

MP Tinian .................................. 6/30/2013 $500,000 .00 establishment ........................................... 2 

MT Columbia Falls ................... 8/4/2009 $100,000 .00 improvement ............................................. 4 

MT Crow Agency (tribal) ........... 7/1/2013 $3,000,000 .00 establishment ........................................... 2 

MT Poplar (tribal) ..................... 7/1/2013 $5,150,000 .00 establishment ........................................... 2 

NC Goldsboro ............................ 7/1/2011 $6,000,000 .00 establishment ........................................... 2 

NE Grand Island ....................... 10/23/2000 $5,102,000 .00 establishment ........................................... 2 

NE Grand Island ....................... 6/28/2012 $267,840 .00 operations and maintenance .................... 4 

NJ Wrightstown ........................ 2/14/2002 $3,400,000 .00 public information center ......................... 4 

NJ Wrightstown ........................ 4/15/2010 $701,750 .00 operations and maintenance .................... 4 

NJ Vineland .............................. 6/28/2011 $300,300 .00 improvement ............................................. 4 

NM Fort Stanton ........................ 4/9/2001 $3,500,000 .00 establishment ........................................... 2 

NV Fallon .................................. 7/1/2009 $1,250,000 .00 establishment ........................................... 2 

NV Boulder City ........................ 4/20/2010 $1,402,076 .00 operations and maintenance .................... 4 

NV Fernley (tribal) .................... 6/7/2013 $1,379,874 .00 expansion .................................................. 1 

NY Putnam County ................... 7/1/2011 $5,000,000 .00 establishment ........................................... 2 

OK Pawnee (tribal) ................... 7/1/2008 $1,950,000 .00 establishment ........................................... 2 

OK Wewoka (tribal) .................. 7/1/2012 $100,000 .00 establishment ........................................... 2 

OK Ponca City (tribal) .............. 7/1/2013 $205,000 .00 establishment ........................................... 2 

RI Exeter .................................. 6/28/2011 $885,947 .00 expansion .................................................. 1 

SC York County (tribal) ............ 6/26/2013 $984,200 .00 establishment ........................................... 2 

TN Knoxville .............................. 7/1/2010 $438,705 .00 operations and maintenance .................... 4 

TN Nashville ............................. 7/1/2010 $307,265 .00 operations and maintenance .................... 4 

TN Jackson ............................... 7/1/2011 $6,000,000 .00 establishment ........................................... 2 

TN Nashville ............................. 4/13/2012 $1,447,975 .00 expansion .................................................. 1 

TN Memphis ............................. 4/13/2012 $1,370,000 .00 expansion .................................................. 1 

TN Knoxville .............................. 4/13/2012 $120,000 .00 improvement ............................................. 4 

TN Eastern Region ................... 5/8/2013 $6,000,000 .00 establishment ........................................... 2 

TX Mission ............................... 2/26/2013 $598,860 .00 expansion .................................................. 1 

TX Killeen ................................. 4/30/2013 $4,437,076 .00 expansion .................................................. 1 

VI St. Thomas ......................... 6/30/2001 $1,200,000 .00 establishment ........................................... 2 

VI St. Croix .............................. 6/30/2001 $1,200,000 .00 establishment ........................................... 2 

VT Montpelier ........................... 6/29/2005 $2,750,000 .00 expansion and improvement ..................... 3 

WA Medical Lake ...................... 6/29/2013 $1,000,500 .00 expansion .................................................. 1 

WI Union Grove ........................ 6/22/2010 $373,905 .45 operations and maintenance .................... 4 

WI Union Grove ........................ 4/13/2012 $4,638,700 .00 expansion .................................................. 1 

WI Spooner ............................... 4/13/2012 $1,671,800 .00 expansion .................................................. 1 

WY Evansville ........................... 2/13/2006 $1,100,000 .00 improvement ............................................. 4 

b. What metrics does NCA use to determine the funding requirements for the 

Grants for Construction of Veterans Cemeteries? 

Response. Each year, NCA’s Veterans Cemetery Grants Service (VCGS) conducts 

a review of all pending pre-applications from the current year and previous years 

and creates a priority list that ranks all pre-applications across four priority groups. 

The priority list is reviewed and signed by the Secretary of Veterans Affairs and 

published by October 1st of each year. The four priority groups are explained below: 

• Priority Group 1: This group includes expansion projects required to prevent an 

interruption in burial service at existing state and tribal Veterans cemeteries within 

4 years of the date of the pre-application. These projects are assigned the highest 

priority. 

• Priority Group 2: This group is comprised of new establishment projects. To determine the funding requirements for new establishment projects, VCGS reviews the 

estimated Veteran population that would be served by the proposed cemetery along 

with the estimated interment rate and partners with states and tribes to adjust 

their project scope accordingly. 

220 

• Priority Group 3: This group includes expansion projects required to prevent an 

interruption in burial service at existing state and tribal Veterans cemeteries outside of the 4 years since the date of the pre-application. • Priority Group 4: This group is comprised of projects to improve existing state 

or tribal Veterans cemeteries and operation and maintenance projects that address 

NCA national shrine standards of appearance. 

VCGS reviews the submitted project scope, budget, and detailed cost estimates for 

all submitted pre-applications. When analyzing project budgets and their associated 

cost estimates, VCGS compares the projected costs against established NCA estimating methodologies. VCGS works closely with all states and tribal organization 

applicants to refine their cost estimates and budgets to reflect the most efficient and 

effective use of VCGS grants funds to serve Veterans and their families. 

VOCATIONAL REHABILITATION AND EMPLOYMENT

Question 179. A significant increase in subsistence allowance payments was projected for fiscal year 2012 due to changes under Post-9/11 Veterans Educational Assistance Improvements Act of 2010, Public Law 111–377, which allowed individuals 

eligible for the Post-9/11 GI Bill to receive subsistence allowance at the basic allowance for housing rate in lieu of the historical monthly allowance rate. The current 

estimated obligations for fiscal year 2013 are $136 million less than projected. 

a. Please describe the reasons why the significant increase of subsistence allowance did not materialize. 

Response. The current estimate for subsistence allowance was updated from $491.7 million to $386.3 million for FY 2013, a decrease of $105.4 million. While 

the current estimate of $386.3 million is a decrease from the initial FY 2013 estimate, it still represents a 28 percent increase over FY 2012 subsistence allowance 

payments, and a 35 percent increase over FY 2011 payments. 

The number of projected trainees receiving subsistence in FY 2013 decreased from 

68,093 to 64,864, based on actual FY 2012 experience. This resulted in a decrease 

of $23.3 million to the subsistence allowance estimate. In addition, the initial projection estimated that 40 percent of trainees receiving subsistence would be eligible for 

the basic allowance for housing (BAH) rate by FY 2013. However, based on FY 2012 

actual experience, this assumption was reduced to reflect that 15 percent of trainees 

would receive subsistence at the BAH rate in FY 2013. This decreased the FY 2013 

current estimate an additional $82.1 million. 

b. Was the decrease due to eligible participants not taking advantage of the basic 

allowance for housing rate? Please explain and detail any other factors leading to 

the decrease. 

Response. Actual experience indicates that fewer trainees are receiving subsistence at the BAH rate than was initially projected. This could be due to an overestimate of the number of Veterans receiving subsistence that are eligible for the BAH 

rate, eligible participants not taking advantage of the BAH rate, or a combination 

of both. At this time, data are not available to determine the primary reason that 

fewer Veterans are receiving subsistence at the BAH rate than expected. 

When applying for benefits, Veterans are informed of which level of subsistence 

allowance they are eligible for and Veterans then determine which benefit they are 

electing to receive. It is unlikely that new participants are applying for the lower 

rate of subsistence when they are eligible for the BAH rate. However, Veterans that 

were already receiving subsistence prior to the enactment of Public Law 111–377 

must ask their Vocational Rehabilitation Counselor to switch to the higher BAH 

rate. On August 9, 2011, VR&E Service directed field staff to provide a standardized 

letter to Veterans that were already receiving subsistence prior to the enactment 

of Public Law 111–377 notifying them about their potential eligibility for the higher 

BAH rate. 

Question 180. The fiscal year 2014 budget request includes ‘‘$104 million [for] a 

new Transition Assistance Program to help separating servicemembers better transition to civilian life.’’ The $104 million will be used, in part, to implement the new 

Transition GPS (Goals, Plans, Success) program, which is part of the redesigned 

Transition Assistance Program. 

a. How many VA FTE or contractors will directly interact with servicemembers 

through the Transition GPS program? 

Response. At the end of FY 2013, VA will have 392 briefers that will directly 

interact with Servicemembers through benefits briefings, career technical training, 

and individual assistance to requesting Servicemembers. The 392 briefers will provide support to 208 locations. 

At the end of FY 2014, VA is projected to have an additional 321 briefers directly 

interacting with Servicemembers through benefits briefings, career technical trainVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00224 Fmt 6633 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
221 

ing, capstone events, individual assistance to requesting Servicemembers, and virtual briefings. The additional 321 will provide support at 247 stateside locations and 

74 overseas locations. 

b. Of the $104 million, how much has been requested for FTE or contractors participating in the Transition GPS program? 

Response. All of the $104 million has been requested for Transition Goals, Plans, 

Success (GPS) contracting. 

c. Please provide a detailed timeline for implementation of VA’s portion of the 

Transition GPS program, including locations inside and outside the United States. 

Response. See attached implementation timeline, ‘‘VBA-SVAC-QFR180cattach.’’ 

d. Please detail the assumptions made for an increased workload due to the implementation of the Transition GPS program. Please include additional Vocational Rehabilitation and Employment (VR&E) and VBA workloads affected by implementation. 

Response. The following assumptions were made in determining briefer support 

for full implementation of mandatory Transition GPS, which incorporates requirements of Public Law 112–56, sections 201–265, 125 Stat. 711. 

• Transitioning Servicemember throughput of approximately 307,000 as provided 

by the Services. 

• 100 percent mandatory participation by Servicemembers. 

• Classroom size of no more than 50 participants. 

• Contract briefers will conduct the VA Benefits I Briefing (4 hours), VA Benefits 

II Briefing (2 hours), and the Career Technical Training Track (16 hours curriculum 

with the assumption that 30% of transitioning Servicemembers will attend and seek 

individual assistance). 

• Briefers will provide individual assistance to requesting Servicemembers with 

a planning factor of 1 hour per Servicemember. 

• Contract Briefers will also support Capstone Events (1–2 hours dedicated to 

each transitioning Servicemember). Service models for Capstone may differ. 

• Travel time and cost to support itinerant installations where there is no permanent briefer support due to lower transition throughput. 

• Initial briefer training for VA Benefits I and II Briefings as well as follow-on 

training for Career Technical Training Track. 

• The end state by September 30, 2014, which includes 713 briefers who will support both U.S. and overseas locations. 

Additional assumptions made for increased workload for second and third-order 

effects, to include VR&E and other VBA workloads: 

• Assumed a 70 percent claims intake rate based on approximately 307,000 separating Servicemembers. The intake rate was adjusted by 67,000 to account for incoming claims with existing pre-discharge programs. 

• Under legacy TAP, only about 50 percent of Servicemembers attended Transition Assistance Program (TAP). With mandatory attendance required for Transition 

GPS and VOW/VEI, the assumption is to expect increases in VA benefit applications 

(across all 6 types of benefits) due to pre-separation counseling and information provided in the VA Benefits I and II Briefings, the Capstone event, individual assistance, military lifecycle planning, and the two-day Career Technical Training Track. 

Question 181. The Vocational Rehabilitation Counselor (VRC) Skill Certification 

Test ‘‘is an internal, professional-level examination that tests technical and procedural knowledge, along with the situational judgment associated with the journeylevel VRC position.’’ 

a. If a VRC fails the certification test, what additional training would a VRC be 

required to take? 

Response. According to the 5 U.S.C. 7106 (b)(1) Pilot Memorandum of Understanding, ‘‘the supervisor and employee will identify training available to gain 

knowledge in deficit areas, to remediate knowledge gaps and allow sufficient time 

for employees to complete the training.’’ VR&E leadership in the ROs identify the 

training that a VRC must complete if he or she fails the certification test. VR&E 

Service recommends VRCs complete the VRC Foundational Training and Performance Support Systems (TPSS) module in order to remediate their knowledge gaps 

and to pass the certification test. 

b. If a VRC does not meet the requirements of the certification test, would the 

VRC be required to pass prior to resuming his or her duties? 

VBA Response: If a VRC does not pass the certification test, the individual is not 

prohibited from resuming his or her duties. 

Question 182. Please provide the Committee with data on VR&E activities by regional office, including but not limited to: 1) number of counselors at each office, 

222 

2) number required at each office, 3) rehabilitation rate, 4) timeliness, 5) cases, and 

6) number of 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. The 

total GOE contracting allocation for VR&E contract counseling services for FY 2013 

is $4,000,000. 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 being backfilled. The table below shows data as of April 30, 2013: 

Vocational 

Rehabilitation 

Counselor 

(VRC) 

VRCs 

Required Rehab Rate 

Days to 

Notification of 

Entitlement 

Determination 

(Timeliness) 

Chapter 31 

Participants 

Number of 

Veterans 

Served 

(All Chapters) 

USA FYTD 2013 ........................... 981 981 78 .1% 44 .2 116,121 124,682 

Eastern Area (16 ROs) ............... 193 195 26,495 26,965 

Baltimore ..................................... 14 14 71 .3% 29 .9 1,938 2,039 

Boston .......................................... 10 10 63 .8% 80 .7 1,406 1,453 

Buffalo ......................................... 14 14 67 .8% 41 .0 1,823 1,961 

Cleveland ..................................... 24 25 87 .1% 52 .5 4,336 4,340 

Detroit .......................................... 30 30 79 .5% 54 .5 4,087 4,189 

Hartford ....................................... 9 10 95 .9% 34 .8 1,510 1,508 

Indianapolis ................................. 20 20 72 .8% 54 .0 2,952 2,962 

Manchester .................................. 5 5 30 .2% 44 .1 515 528 

New York ...................................... 16 16 91 .3% 49 .9 1,618 1,627 

Newark ......................................... 9 10 39 .2% 43 .8 1,657 1,678 

Philadelphia ................................. 14 14 77 .5% 42 .1 1,796 1,807 

Pittsburgh .................................... 9 9 67 .2% 43 .4 782 801 

Providence ................................... 7 6 52 .0% 34 .2 523 515 

Togus ........................................... 8 7 82 .4% 34 .7 714 716 

White River Junction .................... 2 3 100 .0% 44 .1 593 595 

Wilmington ................................... 2 2 89 .6% 48 .6 245 246 

Southern Area (12 ROs) ............. 302 301 34,534 36,388 

Atlanta ......................................... 45 45 81 .8% 47 .2 4,665 4,821 

Columbia ..................................... 28 27 78 .4% 31 .2 2,487 2,693 

Huntington ................................... 9 8 35 .6% 45 .9 643 637 

Jackson ........................................ 6 7 81 .4% 45 .7 1,025 1,050 

Louisville ...................................... 19 19 78 .1% 41 .0 2,345 2,376 

Montgomery ................................. 27 27 90 .6% 36 .6 3,415 3,475 

Nashville ...................................... 21 21 84 .3% 51 .6 2,615 3,061 

Roanoke ....................................... 24 24 63 .3% 38 .8 2,934 3,007 

San Juan ...................................... 6 6 87 .8% 42 .0 701 732 

St. Petersburg .............................. 62 62 84 .8% 43 .8 8,271 8,318 

Washington .................................. 24 24 92 .5% 39 .5 2,389 2,505 

Winston-Salem ............................. 31 31 79 .8% 36 .6 3,044 3,713 

Central Area (14 ROs) ................ 251 248 27,662 30,641 

Chicago ........................................ 15 15 86 .5% 38 .0 1,875 1,962 

Des Moines .................................. 8 8 84 .5% 39 .6 1,210 1,226 

Fargo ............................................ 6 5 72 .1% 29 .3 385 384 

Houston ........................................ 55 55 90 .6% 41 .4 6,243 6,493 

Lincoln ......................................... 8 7 84 .8% 36 .4 680 686 

Little Rock ................................... 11 11 38 .3% 24 .0 1,320 1,313 

Milwaukee .................................... 11 11 88 .1% 29 .5 1,239 1,236 

Muskogee ..................................... 19 19 87 .6% 48 .3 2,126 2,229 

New Orleans ................................ 13 13 77 .0% 34 .4 1,305 1,375 

Sioux Falls ................................... 7 7 66 .7% 33 .5 673 683 

St. Louis ...................................... 18 18 79 .8% 37 .4 1,661 1,716 

St. Paul ........................................ 11 11 83 .0% 41 .0 1,322 1,344 

Waco ............................................ 58 58 80 .7% 52 .1 6,872 9,049 

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Vocational 

Rehabilitation 

Counselor 

(VRC) 

VRCs 

Required Rehab Rate 

Days to 

Notification of 

Entitlement 

Determination 

(Timeliness) 

Chapter 31 

Participants 

Number of 

Veterans 

Served 

(All Chapters) 

Wichita ......................................... 11 10 80 .0% 22 .1 751 945 

Western Area (16 ROs) .............. 235 237 27,430 30,688 

Albuquerque ................................. 8 8 89 .8% 53 .5 1,068 1,090 

Anchorage .................................... 6 6 95 .7% 47 .4 866 863 

Boise* ..........................................

Cheyenne** .................................

Denver .......................................... 25 25 85 .1% 33 .8 3,178 3,377 

Fort Harrison ................................ 6 6 88 .0% 35 .3 770 772 

Honolulu ....................................... 10 11 79 .2% 65 .9 1,347 1,647 

Los Angeles ................................. 25 26 76 .4% 46 .3 4,043 4,129 

Manila .......................................... 2 2 85 .7% 33 .2 158 163 

Oakland ....................................... 22 22 82 .9% 47 .8 3,242 3,331 

Phoenix ........................................ 21 21 85 .0% 46 .6 2,176 2,465 

Portland ....................................... 20 20 75 .3% 63 .3 2,093 2,133 

Reno ............................................. 7 7 90 .7% 42 .9 788 807 

Salt Lake City .............................. 18 18 86 .2% 39 .8 2,159 1,763 

San Diego .................................... 31 31 76 .4% 38 .5 2,220 4,038 

Seattle ......................................... 34 34 83 .2% 66 .0 3,322 3,645 

HOUSING

Question 183. The Committee recently received the following from VA in response 

to a question concerning the National Mortgage Settlement. 

In 2012, the Department of Justice (DOJ) worked to achieve a settlement 

with five banks who participated in the VA home loan program. The twopart settlement contained (1) approximately $10M for violations related to 

mortgage loan origination and servicing (the National Mortgage Settlement), and (2) approximately $45M pursuant to the False Claims Act. The 

first part of the settlement is intended to settle any potential claims related 

to VA guaranty claim payments, which are paid from the loan subsidy account of the Veterans Housing Benefit Program Fund (VHBPF). The second 

part of the settlement addresses impermissible loan transaction fees 

charged to Veterans. 

None of the settlement money due VA, approximately $42M, will be paid 

to VA home loan borrowers. Because the VA Home Loan Program is subject 

to the Federal Credit Reform Act, the following actions will be taken once 

funds are received from DOJ. Funds associated with the National Mortgage 

Settlement will be deposited in the VHBPF loan subsidy account and 

spread over all loan cohorts to cover the potential guaranty claims that VA 

may pay. Funds associated with the False Claims Act portion of the settlement are not deemed ‘‘funds incident to housing loan operations,’’ and will 

therefore be deposited back to Treasury. 

a. How many guaranty claims does VA believe it will pay that would be covered 

by the $10 million portion of the settlement? 

Response. VA does not understand what is meant by ‘‘sufficient’’ with regard to 

the settlement funds. The funds were not tied to specific loans or specific mortgage 

origination/servicing violations. However, VA has not released its right to adjust 

claims if it finds specific instances of origination or servicing violations. As noted 

above, any excess funds within individual cohorts identified through re-estimates 

will be transferred to Treasury. 

b. Of those covered by funds put in the VHBPF loan subsidy account, does VA 

believe the $10 million will be sufficient? Please provide justification. 

Response. VA does not understand what is meant by ‘‘sufficient’’ with regard to 

the settlement funds. The funds were not tied to specific loans or specific mortgage 

origination/servicing violations. However, VA has not released its right to adjust 

claims if it finds specific instances of origination or servicing violations. As noted 

above, any excess funds within individual cohorts identified through re-estimates 

will be transferred to Treasury. 

224 

Question 184. The fiscal year 2014 budget request housing workload section for 

2014 states: ‘‘The number of refinance loans will decrease as interest rates steadily 

rise.’’ In questions for the record regarding the fiscal year 2013 budget request, the 

Committee asked about VA’s interest rate assumptions, as VA had asserted that interest rates would steadily rise during 2012 and 2013. Since the February 29, 2012, 

budget hearing, the 30-year fixed mortgage interest rate, according to Freddie Mac, 

has fallen from 3.9 percent on March 1, 2012, to 3.4 percent on April 25, 2013. In 

light of the continued decline in interest rates, has VA looked at other economic assumptions aside from those prepared by the Office of Management and Budget? If 

so, please explain what assumptions VA now utilizes. 

Response. VA’s guidance for economic assumptions in the budget request is prepared by OMB; VA continues to use OMB assumptions under the requirements of 

the Federal budget process. VA does review outside mortgage industry projections, 

and these have been consistent with OMB’s assumptions, including interest rate expectations. VA will update forecasts for refinance and purchase loan guaranties during the 2014 Mid-Session Review budget cycle in June 2013. 

Question 185. The fiscal year 2014 budget request housing workload section indicates, ‘‘[t]hese economic conditions have led to declining housing prices and tightening credit.’’ The Standard & Poor’s/Case-Shiller 20-city home price index, released 

April 30, 2013, show housing prices increased from an 8.1 percent year-over-year 

gain in January to 9.3 percent in February. 

a. Given the recent news on rising home prices, how would continued growth in 

the housing market effect VA’s workload assumptions for 2013 and 2014? 

Response. In general, housing price changes alone do not have as strong an impact on VA loan volume as do interest rate fluctuations and changes in credit underwriting in the conventional market. This was seen in the increase in VA loan volume following the mortgage market collapse (and decreased availability of conventional credit), and the surge of refinance volume in the recent low interest rate environment. But if housing price increases continue at a consistent rate, leading to a 

full recovery, VA loan volume is likely to increase moderately as a result. 

VA-guaranteed loan workload, and assumptions thereof, must be analyzed by the 

component loan types—purchase loans and refinance loans. Continued moderate 

housing price increases is not expected to have a substantial impact on the volume 

of VA purchase loans as this volume is not particularly sensitive to such increases 

and has historically been stable. However, slight increases in purchase loan volume 

could still result due to current homeowners who are now willing to move and obtain a new loan with the new ability to sell an existing home at a higher price. 

The ability to refinance may improve for certain borrowers if housing prices consistently increase as a lender’s loan-to-value ratio refinance requirements may be 

newly achieved. There may be a slight increase in projected refinance volume as a 

result; however, this must be tempered with the forecasted increasing interest rates, 

which may hold some of these borrowers back from refinancing. 

Should housing prices continue to increase, VA would see more of an impact on 

the number of default resolution options available to borrowers than on loan volume. Underwater borrowers typically do not have the same default resolution opportunities available to them. Increasing home prices will reduce the number of underwater borrowers and increase those opportunities. 

VA will take into account recent changes in housing market conditions and forecasts in its mid-session review and update workload projections as necessary. 

b. How are VA’s workload assumptions effected by regional differences in the 

housing market? 

Response. VA’s workload assumptions are based on projected changes in the overall U.S. housing market. All regions constitute overall volume expectations, in aggregate. However, VA is currently exploring the procurement of a credit market’s 

analytical tool that would provide regional housing data. It remains to be seen 

whether overall program workload assumptions would be adjusted based on the 

data available. The information would likely be more beneficial for targeting default 

resolution outreach to regions with higher projected defaults. 

FILIPINO VETERANS EQUITY COMPENSATION FUND

Question 186. The fiscal year 2014 budget request for the Filipino Veterans Equity Compensation Fund indicated that 3,500 Notices of Disagreement (NODs) have 

not been resolved. The estimate for fiscal year 2014 is that $45.1 million in unobligated funds will remain at the end of the fiscal year. 

a. When does VA expect that the remaining 3,500 NODs will be resolved? 

Response. Through May 8, 2013, the Manila RO received a total of 4,515 notices 

of disagreement (NODs). Currently, only 495 of the NODs remain pending. Of those, 

225 

238 were certified to the Board of Veterans’ Appeals (BVA) and 257 are pending at 

the RO. 

The majority of the 257 appeals pending at the RO are awaiting additional service 

records, service verification, or hearings. The Manila RO regularly provides the National Personnel Records Center (NPRC) a list of all pending requests for service 

verification. Weekly follow-ups are completed via email. Additionally, Filipino Veterans Equity Compensation (FVEC) appeals are given priority in the scheduling of 

hearings. At this time, all hearings have been scheduled. 

Typically, the appeals at the RO are resolved or certified to BVA 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. Please detail what, if any, commonalities exist in the NODs and what steps 

VA is taking to address these. 

Response. There are two commonalities that exist among the NODs. Most of the 

NODs received (89 percent) are denials based on no qualifying military service and 

Question 11 percent were due to untimely filed claims, untimely filed NODs, or untimely substantive appeals. 

As stated earlier, the majority of the 257 pending at the RO are awaiting additional service records, service verification, or hearings. The Manila RO regularly 

provides NPRC a list of all pending requests for service verification and weekly follow-ups are completed via email. Additionally, FVEC appeals are given priority in 

the scheduling of hearings. At this time, all hearings have been scheduled. 

Question 187. The fiscal year 2014 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 VA’s 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. Dep’t 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 is small. However any ruling that the Government’s process or the statute 

itself is legally deficient could conceivably expand the scope of the program in ways 

that are difficult to predict. 

De Fernandez v. U.S. Dep’t of Veterans Affairs is a putative class action brought 

by three individuals and an organization seeking declaratory and injunctive relief. 

The suit principally alleges 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. 

VBA projects that the end of fiscal year 2014 unobligated balance for the Filipino 

Veterans Equity Compensation Fund will be $45.1 million 

b. Does VA have a timeline for when the lawsuits will be resolved? If so, please 

provide that timeline to the Committee. 

Response. Recinto has been dismissed by the district court, and the dismissal was 

affirmed by the United States Court of Appeals for the Ninth Circuit (9th Circuit). 

Recinto v. U.S. Dep’t of Veterans Affairs, 706 F.3d 1171 (9th Cir. 2012). Plaintiffs 

have petitioned the United States Supreme Court for Certiorari. The case should be 

resolved in mid-October, if the Court does not grant the petition. 

Relying chiefly on Recinto, the district court dismissed De Fernandez. Plaintiffs 

have appealed to the Ninth Circuit. Because the case has not yet been briefed, the 

appeal is unlikely to be fully resolved in less than a year. 

RESPONSE TO POSTHEARING QUESTIONS SUBMITTED BY HON. JON TESTER TO

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

Question 188. The President has requested $7 billion to expand inpatient, residential, and outpatient mental health care for Fiscal Year (FY) 2014, an increase of 

$469 million from FY 2013. I appreciate steps taken by the Department of Veteran 

Affairs (VA) to increase its number of mental health professionals. In Montana and 

other rural states, we have not made much progress. 

a. What kinds of strategies is the VA currently using to retain our current mental 

health workforce, particularly those in rural areas? 

226 

b. Do you currently have the tools and flexibility you need to ensure we maintain 

a high quality VA medical workforce in rural America? Are there any statutory obstacles? 

c. Can you speak to any ongoing collaboration with other Federal agencies, such 

as Health and Human Services or the Indian Health Service, to enhance our efforts? 

Are there opportunities to build upon these partnerships? 

Response to a, b, and c combined: VA has been working closely with outside resources to address any gaps and create a more patient-centric network of care focused on wellness-based outcomes. In response to President Barack Obama’s Executive Order 13625, ‘‘Improve Access to Mental Health Services for Veterans, Servicemembers, and Military Families,’’ signed on August 31, 2012, VA is working closely 

with the Department of Health and Human Services (HHS) to establish 15 pilot 

projects with community-based providers. These providers include community mental health clinics, community health centers, substance abuse treatment facilities, 

and rural health clinics, to test the effectiveness of community partnerships in helping to meet the mental health needs of Veterans in a timely way. Both the Health 

Services and Resources Administration (HRSA) and the Substance Abuse Mental 

Health Administration (SAMHSA) of the HHS provided names of potential community partners. The fifteen pilots have been established across Georgia, Tennessee, 

Wisconsin, Mississippi, South Dakota, Nebraska, and Iowa. 

Pilot projects are varied and may include provisions for inpatient, residential, and 

outpatient mental health and substance abuse services. Some sites shall include capabilities for tele-mental health, staff sharing, and space utilization arrangements 

to allow VA providers to provide services directly in communities that are distant 

from a VA facility. The pilot project sites were established based upon community 

provider available capacity and wait times, community treatment methodologies 

available, Veteran acceptance of external care, location of care with respect to the 

Veteran population, and mental health needs in specific areas. 

VA currently collaborates with federally Qualified Health Centers (FQHCs) and 

community mental health clinics across the country. These community partnerships 

were developed locally as a means to provide mental health services to Veterans in 

areas where direct access to VA health care is limited by geography or workload. 

One of the most robust of the pilot sites is in Montana and serves as a prototype 

that other facilities may follow. Since 2001, the VA Montana Health Care System 

has followed a model utilizing community mental health contracted care to address 

the challenges of a geographically large area and the population dispersion of Montana’s Veterans in need of mental health services. Montana has a population of 

989,415 (46% reside in rural areas), a land area of 145,546 square miles and has 

the second-highest Veteran per capita population. Within Montana’s 56 counties, 

part or all of 54 counties are designated mental health care shortage areas. For nonVA community mental health (MH) services, Montana is divided into four regions 

consisting of a regional mental health center and several satellite offices. Under 

these VA contracts, Veterans are seen by mental health providers at 45 sites. This 

allows VAMTHCS to provide mental health services at the local level to Veterans 

in all 56 counties. In 2011, the number of Veterans treated under the contract was 

2,221, increasing to 2,388 in fiscal year (FY) 2012. The choice of contract provider 

depends on the type of clinical services required. A contract provider may be utilized 

for one service while a VA provider may be utilized for a different mental health 

service. 

Question 189. Vet Centers are extremely beneficial to Montana Veterans, and it 

is vital that the number of Vet Centers increase throughout the state. Recent laws 

have expanded Vet Center eligibility to include a number of individuals still on active duty, as well as their families. While I am supportive of these efforts, I also 

believe it might be appropriate for the Department of Defense Health Program to 

fund their share of the caseload. Should the Department of Defense be authorized 

or directed to help supplement funding for Vet Centers if servicemembers begin 

making up a substantial portion of the caseload? Dr. Petzel, has this been part of 

the ongoing discussions with the Department of Defense during the regulatory 

process? 

Response. VA would like to thank the Senator and his staff for their continued 

interest and support of the Vet Center Program. The Veterans Health Administration appreciates the interest in this issue, and VA has had a discussion regarding 

this issue with staff from Senator Tester’s office in June 2013. The VA’s Readjustment Counseling Service (RCS) does have some concerns with a proposal that would 

ask DOD to reimburse RCS for services to active duty Servicemembers and for that 

additional funding to be used to expand the Mobile Vet Center (MVC) program. The 

below bullets outline the concerns: 

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• Reimbursement of services by DOD to RCS 

– There would be no way to ensure that Servicemember confidentiality remains 

intact as some form of identifier would have to be used and communicated from 

RCS to DOD to verify that an individual received services at a Vet Center. Servicemembers and Veterans alike use Vet Centers because they are safe and confidential places where they can remain anonymous. Vet Center staff only break 

confidentiality when clients allow through a signed release of information or in 

situations to avert crisis. 

– VHA has already requested yearly increases to RCS’s budget, specifically to 

provide Vet Center services to Active Duty Servicemembers (increase of staff 

and augmentation of space). 

– RCS is not set up to receive or process any form of third party billing. 

• RCS has recently expanded the MVC Program 

– In 2012, RCS expanded the MVC Fleet from 50 to 70 vehicles to ensure increased access to Veterans and Servicemembers who recently returned from 

Combat Zones or Areas of Hostilities as well as those who are geographically 

distant from existing Vet Center services. With this new expansion, a MVC is 

stationed within a 120 minute drive time to all major Active Duty Military Installations whose base population is over 10,000 and Demobilization Sites. Further, MVCs are located within reasonable driving distances to many of the military installations and Reserve and National Guard Armories that are below this 

population limit. 

– MVCs and staff regularly participate in events where Active Duty Servicemembers are present such as demobilization events or other events on military 

installations and armories. 

VA would welcome the opportunity to discuss the Vet Center Program in further 

detail with Senator Tester or his staff and appreciate his support of the program. 

Question 190. Proportionally, American Indians serve in our Armed Forces in 

greater numbers than any other ethnic group. The United States has unique responsibilities to them both, as veterans who have proudly served our Nation, and as 

American Indians who have sacrificed immeasurably. In Montana, providing health 

care for veterans on reservations is a difficult task. Rural isolation only adds to the 

challenge. I have advocated for the VA to improve its communication and outreach 

efforts with the tribes in relation to its funding for Tribal Veterans Representatives 

or Tribal Veteran Service Centers. Has the VA taken any recent steps to address 

this issue? 

Response. VA’s Office of Rural Health provides fiscal assistance to support annual 

Tribal Veteran Representative training in Montana and other VA networks across 

the country. These training efforts ensure that every tribal community in Montana 

has a local point of contact for Veterans services. This serves as a critical point of 

access to VA services and benefits for Veterans living in some of Montana’s most 

rural areas. The TVR training is also supported by VISN 19. VISN 19 employs tribal outreach workers who support tele-health infrastructure established between the 

VA at tribal sites located throughout Montana. Most TVRs are paid by tribal funds 

or serve as volunteers. 

VA is also in the process of implementing reimbursement agreements to IHS and 

tribal health programs for direct care services provided to American Indian and 

Alaska Native Veterans. It is anticipated that through these agreements, additional 

partnerships will expand between the VA, IHS and tribal governments that will effectively serve the needs and priorities related to access for Veterans living on tribal 

lands in Montana. 

RESPONSE TO POSTHEARING QUESTIONS SUBMITTED BY HON. DEAN HELLER TO HON. 

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

Question 191. I respectfully request that you provide a breakdown of the funding 

allocated to each Department of Veterans Affairs Regional Office (VARO) under the 

Veterans Benefits Administration (VBA). I would like to know the number of fulltime employees at each VA Regional Office as well as the number of pending and 

backlogged claims at each VARO? 

Response. The respective funding allocations, the number of FTE, and the number 

of pending and backlogged claims per RO are broken down on the attached spreadsheet, entitled ‘‘Question 192 funding allocation FTE backlog.’’ The FY 2013 funding 

allocation is pending finalization; however, staffing levels and, consequently, funding levels are expected to remain relatively even with FY 2012. Many ROs administer several benefit programs and activities in addition to compensation (loan guarVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00231 Fmt 6633 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
228 

anty, education, fiduciary hubs, national call centers, pre-discharge programs, 

brokering centers, pension centers, etc.). Therefore any comparisons cannot consider 

only compensation workload. 

Question 192. An integral tool of reducing the VA claims backlog is transitioning 

to a paperless system—the Veterans Benefits Management System (VBMS). Part of 

this transition includes the Veterans Claims Intake Program (VCIP), which scans 

and converts evidence in support of claims into digital information. In the VA’s fiscal year 2014 budget request, VCIP is allocated $136.44 million—which the VA 

budget states is an increase of $119 million over 2013, an addition of 34 full time 

employees, and includes support contract costs to execute VCIP. 

I understand that VBA contracts with the private sector to perform large scale 

scanning operations of paper claims to feed them electronically to VMBS for electronic claims processing. I also understand that there is an internal scanning operation of medical and personnel records at the Records Management Center (RMC) 

in St. Louis. 

How does your internal scanning production at the RMC in St. Louis compare to 

the scanning production at the contractors facilities? If there is a difference in productivity, please explain any discrepancy. If there is no difference, why does VBA 

not keep the scanning work in-house by expanding or replicating the operation performed in-house at the RMC? 

I want to ensure that if Congress provides a significant increase in funding to the 

VCIP that quality and timely production is maximized. 

Response. The limited scale scanning operation at the Records Management Center (RMC) provides document conversion services for Service Treatment Records and 

Military Personnel Files, and is configured differently than operations at the scan 

vendor sites. The current configuration of desktop scanners was specifically selected 

for the handling of these materials, and as a result the RMC scans fewer types of 

evidence, and at a lower page per minute rate than scan vendors. Currently, the 

RMC’s maximum capacity is under 500,000 images per month. 

In contrast, the contracted scanning vendors employ dedicated facilities with highspeed and high-volume scanners to process more evidence types, at a much higher 

page-per-minute rate than the RMC. While this approach requires a significant initial investment, the current estimate for scan operations at these vendors is projected to routinely be in excess of 40 million images per month. 

Expansion of RMC to handle such large volume would require significant investment in developing the expertise, skills, and training of the VBA staff for this function, diverting attention from the priority goals of accurate and timely claims processing. 

The model used at the RMC is based on a specific type of evidence, with a narrow 

focus. To apply the approach used by contract scan vendors would require extensive 

rework of this configuration, and meeting the demand using internal VBA resources 

would require expansion of this staff and the facilities and systems infrastructure 

on significant scale. This would require an investment of time and money greater 

than the use of contractors, with a greater long-term cost to the taxpayer. 

In the first 11 months of operations, the contracted scanning vendors have enabled VBA to convert paper claims materials into over 240 million images cumulatively, with an average 5-day turnaround time from date of receipt of paper claims 

materials to date of upload into VBMS, while maintaining 99 percent accuracy. 

Question 193. In Fiscal year 2014, what has the VA budgeted for its teleaudiology 

program? 

Response. In FY 2014, VHA will fund a total of $655,000 in staffing costs for technicians, equipment maintenance service, and warranty costs for the initial 10 TeleAudiology sites that are providing remote hearing aid fittings and adjustments. 

VHA will also continue its expansion of TeleAudiology sites to 19 of its 21 Veterans 

Integrated Service Networks (VISNs) in FY 2014. All costs for audiologists, additional technicians, and telecommunications are covered by the existing VHA budget 

that is not specific to TeleAudiology. 

Question 194. Between FY 2014–2018, what is the VA projected to spend on the 

teleaudiology initiative? 

Response. VA projects to spend $3,629,000 for currently projected budgets between FY 2014–2018 (excluding audiologists, additional technicians at expansion 

sites, and telecommunications as explained above): 

• FY 2014 = $655,000 ($112,000 for VHA National TeleAudiology Lead + $528,000 

for existing site technicians +$15,000 for annual maintenance service and warranty 

for existing sites). 

• FY 2015 = $743,500 ($640,000 for staff (see FY 2014 above) + $103,500 for annual maintenance service and warranty for 69 original and expansion sites. 

229 

• FY 2016 = $743,500 ($640,000 for staff (see FY 2014 above) + $103,500 for annual maintenance service and warranty for 69 original and expansion sites. 

• FY 2017 = $743,500 ($640,000 for staff (see FY 2014 above) + $103,500 for annual maintenance service and warranty for 69 original and expansion sites. 

• FY 2018 = $743,500 ($640,000 for staff (see FY 2014 above) + $103,500 for annual maintenance service and warranty for 69 original and expansion sites. 

Question 195. In fiscal year 2012, what did the VA spend on veterans’ transportation to and from VA clinics for hearing evaluations and hearing aid services? 

Response. In FY 2012, the average waiting time for hearing aids was 40.5 days. 

Question 196. In fiscal year 2012, what percentage of qualified veterans received 

two sets of hearing aids? 

Response. In FY 2012, 1.3 percent of the 281,893 purchase orders involved two 

sets of hearing aids. A total of 278,250 Veterans had one purchase order for hearing 

aids, and 3,643 Veterans had two purchase orders (65 of these Veterans had 3 purchase orders). The majority of orders (89.6 percent) were for binaural hearing aids 

(one for each ear). 

Question 197. In fiscal year 2012, what was the average wait time for a veteran 

to receive the following items: a hearing evaluation, follow up-service, and a hearing 

aid? 

VHA Response: VHA provides hearing evaluations for new patients and follow-on 

care for established patients in Audiology clinics identified by clinic stop code 203. 

VHA tracks waiting times for both new and established patients. In FY 2012 both 

new and established patient waiting times were measured from the desired date for 

the appointment to the completed appointment. VHA defines a new patient as one 

who has not seen a qualified provider in a specific clinic stop code in the past 24 

months. An established patient is one who has already been seen at least once by 

a qualified provider in a particular clinic stop code within the last 24 months. A 

new patient seeking audiology care will need a hearing evaluation before any treatment can be provided, therefore we assume that a new patient appointment will 

have involved a hearing evaluation and the associated new patient waiting time will 

apply. An established patient has already had the initial hearing evaluation in the 

past 24 months or longer and any appointments now would be considered followon care and the associated wait times for established patients would apply. 

Chairman SANDERS. General Shinseki, thank you very much. 

Let me begin by addressing an issue that is a serious one, that 

I think every member here has spoken of and you have acknowledged, and one that is of great concern to this country. 

Now my understanding is that the VA is now processing more 

claims today than they ever have before—— 

Secretary SHINSEKI. That is true. 

Chairman SANDERS [continuing]. In significant numbers. 

But my understanding is also that according to the most recent 

Monday morning workload report there were nearly 890,000 claims 

for entitlement to benefits pending, almost 70 percent of which 

have been pending longer than the Department’s goal of 125 days. 

And this number does not even take into account other pending 

work, including award adjustments and appeals. 

I believe you established that goal not long after you took your 

position. You brought forth a very, very ambitious goal, and you 

said that you wanted to process all claims in 125 days and with 

a 98 percent accuracy by 2015. Is that correct? 

Secretary SHINSEKI. That is correct. 

Chairman SANDERS. All right, let me ask you this: what benchmarks have you set and must VA meet to make sure that VA 

achieves those goals? 

In other words, I think all of us would agree that the task that 

you have undertaken, going from an unbelievable amount of paper, 

a system that was virtually all paper when you took office, to a 

paperless system is just a huge transformation. 

230 

The concern here—and others have raised it—is, what reason do 

we have to believe that you are, in fact, going to be able to successfully undertake that transformation and meet the goals, ambitious 

goals that you have established? 

Secretary SHINSEKI. Well, thank you for that question, Mr. 

Chairman. I am going to call on Secretary Hickey to add some detail, but let me just describe what situation existed when we 

arrived. 

We were in paper and have been in paper for decades. We continue to get paper today. 

If you are going to manage a situation, it takes a certain kind 

of approach and resourcing. We thought that for the long term the 

benefit to veterans was to end the backlog, and so we set the goal 

of ending the backlog in 2015. 

We did some rough calculations, and the backlog when we arrived was not defined as 125 days, 98 percent accuracy. If we want 

to make a bold move here and help veterans, then we have to move 

quickly. And so we set ambitious goals, we did our best estimates, 

and we have laid out a plan in this budget that is resourced, that 

drives those numbers toward ending the backlog in 2015. 

I think all of you will remember after we established that goal 

of ending the backlog we also took on some unfinished business. 

We had Vietnam veterans—my first year here as I moved 

around—who were not very happy with the fact that they had not 

had their issues addressed. In many cases, I was told that we were 

just waiting for them to pass so we would not have to take care 

of that. I cannot think of a more demeaning circumstance—for a 

veteran to feel that that is what their VA, who exists for them, 

looked upon the situation. 

I heard the same kinds of things from Gulf War veterans—20 

years after the Gulf War, no decisions regarding their health care 

issues. 

Then, as I think all of us can acknowledge, PTSD has been 

around as long as combat and had never been acknowledged as associated with combat—verifiable PTSD. 

So, even as we established ourselves at ending the backlog, we 

took on three pretty significant decisions—for the Vietnam generation, three new diseases for exposure to Agent Orange’ nine new 

diseases never recognized before for Gulf War veterans; and then 

for all combat veterans with verifiable PTSD, access, a service connection so that they could submit their claims. 

I would say that those numbers, added to the paper process that 

we had, in fact, were going to grow the inventory and complicate 

the backlog, and we testified to that when those decisions were 

made. There were a number of hearings on this. 

And my prediction was we are going to go up, but at the same 

time we are going to put in place an automation system that would 

correct all of that, and in time we would bring the backlog back 

down. 

Well, we are in mid-stride here. We are now fielding that automation tool. It took us 2 years to develop it. It is called VBMS— 

Veterans Benefits Management System. It is in 30 of the 56 regional offices. We are seeing some indications that it is having good 

231 

success, and we intend to field the remaining offices as quickly as 

possible. 

We have some good learning that came out of automating the 

new 9/11 GI Bill process, and out of that, the learning indicated to 

us was that there is a tremendous lift that comes once you have 

the system fielded. We followed that model of fielding, incrementally, an IT program that is robust enough to handle our claims 

processing. 

As I say, we are scheduled to complete this year, 31 December. 

We are pulling that as far to the left as we can and fielding as 

quickly as we can and doing it prudently, where we do not run the 

risk of overreach. 

Chairman SANDERS. General Hickey, did you want to add anything to that? 

Ms. HICKEY. I would just like to add to the discussion that the 

Secretary has said. I know that we are asked routinely about our 

milestone. So I wanted to give you just a few bits and pieces of the 

milestones that we have experienced in the education claims process that is literally being built by the same people building VBMS. 

We have tripled—tripled—our productivity through the spring 

season as a result of the automated rules engines that went into 

the long-term solution, our paperless IT system, last fall the 24th 

of September. We went from doing 79,000 claims a month to doing 

more than 285,000 claims a month. Reducing the days it took to 

do those claims down to 4.5 days on average is where we are right 

now today in the body and the bulk of our 9/11 GI Bill claims. 

We are applying the exact same strategy to the rules-based capability going into VBMS where, quite literally, the veteran will go 

online, which exists today on e-benefits, file their claim like they 

do their taxes—apropos to say that today. It goes directly into 

VBMS. 

Without even advertising it—we completed that whole piece here 

this year in January. Without even advertising it, we have 500 

claims a week going into that system. And it goes directly into 

VBMS, never turns into paper, and allows us to immediately start 

working them. 

Today, we do not have 3 percent in paper anymore. We have 3 

percent electronic. We have 14 percent of our paper that has already been converted to electrons just since January the 28th. I 

have more than 116,000 electronic claims now, electronic folders, 

that we did not have before January of this year. 

So we are well moving along in this process, and in fact, this 

week I will have another six regional offices on the new IT system. 

Chairman SANDERS. OK. Thank you very much. 

Senator Burr. 

Senator BURR. Mr. Secretary, the VA backlog reduction plan 

shows that in order to eliminate the backlog by 2015 VA will need 

to decide 1.2 million claims this year, 1.6 million claims next year, 

and 1.9 million claims in 2015. But, VA is projecting in the budget 

submission that it will decide 335,000 fewer claims in 2013 and 

2014. 

So, can the VA reach 2 million claims in 2015? That would be 

a 92 percent increase in productivity over the 2012 level. 

232 

Ms. HICKEY. So, Senator Burr, I am sorry. I do not exactly know 

your numbers, but I am happy to take your numbers and go look 

at them and come back to you and sit down and visit with you. 

I can tell you—— 

Senator BURR. Well, I would be happy to. I am pulling them 

right out of the backlog reduction plan which was submitted in 

January. I got it January 25 in my office. 

The math would work out. To eliminate the backlog by 2015, VA 

would need to decide 1.2 million claims this year, 1.6 million claims 

next year, and 1.9 million claims in 2015. 

Now, in the projections under the budget submission from the 

President, that says that over the next 2 years you will decide 

335,000 less claims than what the backlog reduction plan said. 

I am trying to figure out if 2015 is—if you are certain on that. 

Then that means that you have to process over 2 million claims in 

2015. Is that how your math looks at it? 

Ms. HICKEY. Senator Burr, I would love to come, sit down and 

talk to you about that. Those numbers are a little different to me 

than the numbers we sent across and then have followed up on in 

questions to your staff. So I am happy to do that with you. 

Senator BURR. Well, in the budget submission, you do say that 

you will decide 335,000 fewer claims in 2013 and 2014, right? 

Ms. HICKEY. Senator, the budget submission is slightly different 

than the plan that you received in January that was based on some 

assumptions made last fall, and there have been some differences 

in what we have seen in terms of the actuals that have been submitted to us. We have seen a significant drop in—not significant. 

That is not a good word. We have seen a drop in the number of 

claims that have been submitted to us of late. 

So we have adjusted the budget based on those issues. 

Senator BURR. OK. Currently, nearly 70 percent of the claims are 

backlogged, meaning that they have been waiting for a decision for 

more than 125 days. 

The strategic plan you submitted less than 3 months ago projected that the backlog would be reduced to 68 percent in 2013 and 

57 percent in 2014, but according to the budget submission you 

now expect no more than 40 percent of the claims to be backlogged 

during either of these 2 years. 

So, in revising these projections, what metrics did you look at, 

and what did they show you? 

Ms. HICKEY. Senator, I looked at the actual submissions of receipts of claims that we have received from our veterans over the 

last 5 months, and each month they have been lower than our expected volume. 

Senator BURR. So the math works out to where you would have 

only a 40 percent backlog situation in 5 months? 

Ms. HICKEY. No, Senator, it does not. And I do not think that— 

you all would throw me out of here if I said that that would happen. That is not where we are. 

We are at about 69 percent of our claims right now that are older 

than 125 days, and we are working every single day to drive that 

number south. We are doing it by a focus on our people, process 

and technology solutions and, as far as we can, pushing up our productivity by our folks. 

233 

I can tell you today that my raters are 17 percent more effective 

and at a higher productivity than they were prior to us moving into 

this new transformation plan. 

Senator BURR. But, General Hickey, last year you testified—or, 

excuse me, the Secretary testified that during 2013 the backlog 

would be reduced from 60 percent to 40 percent and that would 

‘‘demonstrate that we are on the right path.’’ 

At the time, did you envision that the backlog would stay above 

65 percent for the first half of the fiscal year or that it would be 

70 percent in April? 

Ms. HICKEY. Senator, we do have some APG guidance, our annual planning guidance, that we communicate with to our Federal 

Government partners, and they are usually aspirational in nature. 

When we see a change or a difference, as the Secretary has 

pointed out, in terms of the workload that we saw increase due to 

Agent Orange, Nehmer, the increased claims associated with PTSD 

and the like, we did note that we would probably not be able to 

meet that 40 percent APG guidance. But the thought was you leave 

your stretch goal out there so that you keep trying to work hard 

to get to it, and that is what we have done. 

Senator BURR. Here would be a simple question: is the strategic 

plan that you sent to Congress aspirational? 

Ms. HICKEY. So, Senator Burr, I grew up as a strategic planner 

in the military for quite a while, and I know that every strategic 

plan I built over the years for the U.S. Air Force always was a 

plan. And plans are always in contact. You know, they change and 

they adjust for reality and actuals. 

So we have and will continue to improve upon that plan and continue to adjust. 

Senator BURR. But when you developed that plan was it developed to be aspirational, or was it developed to give us an accurate 

blueprint of how VA perceived the timeline would move on disability backlogs? 

Secretary SHINSEKI. Senator, I think in all planning there is an 

aspect of aspiration at the beginning, and then it is—with assumptions and the availability of resources—it is adjusted for what we 

think is achievable. 

In a long-term plan like this one, with as much dynamics involved, we make an assumption, for example, that the flow of veterans out of uniform to the VA is going to follow a pattern that we 

have been provided by the Department of Defense. If that changes, 

that adjustment, then we will have to look and see whether we can 

accommodate that change, and if not, then we will have to say we 

have a requirement for resourcing. 

Senator BURR. Mr. Secretary, thank you very much. 

And, Ms. Hickey, I look forward to sitting down with you to look 

at the matrix that brought about such a change in only 3 months. 

And let me just say, Mr. Secretary, that I was not really addressing the increased number of claims that come in the door. I was 

addressing the number of claims that are actually processed and 

determined. 

Secretary SHINSEKI. Yes. 

Senator BURR. And that does not seem to be getting better. 

I thank the Chair. 

234 

Chairman SANDERS. Thank you, Senator Burr. 

Senator Rockefeller. 

Senator ROCKEFELLER. Thank you, Mr. Chairman. 

General, I am going to try to ask you two questions in too short 

a period of time. 

It is homelessness on the one hand, suicides on the other. How 

do you pick the tragedy—the worst tragedy? 

There are up to 22 suicides a day—so let me just concentrate on 

that for a second. 

You are making an enormous move in mental health. You are 

bringing in not only the mental health experts but also the support 

staff that they need to have. It will take time to get them into the 

system and trained. 

But how do you look at the general population—starting with 

PTSD and then, obviously, as it gets into mental health things clarify themselves—and raise red flags? 

How do you take somebody who is on a suicide watch list or 

something of that sort? How do you go to work on that person? 

How do you try to break through? 

Secretary SHINSEKI. Senator, the issue here is no one should 

have to wait for mental health care. And we have resourced our 

Veterans Health Administration by nearly 57 percent, an increase 

from 2009 to the 2014 budget. We believe this is where we have 

to put our emphasis. 

Regarding the suicide number you cited—22—you know, 4 years 

ago we were not receiving suicide information, veterans’ suicide information, from the States. So we wrote, and the States have been 

very responsive. Now we have that information flowing into the 

CDC of which we have this latest number—22. 

Four years ago, we did an estimate by the best way we could, 

from our mental health experts, and they pegged the number at 

about 18. So, while this looks like a growth in the last 4 years, it 

is really a better number based on data we have received. Eighteen 

was a fair call, but we have better information with 22, and we can 

set about doing things that we could only speculate on 4 years ago. 

So an increase in the mental health budget allows us now to do 

things like increase staffing where we find that we need additional 

resources. 

Dr. Petzel will provide an update on where we are with regard 

to hiring additional mental health, and then I will come back and 

close out on suicides. 

Senator ROCKEFELLER. Before he does that, can I ask my second 

question? 

Secretary SHINSEKI. Certainly. Absolutely. 

Senator ROCKEFELLER. I remember a number of years ago the excitement that was felt generally when DOD and the Veterans 

Administration were planning to work together. I went to a number of common facilities, joint facilities, and everyone was full of 

optimism. 

Now all of a sudden, evidently, unless I am wrong, there has 

been a pullback from that. The electronic records and all kinds of 

benefits flow from this cooperation. There has been a pullback from 

DOD. I am curious about that. 

235 

Secretary SHINSEKI. We are both still committed to a seamless 

transition of servicemembers into VA. That has not changed. 

We are both also committed to an electronic health record that 

we share in common. And in the language that we have come to 

use over the past 4 years of growing the concept, it is a single, 

joint, common, integrated, electronic health record, open in architecture, nonproprietary in design. 

All of those terms are code to keep us focused on what we want 

in an electronic health record—one that we share together and one 

that will be as good 5 years from now as it is on the day we first 

invest and purchase it as opposed to being faced over and over with 

an aging electronic health record that we somehow have to refinance years down the road. 

So this is the concept that we have committed ourselves to. 

I would say that my sense is we have not backed away from that 

although Secretary Hagel, who has just arrived, is in the midst of 

getting into this issue. I have agreed that he ought to have time 

to do that. 

Senator ROCKEFELLER. But you do not know of any backaway. 

Secretary SHINSEKI. I am not aware of any backing away. 

Senator ROCKEFELLER. I am happy to hear that. 

Thank you, Mr. Chairman. 

And I apologize for doing that to you—asking two questions. 

Secretary SHINSEKI. Should we answer the first one? 

Senator ROCKEFELLER. No, because my time has run out. You 

know, I have got to play by the rules. 

Chairman SANDERS. Senator Johanns. 

Senator JOHANNS. Thank you, Mr. Chairman. 

Mr. Secretary, in the fiscal year 2014 budget request, I note that 

there is funding for one—just one, across the entire country—major 

medical facility. That is about $150 million for a mental health facility in Seattle. 

I am not questioning at all whether that is needed or not, but in contrast, the minor construction request is for $715 million, substantially more. That is an increase of 17.8 percent from the 2013 

level. 

Does the VA have an estimate of the amount of minor construction funding that is needed to keep aging facilities patched together 

until they finally make their way up the priority list, which, if we 

are only doing one a year, that is going to be a long, long wait? 

But how much of that money then is actually going into trying 

to keep aging facilities operating? Is it all that money? 

Secretary SHINSEKI. Well, Senator, let me answer the broad 

question of our construction budget. It includes $2.39 billion for 

major, minor construction which you have asked about, non-recurring maintenance which has a lot to do with facility condition, and 

major medical leases. 

Minor construction, as you indicated, has increased by 17 percent 

compared to 2013. This is important to us because this is money 

that gets into the hands of hospital erectors very quickly and impacts more facilities for the kinds of things you are concerned 

about and services directly to veterans. 

The major medical leases. Our request there is an increase of 12 

percent compared to 2013. And, here, those leases are intended to 

236 

provide health care delivery closer to where veterans live, and that 

is all this business of community-based outpatient clinics and so 

forth. 

Major construction. The request is for $342 million, and as you 

indicated, there is one major project here on the list. But it is a 

stable program, and we have a plan for in-phase funding the execution of a number of large projects. Non-recurring maintenance, $709.8 million, again remains stable 

in comparison to 2013. And, here, we are dealing with safety, facility condition deficiencies and other high priority needs to make 

sure that the facilities we do have are safe, secure and accessible 

to veterans. 

This is a balance across our programs. And I would just offer 

that it is a stable overall program with emphasis on minor, major 

leases, or medical leases, and assuring that the non-recurring 

maintenance is maintained at a stable level as well. 

Senator JOHANNS. You can kind of see where I am headed. My 

concern is that you have got a whole host of old buildings out 

there. It certainly would not be what you would want if you were 

going to build a facility today, obviously, because they are probably 

50, 60, 70 years old. And I am worried that we are putting money 

into these old facilities, which to me seems almost like a waste. 

Has the VA studied any possibility of trying to jumpstart this 

program, to try to get more new construction versus putting money 

into old buildings, or are we just stuck where we are at? 

Secretary SHINSEKI. I do not describe us as being stuck. I mean, 

if there was another dollar to be had, there is a place I could put 

it in construction, but as I say, it is stable approach to a large footprint. 

Part of our responsibility is to decide what part of that footprint 

we no longer need. In the last several years we have reduced the 

amount of vacant space, and consolidated and reduced the amount 

of underutilized space; in both categories, some 25 or 26 percent reduction. So we do that as well. 

There are other pieces of our property that we can dispose of, 

and we do through either demolition or look for other means to find 

other uses for what we no longer need. 

We used to have an enhanced use lease authorization that expired in December 2011, and our efforts to have that authorization 

renewed and extended have succeeded in providing for an enhanced 

use lease arrangement for homeless requirements only. So we do 

have that. 

And, right now, we have a number of projects where we have created homeless housing for veterans. We have others that are in design, and other work is underway—about 5,500 units in all. 

So we do manage those older pieces of property. We have need 

for some of it, not all of it, and we need a way to efficiently dispose 

of it. 

Senator JOHANNS. Thank you, Mr. Chairman. 

Chairman SANDERS. Thank you, Senator Johanns. 

Senator Tester. 

Senator TESTER. Yes, thank you, Mr. Chairman. 

I have got more questions than we have got time, but we will 

start with the Caregivers Bill of 2010. In that bill was a provision 

237 

to establish a rural veterans’ coordination pilot so that OIF and 

OEF veterans could get care from community-based providers for 

mental health in cases where the VA did not have capacity. The 

provision gave the VA clear authority to contract out mental health 

services for OIF and OEF veterans in rural areas where mental 

health providers are at a premium. 

Can you give me any progress on this? 

Why I say that is because Montana has four community mental 

health centers serving the West, the South, Central, the East, and 

the North, too. None of those are contracted with. 

Just wondering, where are we as far as progress goes on this? 

Secretary SHINSEKI. Dr. Petzel. 

Dr. PETZEL. Thank you, Senator Tester. 

Thank you, Mr. Secretary. 

The event of the bill has really been overtaken by the executive 

order from the President. We are in the process now of developing 

15 contract pilots across the country with federally qualified, community-based clinics to pilot the concepts of the contract. If this is 

successful—and we are quite confident it is going to be—we are 

going to be doing this across the country. 

I was not aware that—you enlightened me. I was not aware of 

the fact that the Montana clinics were not contract pilots. 

Senator TESTER. Well, you can correct me if I am wrong, but I 

do not believe that they are. 

Dr. PETZEL. I will check. 

Senator TESTER. They are not contracted with the VA. 

Now the question is, OK, so these 15 pilots which the executive 

order enhanced in 2010, where are they at? Are they up and running? Is the pilot running so you are going to assess them, and if 

they are not, when will they be? 

Dr. PETZEL. Virtually all of them are delivering care. 

Senator TESTER. OK. 

Dr. PETZEL. A number of them are doing it by contract. Some 

others had difficulties getting the contracts executed immediately, 

so they are doing it on a fee basis. But the contracts are in process, 

and we expect that within a month or two everybody will be operating on a contract. 

Senator TESTER. OK. And when would you anticipate an assessment of their effectiveness will be done? 

Dr. PETZEL. I would hope that we could do that late summer. 

Senator TESTER. Super. 

I want to talk a little bit about health care providers in general, 

mental health care providers specifically, and this can still go to 

you, Dr. Petzel, if appropriate; if not, you, Mr. Secretary. 

We have issues. It goes along with the partnerships, but we have 

issues with folks—mental health care professionals and health care 

professionals in general—being staffed up to snuff. We have had 

conversations off the grid with you on that. 

What kind of strategies are the VA using to retain the current 

mental health workforce, particularly in rural areas, and if it applies to regular health care folks, could you address them both? 

Dr. PETZEL. Thank you, Senator Tester. 

The VA has got really very flexible possibilities when it comes to 

hiring and retaining people. First of all, for clinical psychologists, 

238 

psychiatric social workers, nurse practitioners in mental health, 

and psychiatrists, we have great flexibility in terms of the salary. 

Our salaries are very competitive almost anywhere around the 

country. 

Senator TESTER. Who has that flexibility? Is that locally with the 

State VA or is that with the VISN or is that with you? 

Dr. PETZEL. The flexibility lies with the individual facilities. 

Senator TESTER. OK. 

Dr. PETZEL. There are certain circumstances where they would 

have to come in, but it is unusual. They have great ranges of salaries that they can work with. 

Senator TESTER. Do you need any other tools for recruitment? 

Dr. PETZEL. I think that the thing that limits us a little bit is 

the fact that our debt forgiveness stops at $60,000. Particularly for 

medical students and residents, that may be a drop in the bucket, 

so to speak. I would like to see if we can raise the limit on which 

we can forgive debt. 

Senator TESTER. I would love to have a recommendation since 

you are in the business. I do not have any idea what a nurse practitioner with a mental health background would come out of college 

with as far as debt, but I would love to get some recommendations 

from you on where that $60,000 cap ought to be. 

Dr. PETZEL. We will talk. 

Senator TESTER. OK. The other I wanted—— 

Secretary SHINSEKI. Senator, I would just—— 

Senator TESTER. Yes, go ahead. 

Secretary SHINSEKI. Senator, I would just like to put a fine point on the last statement. Sixty thousand dollars is $60,000. It is not 

a drop in the bucket, but increasing it would give us flexibility we 

do not have today. 

Senator TESTER. I understand, General. And you are right, $60,000 is a lot of dough, but some of these folks are coming out 

college with maybe $200,000 of debt. I do not know how much. I 

just do not. 

So it would be good to—we will do some research on that end, 

too, so it is not all on your shoulders. 

The last thing that I have—well, I have got more but real quickly, if you might, and I am not going to play by the rules. 

What kind of impact does this have—I am talking about flexibility on salary. What kind of effect does that have on existing 

staff? 

I do not want to be the devil’s advocate here, but if you have got 

somebody on staff that is making—I will just pick a figure— 

$75,000 a year and you offer somebody new in $100,000, what kind 

of impact does that have on morale, and is it something you are 

cognizant of? 

Is there some way you can address existing staff that are doing 

a hell of a good job and that are already there? We do not want 

to take those folks for granted. 

Dr. PETZEL. The short answers to both questions is yes and yes. 

We are cognizant of the fact that, particularly with psychiatrists, 

that that could be a problem; and we have ways that we can address that with existing staff. 

Senator TESTER. Super. Thank you very much. 

239 

Chairman SANDERS. Thank you, Senator Tester. 

Senator Isakson. 

Senator ISAKSON. Thank you, Mr. Chairman. 

Secretary Shinseki, I want to follow up just a second on what 

Senator Johanns was talking about on leases. In the President’s 

budget, in the construction account, there is $6.4 million for the relocation of a CBOC in Cobb County—it is an old facility of 7,900 

square feet in Austell—to a newer facility in the northeastern part 

of that area. That is a huge area of metropolitan Atlanta that 

serves a lot of veterans that many times are forced to go to the veterans’ hospital in Decatur, GA, which puts more pressure on that 

facility. 

I just wanted to say thank you to the President and to you because I know your request had to have something to do with that. 

I hope that is a two-for. One, it is a better facility for the veterans, but two, I think it is a lot more efficient on cost than anything else we could do, especially with the current facility. So, 

thank you very much. 

Second, Under Secretary Hickey, I notice you had a Washington 

moment last week when the Washington Examiner got a hold of 

one of your emails, which I read. First of all, having had my emails 

gotten into before, I know how it feels when somebody does that. 

But they commented on an email you had sent to someone—doesn’t 

matter who it was—talking about assembling a bunch of big brains 

quickly to deal with the problem of timing in terms of claims 

approval. 

It was dated, I think, March 30, which was a couple weeks after 

the hearing we had here on claims, where you had indicated we 

were kind of on track on claims. Then this email goes out, looking 

for the best brains you can get to come in and help since you have 

got a real crisis. 

Can you kind of clarify that for me? 

Ms. HICKEY. Thank you, Senator Isakson. 

Secretary SHINSEKI. Senator, can I just start and let Secretary 

Hickey finish up? 

Senator ISAKSON. You are the boss. 

Secretary SHINSEKI. I would just say from the perspective of innovation, this has been something we have been doing for 3 

years—going out and getting the best minds to come in and help 

us, inside VA, outside VA, casting a broad net. In that first year 

we got 40 initiatives which we have taken aboard. Not all of them 

work, but we investigated all of them. The next year we did the 

same thing. 

So, I would just say this sort of fits our always looking for a better way to do what we are doing to address the needs of veterans, 

get it to them as fast as we can. I think Secretary Hickey was a 

part of that. 

And I would say in 2015, when we hit the target we have set for 

ourselves, we will still be looking for good ideas. 

So, with that, Secretary Hickey. 

Ms. HICKEY. Senator Isakson, the Secretary said it very well. We 

keep doing process improvement. In fact, it is now part of the culture and the governance in VBA. We actually have people whose 

job it is to create process improvement. 

240 

So this was nothing more than let’s keep thinking about this. 

Let’s keep getting more and more ideas on the table, and let’s keep 

charging hard with the plan we believe is going to get us there. 

But we were not even just looking at compensation claims. We 

were looking at our whole—I have six other business lines. We 

were looking at everything we do and how we can do more and better to increasingly serve our veterans, their family members, and 

their survivors. It was a course of action to keep going. 

Probably if you saw every other email in my box, you will see we 

have got an urgency in VBA, no matter what we are doing right 

now, to just do a much better job by our veterans, their family 

members, and their survivors. 

Senator ISAKSON. What you said was what I hoped the answer 

was to the question. Now I pose this to you—and I am speaking 

for myself now, though the Chairman and Ranking Member may 

disagree. We do not necessarily fall in the big brain category, I do 

not think, but I will speak for myself on that point. 

But, you know, it might be helpful to us, to call out to us to come 

down to see what your problems are, to look at them firsthand, just 

to get our eyes on them because sometimes we will ask questions 

about why something is taking so long to do or something is not 

happening, and you will give us the very best answer, I am sure, 

that you can give us at the time, and then the next meeting comes 

up, and we have the same tiny, little waltz. 

It just occurred to me when I read that email that it would be 

great to invite us down and say, ‘‘Look, this is where we are having 

trouble; have you guys got any ideas?’’ Because rather than us always being the critics in the peanut gallery, we can get down on 

the ground floor with you and see what those things really are. 

I think outreach is important, and I think it ought to be inclusive 

of all those who have a stake in the game. That was my reason for 

asking the question. 

Secretary SHINSEKI. Thanks, Senator. Great offer on your part, 

and we are happy to take you up on it. 

Senator ISAKSON. One last thing; a question for me. The Vet- erans Benefits Management System request is for $155 million in 

this year’s budget. Is that right? 

Secretary SHINSEKI. That is correct. 

Senator ISAKSON. And I think $32.8 million is for development of the system. What would the other $122 million be used for? Personal services or personnel or payroll or what? 

Mr. WARREN. Thank you, Senator, for that question. 

The balance is to pay for sustainment costs. So the systems that 

we have been bringing online for the past 2 years—you have to pay 

the bills, to pay the licensing on it, as well as the operations cost 

to continue the program going forward. 

Senator ISAKSON. When you say licensing, I guess you are talking about a site license for the use of the software. 

Mr. WARREN. It would be the software license, the hardware 

maintenance, and system maintenance as well. 

Senator ISAKSON. And that is an ongoing cost, correct? 

Mr. WARREN. Yes, it is, sir. 

Senator ISAKSON. OK. I just wanted to be sure. 

Thank you, Mr. Secretary. 

241 

Chairman SANDERS. Thank you, Senator Isakson. 

Senator Begich. 

Senator BEGICH. Thank you very much, Mr. Chairman. 

Again, Secretary Shinseki, thank you very much for being here. 

I know you have said it in your prepared comments and so forth, 

but let me just ask you to restate it. In regards to the disability 

claims, restate your goal on when you think you will have as much 

as you feel comfortable to have under control in the sense of the 

backlog. 

I know you have a target. Can you restate that for me, and then 

tell us what is your confidence level in that? That’s what I guess 

I want to ask you. 

Secretary SHINSEKI. Well, there are assumptions—— 

Senator BEGICH. It is a tricky question because whatever you say 

I am going to keep track of it. 

Secretary SHINSEKI. Well, I would like to provide a more specific 

answer to you, Senator, but again, this is based on our experience 

with the Post-9/11 GI Bill which, as you know, we started building 

in 2009. And by the spring of 2010 we had Version 1, and we have 

been building on it ever since. And Secretary Hickey described sort 

of this lift when it all kicked in. 

We are still in the process of fielding VBMS. We are 30 and soon 

to be 36 out of 56. So we are moving as fast as we can. 

We started in September in last year. We are barely 6 months 

into it, and we are looking at a fielding much earlier than December this year, which is the plan. I think once we are fielded, fully 

fielded, we are going to begin to see production impacts. 

We are also tied with DOD providing us electrons beginning in 

January 2014. 

Senator BEGICH. If I can interrupt you on that, how much faith 

do you have that DOD will actually perform what you need them 

to do—because I know that has been a struggle in the past. So do 

you believe they will meet the goals that you have for the information flow so it becomes more seamless and electronic, that DOD 

will do actually what they say? 

Secretary SHINSEKI. They have committed to date and time specific. We have the date and time here. 

Senator BEGICH. Let me here that. 

Ms. HICKEY. They have committed to give me immediately, point 

forward, full—— 

Senator BEGICH. So all new that are leaving from now forward, 

they are going to complete electronically. 

Ms. HICKEY. They are going to first give it to me in paper, which 

I would rather not have—— 

Senator BEGICH. Right. 

Ms. HICKEY [continuing]. But they are committed to building a 

system called HAIMS, the Health Artifact Information Management System. 

They are right now, today, giving me something we have never 

had in VBA before, which is they are going through and finding 

their medical records, going out and reaching out to TRICARE and 

pulling those medical records in, and they are pulling in their contract medical records. And they are doing the business on their end 

of pulling all that together, certifying it is 100 percent complete 

242 

and handing me, for the first time ever, a fully complete medical 

record. 

Senator BEGICH. So that will be a complete written record. Then 

when will they go to electronic? 

Ms. HICKEY. In December of this year. 

Senator BEGICH. Of this year? And that is of cases from that date 

forward? Then you have the backlog which is the longer challenge. 

Am I reading that right? 

Secretary SHINSEKI. That is correct. 

Senator BEGICH. OK. So now DOD is doing all the combining of 

the work, which is important because you have Guard and other 

folks all kind of in this mix now. That will come to you immediately. In December, the electronic efforts of anyone who then 

leaves after December 31 will be coming to you electronically. And 

then they will commit to move those others in which way? 

How will all the backlog information—— 

Ms. HICKEY. Essentially, the backlog information, I am handling 

by—— 

Senator BEGICH. It is all piled on you now. 

Ms. HICKEY [continuing]. Turning it to a scanning environment. 

Senator BEGICH. Your target for getting that moved into full implementation of electronic will be? 

Ms. HICKEY. I am doing it right now. I have 116,000 that are already in an electronic folder right now, today, since January 28 of 

this year. 

I am also committed to any new claim that comes in the door 

gets immediately scanned by one of our two vendors—they are 

doing a very good job—turned into an electronic claim and worked 

through the VBMS electronically. 

If you are a veteran who is not going to come back to us, then 

I will not expend the resources to turn you into an electronic claim. 

Senator BEGICH. Can I try to ask two more quick things? 

First off, I know you have your patient-centered care program. 

You have budgeted 250-some million dollars for that investment, 

which we think is great. It is part of the implementation of your 

Patient Aligned Care Teams—PAC Teams. 

I know your PAC Teams went up to Alaska and looked at a system that we use, called NUCA, which is our native tribal system, 

which is very similar to what that hopefully will do. Can you tell 

me about a connection—if there are resources in there to try to utilize the NUCA model within the VA? 

I do not know who would like to answer that. 

Secretary SHINSEKI. Dr. Petzel. 

Dr. PETZEL. Thank you, Mr. Secretary. 

Senator Begich, we are very much enamored of the NUCA model. 

It is very similar to what we want to do in terms of patient-centered care, proactive, personalized health care, but it is doing some 

things that we, frankly, had not thought about. We have sent four 

teams up there so far, for educational experience with them, and 

we plan on continuing that effort. 

I am going to be meeting with Kathleen Gottlieb—— 

Senator BEGICH. Excellent. 

Dr. PETZEL [continuing]. The CEO of NUCA. 

Senator BEGICH. You see a value in that program? 

243 

Dr. PETZEL. Absolutely. We can learn from them. 

Senator BEGICH. OK. The last question is, you had $52 million, 

I think, in your budget for reimbursement to Indian Health Services for some of the new programs which you are doing now on reservations as well as within the Alaska rural component. Is that 

enough, or do you have a sense on that at this point? 

Again, I want to thank you for reaching out for first people in 

this country, especially Alaska Native and American Indians, and 

trying to do something very different with health care systems that 

exist already. 

Is that enough reimbursement or is it hard to say? Give me a 

sense. 

Secretary SHINSEKI. I think at this moment we are just standing 

up the agreements and beginning to activate them. I think that is 

a good start point. 

Let me ask Dr. Petzel and see if he has any more details. 

Dr. PETZEL. No more details, but I would agree with the Secretary. We think that this is enough. There are 10 pilots that are 

being developed to get the business rules fixed for this environment, and we think that this $52 million will be sufficient in 2014, 

yes. 

Senator BEGICH. Very good. I will end there. I have some other 

questions for the record. 

Mr. Chairman, that last question I asked was something that I 

know you and I have talked about—of how to maximize this delivery to veterans in very tough locations, rural locations. So we will 

see more on that. 

I really do thank VA for that effort. 

Chairman SANDERS. Senator Blumenthal. 

STATEMENT OF HON. RICHARD BLUMENTHAL, 

U.S. SENATOR FROM CONNECTICUT 

Senator BLUMENTHAL. Thank you, Mr. Chairman, and I apologize 

for being late, but I have been following some of the testimony. 

I want to thank you all for your service and, Mr. Secretary, particularly for your active duty service to our Nation and now in the 

Department of Veterans Affairs; and I thank the President for increasing the resources available to our veterans in a very difficult 

time, fiscally. 

Let me begin with Senator Begich’s area of inquiry relating to 

the electronic health records. I understood that you described what 

was going to happen, Ms. Hickey, but I am not sure that I heard 

what the target date was. Senator Begich asked for a target date 

for completing the program. 

Secretary SHINSEKI. We are talking about claims here? Completing the claims? 

Senator BLUMENTHAL. The electronic medical records system. 

Ms. HICKEY. I think we are talking two different issues. There 

is the electronic health record, and there is this other effort I am 

doing with the fully complete certified—— 

Senator BLUMENTHAL. Well, maybe you are not the right one to 

ask. 

The electronic health record system—— 

Secretary SHINSEKI. Yes. 

244 

Senator BLUMENTHAL [continuing]. Is still going forward? 

Secretary SHINSEKI. As far as VA is concerned, we are committed 

to it, and we await the Department of Defense’s signaling to us 

that we have agreement here, but I believe we are on track. Secretary Hagel has asked for the opportunity to get into and review 

his structure and process, and that is what he is doing right now. 

Senator BLUMENTHAL. So you have no assurance right now from 

the Department of Defense as to when or whether it will go 

forward? 

Secretary SHINSEKI. I do not have when, other than both secretaries are pushing very hard on this. 

Senator BLUMENTHAL. Both you and Secretary Hagel have indicated that you are agreed to go forward but no other details? 

Secretary SHINSEKI. For VA, it is we have chosen VistA as our 

core. We are committed to a 2014 initial operating capability of this 

integrated electronic health record in two locations that we have 

specified and then to follow on, full operating capability in 2017. 

That’s the plan, and that is what both departments have agreed to. 

Senator BLUMENTHAL. So the departments have agreed to that 

plan and have both committed to VistA? 

Secretary SHINSEKI. DOD is looking and reviewing what their decision on a core is going to be. We have selected VistA and offered 

VistA for their consideration, so Secretary Hagel and his acquisition folks at DOD are reviewing VistA at this time. 

Senator BLUMENTHAL. Forgive me for revealing my limited IT 

knowledge, but how would the system work if you are committed 

to VistA and they are not; in other words, if they go to a different 

system? 

Secretary SHINSEKI. Well, we today have two different electronic 

records, health records. What we have committed to is solving that 

problem, that challenge, by coming up with a single, joint, common, 

integrated, electronic health record. And all of those terms are code 

words to get us on the same sheet of music. 

Senator BLUMENTHAL. I apologize again for belaboring a point 

that may be obvious to everyone else in the room, but it strikes me 

from what you are saying that the details have not yet been resolved. Is that fair to say? 

Secretary SHINSEKI. We await a decision by DOD on their selection of a core. 

We have offered consideration of VistA, which is governmentowned, government-operated. We have also put VistA into the open 

architecture, so anyone else can use the code that goes with VistA 

and will not have to pay for it. 

Senator BLUMENTHAL. Thank you. 

To shift subjects here, unemployment among veterans is one of 

my major and paramount concerns. I wonder if you could tell us 

about new initiatives that you are contemplating to address unemployment among veterans. 

Secretary SHINSEKI. Yes. Well, Senator, we have taken the leadership of the White House in this as well. Joining forces has been 

a magnificent initiative—reaching out to the private sector for corporations to commit to hiring veterans as a part of their campaign 

to help us reduce the unemployment numbers for veterans, especially our youngest veterans. The request of the private sector was 

245 

100,000 new jobs for veterans or military spouses before the end 

of 2013. That goal was exceeded in late 2012, as I understand, and 

there are more commitments now to increase to something in the 

neighborhood of 250,000. So the commitment is there. 

I would also say that across government, we in the departments, 

we hire veterans. We have hired—we have over 100,000 veterans 

as part of our workforce, fully 30 percent, and our goal is 40 

percent. 

We have also held hiring fairs for veterans interested in employment. We have held three of them. It is not something we have expertise in, but we have learned with each of these how to bring together veterans looking for work and the employers with the jobs. 

We also encourage veterans who own small businesses to stand 

up. Our experience is a veteran business owner is more willing to 

hire veterans. So, the more successful small business owners we 

have, which is where the hiring really goes on, the more churn we 

have in the job market. 

Senator BLUMENTHAL. And are there additional resources in your 

project for those types of efforts? 

Secretary SHINSEKI. We have resourced at least our hiring fairs, 

and as part of our hiring campaign for veterans, we continue to increase that within our allocations—budget and FTE allocations. 

Senator BLUMENTHAL. Thank you. 

And if I could get from you at some point—I do not know that 

you have them here today—the latest numbers on employment 

among veterans in different age groups and so forth, any of the demographics that you have, I would appreciate it. 

Secretary SHINSEKI. We can do that. 

Senator BLUMENTHAL. Thank you. 

Secretary SHINSEKI. The numbers are generally improving. We 

have month-to-month variations, but over time the unemployment 

rate for veterans overall has been below the national average for 

unemployment. 

For younger veterans, this is still a challenge for us, and we have 

to do more. All of us have to do more to take this on. 

Senator BLUMENTHAL. Thank you. 

Thank you all—all the members of the panel—for your service to 

our country and thank you for your testimony. 

Chairman SANDERS. Senator Moran. 

STATEMENT OF HON. JERRY MORAN, 

U.S. SENATOR FROM KANSAS 

Senator MORAN. Mr. Chairman, thank you. 

Mr. Secretary, thank you very much. 

To follow on what Senator Blumenthal was talking about—jobs 

for veterans—one of the aspects that we have focused on is entrepreneurship and startup businesses. In this Committee on Thursday, we will have a roundtable discussion in regard to the VA, to 

veterans’ opportunities to support entrepreneurship and startup 

businesses as a method of earning a living and providing for 

families. 

So I appreciate that that is occurring, Mr. Chairman. Thank you 

very much. 

246 

Mr. Secretary, when we last visited, which I think was in January, I, as usual, highlighted the shortage of professional health care 

providers within the VA system, especially at least what I am most 

familiar with is in Kansas. We talked about CBOCs. 

Kansas is a very rural State—long distances to travel to the VA 

hospital. We have been successful with the VA’s help in opening 

CBOCs, but we have a tremendous shortage of physicians, nurse 

practitioners, and physician assistants. And most of our CBOCs no 

longer have a physician. 

And my understanding is that has not changed since we visited 

in January. So I want to highlight that problem once again. 

I also raise the topic of mental health professionals. The VA’s 

plan in April was to hire 1,600 new clinical mental health staff, including marriage and family therapists and licensed professional 

counselors. And my understanding is—and maybe you have included this in your testimony—that a significant number of that 

1,600, a little over 1,000, have been hired. 

But the numbers in Kansas are surprising, or discouraging, to 

me. And Kansas, again because of our rural nature, that is not an 

atypical way of providing mental health services, either utilizing 

MFTs or LPCs. From August 2011 to August 2012, there were no 

MFTs and no LPCs hired at any Kansas facility. 

On USAJobs.gov, VA has posted zero positions in Kansas for either one of those professions, for either one of those professional 

licenses. 

VISN 15, as a whole, in Kansas City, MO, had two MFTs and 

zero LPCs on staff. 

St. Louis had two LPCs and zero MFTs. 

These two groups represent 40 percent of the mental health professionals in the United States but only 1 percent of the VA workforce. I would be interested in your response and your suggestions 

of how we can provide mental health services to more Kansas 

veterans. 

Secretary SHINSEKI. Let me call on Dr. Petzel. 

Senator MORAN. Thank you. 

Dr. PETZEL. Thank you, Senator Moran. 

The MFTs and family counselors are new positions, relatively 

new positions to the VA. Less than 2 years ago we certified them 

and got them into the mix of people that we can hire. And we are 

behind the power curve in terms of hiring these people. 

I do not know specifically the numbers about Kansas. I will go 

back and find out and get back to you. 

[The information requested was received in July 2014 by Senator 

Moran’s office and is not being reproduced here.] 

And you make an excellent point; hiring these people who are 

recruitable in rural areas, I think, is a very good alternative to the 

difficulty that we have in hiring psychologists and psychiatrists in 

those areas. So, I will be in communication with you about Kansas 

specifically and what we might be able to do. 

Senator MORAN. I appreciate that and look forward to your response. 

It reminds me of the effort when I was the sponsor of legislation 

in the House, now years ago, to incorporate chiropractic care within 

247 

the VA. Can you, Secretary Petzel, bring me up to date on chiropractic services within the VA? 

Dr. PETZEL. I would like to take that for the record if you do not 

mind. 

We do employ them at virtually every one of our medical centers 

and a substantial amount of referral business outside. 

[The information requested during the hearing follows:] 

FROM THE PREPARED STATEMENT OF ROBERT L. JESSE, M.D., PH.D., PRINCIPAL DEP- UTY UNDER SECRETARY FOR HEALTH, U.S. DEPARTMENT OF VETERANS AFFAIRS AT

THE MAY 9, 2013, HEARING ON PENDING HEALTH CARE LEGISLATION

* * * * * * * 

S. 422, CHIROPRACTIC CARE AVAILABLE TO ALL VETERANS ACT OF 2013

S. 422 would require VA to establish programs for the provision of chiropractic 

care and services at not fewer than 75 medical centers by not later than December 31, 2014, and at all VAMCs by not later than December 31, 2016. Currently, VA 

is required (by statute) to have at least one site for such program in each VHA geographic services area. 

Section 3(a) would amend the statutory definition of ‘‘medical services’’ in section 

1701 of chapter 17, U.S.C., to include chiropractic services. Subsection (b) would 

amend the statutory definition of ‘‘rehabilitative services’’ in that same section to 

include chiropractic services. Finally, subsection (c) would amend the statutory definition of ‘‘preventive health services’’ in that same section to include periodic and 

preventive chiropractic examinations and services. 

The bill would also make technical amendments needed to effect these substantive 

amendments. 

In general, VA supports the intent of S. 422, but believes the decision to provide 

on-site or fee care should be determined based on existing clinical demands and 

business needs. Chiropractic care is available to all Veterans and is already part of 

the standard benefits package. 

As VA increases the number of VA sites providing on-site chiropractic care, we 

will be able to incrementally assess demand for chiropractic services and usage, and 

to best determine the need to add chiropractic care at more sites. 

Currently, VA does not have an assessment that would support providing on-site 

chiropractic care at all VAMCs by the end of 2016. Such a mandate could potentially 

be excessive, given the availability of resources for on-site chiropractors and nonVA care to meet the current need for services. VA does not object to sections 3(a) 

and (b) as those changes reflect VA’s consideration of chiropractic care as properly 

part of what should be considered medical and rehabilitative services. VA, however, 

cannot support section 3(c) for lack of a conclusive consensus on the use of chiropractic care as a preventative intervention. 

Senator MORAN. It remains a priority for me. Again, the rural 

nature of Kansas chiropractic care is a significant way that health 

care services are delivered, and it may be the same pattern. 

The VA, in my view, was very slow. This is before either one of 

your time, but very slow in incorporating the mandate, the requirement that the VA provide for chiropractic care within the VA 

system. 

Let me raise one more topic before my time expires. I asked this 

question last January and I have not received a reply. It is apparently not in the fiscal year 2014 budget. 

There has been considerable planning for a joint VA/DOD medical facility at McConnell Air Force Base and not in the budget, 

and I asked for a status update last January about McConnell and 

the Dole VA in Wichita. And perhaps, again for the record—or if 

you have the information today, I would be pleased to know—what, 

if any, progress is being made? 

Secretary SHINSEKI. Dr. Petzel. 

Dr. PETZEL. Thank you, Senator Moran. 

248 

There is a proposal that has been developed for a major construction project that would be a joint venture with, as you point out, 

McConnell Medical Center. It is $154 million. It was submitted. It 

was in the mix of those projects that were rated in the SCIP process, which rates the construction projects. It did not score high 

enough to be funded in 2014. 

Senator MORAN. And that scoring takes place at the VA or within the Administration? Where is that scoring done? 

Dr. PETZEL. The scoring is done by the Department of Veterans 

Affairs. 

Senator MORAN. OK. And what does that mean then for the future of this project? 

Dr. PETZEL. Well, the expectation would be that this project will 

be submitted again and will be scored again. 

Senator MORAN. I would like to follow up with you and see if I 

can find out where perhaps the need for greater information or any 

deficiencies that we ought to be addressing in regard to this 

project. 

Dr. PETZEL. Certainly. 

Senator MORAN. Thank you. 

Secretary SHINSEKI. What usually happens on the Strategic Capital Investment Plan—this rank ordering, this prioritizing—is the 

ones that are funded get worked off, and then there is a review, 

and then others move up in subsequent cycles. 

Senator MORAN. We would like to work with you to see that it 

moves up as quickly as possible. 

Thank you, Mr. Secretary. 

Thank you. 

Chairman SANDERS. Thank you, Senator Moran. 

Senator Hirono. 

STATEMENT OF HON. MAZIE HIRONO, 

U.S. SENATOR FROM HAWAII 

Senator HIRONO. Thank you, Mr. Chairman. 

Secretary Shinseki, of course, I join my colleagues in thanking 

you and the rest of the panel for your service. 

I do apologize for missing some of the hearing, but I did have a 

chance to talk with you earlier, General Shinseki. So I appreciate 

that. 

I want to focus on women veterans’ health. In your testimony, 

you noted that nearly 50 percent of VA facilities do have comprehensive women’s clinics and that you have asked for more 

money for an increase in the budget for gender-specific medical 

care for women veterans. 

So is it your intention and goal that 100 percent of VA facilities 

will have these kinds of comprehensive care for our women 

veterans? 

Secretary SHINSEKI. I am going to call on Dr. Petzel for the 

specifics. 

But, Senator, I would just say today I believe women are maybe 

6 percent of our veteran enrolled population, and we know in the 

active force they represent 15 percent of the population; in the reserve components, maybe 17 percent. So we know growth is going 

to occur, and we are doing everything we can to put in place the 

249 

decisions that when they arrive we are not playing catch-up as has 

been previous experience of mine. 

So, if we were to look at women veterans’ funding since 2009, between 2009 and 2014, we have increased that by 134 percent, and 

we will continue to put emphasis on this as one of our key areas. 

Dr. Petzel. 

Dr. PETZEL. Thank you, Mr. Secretary. 

Senator, the specific question you asked about women’s comprehensive clinics—there are three ways that we try to provide the 

primary basic care that women veterans might need. 

In our large medical centers, where we have large numbers of 

women, we have comprehensive clinics that bring together not only 

primary care providers but obstetricians, gynecologists, mental 

health professionals, endocrinologists, all in the same clinic—the 

same clinic area. 

Senator HIRONO. Yes. 

Dr. PETZEL. In places that are smaller, where we do not have— 

may not even have—all of that specialty expertise, we have primary care clinics that are devoted exclusively to women’s issues 

and to women veterans. Those practitioners are trained to recognize and take care of the primary care needs of women veterans. 

And then in very small areas, where we might have a CBOC 

with only one or two providers, we train those primary care providers in the needs of women. 

I think there will be some increase in the number of comprehensive clinics, but I think most of the medical centers that have a 

large enough population to do that probably have already done 

that. 

I do want to point out that we have an obligation here to provide 

the kind of an atmosphere where women feel safe and feel as if the 

providers understand their specific needs, which are different than 

our male patients. And I think the VA has worked hard over the 

last 10 years to try to accomplish that. We still have work to do. 

Senator HIRONO. Thank you. 

I think that that is really important, and I commend you for the 

steps you are taking to recognize that this is a different population 

of veterans than perhaps—so do you do outreach efforts to make 

sure that they are aware of the services and the kind of services 

that are available to women veterans? 

Dr. PETZEL. Yes, we do. Under the direction of Dr. Patricia 

Hayes, who runs our women’s program, we have an extensive outreach program including help lines, public service announcements 

and advertisements, first of all, trying to make women understand 

they are veterans. In many instances, they do not necessarily view 

themselves as being veterans, and then on top of that they do not 

necessarily see the VA as a friendly place for them to get health 

care. 

So we work hard to try to bring that message to them. 

Senator HIRONO. Thank you. 

Secretary Shinseki, I know that one of your major priorities is to 

address the needs of homeless veterans, and that is a challenge. So, 

are there particular programs or things that you are doing that 

work with this population? 

250 

I realize that it is not a monolithic group of folks. But any particular successes, programmatic successes, that can be ramped up? 

Secretary SHINSEKI. We committed to ending the rescue phase of 

veterans’ homelessness in 2015. What that means is when you hear 

the word homeless you think of people on the street. That is a visible—it is an estimate, but that is a visible population. 

There is a larger invisible population of homeless veterans at 

risk—one paycheck, one more missed utility payment, away from 

being a foreclosure. 

So, while we are committed to ending the rescue phase, which is 

get out and find our veterans and ensure that we are moving them 

to treatment and safe housing—and to do that we have partnered 

with many of the experts in communities across the country, provided funding for supportive services to veterans’ families, shelter 

grant per diem support where at the same time we are doing yeoman work on the prevention piece. 

GI Bill, the most generous education program we have—any 

youngster who does not complete schooling is at risk. 

Last year, we had 70,000 veterans who had defaulted on their 

home loans and at risk of foreclosure. Our analysts became involved, worked with them to lower payments and extend their payment periods with financial institutions. Those 70,000 were kept in 

their homes and precluded from foreclosure. 

Part of the homeless issue is mental health and substance abuse. 

In our Veterans Health Administration—very large and aggressive 

programs to deal with depression, substance abuse and other issues 

of mental health. We want to get veterans in early and get them 

into treatment. Our experience is when we diagnose and treat, people generally get better. 

You know, this is a broad effort. 

Senator HIRONO. That makes a lot of sense. Perhaps you can give 

us some data on how these prevention programs are working and 

the number of people you talk to or work with and what the outcomes are. 

Secretary SHINSEKI. Dr. Petzel. 

Senator HIRONO. Thank you. 

You can send me the information or send the Committee the 

information. 

Secretary SHINSEKI. All right. 

Senator HIRONO. Thank you, Mr. Chairman. 

Chairman SANDERS. We have gone through the first round. I 

would like to ask a few more questions if we can keep it brief. 

Senator Burr, do you want to—all right. So, if it is OK with you, 

we will just ask a few more questions, and then we will get out of 

here. 

I wanted to pick up on a question that Senator Moran asked. He 

was concerned about chiropractic care. I am concerned more generally about complementary medicine, and I think people would be 

surprised to know that the VA has been a leader in that area, in 

this country. 

Recently I was at the VA facility in Brooklyn and the VA facility 

in Los Angeles, and the directors there told me that at both facilities complementary medicine is widely used and appreciated by 

veterans. 

251 

I want to work with you to expand those concepts, to be more aggressive, because I think you have a lot of folks out there who are 

concerned about overmedication, the ways that we can deal with 

pain without a lot of drugs, et cetera. 

Can you tell us, Dr. Petzel, briefly, what ideas you have as to 

how we can expand complementary medicine? And I am talking 

about acupuncture, guided imagery, meditation, chiropractic care, 

yoga, et cetera. 

Dr. PETZEL. Thank you, Mr. Chairman. 

I just wanted to point out that 89 percent of our facilities, 125 

of them, actively have CAM programs. 

Chairman SANDERS. That may be true, and correct me if I am 

wrong. If somebody is a well trained, qualified acupuncturist, for 

example—that person as an acupuncturist as opposed to, say, being 

an M.D. who practices acupuncture—that acupuncturist, himself or 

herself, could not be hired under that definition. That is my understanding. Is that correct? 

Dr. PETZEL. I will have to find out, Mr. Chairman. I am not 

aware that that is the case. 

Chairman SANDERS. That is my understanding. 

Dr. PETZEL. I know that the places that I am familiar with that 

do acupuncture happen to have anesthesiologists who are acupuncturists and do acupuncture. 

We, as you mentioned, do a number of different things—yoga, 

hypnosis, acupuncture, animal-assisted therapy, biofeedback, stress 

management, relaxation therapy and meditation. 

Chairman SANDERS. Let me interrupt you. I am aware of that, 

and I think you guys should be very proud of that. 

My question is that while you are sitting here supporting those 

initiatives, there is also an argument that it has not quite filtered 

down with as much excitement and appreciation as it might. Is 

that a fair statement? 

Dr. PETZEL. I think that is a fair statement, Mr. Chairman. 

And I think that one of the crucial parts of helping that to filter 

down is something that we are also engaged in, and that is research to demonstrate the efficacy in specific circumstances of certain alternative medicine therapies. Meditation would be an example. We are spending $5 million 

this year looking at meditation and its role in treating PTSD—3 

pilot projects and 4 research projects to, indeed, look at the 3 different kinds of meditation and how they work. 

And I think we need to do, quite frankly, more of that to demonstrate to the treating public—to the treating physicians that, indeed, these things are effective and do work. 

Chairman SANDERS. I believe you are also looking at guided imagery in terms of sexual assaults and so forth. 

Dr. PETZEL. Yes. 

Chairman SANDERS. Sexual trauma. 

Dr. PETZEL. That is also correct. 

Chairman SANDERS. OK, Senator Burr. 

Senator BURR. Secretary, you said earlier that we will move out 

of the rescue phase on homelessness. Would that be the reason that 

there is a reduction between 2014’s and 2015’s budget for homelessness? We have got a drop from $1.2 billion to $857 million. 

252 

Secretary SHINSEKI. I believe that adjustment is based on the 

fact that we think we will be making good progress toward our 

2015 targets, and so the adjustment is in the level of energy here. 

Senator BURR. OK. A letter from the VA dated February 2012 included the timeline of VA’s homelessness reduction strategy, 2009 

to 2015. This timeline included decisions regarding increasing or 

decreasing budget requests, reallocating funding, and a decision as 

to whether to extend the timeline. Have any of those decisions been 

made to date? 

Secretary SHINSEKI. To extend the timeline? 

Senator BURR. Increasing or decreasing budget requests, reallocating funding, and a decision as to whether to extend the timeline. 

Secretary SHINSEKI. I am sure there may have been some discussions, but I have not participated in extending the timeline. Twenty fifteen remains our target. 

Senator BURR. OK. Mr. Warren, according to the fiscal year 2014 

Budget Fast Facts information sheet, VA has allocated $344 million for the integrated electronic medical records system. In addition, the Office of Information and Technology’s budget requests 

$252 million for the development, modernization, and enhancement 

of iEHR and VLER. Does the $344 million include the $252 million 

for the development of iEHR and VLER, or is the $252 million additional funding for those two? 

Mr. WARREN. Thank you for the question, Senator Burr. 

The 344 includes the 250 for development. 

Senator BURR. Two fifty-two, OK. 

The Project Management Accountability System, or PMAS, creates and monitors milestones for IT projects to reduce risk associated with the development of large IT systems. How many milestones have iEHR and VLER missed? 

Mr. WARREN. Let me take that for the record instead of flipping 

through the spreadsheet, which was delivered to your staff today, 

sir. We will get back to you. 

Senator BURR. I appreciate that. 

RESPONSE TO REQUEST ARISING DURING THE HEARING BY HON. RICHARD BURR TO

STEPHEN W. WARREN, ACTING ASSISTANT SECRETARY FOR THE OFFICE OF INFORMATION AND TECHNOLOGY, U.S. DEPARTMENT OF VETERANS AFFAIRS

Response. As a follow up to our prior correspondence to Senators Burr and Murray on September 12, 2102, VA provides the following update to its scheduling procurement efforts: 

VA will procure a scheduling solution in two phases. In the first phase, currently 

ongoing, VA is running a risk-reduction contest under the America Competes Act 

calling for scheduling application submissions. The purpose of this contest will be 

to reduce procurement and deployment risk. VA will offer up to three prizes for 

scheduling packages that demonstrate their compatibility with the Open Source 

version of VA’s electronic health record, VistA. Contest submissions are due in June, 

and VA is scheduled to announce winners in September. 

The second phase will include the actual procurement of a scheduling solution. As 

this risk-reduction activity proceeds, VA will continue working with the Department 

of Defense and the Interagency Program Office to determine joint requirements and 

a master development and acquisition plan. The master development and acquisition plan will be based upon an evaluation of contestant responses for proposed 

functionality and compliance with iEHR architecture. 

Office of Information and Technology 

May 2013 

253 

Senator BURR. Mr. Warren, according to the fiscal year 2014 

Budget Fast Facts information sheet, again, the Department of 

Veterans Affairs has allocated $155 million for the total development and implementation of the Veterans Benefits Management 

System. I am getting to a question that Senator Isakson talked to 

you about. The President’s request includes roughly $33 million for the de- velopment of VBMS, a $71 million decrease. 

I think you answered that, if I remember correctly. If you did 

not, I will allow you to do it, but I also want a clarification. Did 

you tell the Committee that it was going to cost $122 million a year 

to sustain that program, in fees? 

Mr. WARREN. No. The question was, of the amount stated, is it 

all development or did it include sustainment? It does include 

sustainment. 

Senator BURR. What is the estimated sustainment cost? 

Mr. WARREN. For which year, Senator, please? 

Senator BURR. On an ongoing basis. 

Mr. WARREN. One of the challenges we have, Senator Burr, is if 

you look at the elimination of the backlog and you think in terms 

of the ingest or the input of information, moving from paper to 

electrons, the engine—in terms of how do we make the decision 

about what the benefit is and then the payment process that comes 

out the end—so there is a multitude of systems out there. 

When you ask the question, based upon where you draw the 

boundaries, the dollars either go up or down. So, when we talk 

about the 155, it picks up $32 million to pay for the development 

of the engine, also portions of the payment piece once a decision 

is made through to the check. 

If I add all of the pieces up—so the multiple entries in the budget that cover not just the engine, which is the VBMS system, but 

includes all of the ingests in terms of e-benefits that portal that we 

use to bring the information in, that the veteran uses for self-service; the SEP or the VSOs are able to assist the veteran and do that 

work; the unified desktop or our call centers are able to give a complete view of the status as well as the output. The sum total is $275 million in fiscal year 2014, which is VBMS 

and VRM. So it is a large investment to make sure that not only 

the engine is working, once we get the electrons, but to pay for that 

change from paper to electrons. 

Senator BURR. Are we going to have to pay for any more of the 

engine after 2014? 

Mr. WARREN. The program—— 

Senator BURR. Or is the engine complete? 

Mr. WARREN. The program plan today, as we turn the automation on, as we look at what the rules engines are and we get the 

same pick-up, the kick that we are able to get from chapter 33, it 

is possible that we are going to see more areas where we can 

automate. 

It is also subject to any change in laws passed as well as any 

court rulings in terms of needing to add automation for our partners in the benefits administration. 

Secretary SHINSEKI. Senator, I think we will continue to improve 

VBMS as we go forward where those opportunities show themVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00257 Fmt 6633 Sfmt 6601 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
254 

selves. I do not think that the VBMS we field by 2014 is the end 

state. 

Senator BURR. I appreciate that, Mr. Secretary, and I encourage 

it. I do not want to bog us down, staying here any longer. 

But let me suggest, Mr. Warren, maybe you need to come up and 

meet with some of us on the Committee. We would like to know, 

of its original design, when will this program be paid for? When 

will we be fully invested? 

Hopefully, that coincides with some period before 2015 since in 

2015 it is our answer to backlog. There is not a plan B. This is plan 

A, B, C, D, E, and F. 

Mr. WARREN. Glad to come up, Senator. 

Senator BURR. But, more importantly, I think we need to understand better, what is our long-term annual commitment to a program of this magnitude? 

I realize that there are parameters that might change that— 

court rulings, benefits, scope of benefits, that type of thing. But I 

think we need to better understand it, if, in fact, we provide fair 

but effective oversight to an IT program of this size. 

Mr. Chairman, you have been awfully generous. 

I know Under Secretary Muro is dying for me to ask him a question, but I am going to forego that today. 

[Laughter.] 

Chairman SANDERS. I am sure he is deeply disappointed. 

Senator BURR. He is always neglected in these hearings, and I 

have asked him not to take it personally. I will follow up with some 

audit questions in writing, if I may. 

Mr. MURO. Thank you. 

Senator BURR. Mr. Secretary, thank you and thank you to your 

entire team. 

Chairman SANDERS. OK. Secretary Shinseki, thank you for being 

here and thank you for your staff being here. 

This hearing is now concluded. 

[Whereupon, at approximately 4:33 p.m., the hearing was 

adjourned.] 

(255) 

A P P E N D I X 

PREPARED STATEMENT OF JEFFREY C. HALL, ASSISTANT NATIONAL LEGISLATIVE

DIRECTOR, DISABLED AMERICAN VETERANS

Chairman Sanders, Ranking Member Burr and Members of the Committee: On 

behalf of the DAV (Disabled American Veterans) and our 1.2 million members, all 

of whom are wartime disabled veterans, I am pleased to be here today to present 

recommendations of The Independent Budget (IB) for the fiscal year (FY) 2014 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. 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 

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. 

Today there are about 900,000 claims for compensation and pension awaiting decisions at VBA, more than double the number pending four years ago. Of those, fully 

70 percent have been waiting more than 125 days, VBA’s official target for measuring the backlog, which is double the number from just two years earlier. Moreover, the length of time it takes to process veterans’ claims also continues to rise, 

with the average processing time now almost 280 days, far from VBA’s target of 80 

days. Looking at these numbers, it is clear that the challenges facing VBA are enormous, and in many ways they are the same core problems that have plagued VBA 

for decades. The solution will require new technologies and business processes, and 

most importantly, a cultural transformation built upon the foundations of quality, 

accuracy and accountability. 

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. 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 2014 budget for VBA includes additional funding for scanning and conversion of existing paper claims files that is absolutely critical for VBA to complete their transformation from an outdated, paper-based claims 

system to a modern, paperless, automated claims system. 

256 

Mr. Chairman, one of the most important signs of positive change over the past 

four years has been VBA’s unprecedented openness and partnership with VSOs. 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 

IBVSOs have also been increasingly 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 consistently reached out to consult and collaborate with VSOs 

and we are confident that this partnership 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 new Veterans Benefits 

Management System (VBMS), its new IT system. VBMS has been rolled out to 20 

Regional Offices and is scheduled to be fully deployed to all remaining Regional Offices (ROs) by mid-year. 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 

claims files. At present, there are an estimated 200,000 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 longstanding 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, particuVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00260 Fmt 6601 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
257 

larly 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. 

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

Over the past five years, the 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 fiscal year (FY) 

2013, VBA’s budget supports an additional 450 FTEE above the FY 2012 authorized 

level, and the FY 2014 level adds less than 100 new FTEE. 

Compensation Service Staffing 

Since VBA is in the middle of a comprehensive transformation that makes 

changes in the roles and responsibilities of its employees, it is difficult to determine 

whether Compensation Service’s staffing levels are sufficient now or will be in the 

near future. Without knowing the outcome of the transformation, it is difficult to 

estimate whether they will require additional or even fewer personnel to address the 

future workload they will need to process. For this reason, the IB does not recommend a specific staffing increase for FY 2014, although it is important that Congress and VBA be certain that staffing levels are regularly adjusted to remain 

aligned with changes in workload and productivity. 

258 

In this regard, it is imperative that VBA and Congress continue to closely monitor 

Compensation Service’s actual and projected workload, measurable and documented 

increases in productivity resulting from the new organizational model and the 

VBMS, as well as personnel changes, such as attrition, in order to ensure that staffing is sufficient. Furthermore, VBA must develop a better, more consistent and 

data-driven method of determining future staffing requirements to more accurately 

inform future funding requirements. 

Board of Veterans’ Appeals Staffing 

Based on historical trends, the number of new appeals to the Board averages approximately 5 percent of all claims received, so as the number of claims processed 

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 proposed FY 

2014 budget actually cuts funding for the Board and further reduces staffing down 

to just 492 FTEE, despite expected workload increases each year. Even adjusting 

for projected productivity gains, the IBVSOs believe that the Board should have at 

least 544 FTEE in FY 2014 in order to reduce its backlog. 

Vocational Rehabilitation and 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 estimates that 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. VA is expected to increase its VetSuccess on Campus program from 34 colleges in FY 2012 to 84 colleges in FY 2013 and Congress must ensure that sufficient 

funding is provided in the FY 2014 budget for this program. 

RECOMMENDATIONS FOR IMPROVEMENTS TO VA BENEFITS

Automatic 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 increasing 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 IB veterans service organizations 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 eventually made it permanent. 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. 

259 

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 service-connected 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 disability 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 Dependency and Indemnity Compensation. 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 

260 

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 

exists. 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 

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. 

261 

PREPARED STATEMENT OF TOM TARANTINO, CHIEF POLICY OFFICER, IRAQ AND

AFGHANISTAN VETERANS OF AMERICA

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

Committee: Iraq and Afghanistan Veterans of America (IAVA) would like to thank 

you for holding this hearing today on the critical priority of properly funding the 

Department of Veterans Affairs (VA). We also appreciate your continued dedication 

to improving the functioning and capabilities of the VA, and to improving the lives 

of America’s veterans. 

IAVA is the Nation’s first and largest nonprofit, nonpartisan organization for veterans of the wars in Iraq and Afghanistan and their supporters. Founded in 2004, 

our mission is simple—to improve the lives of Iraq and Afghanistan veterans and 

their families. With a steadily growing base of over 200,000 members and supporters, we strive to help create a society that honors and supports veterans of all 

generations. 

IAVA is acutely aware of our Nation’s current fiscal situation. However, I think 

we are all in agreement that the VA should continue to be fully funded so as to 

enable the department to adequately care for and support those who have faithfully 

shouldered the burden of our Nation’s defense. Our funding of the VA’s budgetary 

requirements, including its discretionary accounts, is not generosity, it is not charity, and it is not a handout. It is part of a sacred obligation we as a society have 

to care for our Nation’s veterans. It is part of an implicit social contract we entered 

into when we accepted each and every one of them into the ranks of our military— 

to provide for their needs should they leave the service less whole than they were 

when they entered. 

In light of this overarching philosophy we espouse in caring for our Nation’s veterans, IAVA is pleased to see just over a 10% increase in the President’s VA budget 

request above the previous fiscal year’s funding levels, including both mandatory 

and discretionary accounts. IAVA is especially thankful to see a nearly 14% increase 

in funding for programs and initiatives that Iraq and Afghanistan veterans need to 

help them deal with the repercussions of more than a decade of war and to help 

them successfully transition back into civilian life. These programs, which span 

issues as diverse as access to mental health care and suicide prevention to job training and employment assistance, continue to be priorities for IAVA because they are 

priorities for our members. 

At IAVA, our broad and diverse membership is the backbone of our organization. 

As they communicate their needs, frustrations, suggestions, and wishes to us, we 

in turn translate that feedback into IAVA’s policy priorities. And this year, IAVA’s 

top policy priority has become ending the excessive VA disability claims backlog. 

This issue is not just a numbers problem for us, although the numbers alone are 

enough to astound even the most patient and forgiving of observers, including wait 

time averages on disability claims decisions of 619 days in Los Angeles, 612 days 

in Indianapolis, 586 days in Houston, 642 days in New York, and 681 days in Reno. 

But for us, the problem has a human face and a real voice, like that of IAVA 

member Rachel McNeil, who joined the Army Reserves in 2002 and deployed to Iraq 

in December 2004. Rachel filed a claim after she came home from Iraq in 2006, and 

it has been more than 827 days since the VA even acknowledged that she filed a 

notice of disagreement with their decision in 2010. 

IAVA member John Wypyszinski spent 16 years in the military in both the Army 

and the Navy as a nuclear, biological, and chemical operations specialist, and 

later?as a medic and a hospital corpsman with the Marines. He deployed twice to 

Iraq before he was medically retired in 2007 due to injuries, but he was lost in the 

VA disability claims process for an excruciating 963 days. 

And then there’s IAVA member Luis Cardenas Camacho, who served in the Marine Corps from 2004–2008 and deployed to Iraq three times. Upon returning home, 

Luis found himself fighting new enemies, including PTSD, depression, and his physical injuries. Luis has been dealing with the VA disability claims office for five years 

and still hasn’t received his benefits. 

It is stories like these—the real stories and real lives of real heroes—that motivate us here at IAVA, that fuel our outrage at the slow pace of progress on the backlog, and that exacerbate our impatience sometimes with the Veterans Benefits Administration (VBA). So we are pleased to see the President requesting a 13.6% increase in funding for VBA. Yet we remain concerned about whether this is actually 

sufficient to provide VBA with what it really needs to end the backlog, even by it’s 

protracted goal of 2015 (of which many remain skeptical). If, as the VA has said, 

the funding level requested for VBA would enable it to process 1.3 million claims 

in the next fiscal year, yet that amounts to roughly the same number of claims it 

processed last year, then VBA is simply requesting funding sufficient to tread water. 

262 

It is details like this that call into question whether the VA’s rhetoric on ending 

the backlog, even as far out as 2015, is realistic. By its own admission, the problems 

that led to and exacerbated the backlog were perfectly predictable. Yet what has 

clearly led to the existence of such a severe problem with the backlog is a failure 

on the part of the VA to adequately plan and prepare for these predictable spikes 

in claims. Given this record, we remain seriously concerned about whether the resources currently being requested are indeed sufficient to bring about an end to the 

backlog. These veterans stuck in this shameful backlog have waited long enough, 

whether they be Iraq and Afghanistan veterans, Gulf War I veterans, Cold War veterans, Vietnam veterans, Korean War veterans, or even World War II veterans, all 

of whom are a part of this excessively large backlog. 

While we remain gravely concerned about this problem, IAVA is also hopeful that 

Members of this Committee will use their platform and their power to not only hold 

the VA accountable, but also equip it with the financial resources it needs to better 

serve America’s veterans. This is our constituency, this is the VA’s constituency, and 

this is this Committee’s constituency, and together we can accomplish the goal of 

ending the backlog, fully caring for veterans and their families, and improving the 

lives of all who have served. 

We again appreciate the opportunity to offer our views to the Committee on the 

VA’s budget request, and we look forward to continuing to work with each of you, 

your staff, and the VA to improve the lives of America’s veterans and their families. 

Thank you for your time and attention. 

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 2014. 

As the country faces a difficult and uncertain fiscal future, the VA likewise faces 

significant challenges ahead. Congress and the Administration continue to face immense pressure to reduce Federal spending. With these thoughts in mind, we cannot 

emphasize enough the importance of ensuring that sufficient, timely and predictable 

funding is provided to the VA. Unfortunately, we do not believe that the Administration’s FY 2014 Budget Request, which includes advance appropriations for medical care for FY 2015, meets that standard. In fact, analyzing the projected increase 

in funding for all medical care in the Administration’s budget from FY 2014 (based 

on the assumption of $157 million additional needed dollars) to the advance appropriations recommendation for FY 2015 suggests that the VA budget will not begin 

to meet the projected needs of veterans already in the system and those coming to 

the VA for the first time. In fact, we believe that the $1.1 billion increase that the 

Administration projects from FY 2014 to FY 2015 does not even meet current services increases impacted by inflation (conservatively estimated to be around 3.0 percent for general medical care). With that thought in mind, the Administration’s 

budget would certainly not be sufficient to address the needs of new utilization. 

Meanwhile, The Independent Budget co-authors are particularly 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, instead choosing to fund the Federal Government through a 6-month Continuing Resolution and subsequently completing the 

appropriations work for the current fiscal year nearly 6 months into the year. As 

a result of the enactment of advance appropriations, the health care system is generally shielded from the difficulties associated with late appropriations (an occurrence that has become the rule, not the exception). However, we cannot be certain 

that health care operations have not been negatively impacted by this 6-month continuing resolution. Moreover, the rest of the operations of the VA have most certainly been hampered by this broken process. 

The Independent Budget co-authors remain concerned about steps VA has taken 

in recent years in order to generate resources to meet ever-growing demand on the 

VA health-care system. In fact, once again this year 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. The FY 2014 Budget Request includes estimates for savings as a result of presumed ‘‘management improvements.’’ As a result, the Administration concludes that 

it can reduce appropriations requirements for FY 2014 and FY 2015. The budget 

specifically outlines $482 million in proposed savings for both FY 2014 and FY 2015. 

Additionally, the budget projects $1.328 billion in operational improvements for both 

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FY 2014 and FY 2015. This is a wholly unacceptable way to fund the operations 

of the VA health care system. These savings are often never realized leaving VA 

short of necessary funding to address ever-growing demand on the health-care 

system. 

Additionally, the VA continues to overestimate and underperform in its medical 

care collections. 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. The fact that the 

VA continues to experience problems with its medical care collections reflects an 

even greater need to Congress to properly analyze, and if necessary, revise the advance appropriations from the previous year to ensure that the VA health care system is getting the resources it needs. 

FUNDING FOR FY 2014

For FY 2014, The Independent Budget recommends approximately $58.8 billion for total medical care, an increase of $3.3 billion over the FY 2013 operating budget. 

Meanwhile, the Administration recommended, and Congress recently approved in 

Public Law 113–6, the ‘‘Full-Year Continuing Appropriations Act,’’ an advance appropriation for FY 2014 of approximately $54.4 billion in discretionary funding for 

VA medical care. When combined with the $3.1 billion Administration projection for 

medical care collections, the total available operating budget recommended for FY 

2014 is approximately $57.5 billion. We believe that this level is insufficient to fully 

meet the continually growing demand for the wide range of health care services in 

the VA. Unfortunately, the Administration only recommends an additional $158 million for funding for FY 2014. Once again, it appears that the Administration has 

offered limited analysis and only minor revision of those estimates originally recommended in the advance appropriations estimate for FY 2014 last year. 

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 2014, The Independent Budget recommends approximately $47.4 billion for Medical Services, approximately $800 million more than the advance appropriations (when medical care collections are also 

taken into account) included in Public Law 113–6, the ‘‘Full-Year Continuing Appropriations Act for FY 2013.’’ Our Medical Services recommendation includes the following recommendations: 

Current Services Estimate ............................................................. $45,552,079,000 

Increase in Patient Workload ........................................................ 1,184,999,000 

Additional Medical Care Program Costs ...................................... 675,000,000 

Total FY 2014 Medical Services ............................................. $47,412,078,000 

Our growth in patient workload is based on a projected increase of approximately 

81,200 new unique patients—priority groups 1–8 veterans and covered nonveterans. 

We estimate the cost of these new unique patients to be approximately $827 million. 

The increase in patient workload also includes a projected increase of 96,500 new 

Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF), as well as 

Operation New Dawn (OND) veterans at a cost of approximately $358 million. Our 

recommendations represent an increase in projected workload in this population of 

veterans over previous years as a result of the withdrawal of forces from Iraq, the 

drawdown of forces in Afghanistan, and a potential drawdown in the actual number 

of servicemembers currently serving in the Armed Forces. And yet, we believe that 

growth in demand for this cohort specifically could be far greater given the changing 

military policies mentioned above. In fact, we believe that recent reporting from the 

VA suggests that the actual number of new unique OEF/OIF/OND veterans is greater than 120,000. This leads us to conclude that our estimate of cost for this population should be even greater. 

Finally, The Independent Budget believes that there are additional projected funding needs for VA. Specifically, we believe there is real funding needed to address 

issues in the VA’s long-term care program and to provide additional centralized 

prosthetics funding (based on actual expenditures and projections from the VA’s 

prosthetics service). In order to support the rebalancing of VA long-term care in FY 

2014, we believe $112 million should be provided. Additionally, we believe $75 million should be targeted at the VA’s Veteran Directed-Home and Community Based 

Services (VD-HCBS) program. The remainder of the $375 million that the IB recVerDate Mar 15 2010 15:09 Sep 25, 2014 Jkt 000000 PO 00000 Frm 00267 Fmt 6601 Sfmt 6621 H:\113TH HEARINGS PRINTED\80510.TXT PAULIN
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ommends for long-term care services would begin to restore the VA’s long-term care 

capacity 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 $300 million. This increase in prosthetics 

funding reflects an increase in expenditures from FY 2012 to FY 2013 and the expected continued growth in expenditures for FY 2014. 

For Medical Support and Compliance, The Independent Budget recommends approximately $5.84 billion. This recommendation is approximately $189 million less 

than the advance appropriation amount recently included in Public Law 113–6. Finally, for Medical Facilities, The Independent Budget recommends approximately 

$5.57 billion. While our recommendation does not include an additional increase for 

Non-Recurring Maintenance (NRM), it does reflect a FY 2014 baseline of approximately $750 million. While we appreciate the significant increases in the NRM baseline over the last couple of years, total NRM funding still lags behind the recommended two to four percent of plant replacement value. In fact, VA should actually be receiving at least $1.7 billion annually for NRM. Meanwhile, we are very 

disappointed that the advance appropriation amount included in Public Law 113– 

6 significantly reduces funding for Medical Facilities, particularly with regards to 

the NRM portion of that account. This level of funding, particularly if the trend continues in the coming years, will have a devastating impact on the ability of the VA 

to meet the maintenance needs of the health care system. The impact will be even 

more pronounced given the fact that the Administration’s FY 2014 Budget Request 

decimates funding for Major Construction and provides only a marginal increase for 

Minor Construction. Given the current condition of VA’s existing infrastructure, 

Congress and the Administration need to show greater commitment to these needs 

and provide truly adequate funding. 

For Medical and Prosthetic Research, The Independent Budget recommends $611 

million. This represents approximately a $28 million increase over the FY 2013 appropriated level, and approximately $25 million more than the Administration’s FY 

2014 recommendation. The VA research program is a jewel within the VA that we 

support without hesitation or reservation. That program and its nearly 4,000 principal investigators have made myriad improvements not only to veterans’ health in 

VA care, but have elevated the standard of health care of the Nation and the world. 

Despite scientific discoveries and prosthetic inventions too numerous to mention 

here but that are well known, the Administration now for the fourth year in a row 

has requested essentially flat funding for VA research, and Congress has effectively 

acquiesced. From FY 2011 through the FY 2013 appropriation, virtually nothing has 

been added by Congress to that program’s budget baseline. No allowance has been 

made to cover uncontrollable research inflation, which averages around 3 percent 

annually; no funds have been provided for new initiatives beyond the baseline; and 

no funds have been requested or provided to help repair or upgrade VA’s research 

laboratories, concerning which a 2012 independent evaluation estimated that almost 

$800 million would be required to bring them up to par. And disappointingly, no 

funds have been requested for special research initiatives focused on the needs of 

Iraq and Afghanistan veterans. These are major lapses that deserve correction. 

ADVANCE APPROPRIATIONS FOR FY 2015

As explained previously, Public Law 111–81 required the President’s budget submission to include estimates of appropriations for the medical care accounts for FY 

2013 and subsequent fiscal years. With this in mind, the VA Secretary is required 

to update the advance appropriations projections for the upcoming fiscal year (FY 

2014) and provide detailed estimates of the funds necessary for the medical care accounts for FY 2015. 

For the first time this year, The Independent Budget offers baseline projections 

for funding for the medical care accounts for FY 2015. 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. The fact that for two fiscal years in a row the 

Administration recommended funding levels that were not changed in any appreciable way upon review, and the fact that Congress simply signed off on those recommendations without thorough analysis, leads us to conclude that VA funding is 

falling farther and farther behind the growth in demand for services. We believe the 

continued feedback from veterans around the country about long wait times and 

lack of access to services affirms this belief. As such, we have decided to offer our 

own estimates of what we believe the true resource needs will be for the VA health 

care system in FY 2015. 

265 

For FY 2015, The Independent Budget recommends approximately $61.6 billion for 

total medical care, approximately $2.8 billion more than what the Administration 

has recommended for advance appropriations for FY 2015. We believe that this recommendation by the Administration is woefully inadequate to address the future 

needs of veterans seeking health care services from the VA. Our recommendation 

includes approximately $49.8 billion for Medical Services, approximately $1.6 billion 

more than the advance appropriations recommendation (when a medical care collections estimate of $3.2 billion is taken into account). Our Medical Services recommendation includes the following recommendations: 

Current Services Estimate ............................................................. $48,042,797,000 

Increase in Patient Workload ........................................................ 1,105,821,000 

Additional Medical Care Program Costs ...................................... 675,000,000 

Total FY 2015 Medical Services ............................................. $49,823,618,000 

Our growth in patient workload is based on a projected increase of approximately 

60,000 new unique patients—priority groups 1–8 veterans and covered nonveterans. 

We estimate the cost of these new unique patients to be approximately $737 million. 

The increase in patient workload also includes a projected increase of 96,500 new 

OEF/OIF/OND veterans at a cost of approximately $369 million. Meanwhile, we are 

particularly interested to see the trends that the VA Budget Request projects for 

new utilization in the coming years. While the growth in utilization of some new 

unique patients seems to be trending downward, we believe that the OEF/OIF/OND 

population will continue to trend upward as the military services drawdown their 

forces and as worldwide conflicts end. Additionally, it remains to be seen what impact the full implementation of the Affordable Care Act will have on utilization of 

VA health care services. 

As with FY 2014, The Independent Budget believes that there are additional projected funding needs for VA. In FY 2015, the IB once again believes that $375 million should be directed toward VA’s long-term care program. 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 $300 million. 

Finally, for Medical Support and Compliance, The Independent Budget recommends approximately $6.14 billion, approximately $266 million more than the advance appropriation recommendation for FY 2015. Of greater concern to The Independent Budget is the continued effort to slash funding for Medical Facilities and 

particularly for NRM. For Medical Facilities, The Independent Budget recommends 

approximately $5.69 billion, nearly $950 million more than the advance appropriation for FY 2015. If the Administration, and ultimately Congress, continues this 

trend of woefully underfunding Medical Facilities, the long term condition of the infrastructure of VA will collapse. It is time for Congress to correct this wrong before 

it persists for too long. 

Additionally, GAO’s responsibility is more important than ever, particularly in 

light of their findings concerning the FY 2012 budget submission last year. The 

GAO report that analyzed the FY 2012 Administration budget identified serious deficiencies in the budget formulation of VA. Yet these concerns were not appropriately addressed by Congress or the Administration. This analysis and the subsequent lack of action to correct these deficiencies simply affirm the ongoing need for 

the GAO to evaluate the budget recommendations of VA. For this reason, we urge 

the Senate VA Committee to consider legislation similar to H.R. 806, the ‘‘Veterans 

Healthcare Improvement Act.’’ This legislation permanently establishes the Government Accountability Office’s reporting requirements as a part of VA advance appropriations. 

Finally, we would also like to urge the Committee to consider legislation similar 

to H.R. 813, the ‘‘Putting Veterans Funding First Act of 2013,’’ introduced by House 

Committee on Veterans’ Affairs Chairman Jeff Miller (R-FL) and Ranking Member 

Mike Michaud (D-ME). This legislation requires all accounts of the VA to be funded 

through the advance appropriations process. It would provide protection for the operations of the entire VA from the political wrangling that occurs as a part of the 

appropriations process every year. 

Ultimately, the health care, research, and construction accounts of the Administration’s FY 2014 Budget Request and FY 2015 advance appropriations are totally 

unacceptable. Those funding levels specifically do not properly reflect the obligation 

that this country has to ‘‘care for him who shall have borne the battle, and his 

widow and his orphan.’’ 

266 

1 38 U.S. Code section 1705. 

Once again, we thank you for the opportunity to submit our views for the record. 

The co-authors of The Independent Budget would be happy to answer any questions 

that you might have. 

PREPARED STATEMENT OF WOUNDED WARRIOR PROJECT

Chairman Sanders, Ranking Member Burr and Members of the Committee: 

Thank you for inviting Wounded Warrior Project to submit our views on the President’s VA budget for Fiscal Year 2014, and for your timely focus on this plan. 

WWP welcomes the commitment to veterans reaffirmed in this budget, and deeply 

appreciates the broad recognition it provides to the debt this country owes those 

who served and sacrificed. That recognition, manifest in funding increases at a time 

of fiscal constraint for important programs within the Department of Veterans Affairs signals an ongoing effort to stand by America’s veterans. 

Nevertheless, one can rightly look deeper and ask—more than a decade into a war 

that continues to shatter bodies and minds—whether this budget truly meets the 

very profound needs experienced by many of our wounded warriors. This surely is 

an apt lens through which the Committee can look. 

VA does certainly have additional programmatic resource needs. Importantly, 

however, we see this budget as falling short in some key areas—both with respect 

to its failure to make timely programmatic investments in strategically important 

areas, and in maintaining a largely unchanging course in areas where we would 

have hoped for new and bolder vision. 

To illustrate the point, it is noteworthy that this budget asks Congress to make 

permanent two tax credits to encourage employers to hire veterans. For many warriors, however, military careers were cut short by life-altering injuries, and the challenge of finding employment is compounded by the need to develop new skills, tools, 

training or education, even as they attempt to re-integrate into their communities 

and rebuild their lives. While the Post-9/11 GI Bill is an answer for some, many 

others need good counseling and support. VA’s vocational rehabilitation and education program (VR&E) should be an answer, a key transitional pathway. VA has 

failed, however, to give this program the priority and resource support needed for 

this generation of wounded warriors to get the kind and extent of help they need. 

For too long, for example, the size of counselors’ caseloads has limited their ability 

to provide the extent of support needed, particularly for those with PTSD and Traumatic Brain Injury. It is disappointing, therefore, to see that VR&E staffing levels 

under this budget remain flat, despite a projected increase in workload. But absent 

any plan to increase funding for this important program, we urge consideration of 

another approach to better ensure adequate support for wounded warriors—establish a system of prioritization. Consistent with the system of prioritization already 

in law with regard to enrollment in the VA health care system,1 the vocational rehabilitation program could be structured to establish relative priorities, such that the 

most severely injured would have higher priority for receiving needed rehabilitative 

services than a veteran with a substantially lower percentage of disability. 

Last year, adopting provisions on long-term TBI care that originated in legislation 

introduced by Senator Boozman and Congressman Tim Walz, this Committee approved and Congress enacted the Honoring America’s Veterans and Caring for 

Camp Lejeune Families Act. The Boozman-Walz provision requires that VA provide 

veterans suffering from TBI with the opportunity to maximize independence 

through community-based services such as supported employment and life-skills 

coaching. It further requires that rehabilitation focus not only on achieving functional gains but on sustaining them. This important provision was intended to remedy VA’s failure to meet such basic expectations of TBI rehabilitation. We see no 

indication in the fiscal plan for FY 2014, however, that VA is in any way budgeting 

to implement this important provision. 

In contrast, VA points with some pride to a significant increase in funding for 

mental health. While we applaud the commitment reflected in that budgeting decision, we do not see a commensurate basis for confidence that the funding will have 

the decisive impact for which one would hope. Nor do we see evidence of a clear 

strategic plan underlying the $7 billion mental health budget. Instead we see relatively little in the way of course-correction beyond a plan to increase funding. We 

see little in the budget to foster a belief, for example, that those warriors who need, 

but have been reluctant to seek, behavioral health care from VA will now visit VA 

facilities. Many warriors have begun—only to drop out of—treatment; the budget 

suggests nothing to win them back or to keep others from following that course. One 

267 

resource that many of our warriors cite with approval is the Vet Center program. 

But despite the drawdown and the likelihood of greater numbers in need of help, 

the budget projects no growth in that program. The mental health challenges facing 

wounded warriors alone would lead one to believe that VA should look beyond its 

own facilities and plan to work with the communities where our warriors live. But 

the budget is devoid of a real strategy for engaging communities, or even of a plan 

to increase substantially the numbers of veterans who would be afforded mental 

health care through fee or contract arrangements. We do, however, see two promising signs: the hiring and training of veterans to provide peer-support services is 

a very encouraging step, as is the steady growth in tele-mental health services. 

These are dwarfed, however, by a seeming need to be ‘‘doing something,’’ that translates into a plan simply to increase funding. 

In a similar vein, the budget proposes increases in funding in a number of highvisibility programmatic areas, several of keen importance to wounded warriors. To 

illustrate, the budget proposes increases in funding for prosthetics. What it does not 

do, however, is acknowledge the need to improve prosthetics care—an area in which 

VA’s leadership role has declined and where a vision for change has yet to be 

realized. 

Finally, we welcome the priority given VA’s effort to remedy the long-festering 

compensation and pension claims backlog. Wounded warriors certainly suffer as the 

result of shortcomings in a system intended to provide timely disability compensation. We encounter too many warriors who after sustaining severe wounds, receive 

only limited military retired pay (often because of too-hurried military processing), 

and too often experience many months of severe financial need while VA completes 

the process of adjudicating the warrior’s claim. While we at WWP have provided 

monetary and other supports to individuals who find themselves in such straits, 

there should be no excuse for leaving combat-wounded warriors in limbo. It bears 

noting, however, that these problems are not exclusively of VA’s making. While VA 

does ‘‘own’’ serious claims-adjudication problems, we should be cautious in believing 

that additional funding alone will produce an optimal system. (We recognize that 

VA has instituted some important streamlining efforts, though the promise in those 

efforts will take time to realize.) Not only are there ‘‘upstream’’ problems that require DOD resolution, but long experience persuades us that timely, effective 

claims-adjudication will continue to elude the Veterans Benefits Administration 

(VBA) until it effectively grapples with some underlying managerial problems. Indeed, in framing the challenge numerically—viewing determinations of service-incurrence and extent of disability solely as work to be counted and sped through a 

system—VBA risks cementing in place a system that does not necessarily serve either the veteran or its workforce well. These are not after all assembly-line ‘‘widgets,’’ but determinations critical to the well-being of a wounded individual. Understandably, the singular focus on ‘‘moving claims’’ has bred morale problems among 

adjudication staff. While appreciating that VBA is redesigning systems and harnessing technology to eliminate a claims backlog, there is room as well for a complementary focus—one aimed at instilling in leadership and management the goal 

of empowering employees to do good work, rather than instilling a fear of punishment for failing to meet numerical indicators. Leadership is a first step in establishing that much-needed cultural change. 

Thank you for considering our views. 

Æ